For over 17 years, barangay health worker Aprolin Alameda has witnessed how religious, cultural, gender and social beliefs shape the opinions about family planning of families in the municipality of Cagwait, Surigao del Sur.
According to Aprolin, this is why many in their community do not believe in contraception and birth spacing.
“The traditional notion of not using modern contraception is sometimes deeply embedded and can take a long time to change. This is because most of the families here are still living with their grandparents who have strong beliefs against family planning,” Aprolin said.
A study published by Oxfam Pilipinas in May 2020 showed that discriminatory norms jeopardize the sexual and reproductive health, safety, and rights of women and girls in the Bangsamoro Autonomous Region in Muslim Mindanao (BARMM) and Caraga Administrative Region since some believe that a large family is socially desirable.
Aprolin added that she has heard stories as well about how men see condoms as an unacceptable form of contraception because it does not give them pleasure.
To help improve the health of women and their families in Cagwait, Oxfam Pilipinas, through Sibog Katawhan Alang sa Paglambo (SIKAP), is implementing the Sexual and Health Empowerment (SHE) project, which is funded by the Global Affairs Canada.
The project carries out strategies to shift social norms by finding ways to change people’s attitudes, beliefs, norms, and behaviors when it comes to sexual and reproductive health and rights.
One of the notable strategies is a series of community dialogues that tackles responsible parenthood, family planning, and other sexual and reproductive health services with the residents. The series of dialogues provides families, couples, and health workers an opportunity to discuss the importance of sexual and reproductive health and rights.
While the project mainly focuses on couples, SIKAP Community Development Facilitator Imelda Gamoñez said it is also an opportunity for them to train village or barangay health workers on better ways to communicate relevant and correct information on family planning and the use of contraceptives with their patients.
“The healthcare workers are not only crucial in the provision of contraceptives and dissemination of contraceptive information but are also part of the process of shifting the community’s attitudes towards family planning,” Imelda said.
This is why the village health workers are trained in interpersonal communication, even undergoing extensive training before facilitating discussions with couples.
According to the SIKAP, they were able to train a total of 93 village health workers since the project started in 2018.
Reaping the rewards
In just a few months after the implementation of the project, Aprolin was amazed by the results and the huge changes in the community’s attitudes and perceptions.
“With the help of the SHE project and the training provided, I’ve learned how to properly communicate with the community, how to persuade them to join the training, and how to convince them to use contraceptives. It’s a huge change because we used to rely on the nurses and midwives; but now, we can communicate with the people on our own because we are knowledgeable enough,” she said.
She also observed that the demand for contraceptives has risen. Both women and men now see contraceptives in a positive light and are reporting better access to contraceptive products.
Anabeth Legaspo, a public nurse in Cagwait, said one of the greatest transformations they saw was when they were able to convince Indigenous Peoples groups in the villages of Mam-On and Bacolod to try family planning methods.
“It’s always been a challenge for us to change the perceptions of the IP community since as we all know, culture and traditions are deeply rooted in their lives especially in their sexual and reproductive health; but through the SHE project, we were able to accomplish this. Now, the women use pills, implants, and intrauterine devices,” Anabeth said.
SIKAP believes that family planning is one of the strategies that would help Filipino families achieve better quality of life. They are able to provide timely and correct information to communities on SRHR so that they are able to make informed decisions over their own body and empower women to take control of their reproductive health. It also helps families improve their situation by ensuring that they can adequately provide for their children. This should also allow some couples, and especially women, to find ways to improve their income and better provide for their families.
SIKAP seeks to bring in together services and information to change the community’s perceptions on SRHR. The healthy and open discussion on sexual and reproductive health slowly breaks down the walls of shame and taboo, ensuring that women’s issues and needs are addressed.
Anabeth added that women in Cagwait are now more open to discussing their sexual and reproductive health rights. They even get to talk with teens about sexual preferences and the methods to prevent sexually transmitted infections.
Aprolin and Anabeth believe that there is still a long way to go to fully convince the community about family planning and contraceptives but they are hopeful that it will come soon.
For now, they consider open discussion with the residents about contraceptives and family planning a big achievement. Without disrespecting the local culture, the village health workers of Cagwait have played important roles in enlightening couples about the benefits of prioritizing sexual and reproductive health.