Promoting Family Planning within the Context of Environmental Management Yields Higher MDG Achievement: Evidence from the Philippines
Joan Regina Lupoyon Castro and Leona Ann D'Agnes
Background/Significance
The Philippines is a nation of 85 million people and one of the fastest growing countries in Asia. Majority of Filipinos reside in the coastal zone where rates of fertility, teenage pregnancy and unmet need for family planning (FP) exceed national average figures and contribute to high poverty incidence (44%) among fisherfolk. Resistance from religious leaders and conservative groups undermine efforts to promote FP while geographic barriers pose challenges to contraceptive access and use in rural coastal areas. Other data showing children of fishers are more likely to be underweight – particularly if their mothers do not practice family planning - suggest interrelationships between poverty, high fertility and malnutrition in fishing communities. Integrated approaches to population and environmental management present opportunities to promote FP within the broader context of poverty alleviation while responding holistically to the multifaceted needs of fishing-dependent communities.
Operations Research Hypothesis and Interventions
A quasi-experimental evaluation design was implemented to examine the hypothesis that integrated approaches to population and coastal resource management generate higher impacts on human and ecosystem health outcomes compared to sectoral management approaches. In one experimental site, population/reproductive health (Pop/RH) interventions were implemented in isolation. In a second site, coastal resource management (CRM) interventions were implemented independently. In the third experimental site, Pop/RH and CRM interventions were implemented in an integrated fashion (the “IPOPCORM” intervention).
The Pop/RH intervention aimed to build the capacity of local institutions to deliver family planning (FP) information and counseling for informed choice, community based distribution (CBD) and social marketing of non-clinical methods of contraception (condoms, oral pills), and peer-mediated behavior change communication (BCC) for pregnancy prevention.
The CRM intervention sought to build local capacity to deliver coastal conservation education, establish and manage marine protected areas (MPA), formulate community-based management plans and committees, safeguard the protected areas, implement mangrove reforestation, and encourage compliance with laws prohibiting use of dynamite and cyanide in fishing.
The Integrated Population and Coastal Resource Management (IPOPCORM) intervention focused on building local capacity to deliver the same Pop/RH and CRM interventions in an integrated fashion in order to improve food security from the sea.
All three models include an economic development component that supported environment-friendly enterprise development (EED) training and micro-credit facilities targeted to economically disadvantaged groups in coastal areas, mainly women and youth.
Methodology
The three intervention models were implemented in three distinct areas of Palawan Province by selected NGO partners working in collaboration with local governments and PATH Foundation Philippines. Independent research groups conducted community surveys and ecological assessments in the three study sites before (2001) and six years after (2007) the interventions were introduced. The implementing NGO partners also implemented period behavioral monitoring surveys (BMS) to track changes in family planning and fishing practices among the target groups which primarily consisted of fishers, women and youth.
Data
Eighteen ecosystem health indicators are included in the analysis, grouped under three categories: coral reef, reef fish, and mangroves. Nine human health/wellbeing indicators were also examined under two categories: reproductive health and food fish security. Regressions analyses were performed on the 2001 and 2007 datasets to examine the statistical significance of the differences in the indicators over time while controlling for other related factors.
Findings
The IPOPCORM intervention generated higher impact on both the Pop/RH and CRM indicators compared to the sectoral management approaches. Among others, the data show a positive and statistically significant change in use of any FP methods among adults and youth, significant decline in use of dynamite and cyanide in fishing, and fewer young adults reporting income levels below poverty threshold. More positive and statistically significant trends in coral and mangrove condition indices were also observed in the integrated site. BMS data indicate fish catch rates doubled and fishers’ average monthly income increased by 21% in the IPOPCORM site. Community leaders noted that IPOPCORM was able to deflect opposition from religious leaders by promoting family planning as an integral component of CRM for food security.
Knowledge Contribution or Lessons Learned
Integrated approaches to family planning and environmental management generate higher yields than sectoral management approaches and contribute more directly to MDG achievement. The IPOPCORM intervention contribute directly to MDG1 (eradicate extreme poverty and hunger) by reducing poverty incidence among fishers and youth. By enabling women to participate more fully in CRM and livelihood activities, IPOPCORM contributed directly to MDG3 (promote gender equality and empower women). It also generated higher levels of family planning and safer sex practices among adults and youth which contribute directly to MDG 4 (reduce child mortality), MDG 5 (improve maternal health) and MDG 6 (Combat HIV/AIDS). The integrated approach also enhanced the community’s role in CRM while the RH component lends sustainability to CRM gains – both of which contribute to MDG 7 (ensure environmental sustainability). The public-private partnerships fostered under the project contributed to MDG 8 (develop a global partnership for development).
International Conference on Family Planning: Research and Best Practices
Kampala, Uganda
November 15-18, 2009