In the same study referred to in my post Building youth agency, another finding piqued my attention, that on methods availed of by young people to avoid pregnancy. The top response is contraceptives bought at pharmacies. Services from a government hospital or health center came in second though there’s a huge difference in response rate with the first.
What this means is, these young people are aware of what’s available over the counter. The study did not detail where they got the information, but recalling a similar study commissioned by another organization, friends were the primary informants. But using the more sophisticated contraceptives without prescription has it’s dangers as what works for one may not for another.
As to the low access to services offered by public health centers, my field experience on this is, for most young people going to the midwife or health volunteer at the village health center especially for RH information and contraceptives is like paying your aunt whom you haven’t spoken to in ages a visit and telling her details of your sex life and asking for condoms to boot. No sooner than you’re out her door, she rings up your folks. Then you not only have to deal with your aunt (and your embarrassment) but also your folks (and of being endlessly preached at for immoral and shameless behavior). The midwife and health volunteers are people from the village, perhaps their relatives even. So it’s suicide to even contemplate that option, and young people are not known to have an open and comfortable relationship with older members of their families. Moreover, they live in rural Philippines where reputations are ruined by mere hearsay.
This has implications on improving access to RH services:
- Where and how are the individual’s choice. The important thing is, regardless of ‘where’ is, whether it’s a public or private health center, RH care providers are capable and ready and networked into a functioning referral system.
- For public health centers, especially village health centers, privacy and confidentiality should be maintained. Confidentiality is essentially behavior toward clients. I have visited village health centers that had separate rooms for consultation and check-up but then the health care providers’ voices as they were talking with their clients were so loud that the entire village is practically privy to details of the clients’ histories and concerns.
- There is tendency among women health care providers to speak condescendingly to female clients who are young, lacking education, who have plenty of children, poor. I have come across providers who, unconsciously, go lecture their clients. Talk of morality is best left to spiritual directors and confessional boxes. When clients express desire for such direction, however, providers need only refer them to the right persons. RH care providers should endeavour to extend without discrimination quality care all the time to all in need.