CHAPTER 1: Introduction Considering the population explosion, increasing inflation and scarcity of resources, the family trends have

shifted to nuclear families with number of children limited to one or two. Family planning refers to the natural and artificial birth control methods that allow you to control the size of your family and the gap between your children. Evidence shows that many pregnancies that start at a very early age or relatively advanced age (below 35 years old) occurring at very short intervals (less than 15 months from previous pregnancy), too many (more than four pregnancies) and to a sick or undernourished women pose dangers to the processes of reproduction, either to the childbearing women, to the children she bears and to other members of the family. Poverty and lack of access to education and family planning services exacerbates these dangers. There is no doubt therefore, that the quality of Filipino life can be proved and maintained through family planning. (Family Planning in the Philippine Setting) According to World Health Organization (WHO), Department of Reproductive Health and research, Family planning implies the ability of the individual and couples to anticipate and attain their desired number of children and the spacing and timing of their births. It is achieved through the use of contraceptive methods and the treatment of involuntary infertility (http;/ /www.who.int). Family planning is not just a matter of providing contraceptive services. Effort should also be considered to make couples appreciate the advantage of a small family in order to enhance family welfare. A large population requires a greater demand of the familys available resources to attain their needs, thus, failure in attaining these needs of each family member will result to poor health status and welfare. There is also numerous significance of family planning. It helps the couples and individuals achieve their desired family size within the context of

responsible parenthood and improve their reproductive health to attain sustainable development. It may help balance the population and available resources of the family. It prevents the birth of children who have little chances to be healthy or even to survive because of disease and malnutrition. It provides the greater sexual freedom by reducing or eliminating the fear of unwanted pregnancy and is concerned with the mother and potential offspring,. It controls pregnancy in a way that is acceptable to the mother and in harmony with the couples beliefs and lastly, it implies the responsibility for the whole family and responsibility to society Various methods of birth control have been practiced for thousands of years, yet most of these primitive methods were highly vulnerable or not effective not until the 19th century when more reliable methods of contraception developed. Even more developments in the 20th century have recently led to methods of contraception, which are the most effective ever. Effectiveness, degree to which action achieves the intended health result under normal or usual circumstances, is the most important factor to consider when choosing a method of contraception for you and your partner; the side effects, problems that occur when treatment goes beyond the desired effect or problems that occur in addition to the desired therapeutic effect, should also be considered. Effectiveness is measured in terms of its failure rate, or probability of failure. This probability is calculated by determining the number of sexually active women out of 100 who become pregnant in the course of the year while on particular method. (Allgeier & Allgeier, 1995) The effectiveness of the contraceptive is measured in terms of both the theoretical and the actual failure rate. Theoretical rate is the number of failure that occurs when the method is used correctly. (Allgeier & Allgeier, 1995) The failure is due to method of contraception not performing properly. In contrast, The actual failure rate is the total number of pregnancies that occur as a result of either failure of the method or to use a method correctly. (Allgeier &

Allgeier, 1995) Lack of education on contraceptive use is one of the main reasons that the actual failure is usually higher than that of the theoretical failure rate. Reproductive health bill; the bill is national in scope, comprehensive, rights-based and provides adequate funding to the population program. It is the departure from the present setup in which the provision for reproductive health services is revolved to local government units, and consequently, subjected to varying strategies of local government executives and suffers from a dearth of funding. The reproductive health (RH) bill promotes information on and access to both natural and modern family planning methods, which are medically safe and legally permissible. It assures an enabling environment where women and couples have freedom of informed choice on the mode of family planning they want to adopt based on their needs, personal convictions and religious beliefs. The bill does not have any bias for against either natural or modern family planning. Both modes are contraceptive methods. Their common purpose is to prevent unwanted pregnancies. The bill will promote sustainable human development. The U.N. stated in 2002 that Family planning and Reproductive health are essential to reduce poverty. The UNICEF also asserts that Family planning could bring more benefits to more people at lesser cost than any single technology now available to human race. The fact that limitation of offspring has become an important social and medical problem needs no elaboration here. Whatever the individual physicians own attitude, it must be toward organized movements for birth control, he is sure to be frequently facing the problem in his own consultation room, so that he must be familiar with the various methods which are in vague for

the control of conceptions. The medications for such control are often decided by the individual physician chiefly according to his religious belief and according to conservative or radical trends. (Gynaecology by Emil Norak) Despite of the availability of cheap and effective contraception, it looks as if we are not careful in our decisions about reproduction as all the talk of family planning might suggest. (Hugh Mackay) Clients particularly adolescence may find it difficult to adhere to abstinence, refraining from sexual intercourse, or they overlook it as an option. Some women dislike the use of diaphragm, mechanical barrier contraceptive device fitted over the cervix of a woman, because they must be inserted before coitus and should be left in place for 6hours afterwards. Some couples may find this precaution restricting. Some women appears to lose interest in coitus after taking for about 18 months possibly because of long term effect of altered hormones in their body. Sexual interest increases again after change to another form of contraception. Some women experiences nausea with the pill and that interfere sexual enjoyment as well as with other activities. Some men find that condoms dull their enjoyment of coitus. Some couples do not like the fact that the male must withdraw promptly after ejaculation. Concern that the condom may break or slip also may inhibit sexual pressure. Latex condoms have the additional potential of preventing the spread of STIs, and their use has become a major part of the fight to prevent infection with Human Immunodeficiency Virus (HIV). Various preparations are available including gels, creams, sponges, foams, and suppositories. The woman should do this no more than 1 hour before coitus for most effective

result. She should not be douche for 6 hours after coitus to ensure that the agent has completed its spermicidal action. In addition some women find vaginal leakage after use of the products bothersome. Some couples find the foam or moistures irritating to vaginal and penile tissue during coitus and therefore are unable to use them. (Maternal and Child Health Nursing, 2007) Level of education is very much essential on the use of contraceptive methods according to Pillitteri Adelle, Maternal and Child Nursing (1999), the elders and those with higher educational attainment has much knowledge regarding the use of contraceptives and the DOH supports the family planning programs that increase their level of awareness. Roman Catholic is the major recipients of contraceptives although they are procreation. It has been frequently noted that preaching on contraception may be one of the hardest things for the priest or deacon to do. But preaching on any sin is hard to do because there is a real chance that you might catch a substantial number of listeners who practice that sin. (The Case Against Contraception by W. Patrick Cunningham). The study is conducted at Ilocanos Sur, City of San Fernando La Union. The study was delimited to the level of awareness and extent of utilization on family planning methods among ages, religion, and educational attainment. Theoretical/ Conceptual Framework

PARADIGM INPUT Profile of MACRA Age Educatinal attainment Socio-economic status Religious affiliation Analysis of the factors affecting the level of awareness and extent of utilization on family planning methods of MACRA along: Factors affecting the level of awareness and extent of utilization of MACRA Personal Socio-economic Spiritual Personal Socioeconomic Spiritual PROCESS OUTPUT

Family Planning Implementati on Guide

Analysis of the level of awareness and extent of utilization and beliefs on family planning methods of MACRA along:

Usage/indicat ion Side Effects Methods

Level of awareness of MACRA along Usage/indication Side effects Methods

Extent of utilization of MACRA along Usage/Indicatio n

Formulation of a family planning Implementation Guide

Figure 1 presents the paradigm of the study. The input are the profile of the respondents which includes age, educational attainment, socio-economic status, and religious affiliation of MACRA, the level of awareness and the extent of utilization of MACRA along personal, socioeconomic, spiritual, usage/indication, side effects and family planning methods. The process includes the analysis of the level of awareness and extent of utilization of MACRA along personal, socio-economic, spiritual, usage, side effects and family planning methods. And the output is the family planning implementation guide for the married couples of reproductive age to understand better the different family planning methods and to be able to use it effectively.

Statement of the Problem The level of awareness and extent of utilization of Family Planning of Married Couples of Reproductive Age (MACRA) in Ilocanos Sur, City of San Fernando La Union: Basis on FPIG Specifically it sought the answers to the following questions: 1. What is the profile of the respondents in terms of: a. Age b. Educational Attainment c. Socio-economic d. Religious Affiliation 2. To what extent do the following factor affect the level of awareness along: a. Personal b. Socio-economic c. Spiritual 3. To what extent do the following factor affect the extent of utilization along: a. Personal b. Socio-economic c. Spiritual 4. What is the level of awareness of the respondents along:

a. Usage or indication b. Side effects c. Methods 5. What is the extent of utilization of the respondents along: a. Usage or indication b. Side effects c. Methods 6. Is there a significant relationship between the profile of respondents and level of awareness along: a. Usage b. Side effects c. Methods 7. Is there a significant relationship between the profile of respondents and beliefs on contraceptives along: a. Usage b. Side effects c. Methods Hypothesis

1. The profile MACRA in terms of age, educational attainment, socio- economic status and

religious affiliation is of no significance to their level of awareness and extent of utilization of family planning methods.
2. There is no consistency on the level of awareness and extent of utilization of family

planning methods of MACRA. 3. The level of awareness on family planning methods of MACRA in terms of usage or indication, side effects and methods are not aware.
4. The beliefs of MACRA on contraceptives along usage or indication, side effects and

methods are not reliable.

5. There is no significant relationship between the profile of MACRA and the level of

awareness and extent of utilization along usage or indication, side effects and methods.

Significance of the study The significant findings of this study can be a possible contribution to the education and welfare of all the people especially the residents of Barangay Ilocanos Sur with regard to their level of awareness and extent of utilization of MACRA on family planning methods. The findings of the study are important to the following: To Health Care Providers: it is one of their responsibilities to teach and impart information on family planning. It will provide a broader knowledge on family planning so that the effectiveness of encouraging couples to use family planning will be assured.

To Student Nurses: as we all know, one of our duties is to render teachings about family planning and this study will increase and update their knowledge about it. The will help to enhance students in their perception in family planning programs. To Nursing Profession: this study will give information that could develop the family planning program imposed by the government. This will also give an overview on how the couples will accept their programs. Reseachers: this will help us to determine the level of awareness and extent of utilization of MACRA on family planning methods at barangay Ilocanos Sur, Sanfernando City, La Union. Through this study they can able to make a family planning implementation guide that would improve the families health in this said barangay. To the Future Researchers: This may serve as a reference material for those who wish to make a similar study in the future. It will widen their knowledge on family planning which may apply in educating others as well as for their own use in the future. The outcome of this research study will provide and will serve as a guide to continue the search of the effectiveness of the family planning methods to every married couples of reproductive health. To the married couples: The result of this research study will make them understand the importance of family planning, they will be able to gain knowledge on different family planning methods, they will be able to know the different side effects, methods and the use and effectiveness of this family planning methods. It will also help them appreciate family planning and attain their desired number of children in accordance to their available resources. Readers: The result of this study will serve as an additional reference to their related lessons.

Community Residents: Through this research, community residents will be able to become aware of the benefits of different family planning methods in their family health. They will be able to gain knowledge about the different side effects and also proper usage of this different family planning methods, thus they will be able to promote health within their family. School administrators and instructors: With this research, school administrators and instructors will gain more knowledge about family health and they will be able to emphasize to the minds of their students the importance of being aware on this topic and thus give support also to incoming researchers about the family planning program to MACRA. Students will be the instruments of promoting health to different families and to their own. Department of Health: This study will serve as first line basis in the implementation of more possible programs that may directly or indirectly be concerned with the utilization and adoption of the family planning program to the community members.

Scope and Delmination of the study The scope of this study covered the selected married couples of reproductive age (15-49 years old) in Barangay Ilocanos Sur, SanFernando City, La Union. The aspects looked into were the profile of MACRA such as age, gender, educational attainment, socio-economic status and religious affiliation, the factors affecting their level of awareness and extent of utilization along personal, socio-economic and spiritual, the level of awareness, extent of utilization and beliefs of MACRA on family planning methods along their usage or indication, side effects and lastly the methods.

It is basically designed to determine the level of awareness and extent of utilization of various family planning methods among married couples of reproductive age which serves as a basis for proposing family planning implementation guide. Definition of terms Abstinence one of the most effective ways of natural Family planning. Couples who do not have a baby and want to avoid taking artificial contraceptives should keep away from sexual intercourse during the fertile days of the women. Artificial family planning - signifies various contraception methods that include hormonal methods like birth control pills and Norplant implant, barrier methods like condoms which act as foremost male contraception, cervical caps and diaphragms, and sterilization or permanent contraception.

Birth Control Pills stop the development of the egg and also help in the thickening of cervical mucus in the uterus thus restricting the passage of the sperms to the egg. This can be an effective method if the pills are taken regularly and in the correct manner. Cervical cap looking like a small diaphragm and made of plastic or rubber. It fits snugly over the cervix Condoms most commonly used male contraceptive to escape pregnancy. Using condoms during sexual intercourse acts like a barrier from sperms to enter the vagina, thus restricting their contact with the egg. It helps also in the prevention of sexually transmitted disease. Diaphragm - a small dome-shaped cup made of latex. Rubber and stretched over a flexible ring.

Family planning - the concept or a program of limiting the size of families through the spacing or prevention of pregnancies, especially for economic reasons.

Female condom - Polyurethane sac inserted into a woman's vagina over cervix to prevent sperm from entering uterus; may be used with a spermicide. Injectables - Hormonal injection given by a health-care professional in a woman's arm or buttock; prevents ovaries from releasing an egg, thickens cervical mucus to keep sperm from reaching an egg, and/or prevents the lining of the uterus from thickening so that a fertilized egg cannot implant. Intra Uterine Device - is a catchall label that refers to a variety of small plastic and metal devices used to prevent pregnancy. Designed for insertion through the cervix into the womens uterus, each IUD has a long thread attach to allow for easy removal Male condom - Sheath of latex, polyurethane, or animal tissue placed on erect penis; may be used with a spermicide. Natural family planning - is based on avoiding sexual intercourse during the fertile period of women. This method is based on physical signs of ovulation like basal body temperature and certain changes in mucus consistency.

Sterilization permanent contraception by surgical procedures, to avoid future pregnancy Tubal sterilization - Surgical procedure to permanently block a woman's fallopian tubes to prevent eggs from reaching sperm

Vasectomy - Surgical procedure to permanently block a male's vas deferens (sperm duct) to prevent sperm from reaching eggs. Withdrawal requires removing the penis from the vagina before the male ejaculates. (Married and Single Life by Riker and Brisbane)

CHAPTER II: REVIEW OF RELATED LITERATURE Age Age is a very influential factor in family planning. Teenagers may not be familiar with birth control and engage in careless sex that increases the risk of pregnancy. Some birth control methods are prescription-only and require a guardian's consent. Teenagers may be too afraid to ask for consent, or parents may refuse in hopes of dissuading their daughters from engaging in sexual activities, which does not always work. According to a 2007 MSNBC report, women in their late 30s and older may have more trouble getting pregnant than young women. Older women also have an increased risk of giving birth to babies with birth defects or low birth weight, according to "Reducing Risk Factors," a Concept Media video on pregnancy. http://www.ehow.com/list_7194360_factors-affect-family-planning.html Personal Beliefs

When it comes to family planning, your personal beliefs may limit your options. For example, the Roman Catholic Church does not believe in birth control, which makes familyplanning options very limited. The majority of churches do not condone abortion, though some make exceptions for instances of rape or a threat to the mother's health. Outside of religion, some people have personal feelings about birth control and abortion. Other people don't believe in having children to begin with. All of these beliefs and feelings can complicate conversations about family planning. Religion Some religions have strict guidelines on family planning while others make general recommendations or are silent on the topic altogether. Whether believers choose to follow those guidelines or not is another matter. The Roman Catholic Church has one of the strictest positions: It officially advocates only Natural Family Planning (NFP), a method based on monitoring a woman's monthly cycle and abstaining during fertile phases. NFP is also used by couples to maximize fertility, and variations of the method are also used by secular couples trying to conceive. Islam permits most methods of birth control, though it generally prohibits irreversible methods such as vasectomy or tubal ligation. Most schools of Judaism permit birth control, though the Orthodox place some limited restrictions. Protestant sects vary widely on the topic. http://www.ehow.com/list_7665965_issues-affect-family-planning.html Educational Attainment Education is said to be a fertile ground for knowledge accumulation. It serves to be the superhighway of different information where people could easily acquire learning for different human face. The educational attainment of parents especially of the mother has consistently been

proven to be an important factor in explaining variations in level of family size. Group with a high educational attainment of either the husband or the wife had lower fertility than those with low educational levels. Educational attainment is largely an indicator of socio-economic status. Highly educated couples, usually obtain relatively higher income, which they could spend for worthy investments. Another explanation is that women who have low educational attainment simply do not know how to control their fertility. Substantial evidence shows that women with high educational attainment tend to marry at a later age compared to those groups of women who had little or no education. The study abide Fernail and Deguzman , presented out that desired family size decline with education, with the un schooled, having about 2 or more children compared to college educated. Extent of Utilization DOH (Department of Health) encouraged the use of contraceptives, and family planning continues to meet the resistance for a number of reasons. One major factor that affects the utilization of contraceptives is the husbands role in determining the family size. Some feel that the family goes against the teaching of their religion. A womans age and educational status figure into her attitudes about family because a little education or who marries at an early age is likely to have more children. According to WHO in 2004 women will still desire to have a reproductive freedom and chose to take advantage and without a prescription. Personal Personal factor can affect the fertility regardless of contraceptive use. Family planning has a great impact on couples physical health and well- being, offering strong evidence that the health benefits outweigh the risks, in contrast, a womans psychological well being of personal

satisfaction may or may not derive from critical decisions that affect their fertility and reproductive life. Level of Awareness Many communities claims to have methods of family planning that pre-date the introduction of modern contraceptives implying that contraception is a culturally acceptable norm. It was therefore postulated that the study of population would have a high level of awareness and practice of natural family planning methods. Usage

Side-effect This is the unwanted effect produced by the natural and artificial family planning methods that was commonly experienced by both men and women (Miles Britton). Common side effects were irregular bleeding, no period, headaches, nausea, dizziness and weight loss. These side effects occurred mainly among pills and injection users. The occurrence of the side effects had a negative impact on continuation rates..Method options need to be widened and counseling needs to be improved to ensure that women fully understand the issue of side effects and make improved about cause of contraception. Methods Family planning methods prevents conception, thus limiting reproduction (Margaret Sanger in 1994). Attempts to control fertility have been going on for thousands of years. Some ancient methods though crude, were based on sound ideas.

But in todays age when couples are busy with their respective careers, many are opting for smaller families or sometimes no children at all. Another major reason for this also includes the high cost of living. For couples who want to stop after having one or more children, there are a variety of family planning methods. Couples can opt from two categories of family planning methods, natural methods and artificial methods. They can choose from a wide variety of methods according to their preference and convenience to avert unwanted pregnancy. CHAPTER III: Methodology Research design The researchers made use of the descriptive type research, specifically descriptive survey wherein this type of research is the most popular used in research project. According to Laurentina Paler- Calmorin (2004) descriptive study was the simpliest form of descriptions to research wherein it was used to combine both of foregoing ideas with respect to data relating standards and to status. According also to project talent (US Office of Education), descriptive research seeks to find answers to questions through the analysis of variable relationships. In other words, descriptive research may be defined as purposive process of gathering, analyzing, classifying, and tabulating data about prevailing conditions or situations, practices, beliefs, processes, trends, development as well as cause-effect relationships and then making adequate interpretation about such data or information with or without the aid of statistical methods. Descriptive studies were of large value in providing facts on which professional judgment may be based. It can contribute to the development of research through creating directly and demand for them and providing normative standardizing procedures by which the scales are evaluated

and calibrated. It includes all those research that present facts concerning the nature and stand of anything, a group of persons, number of objectives and a set of conditions. Researchers used the questionnaire as the main data gathering instrument. The study is focused on the The Level of Awareness and Extent of Utilization of Family Planning Methods of MACRA at Barangay Ilocanos Sur, Sanfernando City, La Union. Casual interviews were also performed with some of the respondents to obtain a more dependable reply and information.

Population and Local of the study

The respondents of this study were the couples of the barangay, Ilocanos Sur, San Fernando City, La Union. From the total population of 452 MACRA are randomly selected to be the subject of the study usi2ng sampling design. Level of error was set to .05%. Slovens formula used to determine the sample size. The formula is as follows. Formula:

n=

1 + N ( e)

Where: n = sample size N = total population e = margin of error

Data Gathering Tools and Procedure The researcher themselves formulated questionnaire. All questions formulated by the researchers were believed to be necessary for the gathering of data. This method facilitates faster gathering of data than other methods. The researchers will provide questionnaires to the married couples of reproductive age to the barangay. The questionnaire that the researcher will prepare consists of four parts: the first part is concerned with the people of the respondents in terms of age, educational attainment, religious affiliation and socio-economic status including media exposure. The second part of the questionnaire involves the factor that affect the level of awareness and extent utilization of MACRA along personal, socio-economic and spiritual. The third part involves in the data concerning the level of awareness and extent of utilization MACRA along: a. usage/indication b. side effects and c. methods of family planning methods. The researchers will explain how to fill up the data on the questionnaire. These questionnaires will be all answerable by checking the corresponding equivalents given. The questionnaire will be floated to the MACRA after the necessary permissions from the proper authorities will be submitted and approved. The questionnaire will be briefly discussed to them also with the purposes and the assurance that the result will be used for academic purposes. The respondents will

assure that their identity will be kept confidential. The researchers will be able to gain their trust and cooperation in answering the questionnaire.

Treatment of the data

The researchers will use the percentage count to determine the profile of the respondents. The weighted mean will be used to determine the level of awareness and extent of utilization of family planning method of MACRA, to interpret the data that will be collected the level of awareness and extent of utilization of MACRA, a 5 point Linkert scale will be used and a 3 point scale will be used to determine the factors affecting the level of awareness and utilization of family planning method of MACRA. 5 point Linkert Scale Scale 5 4 3 2 1 Range 4.21 5 3.41 4.20 2.61 3.40 1.81 2.60 1.00 1.80 Descriptive Equivalent very highly aware highly aware moderately aware fairly aware not aware

3 Point scale Scale Range Descriptive Equivalent

3 2 1

2.41 3 1.41 2.40 0.00 1.40

always sometimes never

Frequency and percentage distribution will be used to determine and differentiate the profile of the respondents. Formula: f 100 N

%=

Where: % = percent f = frequency N = number of cases The total number of population is 452 and a sample size is drawn using the formula below: Formula:
n 100 N

Where: n = sample size N = population Weighted means of the respondents ratings to the different questions will be used in the descriptive analysis on the subjects reaction to the factors affecting the

level of awareness and extent of utilization of family planning method of MACRA in Ilocanos Sur, San Fernando City La Union. The weighted mean will be computed using the following formula. Formula:

x=

x
N

Where:

x = sample mean
= the sum of
= population

For the researchers to complete and cope with the significant relation between the profile and the level of awareness and extent of utilization of family planning methods of MACRA in Ilocanos Sur, San Fernando City, La Union, pearsons was used. Formula:

r=

[n( x ) ( x ) ][n( y ) ( y ) ]
2 2 2 2

n( xy ) ( x ) ( y )

Where: x = observed data for the independent variable y = observed data for the dependent variable n = sample size r = degree of relationship between x and y

The Guide for Persons Interpretation

Range 0.00

Descriptive Rating There is absolutely no correlation between the variables compared.

0.01 to 0.19

There is practically no correlation between the variables compared.

0.20 to 0.39

There is slight correlation between the variables compared.

0.40 to 0.59

There is substantial correlation between the variables compared.

0.60 to 0.79

There is a significant correlation between the variables compared.

0.80 to 0.99

There is a very high correlation between the variables compared.

1.00

There is a perfect correlation between the variables compared.

Critical value (1-tail, 0.05) = +/- .11942 Critical value (2-tail, 0.5) = +/- .14201 To test the significance or r, a t-test was used with formula:

t =r

n 2 1 r 2

The null hypothesis was tested at 5% level of significance.

QUESTIONNAIRE

THE LEVEL OF AWARENESS AND EXTENT OF UTILIZATION OF FAMILY PLANNING METHODS OF THE MARRIED COUPLES OF REPRODUCTIVE AGE(MACRA) IN ILOCANOS SUR, SANFERNANDO CITY, LA UNION.

Part 1 Profile Direction: Please place the information needed by checking or filling up the spaces below.
1. Age:_______

2. Gender:

__Male __Female

3. Educational attainment: __________________________

__Elementary Graduate __High School Undergraduate __High School Graduate __College Undergraduate __College Graduate

4. Socio-economic __employed __unemployed __self employed

Media Exposure: Which of the following medium do you get in information most, choose one: __ Readings __Audio __Visual

Others (please specify) _______________________________ 6. Religious Affiliation:_________________________

Profile II Factor affecting level of awareness on family planning methods of MACRA A. Personal Direction: 5- very highly aware 4- highly aware - moderately aware

5
1. Using condom avoids contagious diseases such as HIV/AIDS,

gonorrhea and chlamydia. 2. Contraceptives avoid unwanted pregnancy. 3. Some contraceptive methods foul because of contraceptive item malfunction. 4. The best way to prevent unwanted pregnancy is through abstinence. 5. Natural family planning is more convenient than artificial family planning methods. 6. Pills can alter body figure.

B. Socio- Economic Direction: 5

1. Condoms or calendar method cycle methods are less expensive

than some forms of contraception such as surgery like vasectomy and tubal ligation. 2. A woman who uses contraception may have more opportunities to become involved in the workforce and in community based act.

3. Having fewer children may relieve some of the burden inherent in raising a range family, so family planning methods is important. 4. A woman who uses contraceptives and produces fewer children may find herself in a state of conflict of her husbands relationship.

C. Spiritual Direction: 5 1. Some religions may have restrictions on contraception based on the belief that it is Gods will to bring children into the world. 2. Roman Catholic Church has disallowed artificial contraception. 3. Abstaining from sex would be morally better than having sex and using contraceptives.
4. Roman Catholic Church only allows natural birth control by

which it means only having sex during the infertile period of women.
5. Using artificial contraceptive is not moral to some churches

because it is against the law. 6. Most of the religions valued highly fertility and having children and using contraception is similar to abortion.

Profile III Factor affecting the extent of utilization on Family planning methods of MACRA A. Personal Direction: 5 4 3 2 1

1. My husband is not amenable in using contraceptives. 2. I do not have enough knowledge on the use of contraceptives. 3. Contraceptive causes allergic reaction to us. 4. I have fear on permanent damage to my health when I use contraceptives. 5. I am shy to buy such contraceptives to any pharmacy or department store.
6. I dont want to use contraceptives because of its side effects and

technical problems that might happen. 7. Using contraceptives diminishes my sexual satisfaction.

B. Socio- Economic Direction: 5 1. We cannot afford to buy contraceptives. 2. I do not use contraceptives like pills because the barangay doesnt have enough pills to sustain us. 3. Using contraceptive is not accepted in our clan. 4. I use contraceptives because it is the rule in the family and within my relatives concerning about family size so that it may improve communication and strengthen relationship.
5. My husband does not support the use of birth control because de

desires to have many children.

C. Spiritual Direction: 5 1. Using contraceptive is against to our religion. 4 3 2 1

2. I do not use contraceptives because it is sacred. 3. I use contraceptive because it is acceptable as a matter of biblically allowable freedom of conscience. 4. I use contraceptive because it is an important moral good. 5. For me I use contraceptive because contraceptive is accepted as long as it does not used to encourage or permit promiscuous belief.
6. I do not use contraceptives because contraceptive is morally

wrong.

Profile IV Awareness A. Usage Direction: Below are list of possible situation or experiences that you might have encountered while using a natural and artificial contraceptive methods. Please check the number of your choice and kindly refer to the scale Questions: Are you aware that. 1. Contraceptive method are for both sexes 2. Contraceptive methods are used for proper spacing of pregnancy 3. IUD must be replaced periodically and a new one can be inserted at the time of removal in the same office visit. 4. Vaginal Ring is only available in only one size and does not require a special fitting or placement. 5. Contraceptive patch can be applied to clean dry, healthy skin on the buttocks, abdomen, upper outer arm or upper torso, but not on the breast. 6. Diaphragm should be left in the place for at least 6 hours after sexual intercourse but no longer than 24 hours. 7. A female condom should, in any case, not be used more than 5 times. 5 4 3 2 1

8. Non medical methods of contraception, even when used in combination, is completely effective in preventing pregnancy when women of child bearing age have sexual intercourse with fertile men. 9. Cervical caps and diaphragm require office visits for fitting, and personal instruction for use. 10. To be effective, the pill must be taken within 12 hours of the same time each day. A. Side- effects Direction: Below are the lists of possible side effects that you encountered or experienced while using natural or artificial family planning methods. Please check on the corresponding number and kindly refer to the scale. QUESTIONS 1 1. Taking oral contraceptives can cause nausea, weight gain, breast tenderness, headache and vaginal infections. 2.IUDs may cause ectopic(tubal) pregnancy, irregular bleeding, cramping and longer menstrual cycles 3. Irritation or allergic reaction especially to latex is a possible side effect of using condom. 4. Hormonal contraceptive(synthetic estrogen ) causes an ovulation 5. Bleeding occur due to male sterilization or vasectomy that may result in hematoma in the scrotum 6. Diaphragms and vaginal sponges can cause allergic reaction, UTI and in rare cases, toxic shock syndrome 7. Contraceptive patch can cause breast discomfort 8. Cervical cap may increase the risk of UTI and allergic reaction 9. Sterilization increases the rate of hysterectomy, ectopic pregnancy, painful periods and increase rate of prostate cancer. B. Methods 2 3 4 5

Direction: Below is the list of statement regarding natural and artificial contraceptive method: kindly represent the extent of your knowledge by checking the corresponding number using the following scale.

Questions: Are you aware that.. 1. There are many choices between natural and artificial contraceptive method to be used to prevent pregnancy. 2. Cervical caps are the smallest cervical barrier.

3. Contraceptive sponge must be run under water until thoroughly before insertion. 4. Diaphragm only has to be used during intercourse. 5. Contraceptive patch is a transdermal patch applied to the skin that releases synthetic estrogen and progestin hormones to prevent pregnancy. 6. Condom can help protect you from sexually transmitted diseases. 7. IUD will not interfere during intercourse. 8. Injectables can help prevent uterine cancer. 9. The use of calendar- based methods are relatively high failure rate compared to other methods of birth control. 10. Depo-Provera (injectables) takes seven days to take the effect if given after 4 days of the period cycle. 11. The plastic female condom has the advantage of being compatible with oil-based lubricants as it is not made of latex 12. Lactation or amenorrhea methods can prevent pregnancy that have given birth less than 6 months. 13. Abstinence is free and available to all. 14. Vaginal ring is used not only to prevent pregnancy but can also use to treat conditions such as irregular period, menstrual cramps. 15. Pill is composed by two hormones estrogen and progestin which can also helps to regulate menstrual periods.

Profile V Utilization A. Usage Direction: Below are the statements regarding the extent of utilization of family planning methods 3- Always 2- sometimes 1- Never 3 2 1

1. Consulting to physician before using contraceptive 2. Knowing the side effect first of the contraceptives before using it 3. Asking my partner if he or she prefer to use contraceptive before intercourse. 4. Knowing the advantages and disadvantages of using or not using contraceptives. 5. Using contraceptive of family planning method though it is prohibited in our religion

B. Side- effects Direction: Side- effects Hypertension Weight gain Nausea and vomiting Headache and dizziness Allergy Urinary tract infection Breast cancer Menstrual cramps Irregular period Breast tenderness 3 2 1

C. Methods

Direction: Below are the lists of different family planning methods; put a check mark on the extent of your use with the corresponding number using the following scale: 3- Always 2- Sometimes 1- Never 3 2 1

Family planning methods Calendar method Withdrawal Abstinence Pills Condoms IUD Cervical caps Suppository Diaphragm Injectables Sterilization

Part VI Beliefs A. Usage Direction: Below are the lists of items concerning attitudes, beliefs and perceptions about the usage of natural and artificial contraceptive methods. Please check the number which corresponds to your answer using the scale below. Questions: Are you aware that 1. Long term pill use does not affect fertility 2. Condoms slightly reduce sensitivity but the peace of mind it 5 4 3 2 1

provides far outweighs the small difference. 3. The belief that the use of IUD can cause cancer is not true; the use of IUD can help prevent endometrial cancer. 4. Abstinence can be practiced at anytime in ones life. 5. Cervical caps should not be used without clinical advice and instructions: it should be fitted by the clinicians. 6. Vaginal suppositories cant last for several contact or intercourse; a new suppository must be inserted deep into the vagina prior to each act or sex. 7. Withdrawal has no medical complications, no hormones, and no supplies and is free. 8. Using diaphragm during menstruation is not recommended. 9. Use of natural and artificial contraceptives methods can prevent pregnancy and not for abortion. B. Side- effects Direction: Below are the lists of items concerning attitudes, beliefs and perception about side effects of natural and artificial family planning methods. Please check the number which corresponds to your answers using the scale below. QUESTIONS Are you aware that 1. Breast-feed infants have lower weight gains when the mother is an oral contraceptives during lactation, since the mothers milk supply is decreased. 2. Take pills with food or at bedtime to help avoid nausea. 3. Pill may reduce cramping and shorten the number of days of bleeding during the menstrual period. 4. Smoking changes the effects of the pill and it predispose the smoking woman taking pills to various serious conditions like stroke and blood clots. C. Methods Direction: Below is the list of items concerning attitudes, beliefs and perceptions about natural and artificial contraceptive methods. Please check the number which corresponds to your answer using the scale below. Questions: 5 4 3 2 1 5 4 3 2 1

Are you aware that 1. Pills does not cause gain weight. 2. The belief that the condom can get lost inside a womans body is not true because it is too big to get through the cervix. 3. The belief that IUD causes cancer is not true because IUD helps to prevent endometrial cancer. 4. Abstinence needs great self control in preventing sexual contact. 5. Not having orgasm has nothing to do with birth control and is not a form of contraception. 6. Contraceptive suppositories work not by blocking the cervix but by killing the sperm cells that come in contact with it inside the womans vagina. 7. A cervical cap is not difficult to carry and may be put in up entering the cervix. 8. A diaphragm works by blocking a mans semen from entering the cervix. 9. Providing information about natural and artificial contraceptive methods arouses curiosity and can lead to sexual intercourse.