MANILA, Philippines – List down all the birth control methods Filipino women really want, and implants are definitely a popular choice – at least in the city of Manila – indicating they want birth control for the long term.

Likhaan director and co-founder Junice Melgar made this observation during one of the sessions at the 7th Asia Pacific Conference on Reproductive and Sexual Health and Rights (APCRSHR) on Friday, June 24.

“In our community, what is highest is the injectable, so the women are choosing more long term. And implant, which was introduced in the Philippines only two years ago, actually has a very high rate of usage. And if it were available, the young women actually choose the implant,” she noted.

Based on the list of family planning methods used in Manila from 2012-2013, she said the trend seems to be moving toward longer-acting methods (implant, IUD, tubal ligation):

• Injection – 41%
• Pills – 36%
• IUD – 11%
• Implant – 7%
• Condoms – 3%
• Tubal ligation – 2%

According to Women’s Health, the contraceptive implant is a plastic rod as big as matchstick that can prevent pregnancies up to 3 years. It is inserted underneath a woman’s skin inside the upper arm.

Although implants are a popular choice, Melgar said only doctors should and can insert them. Specialists are still wary about letting midwives do it.

“And you know that doctors don’t even go to community-based health programs, they’re not there. So that is a problem, that is something that we’re actually trying to modify through advocacy,” Melgar said.

Likhaan runs community health clinics in various parts of Manila, especially in the slum areas, to reach out to marginalized Filipinos in the urban setting. (READ: Abortion cases in PH rising: ‘RH law would be life saver’)

Supply still a problem in PH

But policies at the local government level still hinder a steady supply of implants and other family planning methods in Manila.

In 2011, the city government finally relaxed the decade-long ban on contraceptives that was passed in 2000 by then-Mayor Lito Atienza, who was also former president of Pro-Life Philippines. 

It was a welcome improvement when finally, the new city ordinance left family planning to be a choice of the couple and allowed doctors to do counseling on family planning methods. (READ: Manila relaxes rules on birth control)

But the local government still cannot fund the procurement of contraceptives and will have to rely on donations from the health department and non-governmental organizations like Likhaan.

Because donations are not stable, this, Melgar said, is where the problem lies, and where the reproductive health (RH) law – once implemented – can be a big help in.

The RH law, signed by President Benigno Aquino III in December 2012, was meant to fund the distribution of free contraceptives, requiring government hospitals to provide reproductive health (RH) services, and mandating public schools to teach sex education.

But the Supreme Court stopped the implementation of the measure in March 2013 while it hears arguments on its constitutionality.

Access 

Access of the poor to family planning supplies and services is also an issue in other developing countries like Nepal.

A 2012 study conducted among city and slum dwellers of Pokhara, Nepal, showed that while globally, 40% of people get their health services from local health providers, health facilities in Nepal are usually nearer to the city area than the slums.

It also noted that temporary types of family planning are most likely used by slum dwellers, while city dwellers use permanent and long-term contraceptives.

Likhaan continues to reach out to the largest slum areas in Manila, and if the past two years is any indication, communities are responding positively despite the setbacks.  

“[Through advocacy, we want to] make sure that people understand that there is already a demand. We will lose that current demand if the provision is not there,” Melgar said. – Rappler.com