Predictors of Reproductive Health(RH)–Seeking Behaviors of

4Ps and Non-4Ps Couples in Region 02

Project Leader: Dr. Emolyn M. Iringan

Asst. Project Leader: Mrs. Evelyn Pacquing

Members: Dr. Jesus B. Pizarro

Dr. Josephine Joy Lorica

Collaborating Institution: St. Paul University Philippines

Tuguegarao City
 Chapter 1

THE PROBLEM AND REVIEW OF RELATED LITERATURE

Introduction

Population, poverty and economic development have shown causality in the recent decades. High
population growth particularly in developing countries impedes economic progress, depriving those
societies of funds for investment and of opportunities for improved standard of living. The increasing
fertility trends further exacerbate all aspects of poverty. Hence, government leaders devise integrated
economic development strategies that give a prominent role to population policies and poverty reduction.

In the Philippines, the Department of Health and the Commission on Population launched and
implemented the Responsible Parenting Movement (RPM) in 2007. RPM is one aggressive and
systematic strategy to promote responsible parenting and natural family planning. It is a grassroots
campaign to bring the program closer to its recipients. To mobilize the critical mass of parents who are
involved in the movement, classes in responsible parenting are held in the barangay. Each class is
composed of 10 married couples of child bearing age who want to practice birth spacing through natural
family planning methods (NFP). These couples should be willing to recruit other couples to become
members of the RPM. The RPM’s 8-hour session covers topics such as Responsible Parenting
(Concepts/Values/Practice of Responsible Parenting, Family Relationship, Home Management), Fertility
Awareness (Male Fertility, Female Fertility, Combined Fertility), and Natural Family Planning Methods
(Lactational Amenorrhea Method, Cervical Mucus Method, Billings Ovulation, Mercedes Wilson, Two-
Day Method, Standard Days Method, Sympto-Thermal Method, Basal Body Temperature Methods).
This program empowers Filipino families to consider responsible parenting as a way of life towards the
attainment of sustainable human development.

In relation to this laudable project in 2012, the Commission on Population was tasked by the
Aquino Administration to sustain the gains of the RPM classes by giving priority to Pantawid Pamilya
Pilipino Program (4Ps) couple recipients as participants. In this project, too, POPCOM and the
Department of Social Welfare and Development (DSWD) developed the Family Development Session
(FDS) Sub-module 2.2 on Responsible Parenthood/Family Planning (RP/FP). The said module is an
additional module to the existing FDS used by the DSWD for their 4Ps couple recipients.

Consequently, the implementation of the RPM and FDS Sub-modules 2.2 classes, inspired the
Commission on Population Region 2 to undertake a research study to determine the possible predictors of
the reproductive health-seeking behaviours of 4Ps couples and non-4Ps couples who attended sessions
through the FDS Sub-module 2.2 and RPM, respectively. Data derived from the study would further
extend the frontiers of knowledge on reproductive health (RH) and serve as basis in identifying effective
strategies towards sustained promotion of Reproductive Health and Family Planning.

Review of Related Literature and Studies

The following literature reviewed provided the researchers with adequate information that had
helped them understand the main variables in the study and guided them in the conceptualization of the
research framework. The studies cited provided information about health-seeking behaviors in general
and in terms of specific issues and concerns on Reproductive Health. Furthermore, the studies presented
varied approaches in assessing health seeking behaviors. Some studies dealt on the investigation of
probable factors affecting health seeking behaviors which provided additional inputs in the
conceptualization of the research project.
Pantawid Pamilya Program

Pantawid Pamilyang Pilipino Program is a human development program of the national

government that invests in the health and education of poor households, particularly of children aged 0-18
years old. Patterned after the conditional cash transfer scheme implemented in other developing countries,
the Pantawid Pamilya provides cash grants to beneficiaries provided that they comply with the set of
conditions required by the program. Pantawid Pamilya has dual objectives: namely, social assistance and
social development. Social assistance by means of providing cash assistance to the poor to alleviate their
immediate need (short term poverty alleviation); and social development by means of breaking the
intergenerational poverty cycle through investments in human capital. The Pantawid Pamilya helps to
fulfill the country’s commitment to meet the Millennium Development Goals, namely: Eradicate Extreme
Poverty and Hunger, Achieve Universal Primary Education, Promote Gender Equality, Reduce Child
Mortality and Improve Maternal Health. The Pantawid Pamilya operates in 79 provinces covering 1,484
municipalities and 143 cities in all 17 regions nationwide. The program has 3,996,967 registered
households as of 26 February 2014. (Retrieved: March 18, 2014:
http://pantawid.dswd.gov.ph/index.php/about-us)

Responsible Parenting Movement

The Responsible Parenting Movement (RPM) is in response to the directive of the former
President for the Department of Health and the Commission on Population to formulate and carry out an
aggressive and systematic strategy to promote responsible parenting and natural family planning. The
core of the plan is a grassroots campaign to bring the program closer to the people as possible. The
responsible parenting movement has its purpose of empowering Filipino families in order to make
couples aware of their basic responsibilities as parents, awakening in them a sense or responsibility and
commitment towards their family, neighbors, community, society, and the nation as a whole; consider
responsible parenting as a way of life towards the attainment of sustainable human development and to
establish the organizational structure that will create the critical mass of parents who will join the
movement for responsible parenting.
The Responsible Parenting Movement (RPM) is a network of couples who believe and practice
the principles of responsible parenthood with RPM/NFP barangay classes as the core strategy. Barangay
RPM class as organized by the RPM Team is composed of ten (10) couples. Each couple in the RPM
class is considered a member of the RPM. As member of the movement, each couple is expected to
recruit or invite another couple in the community to attend subsequent RPM class until at least ten (10)
RPM classes in each barangay are organized and federated in various levels. The RPM involves an 8-hour
session on Responsible Parenting, Fertility Awareness, and Natural Family Planning Methods (NFP). To
sustain the gains of the RPM classes, post-RPM class activities included coaching or mentoring through
home visits. The RPM classes are encouraged to merge themselves into clusters and, later on, for these
clusters to organize and form into federations. The RPM is hoped to mobilize a critical mass of parents at
the community level to help ensure continuous practice of responsible parenting as a way of life in every
Filipino family. Its members are connected as a federation to work together in promoting responsible
parenthood and modern natural family planning methods to couples and to various stakeholders to
generate support that would redound to the socio-economic benefits of the members. The target clients of
RPM are those married couples of child bearing ages preferably 21 to 35 years of age, couples with unmet
needs and users of traditional methods. The RPM focuses on Natural family Planning to give emphasis in
the promotion of natural family planning services and to give better option for users of
traditional methods to shift to scientific Natural Family Planning. (Retrieved: March 18, 2014:
http://popcom6.ph/rpm.html)

Reproductive Health and Reproductive Health Bill

Reproductive health, or sexual health/hygiene, addresses the reproductive processes, functions

and system at all stages of life (World Health Organization). Reproductive health refers to the diseases,
disorders and conditions that affect the functioning of the male and female reproductive systems during
all stages of life (National Institute of Health).

Reproductive health is the state of complete physical, mental and social well-being and not
merely the absence of disease or infirmity, in all matters relating to the reproductive system and to its
functions and processes. This implies that people are able to have a satisfying and safe sex life and that
they have the capability to reproduce and the freedom to decide if, when and how often to do so. Implicit
in this last condition are the right of men and women to be informed and to have access to safe, effective,
affordable and acceptable methods of family planning of their choice, as well as other methods of their
choice for regulation of fertility and the right of access to appropriate health-care services that will enable
women to go safely through pregnancy and childbirth and provide individuals and couples with the best
chance of having a healthy infant. (Accessed last March 18, 2014 from http://dirp3.pids.gov.ph/population/documents)

The Responsible Parenthood and Reproductive Health Act of 2012 (Republic Act No. 10354),
informally known as the Reproductive Health Law or RH Law, is a law in the Philippines, which
guarantees universal access to methods on contraception, fertility control, sexual education, and maternal
care. The following are the elements of Reproductive Health: (1) Family planning (FP) information and
services which shall include, as a first priority, making women of reproductive age (WRA) fully aware of
their respective cycles to make them aware of when fertilization is highly probable, as well as highly
improbable; (2) Maternal, infant, and child health and nutrition, including breastfeeding; (3) Prescription
of abortion and management of abortion complications; (4) Adolescent and youth reproductive health
guidance and counselling; (5) Prevention, treatment and management of reproductive tract infections
(RTIs), HIV and AIDS, and other sexually transmittable infections (STIs); (6) Elimination of violence
against women and children; (7) Education and counseling in sexuality and reproductive health; (8)
Treatment of breast and reproductive tract cancers and other gynecological conditions and disorders; (9)
Male responsibility and participation in reproductive health; (10) Prevention and treatment of infertility
and sexual dysfunction; (11) Reproductive health education for the adolescents; and (12) Mental health
aspect of reproductive health care. (Retrieved March 18, 2014 from http/: www.
dirp3.pids.gov.ph/population/documents/HB4110.pdf)

Health Seeking Behavior

Health – seeking behaviour is defined as personal actions to promote optimal wellness, recovery,
and rehabilitation (Mosby's Medical Dictionary, 8th edition, 2009). Health seeking behavior refers to
peoples’ willingness to seek help from health care providers. It is the seeking and acceptance by patients
of health service. Some go readily for treatment, others only when in great pain and in advanced state of
ill health.(Medical Subject Headings).

Barker (1986) in his investigation compared persons 65 years of age or older (N=177) to younger
adults (n=997) with respect to compliance with 20 recommended health-seeking behaviors. Overall, the
elderly group reported greater compliance with these behaviors, attributed more importance to their value,
but perceived themselves as having less control over their future health.

Bailey (1987) made an investigation on the health care-seeking behavior of black Americans in
the Detroit Metropolitan area. Analyses of 176 semi-structured interviews and 27 life history profiles
obtained from participants, nonparticipants, clinic coordinators, community leaders, and health care
professionals at local screening clinics suggest that black Americans follow a culturally specific health
care-seeking pattern, and that such behavior is significantly influenced by socio-cultural factors. This
information should be particularly useful for health care professionals and educators, because it can help
them plan and implement special intervention strategies for the black community.

Rosana (2011) conducted a case study on the influences of socio-cultural factors on malaria
seeking behaviour in Kisii District, Kenya. The quantitative data from 119 heads of households with self-
reporting cases of malaria, qualitative data from informal discussions and participant observation to argue
that malaria is a behaviour as well as medical problem, were obtained. It was observed that overemphasis
of biomedical approach which advocates for single universal malaria intervention programmes for all
communities is not effective. Consequently, the research advocated for the incorporation of social,
cultural and economic factors of malaria that affected people in all intervention programmes. The
research disseminated the results of the study through a book which is intended for scholars and students
of medical sociology, and all those involved in diseases intervention programmes in Sub Saharan Africa.

Shaikh (2009) mentioned in her paper that given the pluralistic and intricate panorama of the
health care delivery system in most of the developing countries, it is essential for researchers to logically
plan and design their research to develop understanding of the health-seeking behaviour of the
populations and the factors behind health service utilization trends. Health seeking behaviour is a
complex phenomenon and its appreciation could be very intriguing and informative for designing a
rational policy. This change in paradigm embodies an opportunity for action on social determinants and to
formulate healthy public policies as opposed to policies concerned with mere delivery of health care
services. Health systems research must aim to build appropriate structures for health care, to influence the
delivery of efficient, sustainable and effective health services and to provide more opportunities for
information and participation for the end users.

Health-seeking behavior is not just a one-off isolated event. It is part and parcel of a person’s, a
family’s or a community’s identity, which is the result of an evolving mix of social, personal, cultural and
experiential factors. The process of responding to ‘illness’ or seeking care involves multiple steps and can
rarely be translated into a simple one-off choice or act, or be explained by a single model of
health-seeking behaviour (Uzma et al, 1999).

Rahman (2000) stressed that a woman’s decision to attend a particular health care facility is the
composite result of personal need, social forces, the actions of health care providers, the location of
services, the unofficial practices of doctors, and in some contexts has very little to do with physical
facilities at a particular service point.

The study of Ahmed (2005) examined the health-seeking behaviour of some identified
disadvantaged population groups, including the effect of poverty focused on non-governmental
development interventions. An emerging cadre of “para-professionals” as the main providers of formal
allopathic care to the disadvantaged populations was observed, in addition to the pre-dominance of self-
care. Household poverty was instrumental in shaping health-seeking behaviour. By improving capacity
for health-expenditure, a grants-based intervention initiated changes in health-seeking behaviour of the
ultra-poor towards greater use of healthcare when ill, and use of ‘formal allopathic’ providers in
preference to unqualified providers. The microcredit-based integrated intervention was found to increase
the use of self-care.

Russell (2008) investigated on the Demand-side Factors Affecting Health-Seeking Behavior in

Ghana. More specifically, this examined the effect that distance from health providers has on health-
seeking behavior of household heads, quantified direct and indirect costs of obtaining health services and
studied the effect that perceived quality of different health providers has on the health-seeking behavior of
household heads. Results showed that among demand side barriers, cost and perceived quality of health
care providers are the most significant factors in the health decision making process. Individuals are
unlikely to go to health providers because of high cost; instead they choose unregulated prayer camps and
drug stores that are less successful than clinics in curing illness. This finding forces the government to
look at the health financing system, from health insurance to road quality. Policy makers and health
providers must take into account the additional hidden cost and opportunity costs such as transport costs
and inability to accumulate income while at the health provider.

The study of Cora (1986) sought to determine how adolescents' (N=156) health-seeking
behaviors, which include self-management and information-seeking behaviors, differ according to age,
race, socioeconomic status, gender, and religion. Findings confirmed gender as a differentiating variable
for performance of information-seeking behavior and found positive health behaviors among Black
adolescents. Subjects reported an overall positive composite of health-seeking behaviors.

Pang, et al. (2003) undertook a qualitative analysis of health-seeking behaviors of 25 community-

dwelling elderly Chinese Americans on the influences of family network, cultural values, and immigrant
experience in their use of health resources. Barriers to health care, pathway of health care, and adaptation
of health care by use of self-treatment and Eastern and Western medicines were also examined. The
investigators used content analysis to obtain themes and key points of focus group interview data to
explore the elderly participants' attitudes, values, and practices in their use of health resources. Survey
questionnaires in Chinese were used to compile demographic data. Findings suggested a shift from
traditional expectations of filial piety to more dependence on neighbors and friends, and a genuine
adaptability to combining Eastern and Western health care modalities. Immigration was not proposed by
these Chinese elders as an explanation of shifts in expectations for family support or values. This study
has implications for research, service delivery, and policy making for health care of ethnic elderly
persons, particularly in addressing structural and cultural issues in access and compliance.

Cheatham, et al. (1987) in their study described the unique barriers to health care and health-
seeking behaviors faced by Black men and to make recommendations to healthcare providers for
improving healthcare access for Black men. This is to address barriers to access faced by Black men
and/or management strategies used to mitigate barriers and improve access. The barriers identified
include socioeconomic status, masculinity, racism, lack of awareness of the need for primary care,
religious beliefs, and peer influences. As singular entities, these may not appear unique, but when viewed
collectively, they represent an overwhelming constellation of obstacles for Black men. Results imply that
individual, community, state, and national level recommendations for nurse practitioner actions to
improve healthcare access for Black men include public service announcements, radio commercials, and
billboards aimed at raising awareness of healthcare issues in the Black community, provision of
preventive services through health fairs, and development of positive provider-patient relationships.

The study of Maroney et al. (2005) aimed to explore how sociocultural (poverty, racism,
prejudice, and discrimination) and psychosocial factors (perceived health status, the lack of personal
efficacy in contributing to decisions about health care. feelings of helplessness, and the lack of trust in the
health care providers) relate to health-seeking behaviors of African Americans. Interviews were
conducted with 111 African American adult patients at a community health center, focusing on health-
seeking behaviors, and socio-cultural and psychosocial factors. Results suggest that when these negative
factors are removed, the health-seeking behaviors of African Americans closely mirror the behaviors of
the majority population. Subjects did not view themselves in poorer health, fail to seek medical attention
when needed, or distrust their primary health care providers. In general, fears associated with health care
were attributed to illness rather than health care providers, although a weak linkage was found between
patient self-esteem and fear or dislike of future treatment by physicians. The study highlights the need for
further study in two areas: cultural competency of health care providers, especially those from Asia and
Africa who are often assigned to community health centers, and the impact of an accessible community
health center on the health seeking behaviors and health status of predominantly African American
communities.

Reproductive Health-Seeking Behavior

Mukaire (2009) investigated on the sexual and reproductive health practices of young women and
men in the age group of 18 - 24 years in Nambale sub-county in Iganga district, Uganda. This inquiry
focused on the perspective of the young population of 18 - 24 years old, examining their ASRH
service-seeking practices, preference and media habits in order to explain reasons for low utilization of
services from the perspective of young people and possible improvements in light of the client-provider
oriented efficiency approach to “unique” public health services like ASRH. Using the case study
approach, the Focus Group Discussion (FGD) techniques using the Participatory Rapid Appraisal
methodology (PRA) for data collection and analysis was employed. Findings of this research imply that
the process which should be used in developing appropriate communication and advocacy strategies
should not be limited to NGO managers or district health officials of participating organizations but
should engage local service providers, local media, local artists, representatives of parents, teachers,
advocates of young people’s rights and young people themselves in order to get a well- balanced content
and process.

Joshi, et. al (2006) in their study assessed the reproductive health problems and heath-seeking
behaviour among urban school going adolescents. A sample of 300 urban school-going adolescents
between 11-14 years were chosen at random and assessed using four tools namely, self-administered
questionnaire; provision of adolescent friendly services; medical screening and focus group discussions.
Results showed that 72% girls and 56% boys reported health problems during survey with an average of
1.93 complaints per girl and 0.5 complaints per boy. However, only 43% girls and 35% boys reported to
the clinic voluntarily to seek help and only one fifth the amount of problems were reported at the clinic in
comparison to the quantum of problems reported in survey, which probably reflects a poor health-seeking
behaviour. A medical check-up will help to increase the client attendance in subsequent period of next
one year from 43% to 60% among girls and from 35% to 42% among boys. They recommended that to
increase help seeking behaviour of adolescents, apart from health and life skill education, their medical
screening with a focus on reproductive health by trained physicians, parental involvement, supported
emphasis on assessment of reproductive health and nutritional status helped in detecting almost the same
number of reproductive health problems as reported by them in survey. This intervention by adolescent
friendly centers (AFC) for counselling, referral and follow up are essential.

The study of Kumar (2008) assessed the perceived health problems and health-seeking behaviour
and utilization pattern of adolescent health clinics. A pre-tested, semi-structured questionnaire was
administered to 360 school-going adolescents who were selected by stratified random sampling from two
sectors of Chandigarh where services were being provided by a school-based and dispensary-based
adolescent health clinic. Majority (81%) of the adolescents reported having some health problem during
last three months prior to the survey; predominant (60%) problems were psychological and behavioural in
nature. To resolve these problems boys consulted mainly friends/peers (48%) while girls consulted their
mothers (63%). Compared to the dispensary-based adolescent health clinic, utilization was significantly
higher in a school-based clinic where proportion of psychological or behavioural problems reported was
also significantly higher (P<0.01). It was concluded that adolescents have greater counselling needs for
psychosocial problems than for medical problems. School-based adolescent health clinic was utilized
more often than the dispensary-based clinic particularly for psychosocial problems.

Singh, et. al (2008) conducted a study among 130 girl students aged 13-17 years in Haryana to
assess their awareness and health-seeking behaviour regarding menstrual and reproductive health. Results
showed that the mean age who first experienced menarche was 13.6-16.83 years, awareness about the
process of menstruation was poor, the most commonly reported menstrual problem was dysmenorrhoea
(40.7%) followed by irregular menses (2.3%) of which only 5.3% consulted a doctor and 22.4%, took
over the counter medications from the chemist shops. Knowledge about normal duration of pregnancy
and need for extra food during pregnancy was poor. Most of the girls knew about importance, duration of
child spacing and need for three medical examinations during pregnancy. Major sources of information
were television (73.1%), radio (37.1%) and parents (36.1%). Girls preferred to consult parents (49.2%)
and doctors (44.6%) for help at times of having reproductive health problems. This study highlights the
need for educating school girls about adolescent health, pregnancy and reproductive health problems
through schools and 'parents by the health professionals.

Sharma (2003) investigated on the Reproductive Morbidity and Health-Seeking Behaviour of

Adolescent Women in Rural India. Results revealed that the most common reason for not seeking
treatment was non-seriousness of symptoms as women though such problems are generally associated
with the birth of a child followed by cost of treatment. Being newly married and young, one of the main
constraints of these women was that they could not go alone for seeking treatment. Moreover, they were
also not confident to travel alone to a PHC/CHC in another village. Moreover, non-availability of female
doctors at public health facilities is also an important factor. Due to the lack of knowledge on
reproductive health issues, adolescent women are less open and frank in discussing their reproductive
health problems compared with older women. They were also embarrassed to seek treatment and did not
discuss about their problems with anyone at home. Health personnel also tended to attribute women's
non-utilization of reproductive health services to social stigma attached to these problems.

Atuyambe, et. al. (2008) conducted a cross-sectional study on adolescent and adult first time
mothers' health-seeking practices during pregnancy and early motherhood in Wakiso district, Central
Uganda. There were 762 women (442 adolescents and 320 adult) interviewed using a structured
questionnaire. Findings revealed that adolescents showed poorer health care seeking behaviour for
themselves and their children, and experienced increased community stigmatization and violence,
suggesting bigger challenges to the adolescent mothers in terms of social support. Adolescent-friendly
interventions such as pregnancy groups targeting to empower pregnant adolescents providing information
on pregnancy, delivery and early childhood care need to be introduced and implemented.

Conceptual Framework of the Study

This study was anchored on the concepts related to reproductive health and health-seeking
behavior. The succeeding paradigm presents the variables involved in the study and how the investigation
was undertaken.

Independent Variables Dependent Variables

 Socio-demographic
profile Care-Seeking
Behavior
 Psychosocial Factors
Health-Seeking
 Knowledge on Information-Seeking
Behavior
Reproductive Health Behavior

 Local health center‘s

Behavioral
reproductive health
Response
services and social
support

Figure 1. Paradigm of the Study

 Reproductive Health Care
 As shown, the study considered the respondents’ socio- demographic profile (i.e. respondents’
classification, age, educational attainment, occupation, family monthly income, religion, ethnic group,
and reproductive health history); their psychosocial (Maroney, et. al , 2005) characteristics(i.e. perceived
health status, personal efficacy in contributing to decisions about health care, level of self-reliance about
health and level of trust in the health care providers); their knowledge and understanding on the different
aspects of reproductive health; the quality of reproductive health care and the social support they
experienced; and their reproductive health-seeking behavior. Health-seeking behavior consists of
respondents’ care-seeking or information-seeking behavior and their behavioral responses when
confronted with problems within the realms of reproductive health. Further analysis was likewise done to
look into possible predictors of reproductive health-seeking behavior.

Statement of the Problem

This study determined the possible predictors of the reproductive health-seeking behaviors of 4Ps and
non-4Ps couples in Region 02. The findings of the study shall serve as a baseline data in identifying
effective strategies towards sustained promotion of Reproductive Health and Family Planning methods,
particularly in the use of modern Family Planning methods.

More specifically, the study aims to answer the following problems:

1. What is the socio-demographic profile of the couples in terms of the following:

1.1 municipality class,

1.2 province of residence,

1.3 couples’ classification,

1.4 couples’ age,

1.5 wive’s age at marriage,

1.6 couples’ educational attainment,

1.7 couples’ occupation,

1.8 couples’ monthly income,

1.9 couples’ religion, and

1.10 couples’ ethnic group?

2. What is the wive’s reproductive health history?

3. Is there a significant difference between 4Ps and non-4Ps couples’ utilization of family planning
methods?

4. What are the psychosocial characteristics of the respondents in terms of the following:

4.1 perceived health status,

4.2 personal efficacy in contributing to decisions about health care,

4.3 level of self-reliance about health , and

4.4 level of trust in the health care providers?

5. Is there a significant difference between the psychosocial characteristics of the 4Ps and non-4Ps
couples along the specified indicators?
 6. What is the respondents’ level of knowledge or awareness on the following aspects of
reproductive health and family planning?

6.1 Reproductive Health

6.2 Fertility awareness

6.3 Responsible parenting

6.4 Family planning methods

7. Is there a significant difference between the 4Ps and non-4Ps couples’ level of knowledge and
awareness of the different aspects of family planning?

8. How do the respondents assess the reproductive health care services and social support in their
respective local health centers?

9. Is there a significant difference between the 4Ps and non-4Ps couples’ assessment on the
reproductive health care and social support services offered by the local health centers?

10. What is the respondents’ health-seeking behavior along the following aspects of reproductive
health and family planning when they are grouped according to profile variables?

10.1 Care-Seeking Behavior

10.2 Information-Seeking Behavior

10.3 Behavioral Responses

11. Is there a significant difference on the 4Ps and non-4Ps couples’ reproductive health seeking
behaviour?

12. What problems do the 4Ps and non-4Ps couples encounter that limit their RH seeking behaviours?

13. What program could be implemented for the promotion of a sustainable Reproductive Health and
Responsible Parenthood?

Hypotheses

The study tested the given hypothesis at 0.05 level of significance.

1. There is no significant difference between the 4Ps and non-4Ps couples in terms of the following:

1.1 their psychosocial characteristics

1.2 their assessment on the reproductive health care and social support services offered by the
local health centers

1.3 their reproductive health seeking behaviour

2. The respondents’ socio-demographic profile, psychosocial characteristics, level of knowledge on

reproductive health /family planning, and reproductive health care services and social support
received from the local health centers do not significantly correlate with their health-seeking
behaviour.
Significance of the Study

The following will find the results of this research beneficial:

Married Couples. Being the major source of data as they would unveil information about their
reproductive health knowledge, beliefs, practices and health-seeking behaviour, the couples will
eventually benefit from this study since intervention plans are directed to their welfare.

Commission on Population. The information to be obtained shall serve as bases for the
Commission on Population in planning for programs and projects that will help promote responsible
parenthood, particularly the use of modern and humane family planning methods.

Department of Social Welfare and Development. The Department of Social Welfare and
Development shall be benefited from the results of the study as these will provide feedback on the impact
of the conducted awareness sessions promoting responsible parenthood.

Barangay/Rural Health Units and Health Practitioners. The study shall present useful information
for health practitioners as they plan for interventions to improve the health services they offer to the
community, particularly on reproductive health.

Media Practitioners. With this research, media practitioners are challenged to collaborate with
the government and non-government sectors in promoting responsible and healthy methods of family
planning.

Learning Institutions. Being the preparatory ground for future parents, learning institutions shall
be provided with necessary information regarding responsible family planning which could be integrated
in their curricular offerings.

Government. The information about the couples’ knowledge, practices and health seeking
behavior in the light of reproductive health will serve as initial input for the government regarding the
status of the implementation of the “ Responsible Parenthood and Reproductive Health Act of 2012 “.

Local Barangay Officials. The data obtained could serve as a valuable input for the barangay
officials for future strategic planning on promoting the welfare of their constituents along health, more
specifically on reproductive health.

Church. The study shall unveil information that the church can look into as it takes its
aggressive move to evangelize church teachings and pastoral efforts in promoting the moral, humane and
natural methods of family planning.

Scope and Limitation

This study will cover 4Ps and non-4Ps couples in Region 02 who had undergone awareness session
on family planning and reproductive health which were conducted by the Commission on Population or
the Department of Social Welfare and Development and local government units. Respondents were
randomly taken from selected municipalities of Cagayan, Isabela, Nueva Vizcaya and Quirino. Profiling
of respondents in terms of their socio-economic characteristics, and assessment of their knowledge on
responsible parenthood and reproductive health care, the family planning practices or family planning
methods they used and their health-seeking behavior was undertaken. Further analysis of the predictors of
reproductive health-seeking behavior was carried out. The entire investigation has its end of designing an
intervention program for eventual implementation to promote the modern family planning method.
Definition of Terms

The terms used in the study are defined to ensure clarity of the objectives, variables used and the
methodologies involved.

Appraisal Interval. Promptness of the respondents in making decisions to seek for care.

Artificial family planning methods. Use of condoms, Depo Provera, Intrauterine Device (IUD),
Pills, Vasectomy , and Bilateral Tubal Ligation (BTL).

Behavioral Responses. Respondents’ mode of addressing sexual activity, discussion of problems

with others, self- treatment (use of non-prescribed medications) and resolution.

Care-Seeking Behavior. Couples’ tendency to seek for care from any health care provider when
dealing with problems on reproductive health, which includes appraisal interval, total care seeking
interval and procrastination interval.

Ethnic group. This classifies respondents according to their ethnicity (i.e. Ibanag, Ilokano,
Tagalogs, etc.)

Factors. Couples’ socio-demographic characteristics, their knowledge, beliefs and practices on

reproductive health, and the quality of reproductive health care services and social support given to them.

Family planning methods . Natural and artificial methods of family planning.

Family planning practices. Couples’ practices pertaining birth spacing and control.

Family planning. Voluntary planning and action taken by couples to prevent, delay or achieve a
pregnancy.

Information-Seeking Behavior. Couples’ predisposition in seeking for health information about

the reproductive health care.

Knowledge. Respondents’ level of understanding of the concepts on reproductive health

including family planning, fertility awareness and responsible parenting.

Modern Natural family planning methods. Abstinence from sex ( i.e. Calendar method, Basal
Body Temp , Mucus Inspection, Symptothermal, Withdrawal, and Lactational Ammenorrhea (Breast
feeding for at least 6 months) and engagement in sex among married couples depending on the fertility
intention of the couple (to postpone or attain pregnancy).

Procastination interval. Number of days between the decision to seek care and the actual clinic
visit.

Psychosocial factors . Perceived health status, the personal efficacy in contributing to decisions
about health care, level of self-reliance on health care and level of trust in the health care providers.

Reproductive health-seeking behavior. Couples’ behavior in seeking for heath care, health
information and behavioral responses when confronted with problems pertaining to reproductive health.

Reproductive health history. Couples in terms of the nature of childbirth, number of children, and
family planning methods used.

Respondents’ classification. Respondents classification as either 4Ps or non-4Ps recipient.

Total Care Seeking Interval. Number of days between problem recognition and the clinic visit.

Type of Locality. Corresponds to the classification of the municipality as either class 1, 2, 3, and
the like)
 Chapter 2

METHODOLOGY

Research Design

This cross-sectional study utilized the quantitative research approach. Specifically, it utilized the
descriptive-correlational research design. This design is apt as it characterized the couples in terms of
their socio-demographic and psychosocial profile; their knowledge on reproductive health and family
planning; their assessment of the quality of reproductive health care services and social support extended
to them; and their health seeking behavior. The study further examined the correlates for reproductive
health seeking behavior, thus, the correlational design was used.

Respondents of the Study

The respondents of the study were the 4Ps and non-4Ps couples in selected municipalities of the
four provinces in Region 02, namely, Cagayan, Isabela, Nueva Vizcaya and Quirino. These couples were
attendees to either the Family Development Session Sub-Module 2 jointly conducted by the Commission
on Population (POPCOM) Office and DSWD or the sessions under the Responsible Parenting Movement
conducted by POPCOM. Respondent-municipalities were purposively sampled to ensure the
representativeness of the 4Ps and non-4Ps participants. Of the 35,377 recorded recruited couples,
21,112 are 4Ps while 14,265 are non-4Ps beneficiaries. Using the Slovin’s Formula at 0.05 margin of
error, 395 was the computed number of target respondents. To ensure the representativeness of the data,
the study considered 480 respondents which included 292 recruited 4Ps and 188 recruited non-4Ps. The
respondents per municipality were selected from each covered barangay to be represented. The wife, the
husband or both were considered as one respondent. The table below presents the respondents covered in
the study.

Municipality 4Ps Non-4Ps

Cagayan 128 58
Isabela 97 78
Nueva Vizcaya 37 32
Quirino 30 20
292 188
Grand Total 480

Instrumentation

A questionnaire was constructed based on previous tools used in researches on health-seeking

behaviour. It included five parts, namely:

Part I involves a checklist on the socio-demographic profile of the couples.

Part II deals with the psychosocial characteristics of the respondents.

Part III assesses the quality of reproductive health care services and social support received by the
respondents.

Part IV determines the knowledge of the respondents on reproductive health. The respondents
are asked to answer the items given the set of options or rate themselves based on a scale in terms of the
stated parameters.

Part V determines the respondents’ health-seeking behavior. This part involves three sub-
components such as care-seeking, information-seeking and behavior response.

The questionnaire went through validation process and reliability tests before it was utilized for
data gathering.
Data Gathering Procedure

The researchers obtained the list of 4Ps and non-4Ps who participated in the RH and FP
awareness sessions from the Commission on Population Office and the DSWD Office.

Prior to the data gathering phase, the researchers sought endorsement from the head of the
Commission on Population, the Department of Social Welfare and Development, and the Department of
Health. Permission from the provincial as well as the municipality administrators of the respondent
municipalities was likewise obtained. Upon approval, the researchers determined the location of the
probable respondents and coordinated with the municipal population officer, the 4Ps municipal links and
concerned barangay council to ensure systematic data gathering. Data enumerators were trained in
administering the questionnaires to ensure valid and reliable results. Informed consent were obtained from
the respondents before administration of the questionnaires. The respondents were guided by the
enumerators as they filled out the questionnaires.

Data Analysis

Descriptive as well as inferential statistics were used to treat the data. More specifically, the data
were analyzed as follows:

Frequency and percentage count. This was used to present the socio-demographic profile of the
respondents and other non-scaled responses. For true or false items, for positively stated items, the “yes”
response weighs 1 point while no point is given to the “no” response. For the negatively stated items,
reverse scoring was adopted.

Weighted Means. Scaled responses were treated using the weighted mean. Reverse scoring for
negative stated items was done before obtaining the item means. A scale was used to interpret the means.

Bivariate and multivariate analyses . T-tests, Analysis of Variance, Regression Analysis and Chi-
Square tests were employed to determine whether there exist significant differences between 4Ps and non-
4Ps with respect to the variables and identify factors associated with reproductive health-seeking
behaviour. The 0.05 of significance was used to test the research hypothesis.

Thematic analysis. Qualitative data that were obtained in the study were analysed thematically.
Workplan Schedule

The table below summarizes the activities to be undertaken

May June July August September October November December

Validation of Data Data Data Data Organization Preparation of Research
Instruments Gathering Gathering Gathering Gathering of Data Research Utilization
and obtaining (Quirino (Isabela) (Isabela) (Cagayan) Reports Workshop
proper Nueva
endorsement Vizcaya)
for the conduct
of the study

Budgetary Outlay

The table below presents the proposed budget in carrying out the research project.

Nature of Expenses Amount

Travel Expenses P 35,000.00
Manpower Resources 110,000.00
Printing of Materials 10,000.00
Meeting and Consultations 10,000.00
Documentation Expenses 5,000.00
Presentation of the Research Output to Key Stakeholders 20,000.00
Administrative Cost 10,000.00
Grand Total P200,000.00

References

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 Appendix A

PREDICTORS OF REPRODUCTIVE HEALTH-SEEKING BEHAVIOR QUESTIONNAIRE

Respondent’s Code: _________________ Municipality: _________________

Type of Municipality: ________________ Barangay: ____________________

Part I. Respondents’ Socio-Demographic Profile

Direction: Check the appropriate box or fill up the blank which applies to you in each item:

1. Classification : 4Ps Non- 4Ps

2. Age: Wife:___
Husband: ___

3. Highest Educational Attainment:

Wife Husband
Elementary Level Elementary Level
Elementary Graduate Elementary Graduate
High School Level High School Level
High School Graduate High School Graduate
College Level College Level
College Graduate College Graduate
Short Term Course Short Term Course

4. Religion:
Wife: ___________________
Husband: ________________

5. Occupation: Wife: ________________

Husband: _____________

6. Monthly Income:
Wife Husband
Below P5,000 Below P5,000
P5,000- P9,999 P5,000- P9,999
P10,000-P14,999 P10,000-P14,999
P15,000-P20,000 P15,000-P20,000
More than P20,000 More than P20,000

7. Ethnic Group:
Wife Husband
Tagalog Tagalog
Ilokano Ilokano
Ibanag Ibanag
Itawes Itawes
Malaweg Malaweg
Igorots Igorots
Bugkalots Bugkalots
Gaddangs Gaddangs
Others, please specify:_______ Others, please specify:_______
Part II. Reproductive Health History

1. Age of Menarche (taong gulang noong unang niregla): ___________

2. OB Score
Gravida (bilang ng pagbubuntis)_____
Para (bilang ng panganganak)____
Term (bilang ng panganganak na kompleto ang buwan)___
Pre-term (bilang ng panganganak ng mababa sa 37 weeks)____
Abortion (ilang beses na nakunan na kung saan ang fetus ay mababa sa 24 weeks ) ____
Number of normal births (bilang ng panganganak na lumabas sa puwerta):______
Number of Caesarian births (bilang ng panganganak ng Caesarian):_____
Number of children alive at birth(bilang ng mga anak na buhay noong ipinanganak):_____
Number of children living (bilang ng mga anak na buhay sa kasalukuyan):______

3. Ages of Children: ______________________________________

4. Gumamit ka na ba ng mga pamamaraan sa pagpaplano ng pamilya (FP)? ____ Oo ___Hindi
4.1 Kapag OO, alin sa mga sumusunod ang nagamit mo na? (Maaring marami ang mga sagot.)
4.1.1 Scientific Modern NFP Methods
Basal Body Temp (pagkuha ng temperatura ng babae pagkatapos nang di bababa sa 3 oras na tuloy
tuloy na tulog)
Symptothermal (pagbabantay sa temperatura, uhog at pagkirot ng puson ng babae )
Lactational Ammenorrhea (eksklusibong pagpapasuso sa sanggol na wala pang 6 na buwan na
kung saan hindi pa bumabalik ang regla ng nanay)
Billings Ovulation/Cervical Mucus Method (pagbabantay sa uri ng uhog na lumalabas sa
pwerta ng babae)
Standard Days Method (para sa mga babae may siklo ng regla na 26-32 na araw).
Two day method
4.1.2. Artificial Methods
Condom (isinusuot ng lalaki sa kanyang matigas na ari bago makipagtalik)
Depo Provera (ineksyon kada 3 buwan, 2 buwan o 1 buwan)
Intra-uterine Device (IUD)
Pills (pag-inom ng pills araw- araw sa takdang oras)
Vasectomy (pagtali at pagputol sa anurang punlay ng lalaki)
Bilateral Tubal Ligation (BTL)( pagputol at pagtali sa dalawang anurang itlog ng babae)
4.1.3.Traditional Methods
Calendar method (gamit ang “cycle beads” upang matukoy ang panahong fertile ang babae)
Withdrawal

4.2 Ano ang iyong mga dahilan sa paggamit sa ganitong mga pamamaraan?

_________________________________________________________________________________
___________________________________________________________________________

4.3 Alin sa mga ‘FP methods’ na ginamit mo noon ay hindi mo na ginagamit ngayon? Bakit di
mo na ito ginagamit?
___________________________________________________________________________
_____________________________________________________________________

4.4. Ano ang kasalukuyan mong ginagamit na‘FP method’? Bakit mo ito pinili?
___________________________________________________________________________
_____________________________________________________________________
4.5 Sino ang nagturo sa iyo kung paano gamitin ang iba’t ibang ‘FP methods’? (Maaring marami ang
sagot.)
Rural Health Midwife Barangay Health Worker Private Doctor
Mother Sisters/relatives Friends
Hilot others, specify __________

4.6 Anong dahilan kung bakit di ka gumamit sa alinmang ‘FP method’?

_________________________________________________________________________________
_________________________________________________________________________

Part III. Respondents’ Psychosocial Profile

Panuntunan: Suriin ang sarili ayon sa antas ng pagsang-ayon sa mga sumusunod na pangungusap.
Strongly Agree Disagree Strongly
Psychosocial Characteristics Agree Disagree

Perceived Sexual Health Status

1. Kung sa aspetong sekswal, ako ay malusog at hindi na kailangang
magpakonsulta sa health center.
2. Kung meron man akong konting karamdamang ukol sa sekswal,alam
kong babalik din ito sa normal kahit di ako magpakonsulta.
3. Hindi ako naaalintana sa aking kalusugang sekswal kasi wala naman
akong nararamdaman na di kanais-nais ukol dito.
4. Alam kong ako’y malusog dahil wala akong nararamdamang
sakit/kirot sa ano mang bahagi ng aking “reproductive system”.
5. Ang nararanasan kong di-kanais nais sa aking sekswal na kalusugan
ay normal lang na epekto ng paggamit ko ng ‘FP method/s’.
6. Wala pa ako sa ‘menauposal stage’ kaya sigurado ako na wala akong
problema sa kalusugang sekswal.
Personal efficacy in deciding about health care
1. Ako’y may kakayahang magkilatis kung meron akong sakit na
sekswal, malala man ito o hindi pa.
2. Meron akong kakayahang tumugon sa mga simtomas na kahit anong
sakit na sekswal.
3. Ako’y natatakot baka meron akong sakit na may kinalaman sa sekswal.
4. Kung meron akong problema sa kalusugang sekswal, ako ay
may kakayahang magdesisyon para sa ikalulutas nito.
5. Alam ko kung kanino at saan ako pupunta sa pagkakataong meron
akong problema sa kalusugang sekswal.
6. Alam ko kung sino ang mga nararapat na tao na dapat lapitan para
makakuha ng payo ukol sa pangkalusugang sekswal.
Level of Self-Reliance
1. Alam ko ang aking gagawin sakaling may problema ako sa sekwal o sa
panganganak.
2. Pinanghihinaan ako ng loob kapag meron akong sakit ukol sa sekswal.
3. Tiwala ako na kayang-kaya kong solusyonan ang anumang
problemang meron ako na may kaugnayan sa sekswal.
4. Sa tingin ko, wala akong magawa tungkol sa anumang problemang
sekswal na aking nararanasan.
5. Kapag may sakit na sekswal ang sinumang myembro ng aking pamilya
o sinumang kamag-anak, wala akong kakayahang magbigay payo sa
kanila.
Level of trust in the health care providers
1. Ang health center ay nagbibigay ng dekalidad na serbisyo ukol sa pag-
aalaga sa kalusugan lalong-lalo na sa kalusugang-sekswal.
2. Limitado ang kaalaman ng mga barangay health workers ukol sa
kalusugang seskwal kaya di nila gaanong alam ang kanilang ipapayo
sa kanilang mga kliyente.
3. Alam ko na ang mga midwives sa health center ay nagkaroon ng
pagsasanay sa pagbibigay ng serbisyo lalong lalo na sa ‘reproductive
health’.
4. Kung tungkol sa kalusugang sekswal, ako ay may higit na kaalaman
kaysa sa mga nars, barangay health workers at midwives sa health
center.
5. Higit na eksperto ang mga nars, barangay health workers at midwives
sa pagbibigay ng karampatang serbisyo ukol sa kalusugang sekswal.

Part IV. Respondents’ Knowledge on Family Planning and reproductive health

Panuntunan: Suriin ang sarili ayon sa antas ng inyong kaalaman sa mga aspeto ng reproductive health.
Very High Low Very
General Knowledge on Reproductive Health High Low
1. Mga impormasyon at serbisyong inihahatid ng health centers ukol sa
Family Planning
2. Siklo ng pagreregla at kung kailan magkaroon ng mataas na
posibilidad na mabuntis o di mabuntis
3. Kalusugan at wastong nutrisyon para sa mga nanay, sanggol at mga bata
4. Impormasyon tungkol sa pagpapasuso
5. Aborsyon at pangangalaga sa komplikasyong dulot nito
6. Paggabay at pagpapayo sa mga kabataan ukol sa kalusugang sekswal
7. Pagsugpo, paglunas at pangangalaga sa mga ‘sexually transmitted’
na mga sakit gaya RTIs, HIV, AIDS and STIs
8. Mga uri ng pag-aabusong sekswal sa mga babae at mga bata
9. Mga palatandaan ng pagkakaroon ng sakit o kanser sa suso o
saanmang parte ng “reproductive system”.
10. Panglunas sa mga sakit o kancer sa suso o anumang bahagi ng
‘reproductive system”
11. Tungkulin at partisipasyon ng lalake sa pagpaplano ng pamilya at
pagpapanatili ng kalusugang sekswal
12. Pagsugpo at paglunas ng pagkabaog at kawalang kapasidad sa
pagtatalik

Panuntunan: Suriin kung Tama o Mali ang mga sumusunod ng pangungusap.

Tama Mali
Fertility Awareness
1. Ang ‘fertility’ ay kakayahan ng babae na magbuntis at ng lalaki na makabuntis.
2. Kapag ang lalaki ay nagsisimulang maglabas ng hinog na punla (wet dreams) ay
pwede na siyang makabuntis.
3. Ang lalaki ay fertile sa araw araw ng kanyang buhay.
4. Ang semilya ng lalaki ay maaring mabuhay sa loob ng matris ng babae ng mga 3-5
araw.
5. Nagsisimula ang pertilidad ng babae sa kanyang unang regla.
6. Ang itlog ng babae ay inilalabas sa panahon ng obulasyon at nagaganap isang beses
sa bawat siklo.
7. Ang paglabas ng itlog ay hudyat na pwedeng mabuntis ang babae kapag may
pagtatalik.
8. Ang hinog na itlog galing sa obaryo ay maaring mabuhay ng 12 – 24 oras.
9. Ang unang araw ng regla hanggang sa araw bago magregla ulit ang basehan sa
komputasyon ng siklo ng regla.
10. Ang panahon ng obulasyon ay ang tinatawag na wet days dahil naghahanda ang
matris sa maaring pagbubuntis.
11. Kung ang siklo ng pagregla ng babae ay 28 na araw, siya ay may kakayahang
mabuntis 7 araw bago at pagkatapos ng kanyang pagregla.
Tama Mali
Responsible Parenting
1. Ang pagpaplano ng pamilya ay pagdedesisyon ng ninanais na bilang ng mga anak.
2. Ang wastong pag-aagwat ng pagbubuntis ay 3 hanggang 5 taon.
3. Ang paggamit ng ligtas, mabisa at maaasahang paraan ng pagpaplano ng pamilya
ay parte ng pagiging responsableng magulang.
4. Ang pagpaplano ng pamilya ay may kabutihang dulot sa bawat miyembro ng pamilya.
5. Ang mag- asawa ay dapat magtulungan sa pagpaplano ng pamilya.
 6. Kaalaman sa kahalagahan ng pagiging magulang at mga responsibilidad na dapat
nilang gampanan ay sakop sa pagpaplano ng pamilya.
7. Ang pagpapahalaga, pagkilala at pagsabuhay ng mga karapatan ng bata ay sakop
ng pagiging responsableng magulang.
8. Ang mga responsableng magulang ay isinaalang-alang ang maayos nilang
pagsasama bilang mag-asawa .
9. Nagtutulungan ang mag-asawa sa pagdidisiplina sa mga anak.
10. Pagbibigay ng wastong kaalaman higil sa sekswalidad.

Panuntunan: Suriin ang sarili ayon sa antas ng inyong kaalaman sa mga pamamaraan sa pagpaplano ng
pamilya.

Very High Low Very

Family Planning Methods High Low
Scientific Modern NFP Methods
1. Basal Body Temp (pagkuha ng temperatura ng babae pagkatapos ng di
bababa sa 3 oras na tuloy tuloy na tulog )
2. Symptothermal (pagbabantay sa temperatura, uhog at pagkirot ng puson
ng babae)
3. Lactational Ammenorrhea (eksklusibong pagpapasuso sa sanggol na
wala pang 6 na buwan at hindi pa bumabalik ang regla ng nanay )
4. Billings Ovulation/Cervical Mucus Method (pagbabantay sa
uri ng uhog na lumalabas sa pwerta ng babae)
5. Standard Days Method (para sa mga babaeng na may siklo ng regla
na 26-32 na araw).
6. Two-day method
Articificial Methods
1. Condom (isinusuot ng lalaki sa kanyang matigas na ari bago
makipagtalik)
2. Depo Provera( ineksyon kada 3 buwan, 2 buwan o 1 buwan)
3. Intra-uterine Device (IUD)
4. Pills(pag inom ng pills araw araw sa takdang oras)
5. Vasectomy(pagtali at pagputol sa anurang punlay ng lalaki)
6. Bilateral Tubal Ligation (BTL)( pagputol at pagtali sa dalawang
anurang itlog ng babae)
Traditional Method
1. Calendar method (gamit ang “cycle beads” upang matukoy ang
panahong fertile ang babae)
2. Withdrawal

Part V. Reproductive Health Care Services and Social Support

Panuntunan: Suriin ang kalidad ng serbisyo at suporta ng inihatid ng mga nars, barangay health worker
and midwife sa inyong lokalidad.
Highly Agree Disagree Highly
Serbisyo Agree Disagree

1. Di isinaalang-alang ng mga nars, BHW at midwife ang aking damdamin

kapag ako’y nakikipag-usap tungkol sa mga usaping sekswal.
2. Madaling puntahan at laging bukas ang health center para sa mga
taong nangangailangan ng payo ukol sa pangkalusugang sekswal.
3. Ang aking pangangailangan sa pangkalusugang sekswal at natutugunan
sa tuwing ako’y nagpupunta sa health center.
4. Panatag ang aking kalooban sa mga nars, BHW at midwife sa health center.
5. Alam ng mga nars, BHW at midwife kung paano tugunan ang aking
pangangailangang sekswal.
6. Lahat ng serbisyong pangangailangan ukol sa kalusugang sekswal ay
nasa health center.
 7. Ang health center ay may sapat na pasilidad at kagamitang pang Family
Planning.
8. Hindi nauubusan ng condoms, pills and iba pang kagamitang pang
Family Planning ang health center .
9. Ang mga nars, BHW at midwife ay naglalaan ng kanilang oras para
matalakay ang wastong pangangalaga sa kalusugan sekswal.
10. Ang mga nars, BHW at midwife ay nagbibigay payo/patnubay sa mga
pasyenteng may malubhang karamdamang sekswal sa kanilang
pagpapagamot.
11. Ang mga nars, BHW at midwife ay nagbibigay ng mga pamimilian sa
paglutas ng mga problema sa kalusugang sekswal.
12. Libre ang serbisyong inihahatid ng mga nars, BHW at midwife sa health
center.

Part VI. Respondents’ Health-seeking Behavior

A. Care-Seeking Behavior

1. Nakaranas ka na ba ng problema o karamdaman ukol sa kalusugang sekswal? ___ Oo ___Hindi

2. Anu-ano ang mga problema o karamdamang ito? (Maaring marami ang sagot.)
_________________________________________________________________
3. Nagpatulong o nagpakonsulta ka ba sa ikalulutas ng mga problemang ito? ___ Oo ___Hindi
3.1 Kung OO, kanino ka humingi ng tulong? (Maaring marami ang sagot.)

_____Midwives in the Health Center/Station _____Friends

_____Doctor in Private Hospitals/Clinics _____Drug Peddlers
_____Doctor from Government Hospitals _____Nurses
_____Hilot or a traditional healer _____Drug Store Seller
_____Prayer Camp/religios people _____Elders
_____Others, please specify______________________________

Kung HINDI, ano ang mga dahilan kung bakit di ka humingi ng agarang tulong?
(Maaring marami ang sagot.)
______Pinakikiramdaman ko muna ang sakit.
______May kalayuan ang health center.
______Mahal ang singil o babayarin.
______Di magandang pakikitungo ng mga doctors, nars, BHW at midwife.
______Mahabang oras sa paghihintay dahil sa dami ng tao.
______Nakakahiyang ibahagi ang karanasang sekswal.
______Di naman masyadong malala ang problema ukol sa pangkalusugang sekswal.
______Kahihiyang makita at mahawakan ang maselang bahagi ng katawan.
______Kakulangan ng gamot sa Health Center.
______Kakulangan ng bentilasyon sa health center.
______Nag-iisip na ang simtomas ay kusang mawawala.
______Serbisyong pangkalusugang sekswal ay di sapat.
______Natatakot kung ano ang maging resulta.
______Natatakot baka malala na ang sakit at ito ay wala nang lunas.
______Others, please specify_______________________________________

4. Noong nalaman mo na may sakit kang ukol sa kalusugang sekswal, mga ilang araw bago
mo naisipang nagpakonsulta o humingi ng payo tungkol dito (Total Care Seeking
Interval)?_____
5. Noong naisipan mong nagpakonsulta o humingi ng payo tungkol sa iyong karamdaman,
ilang araw bago ka pumunta sa health care provider, health center o sa clinic?
(procrastination interval)______
 B. Information -Seeking Behavior
Panuto: Suriin ang sarili kung gaano kadalas ang pagkalap ng mga impormasyon ukol sa
‘reproductive health’ sa pamamagitan ng mga sumusunod:
Source of Information Palagi Madalas Madalang Di Kailanman
1. telebisyon
2. radio
3. pahayagan/magazines
4. internet
5. midwife
6. duktor
7. nars
7. kaibigan
8. kamag-anak
9. health brochures

C. Behavioral Response
Panuto:Itsek ( ⁄ ) kung ginagawa mo o hindi ang mga sumusunod.
Behavioral Responses OO Hindi
1. Kung may problema ako sa kalusugang sekswal, agad akong hihingi
ng payo sa mga ‘health care providers’ para sa kalutasan nito.
2. Nag-iisip ako ng mas epektibong paraan para matugunan ang aking
pangangailangan sa kalusugang sekswal.
3. Nagtanung-tanong muna ako sa ibang tao tungkol sa aking
karamdamang sekswal bago ako sumangguni sa mga ‘health care
providers’.
4. Pinag-uusapan muna naming mag-asawa ang tungkol sa aking
kalusugang sekswal bago sumangguni sa iba.
5. Kung meron akong nararamdamang hindi normal sa aking kalusugan
sekswal, ibinabahagi ko muna ito sa aking nanay o kapwa kong babae.
6. Ako ay nagse“self medication” kapag may karamdaman akong sakit
na sekswal.
7. Ako ay nababahala at di- nakakatulog kapag meron akong
karamdamang sekswal.
8. Ako ay bumabalik sa health center/clinic para masuri ang progreso ng
aking medikasyon (gamutan).
9. Itinago ko ang aking sakit ukol sa sekswal dahil ito ay nakakahiya.
10. Gumagamit ako ng ‘FP method/s’ na iniudyok ng aking mga kaibigan
kahit hindi ito sinasang-ayunan ng mga propesyonal sa kalusugang
sekswal.
11. Bumibisita ako sa health center buwan-buwan para masigurado ko ang
aking kalusugan sa aspetong sekswal.
12. Pumupunta lang ako sa health center kapag meron akong
nararamdaman na sakit.
13. Umiinom muna ako ng herbal na medisina kung meron akong
karamdaman sa sekswal.
14. Iniiwasan muna naming mag-asawa ang pagtatalik kapag meron
akong karamdaman sa sekswal.

D. Training Needs
1. Anong pang mga kasanayan (trainings) o seminar na isagawa ng PopCom, DOH at DSWD para
mapanatili ang inyong kalusugang sekswal?

_________________________________________________________________________________
___________________________________________________________________________
 Appendix B

Total Population of 4Ps and Non- 4Ps Couples Who Participated in the RH and FP Sessions

Municipalities of Cagayan 4Ps Non-4PS

Abulug 181 320
Alcala
Allacapan 152 100
Amulung 186
Aparri 713
Baggao 2230 447
Ballesteros 701
Buguey 781 150
Calayan
Camalanuigan
Claveria 258 322
Enrile
Gattaran 729 67
Gonzaga 465 90
Iguig
Lallo 546 216
Lasam
Pamplona 462
Penablanca 824 201
Piat
Rizal 504 160
Sanchez Mira 100
Santa Ana 356
Santa Praxedes 49
Sta Teresita 246
Santo Nino 169
Solana 544 200
Tuao 624
Tuguegarao City 19 6
TOTAL 10220 1959
Municipalities of Isabela 4Ps Non-4PS
Alicia 1053 167
Angadanan
Aurora
Benito Soliven 216
Burgos 120 81
Cabagan 203
Cabatuan 510 377
Cordon 203
Delfin Albano 307 327
Dinapigue
Divilacan
Echague 135
Gamu 322
Jones 219 352
Luna 376
Maconacon
Mallig 131
Naguilian 590
Palanan 381
 Quezon 79 225
Quirino
Ramon 314 230
Reina Mercedes 295 350
Roxas 164
San Agustin 62 150
San Guillermo 809
San Mateo 287 97
San Pablo 100
Santa Maria 361
Santo Tomas 339 252
San Pablo
Santa Maria 470 153
Santa Tomas 533
Tumawini 404
Cauayan City 278 4613
Santiago City 79 671
Ilagan City 2095
Total 7693 11787
Municipalities of Nueva
Vizcaya 4Ps Non-4PS
Alfonso Castaneda
Ambaguio 133
Aritao 322
Bagabag
Bambang
Bayombong 126
Diadi 91
Dupax del Norte 55
Dupax del Sur
Kasibu 244
Kayapa 106
Quezon 139
Sta Fe
Solano 11
Villaverde 114
Total 1330 11
Municipalities of Quirino 4Ps Non-4PS
Aglipay 715 96
Cabarroguis 83 70
Diffun 278 32
Maddela 321 55
Nagtipunan 202
Saguday 270
Total 1869 253
Batanes 255
21,112 14,265
Grand Total 35,377
 Proposed Schedule for Data Gathering and the Frequency of Respondents
to be Taken from the Respondent-Municipalities

Location Respondents’ Dates

Classification
Province District Municipality 4Ps Non-4Ps
Cagayan II Baggao 20 8 August 6
II Gattaran 20 8 August 19
I Gonzaga 14 8 August 8
I Lallo 17 8 August 22
III Penablanca 20 8 July 15
I Buguey 20 8 July 29
III Solana 17 10 July 11
Isabela I Sta Maria 15 8 August 20
I Tumauini 13 8 September 23
II Quezon 8 8 August 27
II Quirino 13 8 September 5
III Alicia 20 8 September 12
III San Mateo 10 8 July 31
IV Santiago 8 22 September 18
IV Ramon 10 8 September 25
Nueva I Kasibu 10 8 July 25
Vizcaya I Solano 8 8 July 22
I Bayombong 8 8 July 23
I Aritao 11 8 July 24
Qurino I Aglipay 20 10 July 17
I Diffun 10 10 July 18
Total 292 188
480