The Case of Family Planning Program in Barrio Calumpang
Barrio Calumpang is a village which was identified to have a problem on high birth rates which resulted to an increase in population in the area. Since the government considers population increase as a problem, they have decided to build a clinic primarily to counsel couples, in their child-bearing stage, regarding the government’s family planning program.
The government, in the persons of the POPCOM Officers, encountered the problem on the rejection of the change introduced to the couples in the village. The non-attendance of the target group in seminars, the misuse of the constructed clinic and of the contraceptives specially the condoms would signify the target group’s rejection of the program.
Why did the birth control clinic fail? What could be the factors that contributed to the failure?
Failure of the government’s family planning program in Barrio Calumpang primarily boils down to the implementers’ (1) lack of holistic community assessment (2) guided by cultural sensitivity and (3) SMART principles as well as (4) culturally sound information-education communication. These four major deficiencies will be the focus of the foregoing analysis. Had there been data on such valuable information of what the community values and aspire for their children then the program approaches may be tailored fit along those lines.
To obtain holistic assessment data, series of community gatherings may have been conducted. Aside from the needed data as basis for the implementing guidelines, the physical meetings could build up the needed rapport between the possible beneficiaries and the implementers. The element of trust is essential to both parties that are to enter into an engaging relationship, which are more private in more ways, even among uninformed and misinformed urban dwellers.
To address (1) lack of holistic assessment data, there is a need to strategize. At the onset, the implementers’ calls for meetings should involve couples so both will be able to provide information. There is no need for one to explain what transpired in the meeting to the one left at home. Those who may be shy to voice out their ideas will surely be enlightened by the ideas from others in the group.
Mind-setting is a powerful tool in consciousness-raising and diffusion of a novel concept to a people such as family planning. Imposition of anything foreign will certainly be met with antipathy and indifference. And, studies have shown that humans are more of visual learners than auditory and tactile. Hence, the implementers may start off the gathering with a film showing, in an understandable language, about children and their bright future as individuals, belonging to equally better-off individuals in a community. Emphasis on fewer children in a family results to better health and more opportunities for them and their family, including the community. There is always that sense of community welfare to make it more of a community program that needs community participation for it to succeed.
Assessment questions may include (a) what to you are your children? Because if they answer “help in the farm,” then they may be enlightened with the idea that children’s ability to earn is bigger when they will be given the opportunities. And opportunities usually favor those who are able to reach higher education. Other information such as the families’ socio-demographic and economic profiles could be obtained during these gatherings. The people themselves may be able to point out among themselves that they need to lower down the number of their children.
Cultural sensitivity (2) through due consideration of the people’s language and values, allows residents of Barrio Calumpang to understand the goals of the program. They may be able to express their sentiments as well because they will feel included than otherwise. The case emphasis on the non-use of condoms is equated to the program’s failure, which may just be non-preference of the method, whether barrio or non-barrio residents. There are a number of methods available in both artificial and natural family planning that are approved by World Health Organization and the country’s Department of Health. The availability of these family planning methods allows users to choose the one that best suits their preference, for whatever reasons. This is what pro-choice is all about.
Hence, there is a need to explain each of the method available, with both of the corresponding advantages and disadvantages. For the artificial family planning methods, there are hormones (oral p ill or injectable), barrier (intrauterine device aside from condom), and surgical methods (vasectomy and tubal ligation). If there is a need for a demonstration and return demonstration of a particular method, it has to be conducted. This is more effective way of diffusion of the knowledge and skills’ based family planning methods. These methods somehow empower the users in their ability to choose for themselves. The decision they make put them responsible for their children, for their families, for their community.
Of importance to family planning counselling is privacy for the client during the process. In the clinic is a nook, away from other clients, purposely for family planning method counselling. This way, the conservative clients will be able to express their thoughts about certain methods. Implementers have to be trained well in the program’s policies. And the supervisors have to be dynamic in rounding various family planning centers to ensure correct implementation of the program. Just as what Lynn White stated that culture results from technology multiplied by energy. How people do things, like family planning use, largely depend on their technology (FP methods) and the people who carry out the program, the implementers as human resource.
SMART principles (3) propel the program to achieve its goals in a specific, measurable, attainable, realistic and timely manner. The whole action plan of the program will now have sturdy backbone, with the assessment data gathered. Each of the content will be thought of and stated along the SMART components, without forgetting the cultural sensitivity aspect. This shows that culture is integrated. Specific goal has to be stated in vernacular. The specific the goal, the simple it is to understand, especially among residents in a barrio. Measurable can be manifested through the film shown with fell number of children that result to the learners’ better future and more opportunities.
Attainable goals boost the confidence of the clients whenever they have already met the goals. For instance, when the FP users who get pregnant in less than six months post-partum have already passed one year without being pregnant, there is that sense of pride in what was achieved. This has bearing with being realistic, since the latter paved the way for the goals’ attainment. Then the introduction of family planning methods will be too timely as there is high fertility in Barrio Calumpang. It will also be time-bound since pregnancy matters count months or weeks. And so is spacing of pregnancies.
All these principles will be facilitated more when there is presence of the characteristics of adoption of innovation, namely: relative advantage, compatibility, complexity, divisibility and communicability. There is certainly a relative advantage in the use of family planning methods as the latter hasten birth spacing or non-pregnancy at all. Indeed, change can be initiated from within or borrowed from others.
Since there is proper data collection, compatibility is assured. The goals will jive with the people’s culture. The complexity is easily simplified for those who are first-timers and those with relatively low educated. When the implementers are able to subdivide their tasks to meet the goals in a schedule that both parties agree, then the need for divisibility is met. And when the vernacular is used, communicability of ideas is highly probable.
Culturally sound (4) information-education communication (IEC) is a premium to the success of the government’s family planning method. There is a need to make the people understand well the new ideas through proper IEC. When the concepts are communicated in the vernacular, there is a higher probability that the people will consider it. And when the skills’ development by return demonstration, have been conducted in culturally-sensitive manner, then goals’ distance becomes nearer as the days unfold.
Aside from the vernacular language, the implementers can make use of local and indigenous materials within the barrio do the residents will not be chided with the methods. The eggplant or banana can be used in the demonstration of proper condom use. And the implementers have to do the demonstration in a matter-of-fact, non-nonsense manner to convey seriousness of the goals. For sterilization methods, the reproductive systems can be drawn in a huge manila paper so they can appreciate well what will transpire in the cutting off of vas deferens in vasectomy and the fallopian tubes for the bilateral tubal ligation.
All these identified factors, with their deficiencies in the above case program implementation, could help in the betterment of the next cycle of government program or of the enhancement of the already existing program as a resource. Most of them are very much integrated and value-laden. But, each can be easily learned, when the barrio residents become receptive and they open themselves to welcome the change. The suggestions laid here have been highly participative to do away with the derisive impositions. This way, the residents will not be culture shocked and be culturally offended in any way. Even highly educated people would not welcome any change that they do not completely understand. Hence, empathy is really needed among implementers, who have to be chosen well on the basis of their personality disposition and trainings.
+++ This was submitted, as one of the minor requirements for SocioCultural Change Course, to Dr. Erlinda Burton, Professor, Xavier University-Ateneo de Cagayan, Philippines