1. Introduction
The Philippines sexual and
reproductive health (SRH) status is lagging behind in Southeast Asia (WHO, nd). In 2012, the Philippine Government passed a Reproductive Health (RH) Law or the Republic Act (RA) No. 10354. It is an act providing for a national policy on
responsible parenthood and reproductive health. The law was passed as it recognizes on of the fundamental rights of a person, which is the right to health which includes reproductive health (Congress of the Philippines, 2012). It was primarily
introduced to manage the rapid growth rate of the Philippines and address rights of people to choose the life they desire. In the 2004 Pulse Asia Survey reveals that 97% of Filipinos believe the importance to have the ability to control one’s fertility or to plan one’s family. However, about a year later,
the Supreme Court of the Philippines has declared some of the law unconstitutional (SC, 2014). The same decision also issued Temporary Restraining Order (TRO) on some contraceptive drugs and devices for violation of constitutional requirements of due process.
The religious, specifically the Catholic faithful headed by the Catholic Bishops Conference of the Philippines (CBCP) is against the RH Law and identify it as intrinsically evil (Bantiles, 2013). It was believed that the deeply rooted
traditional Filipino culture makes it hard to implement policies such as RH law.
However, there seems a change in mind-set of many Filipinos as revealed in the surveys.
The 2004 Pulse Asia survey reveals that 83% of voters in the 2004 national elections will favour candidates who support the allocation of government funds for family Abstract: The study presented sexual reproductive health (SRH) programs provided to couples in Catbalogan City, Philippines. Data was gathered using a survey questionnaire interviews, and supplemented with secondary data from local SRH providers in Catbalogan and those from the Philippine Statistics Authority. Data showed that efforts from the government and other non- governmental organizations have influenced couples to practice or participate in several family planning related interventions. Half of the respondents reported positive effects on their lives.
Over the years, SRH programs have resulted into declining trend in population growth and fertility rate in the Philippines while there is a sustained positive trend on the use/access of various form of contraception. The said improvement however resulted into outcomes below the desired values.
SRH programs and its implementation strategies need to be revisited to identify additional or more effective forms of interventions to achieve the targets.
Keywords: family planning, population, contraceptive use, maternal and child care
Assessment of Intervention Programs on Sexual Reproductive Health of Couples in Catbalogan City Philippines
Nora L. Lopez1 Laura B. Boller, Anacorita M. Villanueva & Art T. Roncesvalles College of Education, Samar State University, Philippines
Nora.lopez@ssu.edu.ph
22 planning with only 2% saying otherwise. In
the 2013 National Demographic and Health Survey reveals that about 54% of married women do not want additional children and an additional 9% are already sterilized. The same survey says that 81% of married women want either to space their births or to limit childbearing altogether. This change of attitude towards having children can be seen in the downtrend of women fertility rate. In 1973 it was 6.0% and was reduced to half (3.0%) in 2013. The growth rate of the Philippines has also declined from 2.35 for years 1990-2000 and went 1.9% for years 2000-2010 (PSA). This suggests that the efforts to manage population is working, however the ideal growth rate is yet to be achieved.
Samar Island is the third largest in the Philippines where a total of about 1.75M population (PSA, 2010). As of August 2015, (Western) Samar Province has a total of 780,581 people, 103,879 (13.3%) of which are in Catbalogan City. Like that of the whole Philippines, Samar population growth rate was also declining from 1.85% at the beginning of year 2000, 1.35% in 2010 and goes down to 1.25% as of August 2015. The decline can be attributed to the success of the government RH programs such as those that are stipulated in the RH law.
In the Philippines 2013 National Demographic Survey revealed that women surveyed have knowledge of at least one method of contraception, 55% of them are using it and 38% uses modern methods. The same report have shown that 18% of women have an unmet need for family planning, 7%
because they wanted to delay their next pregnancy and 11% because they wanted no more children.
Who is providing the SRH services in Samar, specifically in its capital city of
Catbalogan? What are the programs or intervention activities and how good is it?
2. Objectives
This paper assessed the SRH intervention programs provided and the extent of awareness and practices of couples in Catbalogan City, Philippines, specifically it;
1. Identified agencies and organization implementing SRH intervention programs;
2. Determined the SRH awareness and practices of the respondents as a result of intervention programs implemented; and 3. Determined the satisfaction level of
respondents regarding the SRH programs provided.
3. Methodology
The paper used descriptive research methodology. It uses survey instruments to gather responses from randomly selected couples in the City of Catbalogan followed- up by an interview to supplement data acquired. It also used secondary data from various sources.
Respondents come from the five most populous barangays (villages) in Catbalogan. Names of couples were taken from the Barangay records. Tables 1 and 2 are the respondents profile in terms of sex, occupation and religion. All records were secured to protect identity of the
respondents.
The respondents are couple, however only six of the 85 couples have agreed to participate as respondent in the research.
The response of the female partner was considered as the couple’s response.
Lopez et.al. (2016) 23
Table 1. Couple Respondents
Baranggay Sex Total
M % F % %
Mercedes 0 0.00 18 100.00 18.75 Guindapunan 0 0.00 20 100.00 20.83 Canlapwas 2 8.33 22 91.66 25.00 Barangay 13 3 15.76 16 84.21 19.79 Bu-ao, Ubanon 1 6.66 14 93.33 15.62 Total 6 6.25 90 93.75 100.00
Table 2. Profile of Respondents
Occupation % Religion %
White Collar 1.0 Roman Catholic 90.8 Blue Collar 18.8 Iglesia ni Cristo 3.1 Pink Collar 5.2 Born Again 3.1
Grey Colalr 16.7 UCCP 1.0
Housewife 56.3 Mormons 1.0
Others 2.1 Ohers 1.0
Total 100.0 100.0
Table 3. Occupation of (Couple) Respondents
Occupation Barangay
Mercedes Guindapunan Canlapwas Brgy.13 Bu-ao Total %
OFW 0 0 2 0 0 2 2.08
Saleslady 1 0 1 1 1 4 4.16
Employee 1 0 0 1 1 3 3.12
Caretaker 1 0 2 0 0 3 3.12
Teacher 1 0 0 0 0 1 1.04
Manicurist 1 0 0 1 0 2 2.08
Vendor 0 2 4 1 3 10 10.41
Laundrywoman 0 2 0 0 1 3 3.12
Maid 0 3 0 2 2 7 7.29
Welder 0 0 0 1 0 1 1.04
housewife 13 13 14 8 6 54 56.25
Waiter 0 0 0 0 1 1 1.04
Tricycle Driver 0 0 1 2 0 3 3.12
Others 0 0 0 2 0 2 2.08
Total 18 20 24 19 15 96 100
Table 4. Occupation of (Couple) Respondents
Occupation Barangay
Mercedes Guindapunan Canlapwas Brgy.13 Bu-ao Total %
OFW 0 0 2 0 0 2 2.08
Saleslady 1 0 1 1 1 4 4.16
Employee 1 0 0 1 1 3 3.12
Caretaker 1 0 2 0 0 3 3.12
Teacher 1 0 0 0 0 1 1.04
Manicurist 1 0 0 1 0 2 2.08
Vendor 0 2 4 1 3 10 10.41
Laundrywoman 0 2 0 0 1 3 3.12
Maid 0 3 0 2 2 7 7.29
Welder 0 0 0 1 0 1 1.04
housewife 13 13 14 8 6 54 56.25
Waiter 0 0 0 0 1 1 1.04
Tricycle Driver 0 0 1 2 0 3 3.12
Others 0 0 0 2 0 2 2.08
Total 18 20 24 19 15 96 100
24 Rating of SRH services uses a 5
point scale with aggregated score interpreted as follows;
1.00-1.5 – Poor
1.51-2.5 – Unsatisfactory
2.51-3.5 – Moderately Satisfactory 3.51-4.5 – Satisfactory
4.51-5.0 – Very satisfactory
Frequency counts, percentage and diagrams/chart were used to present gathered data.
4. Results and Discussion
The foregoing are the results of survey, interviews and documentary analysis related to SRH in Catbalogan City, Samar Philippines. Catbalogan City data was compared with national level data.
4.1 Agencies Providing SRH Interventions
There are only three
agencies/organizations currently providing SRH intervention activities in the city.
These agencies are the Samar Provincial Hospital (SPH), Family Planning Office of the Philippines (FPOP) and the Rural Health Unit (RHU) of the City of Catbalogan, Philippines. All of these identified organizations provided information dissemination campaign in various forms including flyer/leaflets distribution, radio programs, symposia, seminars and the likes.
More importantly, these units also have provided medical assistance to couples seeking help. Smaller unit such as local youth organizations also provide interventions through information
dissemination activities. The SPH and the RHU are very dependent on government funds while the FPOP relies from private donors. The FPOP is the largest and most prominent non-governmental family
planning organization in the Philippines providing SRH services (IPPF, nd.) 4.2 Family Planning Profile
According to the 2003, 2008 and 2013 National Demographic and Health Survey, sexually active women have used any form of contraceptives (modern and traditional method) have declined from 47.3% to 32.6% or a total % drop of 31.1%.
About 39% drop of modern use of contraceptive was observed in the 2013 survey. Based on the 2013 survey, married women in the Philippines uses modern contraceptives such as pill (19%), female sterilization (9%) and 4% each for injectables and IUD (PSA, 2014). The number of married women using pill has declined by about half as compared to 2003 and 2008 similar surveys wherein 38 to 43%
of them using it (NSO, 2004; PSA 2009).
Table 5. Oral Contraceptive Pills (OCP) Type of
OCP
Year Total
2010 2011 2012 n %
Exluton 350 1,100 410 1,860 27.9
Nordett 473 612 - 1,085 16.3
Roselle - 180 383 563 8.5
Triquilar 184 278 - 462 6.9
Microgynon - - 60 60 0.9
Trust - 96 - 96 1.4
Lady Pill 82 412 105 599 9.0
Micropil - 222 23 245 3.7
Althea 10 18 - 28 0.4
Marvelon 72 428 420 920 13.8
Ruby- Natasha
- - 780 780 11.7
Total 1131 3346 2181 6,658 100.0
Oral contraceptives Pills (birth-control pills). OCP are extremely effective if used correctly at preventing pregnancy with only five getting pregnant in every 1000 women taking it (Womens Health, 2013). The pill prevents ovulation by maintaining more consistent hormone levels in the body of the woman. Table 5 shows the type of pills
Lopez et.al. (2016) 25
accessed from the FPOP in Catbalogan.
Most of them uses Excluton and Nordentt totalling to about 72.77% of all OCP consumed in 2010. In 2011 and 2012, the other types of OCPs have also been accessed by couples. The Ruby-Natasha type of OCP was the most accessed pill in 2012. For the three year period of observation, it was revealed that top five OCPs used are Excluton, Nordett, Marvelon and Ruby Natasha.
Intra-Uterine Device (IUD). IUD is not that popular in the City of Catbalogan as
revealed in the data from FPOP Catbalogan.
Which is similar for the entire country.
Based on the PSA survey, IUD by the sexually active women in the Philippines is also not that popular. The use of IUD has gone down from 6.4% in 2003 to 2.2% in 2013. The contraceptive prevents
fertilization of the egg by damaging or killing the sperm, it also affects the uterine lining where a fertilized egg would implant and grow (WebMD). The IUD is estimated to be effective at 99% while pills are estimated at 95% success rate in preventing pregnancy. Majority of respondents who were asked about preference between IUD and pills choose the later because the insertion of a plastic string with an IUD through the cervix into the vigina is uncomfortable and they believe it to be painful.
Condom. Another form of contraceptive is the wearing of condom of males during intercourse. As shown on table 6, the use of condoms in Catbalogan City have increased by about 169% in a matter of three years. Of the available condoms, males prefer to use the skinless skin type totaling to about 80.8% followed by the use of Trust branded condom having 16.4% share of users.
Table 6. Condom Condom
Brand
Year Total
2010 2011 2012 n %
Skinless Skin
1,413 1,615 2,668 5696 80.8 IPPF
Generic
- 46 110 156 2.2
Trust 15 24 1,116 1155 16.4
Frenzy 17 22 - 39 0.6
Total 1,445 1,707 3,894 7046 100.0
There was an observed spike of the Trust condom brand from 15 and 24 in 2010 and 2012 to about 1,116, about 45.5 times higher in 2012. In contrast, there was a decline of women in the Philippines who said that their partners used condom, from 9.9% in 2003 it went slightly up to 11.2% in 2008 and down to 1.4% in 2013 (NSO, 2004; PSA 2009, PSA, 2014). Purchasing, carrying, storing, using and disposing of condoms cause embarrassment to users. A number of articles illustrates this reality and was a subject of study of Moore et.al.(2007).
The study showed that purchasing condoms elicits the most embarrassment of all. The use of condom is also considered by many as less enjoyable (Thornton, 2014).
Injectables. Depo-Provera a type of
injectable is a progestin-only method, done in a 3-month period to inhibit ovulation (ARHP, 2014). The failure rate with perfect use is only 0.2% while typical use is about six percent (Trussell, 2011). The use of injectable in Catbalogan City has declined by about 84.4% from 1445 in 2010 to only about 225 in 2012.
Table 7. Injectables (amp and vial) Type of
Injectable
Year Total
2010 2011 2012 n %
Depo-Proera 230 621 225 1076 80.2
Petogen 264 2 - 266 19.8
Total 1445 1707 225 1342 100.0
26 Table 8 on the other hand shows an
increase of counselling services, most of which are on SRH related counselling. The low availment of the two other services may be attributed to socio-cultural factors
(NEDA, 2011) such as stigma and
discrimination, fear of disclosure preventing people to talk about it. Table 5 also suggest that there is an increase of people engaged into sex. This is similar to the national profile on number of people engaged in sexual contact as early as 15 years old. In 2014, the Philippine Council for Health Research and Development (PCHRD) reported that 32% of young Filipinos aged 15-24 has engaged in pre-marital sex, about 9% higher than the 2002 survey according to the 2013 Young Adult Fertility and
Sexuality study.
Table 8. Family Planning Counselling Services in Catbalogan City
Type of Counseling
Year
2010 2011 2012 n %
SRH Counseling
1,253 817 1306 3376 99.3 Abortion
related counseling
4 0 0 4 0.1
STI Services 20 0 0 20 0.6
Total 1277 817 1306 3400 100.0
The prevalence of STI infections in the country’s general population is high (UNICEF, 2006). STI among couples is
highly probable when one of them has multiple partners. About six in every ten women surveyed in 2008 and 2013 were in union (PSA, 2009; PSA, 2014). In 2011, there were 476,408 marriages registered in the Philippines, about 1.3% lower than 2010 registry (PSA, 2013). Eastern Visayas recorded the biggest decrease at about 18.8% (ibid). The decrease of the number of couples going into legal marriage is due to the increase of cohabitation as it is fast becoming acceptable. Vancio (1980) says that 36% males and only 2% females among married couples in the urban areas of the Philippines have extramarital affairs, this numbers must have changed in the later years. In this study, out of 96 respondents, 82% were married, 5% are widowed and 4%
have never married. About 6% of them have extramarital affairs.
Table 9 shows the annual contraceptive service provision by six drugstores in Catbalogan City and volume is almost similar from 2008 to 2012.
Purchasing of condoms and contraceptive pills share almost similar percentage followed by procurement of contraceptive injection. This is similar to the 2013 survey showing pill is best known (99%)
contraceptive and followed by male condom (97%). The first two are readily accessible in the local drugstores in Catbalogan City. The frequency of condom sales in the six
drugstore is different from the condoms
Table 9. Annual contraceptive service provision (2008-2012)
Item Year Total
2008 2009 2010 2011 2012 n %
Condom 3631 6552 7056 6792 5520 29551 42.78
Contraceptive Injection 1548 1548 1648 1648 1648 8040 11.64
Contraceptive Patch 0 0 0 0 0 0 0.00
Contraceptive Pills 6110 6552 6200 6506 6120 31488 45.58
Contraceptive Ring 0 0 0 0 0 0 0.00
Diaphragm (contraception) 0 0 0 0 0 0 0.00
Emergency Contraception 0 0 0 0 0 0 0.00
Total 11289 14652 15210 14946 13288 69079 100%
Lopez et.al. (2016) 27
made available through FPOP.
4.2 Programs attended by respondents
Almost all of the respondents have attended at least one activities related to SRH provided by the SPH, RHU and FPOP.
Their attendance was encouraged through the benefits they will gain in doing so. Most (91.7%) of the respondents have attended or have accessed information about SRH at the RHU, 56.2% from SPH and about 29.2%
from FPOP all in Catbalogan, About 5.2%
have accessed services from private doctors within and outside of the city. The kind of services received or sought were those free since most of the respondents come from lower income bracket. A little more than half of the, are plain housewife, followed by blue collar (manual labor) and grey collar (manual, gets dirty labor).
4.2.2 Knowledge acquired from programs
All of the respondents are aware on various methods of family planning. They have attributed this awareness to the
activities they have attended, some however also claimed that their friends, relatives, TV and the internet has provided them some knowledge about family planning and other information relative to SRH and child health. The respondents are most aware of the use of contraceptive pills (56%) and 37% are users of the method. In comparison to the 2013 national survey (PSA, 2014), this number is lower by about 43% however number of users (specifically on pills) are higher by18%.
Despite knowledge about methods that requires operation such as tubal ligation
& vasectomy, very few have actually used it as family planning strategy. Overall, only about six in every ten respondents have actually used any form of contraceptives.
Four in every ten respondents said they have used a particular method of family planning because it is effective based on their
experience and of others. Only two in every ten says they use of it because the
doctor/health practitioner recommended it.
Figure 1: Family planning method learned Almost seven in every ten
respondents says, the use of family planning methods have allowed them to manage their meager income. They were able to eat regularly and with better food, send their kids to school and is able to provide time to raise well their children. Furthermore, majority of mothers using family planning methods have said that the use of
contraceptives and other methods made them feel good, they can attend to affairs and other activities such as attending work
0 10 20 30 40 50 60
condom contraceptive pills injectables IUD vasectomy tubal ligation implant withdrawal Others
Use Knowledge
28 (61%), other affairs/events (55%) and
continuing their education or of their children (46%).
Parents, friends and personnel of the SRH service providers have influenced the respondents their use of family planning methods. The number of respondents saying they were influenced to use family planning methods as espoused by the SRH service providers is only 37%.
About six in ten respondents believes that many women (63.5%) unintentionally get pregnant. Despite not intentional, aborting conception is not a choice as it is against their belief. None of those who were interviewed even consider going into an actual abortion.
4.2.3 Frequency of consultation
About four in every ten have visited SRH service provider one to three times in a year. Most of those who have visited more than three are those who are already pregnant and needs to consult a health practitioner regarding their pregnancy.
Figure 2: Frequency of consultation
4.2.4 Assessment on the implementation of maternal and child care program
Figure 3: Pre-natal check-up
Prenatal checkup. Respondents rated the pre-natal check-up as satisfactory with the education and information campaign (EIC) on child health as well as the first trimester check-up receiving the highest score. Tooth examination and prescription is done by a dentist outside of the facility through referral.
The percentage of pregnant women with at least four prenatal visits decreased from 77% in 1998 to 70.4 in 2003. Also, those who received at least two doses of
0 10 20 30 40
1-3 4-6 7-9 10-12
>12 not sure
3.6 3.8 4 4.2 4.4 4.6 First trimester check-up
Home-based mother's record Tooth exam and
prescription Provision of ferous
sulfate EIC on mother and child
health
4 4.1 4.2 4.3 4.4 4.5 4.6 Regular provision
EIC on importance of vaccination Provision of Vitamin A
Oral polio vaccine provision Free anti-measles
vaccine
Lopez et.al. (2016) 29
tetanus toxoid also has decreased to 37.3%
in 2003 from 38% in 1998 and about 76.8%
of pregnant women received iron supplementation during the pregnancy (Vera, 2012).
Figure 4: Under five-year old vaccination Children Vaccination. All of respondents says they have received satisfactory to very satisfactory services when it comes to vaccination of their children below five years old. Receiving lowest score was the provision of vitamin A. Few has said that there are cases when the needed vaccine is unavailable on the scheduled date their children are supposed to receive it. Those who can afford and who cannot wait go to private clinic for the vaccination. Others will just have to wait until the vaccine is
available.
Despite the unavailability of some vaccine, respondents have not rated it low since the access to this services are
relatively new. They further said that it’s far better than before when there were dismal services when it comes to child health care.
Today according to them, the health centers in Barangays have scheduled services and mothers always look forward to those dates.
Even those who can afford services from private clinics find time to visit Barangay Health Centers to access of free vaccination for children.
4.2.5 Education on proper feeding of children under five years old
The mixed and exclusive bottle feeding method of feeding were rated by respondents as just good. This score was not because they have least understood the method but was an expression of preference.
Based on follow-up interview, they rated it low because they don’t prefer using this method because it will be very expensive for
them. Most of the respondents belong to low-income groups, buying milk formula as much as possible must be avoided.
Figure 5: Children Feeding
4.2.6 Methods of family planning
The Philippine National
Demographic and Health Survey categorized two sets of family planning interventions, the modern and traditional methods. In this study, only five of the several methods were considered in the assessment including EIC activities.
Figure 5: Family planning method evaluation Respondents rated the services received from the SRH providers relatively low except the EIC which is found to be
2.5 3 3.5 4 4.5 5
EIC on proper feeding Exclusive breastfeeding Exclusive bottlefeeding Mixed feeding
1.5 2 2.5 3 3.5 4
EIC on family planning methods
Use of pills Use of injectables Use of IUD Rhythm and temperature monitor
30 satisfactory. The unsatisfactory rating
received for the rhythm and temperature method, use of IUD and injectables is due to the complicatedness or the process needed to practice it. Some respondents interviewed said that the said methods requires higher compared to buying pills or condom. This perceptions were based on the respondent’s experiences and by someone they know.
4.2.6 Perception on the impact of intervention SRH programs
Respondents were asked as to the impact of the programs implemented to their attitude towards practicing what are
espoused by the SRH programs and the benefit they received from it.
The family planning interventions, specifically the SRH programs were not only focused on the use of contraception.
There were activities specifically through the EIC activities touching on right of women, their children and their rights as citizens of the Philippines. About one in two of the respondents have said they were able to learn family planning methods,
understood the obligations of parents to their children and their spouses. About six in every ten of them was able to realize that they own their body and they have all the right on how to use it and care for it. Half of those who availed of the services have said that they were able to gain more time for themselves, their family and other activities because they have manageable family size.
The rest of the respondents however also expressed that for some, even if they have managed their family size, they still can hardly met a better life. They claim that their earning is not enough to raise a descent family.
In the Philippine context, despite the 99% knowledge about any contraception
and family planning methods, practice or influence is still at 53.2% (PSA, 2014).
Table 7: Overall assessment on influence of programs to respondents practices
Particulars %
1. Understood ways of planning a family
54.16 2. Have ample time for self, family
and other activities
53.12 3. Learned the obligations of
parents to his/her partner and to the child
53.12
4. Learned personal rights 56.25
5. Conclusion and Recommendation
Data have showed that efforts from the government and other non-governmental organizations have influenced couples to practice or participate in several family planning related interventions. About half of the respondents surveyed have said they have benefited positively from the
interventions they have received from the service provided. Overall, there have been a declining trend in population growth rate and fertility rate, while there is a sustained positive trend on the use/access of various form of contraception, an indicator that the SRH programs are gaining a certain success.
The said improvement however resulted into outcomes that are still below the desired values. Efforts need to be revisited to identify additional or more effective forms of interventions to achieve the targets.
6. Bibliography
Association of Reproductive Health
Professionals (ARHP) (2014). Choosing a Birth Control Method.
http://www.arhp.org/Publications-and- Resources/Quick-Reference-Guide-for-
Lopez et.al. (2016) 31
Clinicians/choosing/Injectable (Accessed:
December 5, 2015)
Bantiles, R. (2013). Why RH law can never be catholic.
http://www.cbcpnews.com/cbcpnews/?p=17 683 (Accessed: January 2, 2016)
Congress of the Philippines, 2012. Republic Act No. 10354, An Act Providing for a National Policy on the Responsible Parenthood and Reproductive Health.
http://www.gov.ph/2012/12/21/republic- act-no-10354/ (Accessed: February 2, 2016)
Department of Education (DepEd), ND. An Introductory Guide to Senior High School, http://www.deped.gov.ph/sites/default/file s/SHS%20Student%20Primer_Colored%2 0HiRes.pdf (Accessed May 12, 2016)
International Planned Parenthood Federation (IPPF), Family Planning Organization of the Philippines. http://www.ippf.org/about- us/member-associations/philippines (Accessed: January 4, 2016)
Moore, SG., Dahl, DW., Gorn, GJ., Weinberg, CB., (2006). Coping with condom
embarrassment. Psychology, Health &
Medicine 11(1).
http://dx.doi.org/10.1080/135485005000936 96
National Economic Development Authority (2011) writers Libang G, Malayang G, &
Padilla CR. Country Analysis of Aids in the Philippines: Gender and Age Situation and Response.
https://www.unicef.org/philippines/Engen derights_Final(1).pdf (Accessed
December 12, 2015)
National Statistics Office (2004). 2003 National Demographic and Health Survey.
https://dhsprogram.com/pubs/pdf/FR156/FR 156.pdf (Accessed: January 4, 2016).
National Statistics Office (2009). 2013 National Demographic and Health Survey.
https://dhsprogram.com/pubs/pdf/FR224/FR 224.pdf (Accessed: January 4, 2016).
Philippine Council for Health Research and Development (PCHRD), (2014). More Pinoy youth engage in risky sexual activities, survey confirms.
http://www.pchrd.dost.gov.ph/index.php/ne ws/3896-more-pinoy-youth-engage-in-risky- sexual-activities-survey-confirms
(Accessed: January 12, 2016)
Philippine Statistics Office(PSA), 2010 Census and Housing Population.
Philippines Statistics Authority (2010),
Population and Annual Growth Rate for the Philippines and Its Regions, Provinces, and Highly Urbanized Cities. 2010 Census and Housing Population.
Philippines Statistics Authority (2014). 2013 National Demographic and Health Survey.
https://dhsprogram.com/pubs/pdf/FR294/FR 294.pdf (Accessed: January 4, 2016).
Supreme Court of the Philippines (2014). En Banc Decision, Re: Constitutionality of RH Law
http://sc.judiciary.gov.ph/jurisprudence/201 4/april2014/204819.pdf (Accessed: January 5, 2016)
Thornton, J., (2014). Can We Reinvent the Rubber? Men’s Health.
http://www.menshealth.com/sex-
women/condom-conundrum-0 (Accessed:
December 2, 2015)
Trussell J. (2011). Contraceptive failure in the United States. Contraception.83(5):397-404.
WebMD, Intrauterine Device (IUD) for Birth Control, http://www.webmd.com/sex/birth- control/intrauterine-device-iud-for-birth- control (Accessed: January 8, 2016)
Womens Health (2013), Birth Control Options:
The Pill.
http://www.womenshealthmag.com/health/b
32 irth-control-pills (Accessed: January 12,
2016)
UNICEF, (2006). East Asian and Pacific Consultation on Children and HIV AIDS- Philippine Country Report.
https://www.unicef.org/eapro/11_philippines .pdf (Accessed: January 12, 2016)
Vancio, J. (1980). The Realities of Marriage of Urban Filipino Women. Philippine Studies 28:5-20.
Vera, M., (2012). DOH Maternal Health Program. https://nurseslabs.com/doh- maternal-health-program/ (Accessed:
January 18, 2016)
