Summary of Family Planning Motivations in the Philippines Report (2020)- USAID's ReachHealth Project

MOTIVATIONS FOR USE OF FAMILY PLANNING AMONG INDIVIDUALS OF REPRODUCTIVE AGE IN THE PHILIPPINES Technical Summary Submission Date: July 1, 2020

CITATION Kumoji E., Rogers, A., De Los Rios, L., Church-Balin, C., Leslie, L., Murga, M., Abellanosa, V., Gultia, A., & Velu, S. (2020). Motivations for family planning among individuals of reproductive age in the Philippines. Philippines USAID ReachHealth Project, Johns Hopkins Center for Communication Programs.

This document was produced for review by the United States Agency for International Development It was prepared by the Johns Hopkins Center for Communication Programs and RTI International for the USAID ReachHealth project.

This document is made possible by the support of the American people through the United States Agency for International Development (USAID.) The authors’ views expressed in this report do not necessarily reflect the views of USAID or the United States Government.

Š 2020 Johns Hopkins University. All rights reserved.

CONTENTS BACKGROUND AND AIMS………………………….....………………………………………………. 1 METHODS OVERVIEW…………………………….……………………………………………………. 1 Food For Thought: Five Key Findings And Recommendations……………….……………………... 2 DIVING DEEPER INTO WHAT WE HEARD………………………………………………………... 3

I

|

1.

Perceptions of Family Planning……………………………………………………………... 3

2.

Awareness and Use of Family Planning Methods…………………………………………... 3

3.

Knowledge of Family Planning…………………………………………………………….... 4

4.

Family Planning Norms……………………………………………………………………... 5

5.

Motivations to use Family Planning………………………………………………………… 6

6.

Motivations to not use Family Planning…………………………………………………… 6

7.

Facilitators of use of Family Planning……………………………………………………… 7

8.

Barriers to use of Family Planning………………………………………………………… 7

9.

Family Planning Communication…………………………………………………………… 8

USAID’S FP/MNH ICP PROJECT—FAMILY PLANNING MOTIVATIONS IN THE PHILIPPINES

USAID.GOV

ACRONYMS CCP

Johns Hopkins University Center for Communication Programs

FP

Family Planning

RH

Reproductive Health

RTI

Research Triangle Institute

SBC

Social and Behavior Change

USAID United States Agency for International Development

II

|

USAID’S FP/MNH ICP PROJECT—FAMILY PLANNING MOTIVATIONS IN THE PHILIPPINES

USAID.GOV

BACKGROUND AND AIMS USAID’s ReachHealth project is led by RTI International in partnership with the Johns Hopkins Center for Communication Programs (CCP). It is a five-year initiative to strengthen and improve access to critical health services for Filipino families. The project is designed to assist communities in the Philippines to reduce unmet need for family planning (FP) services and decrease teenage pregnancy.

Wide variance in FP and reproductive health (RH) indicators persists across provinces and regions throughout the Philippines. While there has been some progress in improving access and meeting demand for FP among Filipinos, there is a need to understand the prevailing factors that may be preventing further advancement in the supply, demand for, and uptake of FP services.

INDICATOR

IN 2013…

IN 2017…

PERCENTAGE OF FILIPINO WOMEN USING ANY MODERN FP METHOD

37.6%

40.4%

PERCENTAGE OF FILIPINO WOMEN WHO ARE SEXUALLY ACTIVE AND WANT TO STOP OR DELAY HAVING CHILDREN, BUT ARE NOT CURRENTLY USING ANY FP METHOD

17.5%

16.7%

In November/December 2019, CCP conducted a formative, qualitative research study to explore the experiences and motivations for FP use among men and women 18 to 59 years old residing in five cultrually distinct project areas in the Philippines (see map below). This research was designed to inform evidence-based health and behavior change communication programming to increase and sustain the use of FP services among individuals of reproductive age.

METHODS OVERVIEW In total, the study team talked to 60 individuals (40 women and 20 men) about FP. The following methods were used to engage participants: 1. Unstructured In-depth Interviews 2. Courage to Change activity 3. Reproductive Health Lifeline plot 4. FP Empowerment grid

Camarines Sur in Bicol

Batangas in Calabarzon

All interviews were transcribed, translated into English, and thematically coded. Results were analyzed overall and for subgroups based on sex, age, user status, and location.

Cebu City in the Central Visayas

Zamboanga Del Norte in the Zamboanga Peninsula South Cotabato in Soccksargen

Learnings at a Glance We need to think differently about FP 1.

2.

3.

4.

5.

1

|

Women don’t know enough about the variety of FP methods or the expected side effects; their FP decisions are highly influenced by the experiences of female family members and friends Most Filipinos start FP too little too late Men are passive toward family planning; they view FP as a woman’s responsibility The main role of health workers has been service provision, not comprehensive FP counseling Traditional community-based demand generation activities may be perceived as a barrier to care; new digital approaches need to be explored USAID’S FP/MNH ICP PROJECT—FAMILY PLANNING MOTIVATIONS IN THE PHILIPPINES

USAID.GOV

FOOD FOR THOUGHT: FINDINGS Heading 3 [Gill SansFIVE 11pt,KEY Initial Caps] AND RECOMMENDATIONS

Body text, body text, body text, body text, body text, body text. Body text, body text, body text, 1. body Family planning evokes of text, anxiety and fear: Wide-spread mythsbody and text, misinformation text, body text, body feelings text. Body body text, body text, body text, body text. about FP methods, coupled with poor knowledge of normal side-effects, cause many women to be afraid of FP, Body text, body text, body text, body text, body text, body text. Body text, body text, body text, especially modern methods. Some say that they would likely use FP if they were sure of its safety and the body text, body text, body text. Body text, body text, body text, body text, body text, body text. normal bodily changes to expect. Based on these findings, we recommend: • Communicating in a way that fosters safety and trust in FP methods (i.e. user-friendly, non-clinical • Bullets style [Gill Sans 11pt] language) • Increasing knowledge of normal and negative side effects to foster realistic expectations of different – Bullets_2nd-level style [Gill Sans 11pt] methods • Designing women-centered solutions to reduce discontinuation due to side effects (i.e. peer support • Bullets_3rd-level style [Gill Sans 11pt] groups, mobile and digital counseling, etc.)

Body text, body text, body text, body text, body text, body text. Body text, body text, body text, 2. Family planning is not for everyone: FP is perceived to be primarily for married people rather than for body text, text, In almost all cases, women use FP to control subsequent births, rather than to delay singles or body teenagers. body text.

Body first births. As atext, result, women often 1: learn about andReachHealth use FP later in Path life when they already have several Exhibit Measuring to Self-Reliance body text, body text, children. Based on these findings, we recommend: body text, body text, • Repositioning FP as appropriate for everyone; focus on different benefits for different age groups, men body versus text. Body text,and unmarried versus married people women, body text, body text, • Getting FP information to people earlier in their reproductive years so they can incorporate their plans into their life planning body reproductive text, body text, body text. Body text, 3. body Family planning is for women: Respondents feel that FP information and use is centered around women text, body text, and that most FP-related communication targets women. FP is also described as being primarily for women, body text, body text, not men, body text. underscoring Body text, a link between childbearing and FP as women’s issues. Only a few men actively participate in FP discussions with their partner, while most simply defer to the desire of the woman. Based body text, body text, on these findings, we recommend: body text, body text, • Promoting gender-equity in attitudes and beliefs about responsibility for and use of FP, access to body information text. Body text, and methods, communication, and decision-making body text, body text, • Strengthening couples’ FP communication, as partner communication is a predictor of use body text, body text, • Using gender-transformative approaches to engage men as FP partners with women body text. Body text, text, body text, text,matter: body text, body text.

Body text, text, body text, text,to occur 4. body Family planning is abody private FP-related discussions andbody decision-making are body expected body text, text. body text, body text, bodyonce text, abody text.reaches Body text, within thebody couple or Body family.text, Health workers are text, oftenbody only consulted woman a decision. As a result, most informants find it difficult to talk about of FP outside their close networks.

Programs, like body text, body text, body text, body text, body text.use Body text, body of text, body text, body text, Usapan, should not assume that FP adopters will automatically become champions of FP in their body text, body text. Body text, body text, body text, body text, body text, body text. communities. In fact, some women find required public meetings, such as Usapan, as a barrier to services.

Based on these 1 findings, we recommend: HEADING HERE • Increasing individual agency and reproductive empowerment with strategies to improve knowledge and Body text, body text, body text, body text, body text, body text. Body text, body text, body text, efficacy and health-seeking behavior body text, body text, body text. Body text, body text, body text, body text, body text, body text.

• Repositioning health workers as sources for FP information and counseling as well as services Body text, body text, body text, body text, body text, body text. Body text, body text, body text, • Using a range of channels to reach women; decrease reliance on community-based efforts body text, body text, body text. Body text, body text, body text, body text, body text, body text. text, body text, body motivate text, bodyuse: text,Many bodyinformants text, bodyare text.

Body text, body desires text, to avoid 5. Body Socio-economic factors motivated to body use FPtext, by their body text, bodyassociated text, bodywith text.providing Body text, body at text, body text, body text,with bodytheir text.motivation to the difficulties forbody manytext, children once.

This is associated provide the best for their children and the belief that FP can help them do that. Although large families are still valued, especially among men, women mention that men engage in conversations around FP best when it is presented in terms of family economics. Based on these findings, we recommend: • Emphasizing links between FP and better socioeconomic status and quality of life • Capitalizing on tradition with the use of family-centered approaches (i.e. FP is for the future of the family)

2

|

USAID’S FP/MNH ICP PROJECT—FAMILY PLANNING MOTIVATIONS IN THE PHILIPPINES

USAID.GOV

DIVING DEEPER INTO WHAT WE HEARD 1.

PERCEPTIONS OF FAMILY PLANNING

Most informants percieve FP to be beneficial for their families. Use of FP is considered a way to prevent the daily hardships of caring for a large family and helps ensure a good future and easy life.

Nevertheless, stories about the side-effects of FP cause anxiety among the majority of both men and women, and among both users and non-users of FP. The fear of side-effects influences decisions to use FP, the type of method to use, and the continuity of a method.

While both single and partnered women use FP, it is considered to be primarily for married couples, rather than singles or teenagers.

Informants also use FP primarily to control subsequent births and rarely to delay childbearing. Consequently, most women start using FP after they already have two or three children, sometimes more.

An older woman, who is not currently using FP, from an urban area states that, “For me, I get scared. I heard about how the IUD [intrauterine device] is bad for your matres [uterus].

That’s what they said. That’s what comes into my mind if someone says ‘family planning.’ And I don’t want it, because I’m scared.”

The majority of informants perceive FP to be a way to take control over one’s body and one’s life circumstances. Most women think about FP as a way to control pregnancy, while some men think of it as part of their plan to control difficult life circumstances. Relatedly, some view the use of FP as being good for the family and for making life easier. They perceive it to increase one’s ability to provide for the needs of the household and its members. Many consider FP to be especially beneficial for the children, as it enables the parents to give each child more focus, attention, and resources.

Put it into Practice • Change negative perceptions of FP as scary and unsafe. Communicate in a way that fosters safety and trust in FP methods (i.e. user-friendly, non-clinical language) • Explore nomenclature around “family planning,” as this may influence the perception of who should use it and has implications for demand generation among subgroups of the population, such as those who are unmarried, teenagers, and youth • Reposition FP as being appropriate for everyone by focusing on different benefits for different age groups, men versus women, and unmarried versus married individuals 2.

AWARENESS AND USE OF FAMILY PLANNING METHODS

Most people are generally aware of what FP does, stating that it is used to control pregnancy. Many can also name a few methods, such as pills, implants, injectables, condoms, and withdrawal, and a few mention traditional herbs. Almost all informants perceive the most popular FP methods for women to be pills or implants and for men, the condom or withdrawal. More older women mention awareness or use of the pill, while younger women frequently mention awareness or use of implants.

Few informants indicate awareness or use of injectables and even less of IUDs. Condoms are not always viewed favorably: men state condoms reduce sensation and pleasure, and women do not trust them and have fears that it will leak, tear, or come off and stay inside them. Trust in withdrawal as a FP method is variable. Informants’ experiences show that withdrawal, rather than condoms, is a more popular option for couples to turn to when women stop use of their FP method.

3

|

USAID’S FP/MNH ICP PROJECT—FAMILY PLANNING MOTIVATIONS IN THE PHILIPPINES

USAID.GOV

3.

KNOWLEDGE OF FAMILY PLANNING

Overall, there is limited and incorrect knowledge of FP and an abundance of misinformation about FP and its normal side-effects. This lies at the heart of the disconnect between positive attitudes towards FP and actual use. Informants lack comprehensive knowledge of modern FP methods. While most women are aware of and able to name several different FP methods, their knowledge often does not go beyond the surface level – detailed information is lacking or inaccurate. Knowledge among men is also variable, with some expressing limited to no knowledge.

Almost all misinformation relates to the perceived side-effects of different FP methods. Common sources of misinformation include family, neighbors, and friends; the experiences of others; rumors; and social media. Informants report side effects, such as cancers, complications from parts of the FP method that get left in the body, changes to the menstrual cycle, weight loss or gain, becoming angry or short-tempered, forgetfulness, and headaches.

There is some confusion around common bodily changes versus harmful side-effects. The cessation of menses, in particular, is misunderstood and viewed negatively by many women. The fear of these side-effects frequently influences women’s decisions to use a specific FP method, to discontinue a method, or to switch FP methods, often times to a less effective method, like withdrawal, which is perceived to be safer.

The majority of respondents stated they first received information about FP after they were married, or after they already had several children. Women often hear about FP in the hospital postpartum while some mentioned they first heard about it at required premartial counseling sessions. Family members rarely introduced or encouraged the topic before childbearing, which is consistent with the perception that FP is used to control subsequent births.

One older woman, who is not currently using FP, from a rural area states, “R: I heard rumors about how it [FP] might cause me to develop myoma because I wasn’t getting my menses.

Where they say your belly will grow big.

I: Where did you hear that from?

R: From the elders who would tell me to stop using contraceptives because I might get... because it stops menstruation. So obviously your menses accumulate.

That’s what the elders say.

Naturally, I was worried. I stopped. I waited to get my period and that’s how I conceived my second-born.”

Put it into Practice • Provide correct and comprehensive information about FP options; promote knowledge of differences in effectiveness to facilitate decision-making and satisfaction with chosen method • Increase knowledge of normal side effects and negative effects to foster realistic expectations of different methods and to help ensure continuity of methods used • Design women-centered solutions to reduce discontinuation due to side effects (i.e. peer support groups, mobile and digital counseling, etc.)

• Create activities to manage myths, misconceptions, and rumors about FP • Ensure equitable access to FP information for youth, men, and unmarried individuals

4

|

USAID’S FP/MNH ICP PROJECT—FAMILY PLANNING MOTIVATIONS IN THE PHILIPPINES

USAID.GOV

4.

An older woman, who is not currently using FP, from an urban area states that, “I stopped using pills, because we decided to have another child.

Because a lot of people say that it’s ugly to have just one child.”

FAMILY PLANNING NORMS

FP behaviors are rooted in family tradition. They are related to privacy, the value of large families, gender roles regarding use, spousal communication, and decision-making. Socio-cultural values around having large families persist in some Filipino communities.

Some men in rural areas describe a preference for large families and, as a result, have a more forceful role in FP decision-making before the couple has several children. It is, therefore, common for FP use to be delayed until after a woman has one or several children.

There is also an inter-generational transfer of knowledge about FP from older family members to younger members. Most married women report strong encouragment from their families to use FP, especially directly after a birth. Many women use a specific method on the advice and experiences of their family members, and occasionally of female friends and neighbors. However, there may be changes to this practice on the horizon, as younger informants mention loosening ties with traditions.

Additionally, FP is seen largely as a private matter. The general sentiment is that there is broad-based support for FP within the community. However, many informants, regardless of sex, age, or user status, said they would not be comfortable discussing FP with the wider community and report low courage to be a community advocate for FP. Most often, the couple or family makes a decision to use FP, and what method to use, before they speak to a provider. While health workers are generally supportive of women’s choice of FP, they are usually consulted late in the decision-making process.

Both men and women informants view FP largely as a woman’s responsibility. FP information and use is perceived to be centered around women and most conversations around FP only target women.

Many men do not see a role for themselves in FP decision-making and are somewhat passive about choice of method, often deferring to the desire of their partner.

Put it into Practice • Capitalize on tradition with the use of family-centered approaches (i.e. FP is for the future of the family) • Reframe norms around the timing of fertility and use of FP; promote norms around delaying first births and ensure that the needs of unmarried youth are met • Reposition the timing of receipt of FP information so users derive the full benefit of FP earlier in their reproductive years (i.e., FP can be used before first births) • Normalize FP discussions in the community (e.g., it’s okay to talk about FP) • Reposition health workers as not only service providers, but also as trustworthy sources for FP information and counseling • Increase women’s individual agency and reproductive empowerment with strategies that build knowledge and the ability to act on that knowledge, ask questions, and be an advocate for FP in their families and communities • Promote gender equity regarding attitudes and beliefs about responsibility for and use of FP, access to information and methods, communication, and decision-making • Use gender-transformative approaches to engage men as FP partners with women

5

|

USAID’S FP/MNH ICP PROJECT—FAMILY PLANNING MOTIVATIONS IN THE PHILIPPINES

USAID.GOV

An older woman, who is currently using FP, from a rural area explained,

5.

MOTIVATIONS TO USE FAMILY PLANNING

The primary motivators for FP use include its perceived influence on socio-economics, a preference for small family size, a fear of consequences of large families, preventing overpopulation, a desire “I pity the child when it’s for single life, and pursuing one’s career. Informants frequently still young; when it’s only a year old then another child make linkages between FP and socio-economic factors, including immediately follows. You poverty, the desire for an easier life, wanting a better quality of life won’t be able to care for it for one’s family, and being unemployed. When resources are in because what you’d care limited supply, it is difficult to provide for your family’s needs. A for is the smaller baby. You manageable number of children, and using FP to achieve that, can’t focus your love on makes life easier and helps families avoid the difficulties of the eldest, right? It gets providing for many children at once. Some mention being able to divided.” provide for their children’s basic needs – shelter, food, clothing – while others also consider providing a high quality of life and successful future through education. The socio-economic motivator for FP use is especially influential for men, who see it as their role to provide financially for the family.

Additonally, pregnancy and childbirth often interrupt women’s employment. FP is seen as a way to ensure one is able to continue working and develop a career without interruptions. Some younger individuals are motivated to use FP to stay single or enjoy the single lifestyle without being responsibile for a partner or dependent.

6.

MOTIVATIONS TO NOT USE FAMILY PLANNING

Some factors that do not motivate people to adopt FP include a desire for many childen, an employed spouse or partner, and being an overseas foreign worker. The typical Filipino family is considered to be a large one. Some people, especially men, value the closeness of large families and believe that having few children increases their risk of being left without support during their old age.

In addition, some informants say their churches encourage their congregations to have large families, indirectly discouraging the use of FP. While not having stable employment influences the use of FP, having a stable job discourages its use.

Those who are employed often do not feel the need to use FP since they are able to adequately provide financially for more children. Lastly, women who have a spouse or partner who is an overseas foreign worker are also not motivated to use FP. A few women said they stopped using FP when their spouse or partner is away on contractural work because they feel it is not needed or that they need to prove faithfulness to their partner in his absence .

Put it into Practice • Promote the short- and long-term benefits of using FP for the family, especially for children • Reframe control of pregnancy in terms of control of life circumstances and the future of the family, especially children • Focus on increased efficacy to achieve personal and family goals by using FP • Link FP to higher socioeconomic status, better quality of life, and an easier life • Create new norms by linking smaller family units to better quality of life, easier life, and ability to focus more on fewer children

6

|

USAID’S FP/MNH ICP PROJECT—FAMILY PLANNING MOTIVATIONS IN THE PHILIPPINES

USAID.GOV

7.

FACILITATORS OF USE OF FAMILY PLANNING

The primary facilitators of FP use include cost, access, ease of use, compatibility of the method with lifestyle and body, a supportive spouse and family, and the perceived safety of the method. Providing free or affordable FP methods One older women, who is not reportedly helps individuals who are happy with their method to currently using FP, from an consistently use it. FP that is readily available also facilitates its use urban area states that, among those who want it, especially if preferred brands are in stock.

FP methods that are quick to administer, simple to adopt, and do not “For me, I would just like require a daily behavioral routine are considered easiest to use. to know if family planning Hiyang is a Tagalog word that means being well suited or compatible.

Being hiyang with a FP method is an important facilitator. Use of FP, thus, was facilitated by methods that the user percieves to “fit” them well – it is suited or compatible with their lifestyle and their body responds well to it without harmful changes.

A supportive partner and family also facilitates a woman’s decision to use FP and her choice of FP method. It also makes it easier to adopt FP and to use it consistently. Some men supported their partner’s use of FP by purchasing pills each month, teaching their wives how to use FP, and reminding them to use their FP.

is dangerous or risky. If not, I will use. That’s the only information I need… like my husband wants me to be safe. As for me, I want to know that I’ll be safe. If I’ll be safe, why not use family planning? If it’s for my personal improvement of my life?”

Put it into Practice • Increase information-sharing about FP options and normal side effects to support women to identify a method that is hiyang • Encourage provision of FP counseling about expected effects and side effects • Develop new approaches to bring FP to individuals • Offer free and low-cost options for FP, including the condom • Provide access to increased method and brand options

8.

A younger woman, who is currently using FP, from an urban area explains, “Before, he [my partner] did not approve, because before he still wanted to have children. He wanted more. But now we have four, so it [FP use] should be okay.”

BARRIERS TO USE OF FAMILY PLANNING

There are several common barriers to the use of FP, including fear and negative experiences with side-effects, an unsupportive partner, prohibitive cost, and perceived individual factors, such as forgetfulness, laziness, and embarrassment. Misinformation and rumors about normal side-effects are a source of fear among women and their partners. These include effects that are personally experienced and those heard from others or on social media. As a result, common bodily changes are often percieved as harmful and lead to the conclusion that a method is not hiyang. Misinformation, and the fear it causes, therefore, influences a couple’s decisions to not use FP or to switch methods.

Lack of partner support is also a barrier to use for some women. This is especially likely when partners hold different views on childbearing and family size. Men often want more children and, therefore, are not likely to support their partner’s use of FP until after they have several children.

In some cases, the cost of FP is also prohibitive and a deterrant to use. Lower-priced methods, such as condoms, and government subsidized options through the health center, are still considered 7

|

USAID’S FP/MNH ICP PROJECT—FAMILY PLANNING MOTIVATIONS IN THE PHILIPPINES

USAID.GOV

pricey for some. Some people do not have access to, or know about how to access, free FP methods.

Lastly, personal factors, such as forgetfulness, laziness, and embarrassment, pose barriers to FP use.

Some people percieve methods that are repeated daily, such as using the pill, as tedious. Others are hesitant to purchase condoms because they feel shy or embarrassed.

Put it into Practice • Manage rumors regarding side effects of FP • Subsidize cost of FP • Increase opportunities for men to be involved in FP (align FP messages for males with economics and improved quality of life) • Support new users to facilitate consistent use and limit discontinuation • Create new norms around perceptions of condoms to associate them with cleanliness rather than dirtiness

9.

FAMILY PLANNING COMMUNICATION

Communication about FP occurs primarily among family members, close friends, neighbors, and to a lesser extent, health workers. Discussions with family and friends focus mainly on advice about adopting FP, recommendations on FP methods, and cautions about side-effects. It is common for women to make the decision to use FP, and to decide on the FP method, before they speak to a health worker. Among women, first exposure to FP information is usually by female relatives, specifically mothers, older aunties, or sisters. Men, on the other hand, have FP-related discussions with their brothers, male friends and neighbors, or their partner. Most often, older women make decisions themselves about whether to use FP, occasionally even without the support of their spouse or partner. Some older men are indifferent and prefer women to make FP decisions, while others insist that they are the final decision-maker on their partners’ use of FP. Females note that discussions about FP are better received by men when it is framed in the context of child care expenses.

Usual sources of FP information include barangay health workers (BHWs), family and friends, and, more infrequently, from lessons taught in high school, pre-marital counseling, and lectures given by government personnel. BHWs are trusted and preferred sources of FP information, especially among older respondents and those living in rural areas. Many think that seminars can provide comprehensive FP information, but some believe attendance is required before they can get a method. Older women mention seminars more frequently, as they prefer community-based approaches, while younger informants said they preferred digital sources, such as social media. Men, on the other hand, prefer more impersonal channels, such as TV, radio, pamphlets, and/or leaflets to read during their commutes.

Put it into Practice • Strengthen couples’ FP communication, as partner communication is a predictor of use • Use digital or social media to reach younger audiences • Promote health care providers as trusted and credible sources of FP information who are easy to talk to and who can help one finds a method that is hiyang • Improve the interpersonal communication capacity of FP service providers

8

|

USAID’S FP/MNH ICP PROJECT—FAMILY PLANNING MOTIVATIONS IN THE PHILIPPINES

USAID.GOV