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Chapter 1

THE PROBLEM AND ITS BACKGROUND

This chapter includes the introduction, statement of the problem, scope

and limitation, significance of the study, hypothesis, and the definition of terms

used.

Introduction

Access to contraception is a critical component of reproductive health and

family planning, with far-reaching effects on people's lives as individuals,

members of families, and members of communities. In the Philippines, a country

marked by diverse socioeconomic, cultural, and geographical landscapes,

understanding the barriers to contraceptive access is of paramount importance.

This qualitative research endeavors to shed light on the multifaceted factors that

hinder or facilitate access to contraceptives in the Philippine context.

The Philippines, an archipelago comprising over 7,000 islands, is

characterized by a rich tapestry of cultures and traditions. These cultural

diversities are mirrored in the varying attitudes toward family planning and

contraceptive usage, creating a unique socio-cultural milieu. Furthermore, the

nation grapples with socioeconomic disparities that stratify access to healthcare

services, including contraception, leaving marginalized communities

disproportionately affected (Siow-ki Li, 2014).

Despite national family planning policies and programs aimed at

promoting contraceptive access, numerous challenges persist, influencing

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individuals' choices and experiences. This study, rooted in qualitative inquiry,

seeks to explore these challenges through the voices and narratives of

individuals from different walks of life across the Philippines.

The findings of this research hold the potential to inform policymakers,

healthcare providers, and organizations working in the field of reproductive

health. By uncovering the multifaceted nature of barriers to contraceptive access

in the Philippines, this study aspires to contribute to the development of more

effective and culturally sensitive strategies that can enhance reproductive health

outcomes and empower individuals to make informed choices about family

planning. In doing so, it not only addresses a critical aspect of public health but

also promotes the broader goal of empowering individuals to shape their

reproductive futures in a manner that aligns with their desires and aspirations.

Statement of the Problem

The aim of contraceptives is to prevent early pregnancy or unintended

pregnancy. It influences partners to use contraceptives if they are not yet ready

to have children. The objective of this study is to determine the different barriers

and factors that prevent contraceptive access. This research aims to answer the

following questions:

1. What are the main barriers faced by vulnerable or marginalized

populations in accessing contraceptives?

2. How do socioeconomic, cultural, and geographical factors impact

individuals' access to contraceptives?

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3. How do misconceptions and myths regarding contraceptives influence

usage rates?

4. What strategies or interventions have been successful in overcoming

barriers to contraceptive access?

Hypothesis of the Study

1. There is no significant difference in the barriers faced by vulnerable or

marginalized populations compared to the general population in accessing

contraceptives.

2. There is no significant difference in socioeconomic, cultural, and

geographical factors impacting individuals’ in accessing contraceptives.

3. There is no significant difference on usage rates in accordance with myths

and misconceptions because it is based on people’s use of

contraceptives.

5. There is no significant difference in strategies or interventions that have

been successful in overcoming barriers to contraceptive access.

Significance of the Study

Understanding and dealing with the many different issues that affect

access to contraceptives become necessary as the world's population continues

to grow. Therefore, this study aims to help and contribute knowledge to the

following:
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For Women Empowerment. Access to contraception is essential for

empowering women. Women can pursue academic and professional

possibilities, take part in social and economic activities, and make decisions

about their life on their terms when they have the power to control their

reproductive choices.

For Policy-Makers. The results of the study can help policy-makers understand

the significance of specialized programs and regulatory improvements to

enhance access to contraceptives. It can also serve as a guide for dedicating

funds to help with projects related to family planning and reproductive health

services.

For Women. Access to contraception aids in preventing unplanned pregnancies,

lowering the risk of health issues and allowing women to establish plans for the

future.

The advocates, who consistently and actively take a stand for the sake of a

certain issue. This study may encourage campaigns to ease barriers on access

to contraceptives and establish laws that encourage reproductive health. This

could improve support and assistance systems for those individuals who are

looking for contraception.

The Researcher, who will get more ideas and additional knowledge on

Contraceptive Access upon completing the study.

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Scope and Limitations of the Study

The scope of the research study is the barriers to contraceptives

experienced by young women in socioeconomic, cultural, and geographical

factors. It focuses on barriers to contraceptives and on how young women face

the difficulty of pregnancy, childbirth, and family planning in low and middle

income countries. It also focuses on how serious the problem is in the practice of

contraception and how healthcare professionals must recognize the value of

contraception and its proper use among married and unmarried couples.

The study’s limitations may arise from limited generalization of findings to

broader populations. The specified socioeconomic, cultural, and geographical

context of the study may not be representative of other regions or populations.

Moreover, there is potential bias amongst researchers in data collections and

analysis, as the researchers’ perspective can influence their interpretations of the

response of the participants. Finally, the research may provide in-depth insights

but may lack quantitative data, making it challenging to measure the extent of

barriers or compare them quantitatively across different groups or regions.

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Definition of Terms

Contraception : Refers to the use of various methods, devices, medications, or

procedures to prevent pregnancy (Cambridge Dictionary)

Contraceptive Access : The availability, affordability, and ease of obtaining

contraceptives (Ross and Hardee, 2012)

Family Planning : The deliberate control of the number, timing, and spacing of

having children in order to meet the desired family size (World Health

Organization, 2022).
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Chapter 2

REVIEW OF RELATED LITERATURES

The literature that will support the present study is provided in this chapter.

This will include research-related publications and articles addressing the

Barriers in Accessing Contraceptives, preconception-related factors influencing

the use of contraceptives, and strategies that have helped in removing barriers to

accessing contraceptives. As a result, these connected studies will aid in the

resolution of research-related issues.

Barriers in Accessing Contraceptives

There have been multiple studies about factors that prohibited the access

of contraceptives to rural and poverty stricken areas. One such study made by

Stephenson, Rob and Hennink (2004) towards family planning use amongst the

poor in Pakistan stated that women were ten times more likely to have used

contraceptives if their husbands approved. It was concluded that the biggest

barrier to contraceptive access was socio-economic and cultural factors. Another

study made by Likhaan Center for Women's Health Inc. (2010) narrated that in

the year 2008, only 44% of women in the Philippines do not participate in the use

of contraceptives because of health related concerns such as the different

contraceptive methods and its side effects. Another concern amongst the women

was the cost of contraceptives. In 2004, a national survey showed that 42% of

women stated that the cost was the reason for not actively using contraceptives

(Likhaan, 2010). In this study it was concluded that preconceptions and lack of
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knowledge, as well as costing were the main barriers from accessing

contraceptives in the Philippines. Another factor that prevented the use of

contraceptives is community level hurdles. According to Landrys (2023) the

barriers and enablers to family planning and contraceptive services and

utilization at the community and health system levels. Previous interventions

have not successfully addressed this unmet need due to other factors at the

community and health system levels. The lack of policies allowing the distribution

of contraceptives in schools, stock-outs of favored methods, significant travel

distances to healthcare institutions, and unfavorable provider attitudes are some

of the hurdles to the health system (Silumbwe, Nkole, and Munakampe, 2018).

The myths, rumors, and misconceptions that women encounter when using

contraception, as well as societal stigma and unfavorable traditional and religious

views, are examples of community-level hurdles. Contrarily, health system

enablers include the political will of the government to increase access to

contraceptive services, the integration of contraceptive services, the availability

of couples counseling, and the availability of staff to provide a basic technique

mix. A community's desire to delay pregnancy, knowledge of contraceptive

services, and functional community health system architecture are all facilitators.

Geographical distance is another significant barrier to receiving

contraceptive care. To access a medical facility that offers contraceptive

services, many people, especially those who live in rural or underdeveloped

areas, must travel a great distance. This problem is even worse in areas with

poor public transit systems. Geographical restrictions have an adverse impact on

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access to contraceptives, especially for vulnerable people, according to the

American College of Obstetrics and Gynecology (2015). According to research,

people who must travel long distances are less likely to consistently seek out

contraceptive care, which raises the chance of unwanted pregnancies (Politi

2016a).

One more factor in preventing contraceptive access is Political reasons. A

research study about access to health care services to women in Peru focused

and highlighted the difficulties women in the area face because of the country's

restricted access to sexual and reproductive health care services (SRHS) and

contraceptives. Access to vital (SRHS) and contraception is becoming more

challenging due to Venezuela's collapsing government services, which have

made an already poor situation worse. Despite the fact that there is a lack of

comprehensive data on SRHS access and contraceptive usage in Venezuela as

a result of this crisis, extant research emphasizes the serious impact on the

accessibility and affordability of modern contraceptives, which has resulted in

unintended pregnancies and unsafe abortions. (Equivalencias en Accion, 2019)

(Turkewitz and Herrera, 2020).

Factors Affecting Access to Contraceptives

Lack of understanding, insufficient knowledge, cultural beliefs, and

accessibility are some of the main factors as to why people – specifically women

– hesitate in the usage of contraceptives. One notable factor affecting the use of

contraceptives is religious beliefs. According to Heather Adewale (2021) Culture

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and religion can be intertwined in certain societies, and can often impact

personal values and beliefs. Some individuals may hold cultural or religious

beliefs that negatively view the use of contraception, which can create barriers to

accessing and utilizing family planning services. It is important to keep in mind

that every individual’s cultural and religious background plays a role in their

decision-making and understanding of family planning.

According to Abdulai, Kenu, and Nyarko (2020) the modern contraceptive

use is complicated and difficult for women in developing nations for a variety of

reasons. Numerous research demonstrates that socio-demographic,

sociocultural, socioeconomic, informational, and family planning aspects are

related to most women's knowledge of and use of contraception.

It is important to understand that while there may be similarities between

the association between socioeconomic disadvantage and health outcomes and

that between socioeconomic disadvantage and the use of contraceptives, there

are also some distinct elements that come into play in the context of

contraception. These elements may have a big impact on how using

contraceptives and being disadvantageous interact. The fact that reproduction is

heavily political and regulated is one distinguishing feature. Women of color,

especially Black women, may prefer user-directed contraceptive techniques in

this environment over provider-directed alternatives like intrauterine devices

(IUDs), which require medical implantation. The historical context of U.S.

institutions controlling the fertility of women of color, frequently through welfare

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rules and unethical research (Roberts, 1999), is the root cause of this

predilection.

Another distinctive aspect is that, unlike a diagnosis of an illness, the

presumed result of reproduction, i.e., pregnancy, does not always have a

generally "negative" meaning. Numerous studies have shown that people's

attitudes on unexpected pregnancies frequently display uncertainty, especially in

the case of those who initially wanted to prevent pregnancies. According to

Higgins (2012), this ambivalence is a complex aspect of reproductive decision-

making. The different levels of desirability connected to the outcome of

pregnancy can add a special element of complexity to the social patterning of

contraceptive usage, perhaps resulting in distinct but unrecognized dynamics in

underprivileged populations.

Influence of Misconceptions Towards Contraceptive Usage

A huge barrier towards the usage of contraceptives is the negative and

misinformed perspectives towards contraception. According to Jerry Parks

(2019) The majority of nations have achieved significant progress in enhancing

access to and voluntary use of family planning in 25 years. Nevertheless, billions

of women are still deterred from starting or continuing to use a technique due to

pervasive, hard-to-dispel myths and misconceptions about modern

contraception. He noted that It is critical to recognize the connection between

fictitious side effects and the very real ones that affect women on a daily basis.

Users and suppliers of contraception frequently attempt to comprehend the

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chemical and biological processes by which contraceptives function, which

results in inaccurate knowledge regarding contraception. Another study stated

that contraceptive use, given that the fear of side effects is one of the most

common reasons why people stop using contraception methods. The study from

Mexico found that a substantial proportion of urban women discontinued using

the pill due to concerns about potential side effects, which highlights the

importance of addressing myths and misconceptions about family planning

methods in clinical consultations (Gueye, Speizer, Corroon, and Okigbo, 2015).

Education is also a factor that influences the notion towards

contraceptives. Numerous studies have consistently shown that young people

and adolescents frequently lack appropriate understanding about contraception

and sexual health. The spread of myths through popular culture and the media

worsens this knowledge gap. In addition, poor sexual education programs in

schools have been linked to the incomplete knowledge of Long-Acting Reversible

Contraceptives (LARCs), as seen in one of the included studies. These programs

may prioritize abstinence promotion over thorough contraceptive education.

Successful Interventions in Overcoming Contraceptive Access

Effective interventions to improve access and use of contraception include

enacting and implementing laws and policies requiring the provision of sexuality

education and contraceptive services for adolescents, Building community

support for the provision of contraception to adolescents, Providing sexuality

education and creating a culture of knowledge sharing, Creating a safe and non-
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judgemental space for young people to receive accurate and evidence-based

information about family planning and contraception, Encouraging open dialogue

and communication between young people and their healthcare providers, and

addressing myths and misconceptions about family planning by providing

accurate and evidence-based information (Patton GC, Coffey C, Sawyer SM,

Viner R,Haller DM, 2009).

Behavioral interventions to improve contraceptive use commonly involve

the use of counseling, which can be delivered orally or through written

communication. According to Lopez (2016), counselors may also use technology

such as mobile phones to provide educational or communication components of

the intervention. The content of these interventions are providing information

about different contraceptive methods, addressing misconceptions and concerns

about using contraception, and discussing potential side effects. The goal of

these interventions is to improve the knowledge and skills of individuals to enable

them to make informed decisions about their reproductive health, including use of

contraception.

According to Venkatraman Chandra-Mouli (2020) Over the past 25 years,

significant strides have been made in lowering rates of adolescent pregnancy

and serving their contraceptive requirements, which supports the need for

continuing attention and investment from the perspectives of public health, the

economy, and human rights. Adolescent pregnancies are a worldwide issue

since they happen in high, middle, and low-income nations. However,

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marginalized families and communities are where they are most prone to occur.

Adolescent pregnancies and births are caused by a variety of circumstances.

The growing accessibility of over-the-counter (OTC) and pharmacist-

prescribed contraceptives in the United States offers a huge chance to improve

access to contraception for women from a variety of socioeconomic, educational,

racial, and ethnic backgrounds. Pharmacists are in a unique position to close the

gap and offer essential contraceptive care to underprivileged communities as

these legislative changes continue to develop. However, there is a compelling

need for further training in marketing and outreach techniques if pharmacists are

to effectively contact and treat these patients and build a more noticeable

presence within the larger healthcare system. Employing pharmacists in the

process of providing contraceptives not only encourages convenience but also

acts as a vital resource for women who might experience difficulties accessing

conventional healthcare settings. These policy reforms give pharmacists a

special chance to broaden their areas of expertise and play a significant role in

promoting the reproductive health of women. It is crucial for pharmacists to see

these legislative changes as a chance to have a long-lasting impact on women

who have historically been underserved or excluded from the present healthcare

system in order to fully realize this potential. In this way, pharmacists may

considerably support the advancement of sexual and reproductive health equity

by ensuring that all women, regardless of their circumstances, can make

educated decisions about their reproductive health and contraception.

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Chapter 3

RESEARCH METHODOLOGY

This chapter includes the research methodologies used in the study. This

includes the research design, sample and population, locale of the study,

research instrument, data gathering procedure and validation of the instrument.

Research Design

A variety of techniques are included in quantitative research, which is

concerned with employing statistical or numerical data to systematically examine

social issues. Quantitative research therefore entails measurement and

presupposes that the phenomena being studied can be quantified. The goals of

quantitative research are to collect data by measurement, examine this data for

trends and relationships, and validate the measurements (Watson, 2015)

The researchers’ goal is to determine the main barriers that prevent

contraceptive access using survey questionnaires used in google forms

platforms.

Locale of the Study

This study will be conducted to the students of a Private School in

Caloocan City. This place is selected for knowing the details and information that

is needed for the availability and safeness of the proposed topic for the students.

In order to respond to the questionnaire, Respondents will be asked to answer

the questionnaire online.

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Sample and Population of the Study

This study will use probability sampling which is the process of random

selection. The sample for this quantitative research study will consist of women

aged 18 to 45 years old who are sexually active and at risk of unintended

pregnancies. 100 women will be selected from various regions within a specific

country, representing both urban and rural areas in marginalized and working

class sectors.

Research Instrument

The researchers prepared a set of questionnaires to be distributed to the

respondents through online (gforms/messenger). The questionnaire consists of

four questions that are related to the study.

The first question talks about the main barriers in accessing

contraceptives. The second question is about the socioeconomic, cultural, and

geographical factors impacting the use of contraceptives. Third question

discusses the misconceptions and myths factors in using contraceptives. The last

part consists of strategies that have been successful in overcoming the barriers

to contraceptive access.

By relaying the inquiries through online surveys, the questions will be

presented to the respondents.

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Data Gathering Procedure

Data collection is the process of acquiring and analyzing information on

relevant variables in a predetermined, systematic way that makes it possible to

respond to stated research questions, test hypotheses, and assess results.

The procedure for acquiring the data required for the study is covered in

the steps that follow. Google forms will be used by academics to carry out online

surveys. The survey's questionnaire will have time allotted for the researcher to

conduct the questions.

Validation of the Instrument

In this research, the researchers’ goal is to thoroughly assess the barriers

to accessing contraceptives to create and validate an instrument. To develop

effective policies and interventions in the area of reproductive health, this

instrument is an essential means for gaining an understanding of the complicated

nature of the obstacles that people deal with in obtaining contraceptives.

This research validation of the instrument was conducted with the

approval and guidance of our research adviser and teacher through the

evaluation of our research instrument, including the survey response form. By

ensuring that the instrument is focusing on "Barriers to Contraceptive Access: A

Study of Socioeconomic, Cultural, and Geographical Factors". Our instrument

has been validated and is appropriate for use in the next research study.
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Ethical Considerations

La Consolacion College-Caloocan adheres to maintain the privacy of the

respondents of every study its students are conducting. The information that will

be provided will be gathered without the use of force and based on the freewill of

the respondents. It is the respondents’ right to withdraw or halt answering the

survey if they deemed it uncomfortable on their part to continue. If they wish to

withdraw, they can be rest assured that it will not affect in any manner to the

service being given to them. Since minors are the primary respondents, the

survey questionnaire shall be accomplished by the pupils with the assistance of

the parent or guardian.

The researcher kept in mind that all the consent, permits, and letters

required by the two locales of the study and all the respondents were made

available before the start of the study. The identity of the respondents, will

remain anonymous all throughout the study; hence, neither names nor private

data will be revealed.

In addition, the gathered data were treated accordingly, considering the

confidentiality of all the respondents involved, and in accordance with the Data

Privacy Act, with the only purpose of accomplishing this study. The authors,

proponents, writers of journals, news articles, and the researches/previous

studies used for the Literature review were cited properly.

There are no risks and expected benefits to the beneficiaries.

Respondents will not be provided with any payment to take part in the research.
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