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Use and Non-Use of the Intra-Uterine Device in the Philippines: Perspectives for the Commercial Sector pp. 113-132 $100.00
Authors:  (Romeo B. Lee, Graeme Armecin, Jonah Martin, Maricel Lim-Nalian, Hiko Tamashiro, Department of Global Health and Epidemiology, Hokkaido University Graduate School of Medicine, Sapporo City, Japan, and others)
Abstract:
The public sector has been dispensing intra-uterine device for free to Filipino women for more than three decades now. Following the country‘s movement towards contraceptive self-reliance, the government‘s role would soon be diminished while the role of the private sector, which is already the major source of pills and condoms, would be expanded to include the provision of intra-uterine device.
A study was carried out to review existing published quantitative data on the use of intra-uterine device and to collect qualitative evidence on women‘s perceptions and experiences regarding their use or non-use of the method. Data were intended to inform the private sector about the method‘s potential number of users and factors that influence women to use or not to use the contraceptive.
The quantitative evidence was derived from the published reports of the National Demographic and Health Survey and the Family Planning Survey, while the qualitative data were drawn from focus group discussions involving current and former users of the intra-uterine device, intenders and limiters.
Quantitative results indicate that the number of intra-uterine device users has been limited. Whereas its users grew by 0.8 percentage-points (3.3% to 4.1%) or by 40,000 new users in 2001-2003, the trend was not sustained; the rates have been declining from 4.1% in 2003 to 3.9% in 2004 and 3.7% in 2008. Since the device has the lowest discontinuation rate and is long lasting, the pool of users has comprised the same individuals through the years. Fortunately, there would be 0.391 million potential users. Qualitative findings suggest that women‘s use and non-use of the intra-uterine device was guided by their perceptions of the advantages and disadvantages of the method, respectively.
As a consequence of their actual experiences in using the method, their perceptions were enhanced, which subsequently influenced their continued or discontinued usage of the method. Thus, continued use was contingent on having positive experiences and discontinued use on having negative experiences of using the contraceptive. The extent in which women had positive or negative experiences depended on the quality of services they had received from health providers. The private sector has to market and promote the intra-uterine device as the next alternative method among contraceptive users and as a top choice among non-users. Whereas strategies must highlight the advantages of the method, these must also incorporate approaches to address the method‘s disadvantages. Strategies must thus seek to address both perceptions and experiences of women. 


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Use and Non-Use of the Intra-Uterine Device in the Philippines: Perspectives for the Commercial Sector pp. 113-132