Conduct of Demand Generation for Family Planning

Proposed Activities
for Albay Population Unit
Background/ Rationale:
By end of 2011, the total population of Albay is 1, 252,700 with an average household of 5.24.
Estimated total number of MWRAs is close to 170 thousand ( 1st district = 63,000; 2nd district =
56,000; 3rd district = 47,000). Estimated modern FP users is roughly 38, 859 ( 21.6%) only of total
MWRAs, while users of traditional method accounts for 59, 861 (36.3%) and a huge number of
66,000 ( 40.2%) are not using any method. There is an unmet need for spacing of 11, 389 ( 11.9%),
while for limiting, roughly 14, 690 ( 8.9%). (data source: Albay PHO; NDHS 2008; DOH/CHD 2011)
The actual use of FP is less than its potential benefits. The following are opportunities that should be
explored in order to achieve better health outcomes and increase contraceptive prevalence rate
from its current rate of 24.6% : 1) huge market potential, maximize existing opportunities such as
public private partnership through strengthening referral and service delivery networks as required
by the MNCHN Strategy ; 2) high traditional users that can be counseled to shift to modern methods;
3) high unmet needs for spacing and limiting, utilize conversation series ( usapan) approach to
encourage MWRAs to access and use any modern methods of FP like pills and injectables; 4)
maintain the high coverage for pre-natal care and integrate FP information provision and counseling;
5) need to attain higher coverage for SBA and facility base deliveries linking intervention to FP use.
The latest DOH Administrative Order 2012-0009 known as the National Strategy towards Reducing
Unmet Need for Modern FP as a Means to Achieving Maternal Health MDGs explicitly states that
government- led intervention to address unmet need for modern FP is necessary due to (1)
inadequate and inappropriate information on FP and means to address unmet needs; (2) the serious
and long term effects of having unplanned pregnancies; and (3) the need to minimize the costs of
reducing unmet need.
Guided by the Administrative Order, Population Office have pivotal role of designing an FP
communication plan to increase demand for FP goods and services; launch advocacy and
information education campaign with emphasis on IPC/C to families through mechanism like CHTs;
act as resource persons in the conduct of responsible parenthood/ FP module of 4Ps family
development sessions; and report to PHO of all RP/FP classes.
Aligned with the current initiative of the DOH/CHD Bicol of strengthening its training system,
through the BRTTH, capacity building for local service providers are on its way. This is ensuring that
local providers for LAPM are available anytime at all times. There are two physicians, one each in JB
Duran Memorial District Hospital and one in Ziga Memorial District Hospital went through a
refresher training course on BTL. They are now ready to provide BTL services to local constituents
with unmet need for BTL. The training attended comes with a certification as local providers, thus
clients for BTL are needed for the two doctors to further perform the procedure and eventually get
certified as local provider
Objective:
By end of 2012, to reduce unmet need for FP by half.
Specifically:
1. Address unmet need for long acting and permanent methods (BTL, NSV and IUD)

2. Build competency of local trained providers of LAPM

Immediate objective:
Generate potential BTL clients for November 23, 2012 certification process for two BTL
trained physicians of the LGU.
Generate potential BTL clients for the two physicians to be held at the JB Duran Memorial
District Hospital and Ziga Memorial District Hospital for the succeeding 4 weeks to gain
competency certification/ completion of training.
Generate potential BTL clients holding PHIC card from 4Ps, NHTS identified families in
coordination with CHTs
Methodology:
Through the local Population unit of the Provincial Health Office of Albay, conduct of regular
demand generation is required. Three Population Officers trained on conversation (usapan) to
conduct sessions in their assigned areas / municipalities while the rests of the Population staff to
continuously coordinate with RHUs. Conversation Series can be held in other municipalities by the
trained staff on scheduled basis. With technical assistance by the provincial FP Coordinator and
HEPO, an execution plan has to be developed in order to be guided in the conduct of the demand
generation.
Since the Population Staff will go through an FPCBT level 1 training, it is recommended that day 5 of
the training be devoted to development of a local demand generation plan: 1) immediate plan till
December 2012; 2) demand generation plan for 2013.

BTL - Important Information and Talking Points for Use by Population Officers in Conduct of
Demand Generation

BILATERAL TUBAL LIGATION Bilateral tubal ligation (BTL) is known as female sterilization as it
provides permanent contraception for women who do not want any more children. It is a safe
and simple surgical procedure to tie and cut the two fallopian tubes located on both sides of the
uterus. The fallopian tubes carry eggs from the ovaries to the uterus. With the fallopian tubes
blocked, the womans egg cannot meet the mans sperm
BTL has the following advantages:

Permanent. A single decision leads to lifelong, safe prevention of pregnancy.

Nothing to remember, no supplies needed, and no repeated clinic visits required
No interference with sex. Does not affect the woman s ability to have sex.
Increased sexual enjoyment because no need to worry about pregnancy.
Has no hormonal side effects
No effect on breast milk.
No known long-term side effects or health risk
Can be performed just after a woman gives birth (immediately and within 7 days after
childbirth)
For interval cases, can be done 6 weeks after delivery
Can be performed at any day of the menstrual cycle provided you are reasonably sure that
the woman is not pregnant.

BTL has the following disadvantages:

Requires minor surgery
Considered to be permanent as reversal surgery is difficult, expensive and success cannot be
guaranteed
If pregnancy happens (very rare), there is a greater risk for ectopic pregnancy compared to
women who have not undergone the procedure
Does not protect against STIs including HIV/AIDS

Information that you need to tell your BTL clients, how to prepare for sterilization operation and
how to take care of oneself afterwards.
Remember, sterilization is a surgical procedure. It is meant to be permanent. After sterilization,
you will no longer be able to get pregnant.
Arrive to the hospital ahead of the scheduled operation.
Before going to the Hospital:
1. Do not eat any solid food for the next six hours before surgery, but you may drink clear fluids
up to 2 hours before the operation. You will be able to eat and drink after the operation.
2. Have a bath. Carefully wash your belly button, belly, and genital area with soap and water.
3. Wear clean, loose clothing. No blue denim pants (maong).
4. Arrange for a family member or a friend to come with you to help you home after the
operation.