DISPELLING MYTHS,

CORRECTING MISCONCEPTIONS

IN

FAMILY PLANNING

ESMERALDO T. ILEM, M.D, MS IV, FPOGS

Head, Comprehensive Family Planning Service
DR. JOSE FABELLA MEMORIAL HOSPITAL

MYTHS AND MISCONCEPTIONS

THE MORAL Contraception is EVIL! THE LEGAL Emergency contraception is allowed in the Philippines. THE SEXUAL Contraception makes one a sex maniac THE PERSONAL Contraception cannot be used by single or unmarried women or even by adolescents. THE MEDICAL Contraception has no health benefits. THE SOCIAL Contraception promotes promiscuity and rise in STIs. THE RIDICULOUS IUD can travel and reach the brain. THE MORBID Contraception can cause illnesses (eg Cancers) and can KILL!

MYTHS AND MISCONCEPTIONS

THE MOST CONTROVERSIAL AND MOST DEBATABLE:

Contraception Causes abortion!

FACTORS AFFECTING DECISION-MAKING

TO

USE A PARTICULAR FP METHOD

Age Number of children Health status Economic status Religious beliefs Relationship with spouse

Marital status

Word of mouth
Culture

Misconceptions

Politics Significant personal experience

ANTAGONISTS TO CONTRACEPTION OUR FRENEMIES

THE RELIGIOUS AND ULTRACONSERVATIVES THE OPPONENTS TO THE RH BILL

THE DISAPPROVING AND NONBELIEVING

HEALTH WORKERS (esp. doctors) FAMILY MEMBERS AND FRIENDS

CLIENTS
POOR/ILLITERATE/IGNORANT/MISINFORMED ABUSED/DOMINATED WHO EXPERIENCED COMPLICATIONS

PERCENT DISTRIBUTION OF MARRIED WOMEN NOT USING CONTRACEPTIVE METHODS, BY REASON OF NON-USE, PHILIPPINES, 2002

REASONS FOR NON-USE

1. WANTS ANOTHER CHILD 2. HEALTH CONCERNS 3. FEAR OF SIDE EFFECTS/COMPLICATIONS 4. DIFFICULTY IN GETTING PREGNANT/ADVANCING AGE 5. INFREQUENT SEX/HUSBAND AWAY 6. MENOPAUSAL OR HAD HYSTERECTOMY 6. LACK OF KNOWLEDGE

PERCENTAGE

18.5% 13.3% 12.6% 11.2% 8.7% 8.1% 2.3%

7. PROHIBITED BY RELIGION
8. OTHERS OR Combination of the Above

2.9%
20.9%

HEALTH PROVIDERS SHARE MISCONCEPTION

MEDICAL PROVIDERS UN-FAVORABLE ATTITUDES TOWARDS FAMILY PLANNING, 1995

ISSUES
1. A woman should have 1 child before taking pills 2. If the husband does not approve of FP, the woman should not use it 3. Religious teachings affect recommendation 4. Reluctant to recommend contraceptives to unmarried women 5. I only discuss contraceptives when the client brings up the subject 6. Health providers should decide on the method for the client 7. Very few patients ask about FP 8. IUD is an abortifacient

TOTAL
54 51 47 44 40 34 27 22

OB-GYN
51 53 48 43 31 25 17 28

GPs
46 52 53 44 46 34 32 23

MW
66 48 40 44 44 43 33 16

9. Against religious belief to recommend non-natural FP methods

18

16

19

22

COUNTERACTING MYTHS AND MISCONCEPTIONS

Most popular and most effective method is through

COUNSELING!
(also Information Giving and Motivational Activities)

ROLE PLAYERS: EVERYONE HAS THE RESPONSIBILITY, BUT THE SKILL TO COUNSEL AS AN ART MAY BE DIFFICULT.

FAMILY PLANNING

FOUR (4) PILLARS/GUIDING PRINCIPLES: 1. RESPONSIBLE PARENTHOOD 2. BIRTH SPACING

3. INFORMED

CHOICE

4. RESPECT FOR LIFE

FOR THE HEALTHWORKERS

PROFICIENCY IN THE ART AND PASSION FOR COUNSELING

THE CURICULUM FOR FP TRAINING COURSES INCLUDES COMPETENCY IN COUNSELING

ADHERENCE TO THE PRINCIPLES OF

INFORMED CHOICE AND

VOLUNTARISM

G-A-T-H-E-R THE G-A-T-H-E-R

APPROACH

G REET

ASK/ASSESS
T ELL HELP

Tells the client about FP methods based on her needs; : short-term, long-term, permanent Tells how the method works Explains effectiveness, advantages, disadvantages, possible side effects

EXPLAIN

Corrects misconceptions

RETURN/REFER

PRINCIPLE OF INFORMED CHOICE AND VOLUNTARISM

Broad range of modern FP methods should be made available at the clinic with referral system for methods not available at the clinic; Service providers and Barangay Health Workers (BHWs) should not be subjected to quotas or targets; There will be no payment of incentives, bribes, gratuities or financial rewards to (1) any clients for becoming an FP acceptor, or (2) service providers for achieving a quota or target;

No person shall be denied any right or benefit based on their decision not to accept FP;
Comprehensible information about benefits and risks of the chosen method, including conditions that might render the method inadvisable (i.e., contraindications?) plus side effects shall be provided. This requirement may be satisfied through counseling, brochures, posters, or package inserts.

Informed consent for BTL and NSV

STRENGTHENING SOCIAL ACCEPTANCE PROJECT OF FAMILY PLANNING IN THE PHILIPPINES:

A COMMUNICATION AND ADVOCACY PROJECT (USAID 2006)

BEHAVIOR CHANGE COMMUNICATION (BCC) COMPONENT

1. Regional advertising campaigns to debunk myths and misconceptions aired
Radio materials aired and monitored, FP Hotline advertised in print media

2. Media and technology to transmit correct FP information to target audiences and the public implemented
FP Hotline monitored for number of questions and question senders

3. Printed materials to deliver correct family planning information to present and potential users of family planning through champions and health providers distributed to intended users 4. Communication activities to promote contraceptive self-reliance 5. Continuing media relations and monitoring activities conducted 6. Quick response mechanism to counteract negative messages on modern methods activated
Media monitoring conducted by POPCOM

MILLENIUM DEVELOPMENT GOALS (2015):

- Eradicate extreme poverty and hunger - Achieve universal primary education - Promote gender equality and

empower women!
- Reduce child mortality - Reduce Maternal Mortality - Combat HIV/AIDS, malaria and other diseases - Ensure environmental sustainability

Women should exercise and enjoy their RIGHTS (including Sexual and Reproductive Rights) to decide to receive FP information and Services.

The 12 Sexual & Reproductive Rights

Right to Life Right to Liberty & Security Right to Freedom of Thought Right to Equality & to be Free from All Forms of Discrimination Right to Privacy

Right to Information & Education as it relates to sexual

and reproductive health for all, including access to full information on the benefits, risks, and effectiveness of all methods of fertility regulation, in order that all decisions taken are made on the basis of full, free and informed consent;

THE 12 SEXUAL & REPRODUCTIVE RIGHTS, CONT.

Right to Heath Care and Health Protection

persons to protection against a requirement to marry without his/her consent and the right to reproductive health care services;

Right to Choose Whether or Not to Marry & to Found and Plan a Family which includes the right of

which includes the right of persons to decide freely responsibly the number and spacing of their children and to access to information and education
Right to the Benefits of Scientific Progress Right to Freedom of Assembly & Political Participation Right to be Free from Torture & Ill-treatment

Right to Decide Whether or When to have Children

WHAT CAN THE MDG DO FOR FP?

MDG I: ERADICATE POVERTY AND HUNGER

Economic Progress is a family planning method as seen among developed countries. It also improves access. Sex education in school esp. among adolescents should help give correct information on FP and answer misconceptions.

MDG 2:UNIVERSAL EDUCATION

MDG 3: GENDER EQUALITY AND EMPOWERMENT OF WOMEN

Women should be able exercise their human, sexual and reproductive rights. The numbers of children dying should create more impact to help couples decide for FP

MDG 4: REDUCTION OF CHILD MORTALITY

WHAT THE MDG CAN DO FOR FP?

MDG 5: IMPROVE MATERNAL HEALTH

Focus on 5B to increase CPR and decrease unmet need for FP especially during the last 5 years of the MDG.

MDG 6: COMBAT HIV/AIDS, MALARIA AND OTHER DISEASES

Especially for HIV/AIDS, to emphasize that FP offers little protection except for acceptance of the protective benefit of condom. More people returning to rural areas assured of livelihood to decrease the impact and negative effects of overpopulation No donor fatigue and more support for development.

MDG 7: ENSURE ENVIRONMENTAL SUSTAINABILITY

MDG 8: GLOBAL PARTNERSHIP

WE DO NOT NEED ANOTHER RUMOR!

But we cannot help but ask if FP opposition in the Philippines has some religious background and interest?
FP brought and started by the Protestants; Philippines being the only Christian country in Asia There are now more Muslims worldwide Overpopulation is a resource as far as Catholic proponents are concerned!

CONCLUSION

Modern times with newer technologies, advanced communications and evidenced-based medicine supporting best practices prove of limited help in dispelling myths and misconceptions on contraceptives;

We need to invest on informing, motivating and training health workers, lay volunteers and prospective clients on effective counselling to help decide to adopt and promote FP.

THANK YOU VERY MUCH!

also
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