The Philippines has one of the highest natural family planning (NFP) prevalence rates in the developing world. Rhythm has been promoted by the Philippine Family Planning Program since its inception. Over the years, a substantial body of research data related to NFP has been accumulated. This paper presents major findings from past NFP-related research, describes current research, and discusses program implications of findings to date as well as needs for future research. Among the findings presented are the following. Most NFP users have relied on and continue to rely on some form of calendar rhythm rather than the more modern forms of NFP. There has been an upward trend in rhythm practice, despite the family planning program's relative emphasis on promoting other methods. Most rhythm users are self-taught or taught by friends rather than by specially trained family planning professionals. Rhythm users' continuation rates are similar to the continuation rates of pill users, lower than those of IUD users, and higher than those of condom users. Rhythm users' failure rates are considerably higher than pill or IUD users' failure rates, but similar to those of condom users. Overall pregnancy rates following acceptance of rhythm are remarkably similar to those of pill acceptors, in spite of the greater effectiveness of pills while in use. Data on the use effectiveness of basal body temperature and the mucus method indicate that these methods tend to have been practiced somewhat more effectively than rhythm but are still much more subject to failure while in use than either pills or the IUD. Rhythm practice varies widely, and its underlying principles do not appear to be well understood by rhythm users. Despite the fact that most Filipinos are Roman Catholics, religious reasons appear to play a only limited role in the decision to use NFP. The main problems with the rhythm method appear to be its relative ineffectiveness, the burdensome requirement of prolonged abstinence, poor instruction, and some husbands' lack of cooperation. (author's modified)
Initiation of family planning at the time of birth is opportune, since few women in low-resource settings who give birth in a facility return for further care. Postpartum family planning (PPFP) and postpartum intrauterine device (PPIUD) services were integrated into maternal care in six low- and middle-income countries, applying an insertion technique developed in Paraguay. Facilities with high delivery volume were selected to integrate PPFP/PPIUD services into routine care. Effective PPFP/PPIUD integration requires training and mentoring those providers assisting women at the time of birth. Ongoing monitoring generated data for advocacy. The percentages of PPIUD acceptors ranged from 2.3% of women counseled in Pakistan to 5.8% in the Philippines. Rates of complications among women returning for follow-up were low. Expulsion rates were 3.7% in Pakistan, 3.6% in Ethiopia, and 1.7% in Guinea and the Philippines. Infection rates did not exceed 1.3%, and three countries recorded no cases. Offering PPFP/PPIUD at birth improves access to contraception.