Family Planning Needs During the Extended Postpartum Period in the Philippines: Reanalysis of the 2008 DHS Data Zhuzhi Moore, MCHIP October 2013

2  Method use and return to fertility  Unmet need  Uptake of FP by characteristics Outline

3 Data and Methodology  2008 Philippines Demographic and Health Survey (PDHS)  Extended postpartum period (PP) here is defined as 0-23 months post-delivery  Hence, the analysis is based on the sub-sample of ever-married women aged who gave birth in the last 23 months  Sample size (weighted)  Total women = 13,671  Postpartum women (0-23 months) = 2,423

4 Part 1 Method use and return to fertility

5 Birth-to-Birth Spacing Among All Women Aged 15-49, All Non-first Births in the Last 5 Years (Birth-to-Birth) N of Non-First Births=4,480

6 Birth-to-Pregnancy Spacing Among All Women Aged 15-49, All Non-first Births in the Last 5 years N of Non-First Births=4,480

7 Early Childhood Mortality Rates According to Birth-to-Pregnancy Intervals NNMR = Neonatal Mortality Rate PMR = Perinatal Mortality Rate IMR = Infant Mortality Rate U5MR = Under-5 Mortality Rate

8 Family Planning Use: Comparing All Currently Married Women and Postpartum Women

9 Method Mix for Postpartum FP Users N=1,145

10 Method Mix Among Non-Postpartum Users N=3,272

11 Family Planning Use Among All Postpartum Women Across Postpartum Periods

12 Family Planning Use Among Sexually Active Postpartum Women Across Postpartum Periods

13 Factors Influencing Return to Fertility Across Postpartum Periods Among All PP Women Postpartum Women: N=2,423

14 Risk of Pregnancy Among Sexually Active Postpartum Women Across Postpartum Periods Sexually Active Postpartum Women: N=2,001 At Risk of Pregnancy

15 Part 2 Unmet Need: What is the unmet need among postpartum women?

16 Unmet Need Among Postpartum Women N=2,423 DHS DefinitionProspective Definition

17 Prospective Unmet Need Across Postpartum Periods

18 Postpartum Women with Unmet Need by Place of Delivery Unmet Need to LimitUnmet Need to Space N=482N=740

19 Method Mix Among Postpartum Women According to Intention of Use Using to Limit Using to Space N=440N=704

20 Part 3 Uptake of FP: What are the characteristics of postpartum women using family planning methods?

21 Uptake of Family Planning (FP) During the Postpartum Period by Urban-Rural Residence

22 Uptake of FP During the Postpartum Period by Women’s Age

23 Uptake of FP During the Postpartum Period by Parity

24 Uptake of FP During the Postpartum Period by Socioeconomic Status

25 Uptake of FP During the Postpartum Period by Number of ANC Visits

26 Uptake of FP During the Postpartum Period (0- 24 Months Post-Delivery) by Place of Delivery

27 Uptake of FP During the Postpartum Period by DPT3 Vaccination of Last Child (6-24 Months)

28 Uptake of FP During the Postpartum Period by Measles Vaccination of Last Child (9-24 Months)

Take Home Messages  One of two women in the Philippines space their pregnancies less than the recommended 24-month birth-to-pregnancy interval.  Women in the Philippines have a significant unmet need for FP during the two years after a birth.  In the Philippines, risk of pregnancy is high during the postpartum period. Program evidence indicates that offering PPFP counseling during antenatal care and offering PPFP services during all maternal and child health contacts, can be effective for increasing awareness of, demand for and use of FP in this critical period. 29