Fertility and Family Planning: 2011 Family Health Survey for 2011

sterilization DIARRHEA

vaccination

Wealth Index High-risk fertility BREASTFEEDING

Respondents MATERNAL MORTALITY

Delivery assistance Reasons for Not Using FP Method MARITAL STATUS Women of Reproductive Health

condoms

INFANT AND CHILD MORTALITY

ANTENATAL CARE

occupation

unmet need EDUCATION

15-49 years old FERTILITY FAMILY PLANNING pills Birth delivery Post-natal care HILOT Household

Content of Presentation • Survey background • Objectives • Sampling design and sample size • Content of questionnaire • Fertility • Total Fertility Rate • Age-specific fertility rate • Birth intervals • Adolescent fertility

Content of Presentation (cont’d)

•

Current use of family planning • Contraceptive prevalence rate • Method mix

•

Current use of family planning by: • Region • Place of residence • Level of education • Socio-economic status

•

Trends in family planning use

•

Reasons for not practicing family planning

•

Unmet need for FP

Survey Background

• The 2011 Family Health Survey (FHS) • provides information on maternal and child

health, family planning and other health-related concerns • updates findings from the series of FPS and various rounds of the National Demographic and Health Survey (NDHS) • Funding support primarily came from United

States Agency for International Development (USAID).

Sampling Design

• 2011 FHS was designed to provide data representative

of the country and each of the 17 administrative regions • It used the 2003 Master Sample (MS) designed for

household-based surveys of the NSO • It used a stratified, three-stage sampling design

Sampling Design

• First stage - primary sampling units (PSUs) were

selected with probability proportional to the number of households from the 2000 Census of Population and Housing. PSUs consisted of one barangay or a group of contiguous barangays.

Sampling Design

• Second stage - enumeration areas (EAs) were selected

within sampled PSUs with probability proportional to size. An EA is defined as an area with discernible boundaries within barangays consisting of about 300 contiguous households. • Third stage - 16 housing units were selected within

sampled EAs, using systematic sampling.

Sampling Design

• All households in a sampled housing unit were

interviewed, except for a housing unit with more than three households. In such sample housing unit, only three households were randomly selected and interviewed.

Survey Methodology

Covered 3,178 enumeration areas Sampled 53,162 households (HH) 49,374 HH were eligible for 2011 FHS 48,586 (98.4%) HH were interviewed using the HH Questionnaire 53,154 women 15-49 years old in the sample HH 52,769 (99.3%) women were interviewed using the IW Questionnaire

Survey Questionnaires

FHS Form 1: Household Questionnaire

FHS Form 2: Individual Woman’s Questionnaire

•

Household membership

•

Background characteristics

•

Membership in health insurance

•

Pregnancy history

•

Health status and health facilities utilization

•

Family planning

•

Prenatal care, pregnancy and breastfeeding

•

Child immunization

•

Maternal mortality

• •

Treatment of members with symptoms of tuberculosis Socio-economic status

Fertility in the Philippines

Total Fertility Rate, Philippines** (1991-2009)

*3.6-3.9

*3.4-3.7

*3.1-3.2

*3.1-3.4

*3.0-3.2

*95% Confidence Interval **Rates reflect 3-year averages centering on the middle of the 3-year period

2006 FPS

2.9 2.9

2011 FHS

4.1 4.0

V. Bicol

2.7 2.8

4.1 4.1

IV-B.MIMAROPA

3.1

IV-A. CALABARZON

2.8

III.Central Luzon

3.0 3.2

II.Cagayan Valley

NCR

Philippines

2.6 2.5

3.2 3.0

I.Ilocos

3.2 3.1

CAR

Total Fertility Rates, by Region: FPS 2006 vs. FHS 2011

Total Fertility Rates, by Region: FPS 2006 vs. FHS 2011 (cont.)

2006 FPS

2011 FHS

3.7 3.8

ARMM

3.1 2.9

XIII.Caraga

XII.SOCCSKSARGEN

3.4 3.4 3.4 3.3

XI.Davao

3.7

X.Northern Mindanao

3.4 3.4

IX.Zamboanga Peninsula

VIII.Eastern Visayas

VII.Central Visayas

VI.Western Visayas

Philippines

3.2 3.1 3.3 3.2 3.3 3.2

3.9 3.9 3.7

Total Fertility Rate, by Place of Residence: FPS 2006 vs. FHS 2011

*3.5-3.7 *3.5-3.7 *3.1-3.2 *3.0-3.2

*2.7-2.9 *2.6-2.8

*95% Confidence Interval

Age group

2006 FPS

2011 FHS

15-19

39

54

20-24

149

159

25-29

171

161

(Live Births per 1,000 Women)

30-34

137

131

FPS 2006 vs. FHS 2011

35-39

93

80

40-44

37

35

45-49

6

5

TFR

3.2

3.1

Age-Specific Fertility Rates

Age-Specific Fertility Rates (Live Births per 1,000 Women)

by Place of Residence: FPS 2006 vs. FHS 2011 Age Group

2006 FPS

2011 FHS

Urban

Rural

Urban

Rural

15-19

34

43

46

64

20-24

126

181

134

190

25-29

158

187

141

185

30-34

126

149

120

143

35-39

78

109

70

90

40-44

29

44

28

42

45-49

4

8

3

7

TFR

2.8

3.6

2.7

3.6

Distribution of Non-First Births in Five Years Preceding the Survey, by Birth Interval in Months, by Region: FHS 2011 Luzon

Distribution of Non-First Births in Five Years Preceding the Survey, by Birth Interval in Months, by Region: FHS 2011 Visayas

Distribution of Non-First Births in Five Years Preceding the Survey, by Birth Interval in Months, by Region: FHS 2011 Mindanao

Median Birth Interval in Months for Non-First Births, by Region: FHS 2011 39.7 36.8 34.1

34.9

37.4

40.7 35.4

32.3

32.5 33.4 33.3 31.4 33.3 33.5 32.6

35.1 31.4 27.3

Percentage of Women Age 15-19 Who Have Begun Childbearing, by Region: FPS 2006 and FHS 2011 15.0 12.9

12.8

13.8 13.6

11.2 9.5 8.5 6.3

8.2

9.0 7.1

6.0

10.0

9.8 7.0

8.6

7.7 6.5

7.5 5.0

6.9 6.0

6.5

5.2

3.0 3.8

8.0

3.5

FPS 2006

FHS 2011

8.6 6.0 6.3

8.0 7.2

7.4 4.9

Percentage of Women Age 15-19 Who Have Had a Live Birth, by Region: FPS 2006 and FHS 2011 11.2 9.9

4.8

6.5

6.5

4.8

6.2 4.6

3.0

5.2

8.0

7.6

7.4 6.2

10.7

8.9

8.6 7.4

11.6

4.8

5.6

5.0

2.9

5.5

6.7

6.0

4.9

3.6

2.1

FPS 2006

FHS 2011

8.0

6.9

6.5

6.0 5.2

4.3

4.4

Family Planning

Manila Times: June Aquino, Family Planning

Contraceptive Prevalence Rate Among CMWRA (2000-2011)

*47.6-50.1

*48.3-50.4

*48.6-50.0

*49.9-51.3

*49.4-52.0

*48.1-49.7

*95% Confidence Interval

Percentage of CMWRA Using Modern and Traditional FP Methods (2000-2011)

Percentage of CMWRA Using Modern FP Methods (2003 – 2011)

33.4 *32.1-34.6

35.1

36

*34.2-36.0

*35.4-36.7

35.9

36.9

*35.2-36.5

*36.1-37.6

2003 2004 FPS 2005 FPS 2006 FPS 2011 FHS NDHS *95% Confidence Interval

Percentage of CMWRA Using Any FP Method, by Place of Residence: FPS 2006 vs. FHS 2011

*49.9-51.3 *48.1-49.7

*50.1-52.1 *48.4-50.8

*49.2-51.2 *47.1-49.4

*95% Confidence Interval

Percentage of CMWRA Using Any FP Method, by Level of Education: FPS 2006 vs. FHS 2011

*45.5-48.9 *42.8-45.8

*49.9-51.3 *48.1-49.7

*51.2-53.9 *50.5-52.6

*50.5-62.5 *47.9-50.6

*17.3-26.2 *16.2-24.6

*95% Confidence Interval

Percentage of CMWRA Using Any FP Method, by Socio-Economic Status: FPS 2006 vs. FHS 2011

*49.9-51.3

*48.1-49.7

*46.2-48.5

*41.7-44.4

*51.6-53.2

*50.4-52.2

*95% Confidence Interval

Family Planning Method Used by CMWRA: FPS 2006 vs. FHS 2011

Family Planning Method Used

2006 2011 FPS FHS

Any method • Any modern Pill Female sterilization IUD Injectables Male condom Other modern • Any traditional Calendar/rhyth m Withdrawal Other traditional

50.6 48.9 35.9 36.9 16.6 19.8 10.4 4.1 2.8 1.6 0.3 14.8

8.6 3.1 3.4 1.2 0.8 12.0

7.0 7.3

3.7 8.2

0.5

0.1

Percentage of CMWRA Using Contraceptive Pills (2000 – 2011)

*14.9-16.3

*16.6-17.6

*16.1-17.2

*14.7-16.7

*19.3-20.4

*12.4-14.0

*95% Confidence Interval

Percentage of CMWRA Using Female Sterilization (2003 – 2011)

*9.8-11.2

*8.9-9.9

*9.0-9.8

*10.0-10.8

*8.5-9.9

*8.2-8.9

*95% Confidence Interval

Reasons for Not Using Family Planning Methods among CMWRA not using FP: FHS 2011

Unmet Need for Family Planning among CMWRA: FHS 2003-2011

*19.5-20.7

*15.2-16.2

*21.4-23.3

*18.8-19.8

*95% Confidence Interval

Percentage of CMWRA with Unmet Need for Family Planning for Spacing and Limiting: 2005-2011

*8.8-9.6

*6.9-7.6

*8.4-9.1

*10.5-11.3

*8.1-8.8

*10.1-10.9

*95% Confidence Interval

Percentage of CMWRA with Unmet Need for Family Planning by Socio-Economic Indicator: 2005-2011

*16.0-17.2

*16.9-18.2 *12.7-13.8

*23.8-25.8

*19.4-21.2

*24.8-26.8

*95% Confidence Interval

Summary Findings

•

TFR in the Philippines has remained unchanged since 2004; it is about 3 children per woman.

•

TFR is higher in MIMAROPA, Bicol Region, Eastern Visayas, Region 10 and Caraga than in other regions.

•

TFR is lowest in the National Capital Region.

•

TFR is higher among rural women than urban women.

•

One in five births in the Philippines is closely spaced, that is, with a birth interval shorter than 24 months

•

Teenage fertility has increased; the percentage who have begun childbearing increased to 10 percent in 2011 from 6 percent in 2006.

Summary Findings

•

In the last decade, CPR has remained at around 50 percent.

•

Significant decrease in family planning use is reported among currently MWRA in Zamboanga Peninsula.

•

Compared with previous years, the use of the pill by CMWRA is higher in 2011.

•

Modern family planning use is associated with the level of education of MWRA, and poverty status.

•

Apart from wanting (more) children, poor access to FP methods, and fear of side effects were cited as key reasons for not using any FP methods.

•

Unmet need for family planning is around 20 percent.

National Statistics Office

www.census.gov.ph 43