BIBLIOGRAPHY SORIANO, JUNELYN T. MARCH 2012....
BIBLIOGRAPHY
SORIANO, JUNELYN T. MARCH 2012. Evaluation of the Decision- making Tool
Flipchart in Promoting Family Planning in Barangay Poblacion, La Trinidad,
Benguet.Benguet State University, La Trinidad, Benguet.
Adviser: Igrelyn P. Pinos- an, BSc.
ABSTRACT
The study on the evaluation of the decision- making tool flipchart (DMT) in
promoting family planning in Barangay Poblacion, La Trinidad, Benguet was conducted
from December 2011 to February 2012. Generally, it evaluated the effectiveness of the
DMT Flipchart in promoting Family Planning. Specifically, it identified the socio-
demographic profile of the respondents; determined the effectiveness of the
Decision-making Tool Flipchart in terms of Comprehensibility, Attractiveness,
Acceptability, Self involvement and Persuasion; determined the problems encountered by
the midwife in explaining the tool; and determined the suggestions of the respondents for
the improvement of the Decision-making Tool.
An interview schedule was used in obtaining data from the 40 respondents
practicing family planning in Municipal Health Office. Also, These were chosen through
purposive sampling.Guide questions were used in obtaining data from the three Barangay
Health Workers.
Results show that, all of the respondents claimed to have comprehended and easily
understood the words. Majority of them also find the decision- making flipchart attractive
while rest thought otherwise. Likewise,majority of them accepted the words used in the
Evaluation of the Decision- making Tool Flipchart in Promoting Family Planning in
Barangay Poblacion, La Trinidad, Benguet / Junelyn T. Soriano. 2012
material and believed in its content.Most of the respondents alsoperceived that the material
was written for them and were persuaded enough to give the recommended family
planning method try.
The BHWs stated that the following problems they have encountered when it comes
to communicating the tool:clients are not attentive during the counseling; were not
financial capable;and were hard to be persuaded due to their different belief system.
The researcher recommends that the flipchart should be encouraged as a medium of
instruction not only in the Health Centers but also at the community at large. The use of
audio- visuals or recorders for more practice discussions between clients and providers
may be considered by the DOH. It is also recommended that BHWs find ways on how they
can motivate both couples or help each other attend family planning counseling.
Evaluation of the Decision- making Tool Flipchart in Promoting Family Planning in
Barangay Poblacion, La Trinidad, Benguet / Junelyn T. Soriano. 2012
TABLE OF CONTENTS
Page
Bibliography. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i
Abstract . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . .
i
Table of Contents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .iii
INTRODUCTION . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . .
1
Rationale . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1
Statement of the Problem. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3
Objectives of the Study . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3
Importance of the Study . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4
Scope and Limitation. . . . . . . . . . . . . . . .. . . . . . . . . . . . .. . . . . . . . . .
4
REVIEW OFLITERATURE . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . .
6
Family Planning . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . .
6
Communication Campaigns . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . .
6
Potentials and Limitations of Flipchart . . . . . . . . . . . . . . . . . . . . . . . . . .
7
Components of Effectiveness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
7
Evaluation of Campaign Effectiveness. . . . . . . . . . . . . . . . . . . . . . . . . . .7
Flipchart Design . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Flipchart Utilization Techniques.. .. . . . . . . . . . . . . . . . . . . . . . . ... . . . 9
Presentation Tips for Effective Communication . . . . . . . . . . . . . . . . .
9
Flipchart as an Effective Trainer- Learner Aid . . . . . . . . . . . . . . . . . .
11
Factors to Consider in Using Flipchart . . . . . . . . . . . . . . . . . . . . . . . .12
Family Planning Methods for Women . . . . . . . . . . . . . . . . . . . . . . . . .
12
v
Family Planning Methods for Men . . . .. . . . . . . . . . . . . . . . . . . . . . . .
13
Natural Family Planning Methods . . .. . . . . . . . . . . . . . . . . . . . . . . . .
14
Permanent Family Planning Method. . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Operational Definition of Terms. . . . . . . . . . . . . . . . . . . . . . . . . . . . .16
METHODOLOGY. . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . .
17
Locale and Time of the Study. . . . . . . . . . . . . . . . . . .. . . . . . . . . . .. .
17
Respondents of the Study . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . .
17
Subject of the Study. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
18
Data Collection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . .
21
Data to be Gathered. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
21
Data Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
21
RESULTS AND DISCUSSIONS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . .
24
Socio-demographic Profile. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
Evaluation of the Respondent
on the Comprehensibility of the Flipchart. . . . . . . . . . . . . . . . . . . . . . . . . . 25
Evaluation of the Respondents
on the Attractiveness of the Flipchart . . . . . . . . . . . . . . . . . . . . . . . . . . .
26
Evaluation of the Respondents
on the Acceptability of the Flipchart . . . . . . . . . . . . . . . . . . . . . . . . . . . .
28
Evaluation of the Respondents
on the Self- involvement of the Flipchart . . . . . . . . . . . . . . . . . . . . . . . .
30
Evaluation of the Respondents
on the Persuasion of the Flipchart . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
31
General Evaluation of Flipchart. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
31
Problems Encountered . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
32
Suggestions of the Respondents. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
SUMMARY, CONCLUSIONS AND RECOMMENDATIONS . . . . . . . . . . . . . 37
Summary . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . 37
Conclusions . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
Recommendations . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
LITERATURE CITED. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40
APPENDICES
A. Communication Letter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42
B. Interview Schedule for the Respondents . .. . . . .. . . . . . . . . . . . . . .
43
C. Guide Questions for Key Informants . . . . . . . . . . . . . . . . . . . . . . . . . . 47
LIST OF TABLES
Table No.
Page
1
Socio- demographic Profile of
the Respondents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
23
2
Respondents Evaluation on the Effectiveness
to the Flipchart. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . 27
3
Respondents Perceived Reasons
for Attraction to the Flipchart. . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . 27
4
Respondents perceived reasons
for Acceptability to the Flipchart. . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . 29
5
General Evaluation of the Respondents
to the Flipchart . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
LIST OF FIGURE
Figure
No.
Page
1
Map of La Trinidad Benguet
showing the locale of the study . . . . . . . . . . . . . . . . . . . . . . . . . 19
2 Map of Barangay Poblacion, La Trinidad, Benguet
showing the locale of the study . . . . . . . . . . . . . . . . . . . . . . . . . 20
1
INTRODUCTION
Rationale
Information, Education and Communication (IEC) materials are needed for
effective information dissemination. According to PIPCCP (1994), IEC activities bring
people and family planning programs together. Communication activities give people the
information they need to make informed choices about using contraception and other
aspects of reproductive health. In family planning as in many other development
activities including health and agriculture, communication campaigns create awareness,
increase knowledge, and build public approval of new ideas and practices.
The World Health Organization (WHO) is the directing and coordinating
authority for health within the United Nations system. It is working with the Department
of Reproductive Health and Research (DRHR) to achieve access to sexual and
reproductive health in order to meet the needs of diverse populations, particularly the
most vulnerable ones. Their principal function is to support the institutions in diffusing
information to the public and creating awareness of their activities (WHO- DRHR, 2005).
In the Philippines, the Department of Health (DOH) is the principal health agency
responsible for ensuring access to basic public health services to all Filipinos. Working
under this agency are the Barangay Health Workers (BHWs). They are health care
providers who have undergone basic training program under any accredited government
or non- government organization and who render primary health care services in the
community.
Among the recipients of the reproductive programs of DOH is Municipal Health
Office (MHO) of La Trinidad. This is the center-most Health Center in the Municipality.
Evaluation of the Decision- making Tool Flipchart in Promoting Family Planning in
Barangay Poblacion, La Trinidad, Benguet / Junelyn T. Soriano. 2012
2
It has only one midwife in- charge and seven Barangay Health Workers (BHWs). They
function to provide the needs of the people especially in family planning program in the
said community.
In promoting this practice, the health care provider specifically the midwife is
using the Decision-making tool Flipchart. This tool for family planning clients and
providers is a new counseling resource developed by the World Health Organization and
the INFO Project at John Hopkins Bloomberg School of Public Health Center for
Communication Programs and was adopted by the Department of Health in our country
as one of the aid material in their promotion of family planning.
The flipchart is a decision-making aid for clients and a reference manual for the
providers. It is a training resource with one page for the client and a corresponding page
for provider. It has helpful pictures, key points and detailed reference information
covering 14 family planning methods. The tool promotes high quality family planning
counseling.
Moreover, the flipchart seeks to improve the quality of family planning
counseling by helping providers apply best practices in client-provider interactions. Also,
it guides providers to respond to the client's expressed wishes and preferences at each
step in the counseling process. Further, this tool encourages providers to give accurate,
relevant and up-to-date technical information at appropriate points. Lastly, it promotes
participation by the clients (Kim et al., 2005).
Thus, this Decision-making Tool Flipchart is an example of an IEC material that
has been used by family planning providers for the past years. However, this flipchart is
seldom used as informational material nowadays because of the emergence of other
3
media used in promoting family planning. Considering its advantages and benefits, there
is a need to evaluate the effectiveness of this medium in promoting family planning to
clients and knowing its importance as a guide to providers.
Statement of the Problem
The study generally evaluated the effectiveness of the Decision-making Tool
Flipchart in promoting Family Planning in Barangay Poblacion, La Trinidad, Benguet.
Specifically, it answered the following questions:
1. What is the socio- demographic profile of the respondents?
2. What is the effectiveness of the Decision- Making Tool Flipchart in terms of?
a.
Comprehensibility
b.
Attractiveness
c.
Acceptability
d. Self involvement
e.
Persuasion
3. What are the problems encountered by the midwife in explaining the tool?
4. What are the suggestions of the respondents for the improvement of the
Decision-making Tool?
Objective of the Study
The study generally evaluated the effectiveness of the Decision-making Tool
Flipchart in promoting Family Planning.
Specifically
it:
1. Identified the socio- demographic profile of the respondents;
4
2. Determined the effectiveness of the Decision-making Tool Flipchart in terms
of:
a.
Comprehensibility
b.
Attractiveness
c.
Acceptability
d. Self involvement
e.
Persuasion
3. Determined the problems encountered by the BHW in explaining the tool;
4. Determined the suggestions of the respondents for the improvement of the
Decision-making Tool
Importance of the Study
The result of this study may help the Municipal Health Office improve their
family planning program through the use of effective IEC materials. In addition, this may
also help the provider improve their interpersonal communication and counseling skills to
their clients. Also, it may be used as a guide to visual designers for lay outing effective
Instructional material. It may also be a help to determine whether flipchart is still
effective and can still be recommended as instructional material for family planning or
can be recommended as minor medium and needs to be supported with other instructional
media.
Scope and Limitations
This study focused on the effectiveness of the Decision-making Tool as a
Communication Information material for promoting family Planning. Also, the factors
5
affecting the clients’ preference in choosing a family planning method after being
exposed with the Decision-making Tool, the problems encountered by the providers in
using the tool and the suggestions of the respondents for the improvement of the
Decision-making Tool were determined.
6
REVIEW OF LITERATURE
Family Planning
Family Planning has been defined as rational, voluntary and moral management
of all the processes of family life including human production. This means that it must be
dictated by reasons and intelligence. It must be a free choice, a practice of man’s God-
given will or violation. And it must be moral so as not to allow doubt and anxiety in
man’s conscience (Lugue and De Leon, 1989).
Family planning use depends on people's private decisions and actions. These
decisions involve individuals, couples, families, and even peer groups. It is not enough
for service providers to know about family planning; rather, all of the people involved in
making family planning decisions, and especially women, need accurate and full
understanding (PIPCCP, 1994).
Family planning according to Quintong (1994) is the conscious efforts of
individuals and couples of reproductive age to regulate/ limit their fertility through the
use of the medically and legally accepted methods of contraception (natural or artificial
means) according to their beliefs, cultural, religious, economic and health circumstances.
This encompasses a responsible attitude among men and women for the outcome
or result of the sexual union such that children are born “not by chance, but by choice”
and that the children are planned, wanted, loved and provided for with the basic human
needs.
Communication Campaigns
According to the Population Information Program, Center for Communication
Programs (PIPCCP, 1994), in family planning programs, communication campaigns play
7
many roles. They make people aware of modern contraception, its proper use, and where
to find services. They counter myths, dispel rumors, and correct misinformation about
modern contraceptives and family planning. They also help link family planning to other
reproductive health care and to broader roles for women. They raise the quality of
services by improving the interpersonal relations skills of providers and by providing
informational materials for clients and providers.
Potentials and Limitations of Flipchart
Non- electronic presentation media or those that are directly shown to an audience
without having to use electronic equipment are relatively cheap and easy to produce.
Many of these media may not last long especially with repeated use (Cadiz, 1991).
Components of Effectiveness
The production of instructional materials according to RITC (n.d.) includes the
following components of effectiveness.
Attraction. It is interesting enough to attract or hold attentions.
Comprehension. It is clear and easily understood.
Acceptability. It does not contain annoying elements, offensive and irritating.
Self- involvement. The message is directed to the target audience.
Persuasion. It is convicting enough to the audience.
Evaluation of Campaign Effectiveness
The effectiveness of the information campaign according to Lugue and De Leon,
(2001) should be evaluated in terms of the meeting the objectives. It can be measured in
terms of four dimensions:
8
a. Audience Coverage
b. Audience Response
c. Communication’s impact
d. Channels of influence and Persuasion
Flipchart Design
In designing flipchart, there are factors to be considered in order to achieve an
organized presentation and enhance the effectiveness of the medium. According to
MTRC (n. d.) these factors must be considered in flipchart design.
Size of page. It must follow “one idea, one visual” principle. It must be easily flip
and handle and it is better if the flipchart is big than small.
Type of illustration. Illustrations must be big and bold with minimum of details.
Illustration must depict the idea or message; and select the best types of line or stick
figure, cartoons, stylized drawings and photographs.
Lettering style and size. Headings, headlines/captions and labels should be at least
1-2 inches high. It is best to use simple lettering style like gothic or block letters. It is also
appropriate to use capital letters for headings/headlines and combine capital and small
letters for caption and labels.
Language levels. Always consider the common language spoken and understood
by audience. Headlines/headings should not be more than seven words. Prefer short,
simple words and be concise.
Layout. Arrange headlines, illustrations, texts or captions in proper sequence or
order. Always aim for simplicity and provide enough space in each flipchart page.
9
Consider dominant areas of the page where you can place the important parts of
the visual.
Color. Use color for contrast and emphasis. Also, use color sparingly; two or
three colors are enough for one single page.
Simplicity and clarity as basic principle.
Flipchart Utilization Techniques
To use the flipchart, there are some of the practical utilization techniques that
providers can use to enhance the flipchart medium. According to MTRC (n. d.), these
techniques must be considered in flipchart utilization.
Keeping the presentation simple and not including too much detail is one.
Secondly, keeping the lettering and visuals simple but large enough for everyone in the
audience to see should also be considered. Third, to place the flipchart where it can be
seen by all its viewers will be good. Fourth, always be sure that the materials or pages are
in their proper sequence and are securely fastened. Fifth, face and talk to the audience,
not to the flipchart. Never block the audience’s view of the flipchart. Sixth, reveal
information only when you are ready to discuss them. And lastly, put summary points on
the separate sheet rather than turning the pages back as you conclude your presentation
(MTRC, n. d.).
Presentation Tips for Effective Communication
According to Cadiz (1991) enhancing and inducing effective learning process, the
educational communicator must be an effective presenter. This means that he must be
adequately arrest learners’ attention, arouse their interest and sustain so that they can
process information presented to them. The following tips must be practiced.
10
a. The presentation must be well- organized, possessing clear transitions to
understand than an unorganized one.
b. Learner participation may be enhanced if the presenter states problem and
guidelines instead of plain solutions. This is to encourage learners to reflect, raise
questions, and think of solutions creatively, not just remain as passive listeners.
c. Presenters must explain why the information they share is important by relating
it to learners’ needs, problems or future situations that they may encounter. This is part of
applying the basic communication principle “know your audience” and the concept of
empathy. To be an effective presenter must be learner- oriented.
d. Presenter must let their communication or learning objectives closely guide
them. Being goal- oriented helps lessen fear among less experienced presenters because it
helps them take their minds from making the right or wrong impressions. Before facing
an audience, he must clarify his mind what his purposes are in meeting them.
e. The proper use of gestures and facial expressions enhances presentation.
f. Humor can spice a presentation and keep the mood right and relaxed. However,
humor must be apt and must not offend learners’ sensibilities. Simply responding to one’s
and learners’ human nature is one way of injecting humor.
g. Surprises can keep learners on their toes. A presenter can maintain learner
interest and stimulate thought by raising controversial issues, drawing unexpected
conclusions, initiating uncontroversial learning activities, showing unusual visual
examples.
h. One paradox in the effective presentation or performance is that of a need to
concentrate and ignore as the same time. The presenter needs to concentrate on his
11
communication objectives and tasks. He must also ignore distractions, such as outside
activities, visible or heard from inside training room. However, they should not be
allowed to keep the presentation off tract in reaching its objectives.
i. The conduct of the presentation cannot be standardized in a rigid manner.
However, certain situation may demand or allow breaking certain pointers in effective
presentation to meet specific learner and presenters’ needs.
Flipchart as an Effective Trainer- Learner Aid
The educational values of the flipchart according to Brown (1985) as cited by
Amadeo (2004) are as follows:
To help concepts. Visual aids can serve as bridges between the concrete and
abstract. Though these qualities, relationships and processes represented symbolically by
words, it helps students to form mental pictures of the realities that they represent.
To arouse and sustain learners’ interest. To help learners experience things
through sensory ways like novelty and variety. Thus, it minimizes monotony and
boredom.
Selecting the materials. This is according to the group’s age, level, intelligence
and experience. Likewise, the legal and ethical aspects, they must be free from bias,
prejudice, distortion, anti-social, attitudes and untruthfulness.
Preparing the group for the visual experience. Motivation should accompany the
preparation. The trainer should discuss the purpose of the activity and suggest points that
will direct attention to key ideas during the activity.
12
Guiding the group through it. This serves as a guide to more fruitful learning. The
trainer can stop at certain points during the presentation to ask questions or to explain to
them what they are experiencing.
Factors to Consider in Using Flipchart
Factors to consider in using flipchart as a visual aids compared with use of a
poster as a teaching material according to Brown (1985) are as follows:
Logistic Problems. Maintain a smooth transition between the presentation and
alternative means for communicating the material.
Setting arrangement. The limitations and the ability of all audience to see the
material.
Time available to cover the material. Time is critical, so the materials should be
developed prior to the actual session.
Amount of information intended to be communicated in the material. The
displayed information should be brief and should highlight only the salient words or
phrases necessary to make a point.
Complexities of the material. Note extensive information during training session
itself.
Family Planning Methods for Women
According to Tiwari (2010), these were the popular family planning methods
which are used by the people practicing family planning and accordingly, it is always
advised to consult a specialist before adopting any of these because of so many side
effects associated to them.
13
Birth control pills. Out of the different family planning methods, this is the most
common and popular artificial method of family planning. This oral contraceptive
restricts the development of the egg and increases the thickness of the uterus cervical
muscles and stops the sperm from reaching the egg. If the regular course of birth control
pills fails, then emergency contraceptive pills can be taken during unsafe sex to minimize
the chances of pregnancy.
Intrauterine device (IUD). This device is commonly known as Copper T. This
method does not demand to follow any regular routine like taking pills. It is a small
device made of metal, plastic or copper that is inserted in the uterus of a woman who
does not plan an increase in her family for some time. It prevents fertilization by
restricting the sperm to enter the vagina, and thus prevents pregnancy for five to ten
years. This device should be used under the guidance of a medical practitioner only.
Cervical cap. It is a cup-shaped rubber device that is flexible enough to fit over
the cervix that prevents the sperms from entering the uterus. Spermicidal are used with it
that make the sperms inactive before they enter the uterus in any case.
Family Planning Methods for Men
According to Tiwari (2010), these were the popular family planning methods
which are used by the people practicing family planning and accordingly, it is always
advised to consult a specialist before adopting any of these because of so many side
effects associated to them.
Condoms. This birth control option is for men, but now female condoms are also
available. When used by males, this contraceptive method acts as a wall between the
sperms and the egg. It does not allow the sperms to establish a contact with the egg and
14
thus, prevents pregnancy. Apart from being one of the effective methods of birth control,
it also prevents many sexually transmitted diseases (STD).
The pills. This contraceptive pill for men involves synthetic hormone gestate or
desogestrel along with the other hormone, testosterone. It is one of the most effective and
promising family planning method and the studies have proved that the sperm count is
dropped to zero when pills are consumed daily. The reverse effect may take few weeks to
be more effective. But, this too has its own side effects like weight gain and shrinking of
testicles.
Chemical sterilization. In chemical sterilization, a chemical through injection is
introduced in the body. In this mild invasive procedure the resultant scarring prevent the
sperms to pass out from the body. This method might take a long time to be effective and
has some side effects associated too because of the chemicals.
Natural Family Planning Methods
According to Tiwari (2010), these are the natural family planning that still exists
nowadays. It is done by the couples to prevent pregnancy but it is not as effective as the
contraceptive methods.
Withdrawal. This is a natural birth control method where the male partner
withdraws the penis the moment before the ejaculation during the process of sexual
intercourse. But, this method does not prevent pregnancy because the liquid secreted
before the ejaculation also contains sperms in little quantity that are more than enough to
fertilize the ovum.
Abstinence. As the name suggests, this method requires the couple to refrain from
intercourse during the ovulation or the fertility period of the female partner. For this the
15
woman has to note down her dates of menstrual cycles and keep a track of the period
when the chances of getting pregnant are the most.
Permanent Family Planning Method
According to Tiwari (2010), these are the examples of permanent family planning
methods.
Vasectomy. This method is for the males who do not plan to have child any more.
This is a simple surgical procedure that requires minor surgery of the tube that carries
sperms to the ejaculatory duct. Vasectomy procedure prevents the sperm from entering
the seminal fluid and thus, prevents pregnancy. But the testis will continue the production
of sperms which will be absorbed by the body itself.
Tubectomy. This method is also known as tubal sterilization which is a permanent
contraceptive method for females. This again is a surgical process like vasectomy in
males. The fallopian tubes that carry eggs from the ovary to the uterus are blocked. This
does not allow the eggs to enter the tubes and thus, inhibits pregnancy.
Operational Definition of Terms
Barangay Health Workers (BHWs). This refers to the midwife and her assistants
working in the Municipal Health Office.
Clients. This refers to the women who have undergone family planning
counseling.
Counseling. This refers to the process of providing family planning information.
16
Flipchart. This is a decision-making aid/tool for clients, a job-aid and reference
manual for providers. This is the one used by the midwife for family planning counseling
in the rural areas.
Providers. This refers to the BHWs who offer counseling to the women practicing
family planning.
Multi- lingual. This refers to the dominant languages used by the clients at home.
These were Kankanaey and Ilokano. Other languages used were Ibaloi and Filipino.
17
METHODOLOGY
Locale and Time of the Study
The study was conducted in Barangay Poblacion, La Trinidad, Benguet (Figs.
1&2). It is situated on the central part of the municipality of La Trinidad. The
municipality has a total population of 103, 367 as of 2011. In barangay Poblacion there
were 17, 228 total number of households. It is the second to the most densely populated
in the municipality and is considered an urban area in La Trinidad.
This barangay was chosen because it is where the Municipal Health Office
(MHO) is located. Ideally, the municipality has 16 Barangay Health Stations (BHSs) and
it handles all other Barangay Health Centers in the Municipality. According to the MHO,
this barangay has the major number of people practicing family planning. This
Community Health Center is a recipient of the reproductive programs of the DOH and is
using the Decision- Making tool Flipchart.
The study was conducted from December 2011 to February 2012.
Respondents of the Study
There were three Barangay Health Workers (BHWs) who served as the Key
Informants of the study. They were the midwife, Eufemia Guzman and two health care
volunteers, Thelma Pasi and Garell Olagat. Since they have been using the flipchart in
counseling, they were described as the Providers.
Also, 40 female respondents who were practicing family planning were chosen
through purposive sampling. The criterion in choosing the respondents was that they
should have undergone counseling in the Municipal Health Office with the use of the
flipchart by the Providers.
18
Subject of the Study
The flipchart is titled, “Decision- making Tool for Family Planning Clients and
Providers”. It is an aid for clients for it is a reference manual and a training resource for
providers. With one page for the client and a corresponding page for provider, it has
helpful pictures like the appearance of the different methods, and the side effects. It also
include key points for the provider that serves as guide to address the need of the clients,
and detailed reference information that covers 14 family planning methods. The methods
include Intraurine Device (IUD), Cervical cap, Chemical sterilization, Pills, Mini- pill,
Injectables, Implants, Vasectomy, Condoms, Vaginal Methods, Lactating Mothers
(LAM), Tubectomy, Withdrawal, and Abstinence .
Topics include were medical eligibility criteria, side-effects, when to start, and
how to use each family planning method.
The flipchart has 232 pages, landscape in its layout and with a size of 10.84” x
7.50”.
For the pages, they consistently used Arial font style with a size of 22 for its
descriptions. While the headline is double the size of the descriptions. Generally, there
were six colors in the flipchart. These are red, yellow, blue, green, violet, and pink.
Graphics were used to support the information in the flipchart.
Front cover included: WHO family planning cornerstone logo, DRHR- WHO
logo, and John Hopkins Bloomberg school of Public Health logo.
19
Figure 1. Map of Benguet showing the location of La Trinidad
20
Figure 2. Map of La Trinidad showing the location of the study
21
Data Collection
The study was conducted in Barangay Poblacion, La Trinidad, Benguet where the
Municipal Health Office (MHO) is located. Data were collected during the schedule of
family planning in the MHO scheduled every Tuesdays and Thursdays. Respondents
were asked by the researcher using Interview schedule. A print out copy of the flipchart
was shown to them as a reference in replace of the original flipchart. Also, Key
informants were interviewed using guide questions.
The researcher observed that there was great number of clients coming to the
center in the morning schedules of check- up than in the afternoon.
Data to be Gathered
The data gathered were the socio-demographic profile of the respondents which
were in terms of age, address, language spoken, occupation, sex, civil status, religion,
number of children and educational attainment; the effectiveness of Decision- Making
tool in terms of Comprehensibility, Attractiveness, Acceptability, Self involvement,
Persuasion; the common problems encountered by the provider in using the tool and, the
suggestions of the respondents for the improvement of the Decision- Making Tool.
Data Analysis
The data and information gathered were organized, tabulated using frequency
counts and percentages. Data were also summarized and were presented in a narrative
form. Key Informants voices towards the flipchart were also use in the results of the
study to validate the evaluation of the clients towards the material. Also, other researches
were also used to support and compare the result of the study.
22
RESULTS AND DISCUSSION
Socio- demographic Profile of the Respondents.
Table 1 shows the socio- demographic profile of the respondents. These were in
terms of age, address, language spoken, occupation, sex, civil status, religion, number of
children and educational attainment.
Age.
The data shows that majority (22) of the respondents was aged 26-35, 10
were aged 15-25 and 8 were aged 36-45.
This implies that among the respondents, those who were 30-35 years old were
more involved in practicing family planning in MHO.
Civil status and Sex. Results show that almost all of the respondents were married
(39) and were female (38). Only 2 of them were male. This implies that married couples,
especially the females were the most active participants in family planning counseling.
This supports Lugue and De Leon (2001) stating that at the most basic level,
family planning programs involved women more often than men as acceptors of
contraception. It is essential that women be involved not merely as acceptors of this or
that contraceptive device, but as makers of decisions and active participants on an equal
basis with men in the formulation of policies which will profoundly affect their lives.
As to the role of being wives and mothers, it is still very important that men
should be involved in the family planning programs because as married couples they do
not just desire for parenthood but also the responsibilities involved.
Languages spoken. Results show that the respondents were multi-lingual.
Majority (22) of the respondents knew how to speak Ilocano and Kankana-ey.
23
Table 1. Shows the Socio- demographic Profile of the Respondents
CHARACTERISTICS FREQUENCY
(n=40)
PERCENTAGE (%)
Age
15-25
10
25
26-35
22
55
36-45
8
20
Total 40
100
Sex
Female
38
95
Male
2
5
Total 40
100
Civil Status
Married
39
97.5
Single
1
2.5
Total 40
100
Educational Attainment
College Graduate
14
35
College Level
11
27.5
High School Graduate
7
17.5
High School Level
4
10
Elementary Graduate
4
10
Total 40
100
Occupation
House wife
25
62.5
Self- employed
13
32.5
Government employed
2
5
Total 40
100
Language Spoken
Ilocano
22
55
Kankanaey
22
55
Ibaloi
12
30
Tagalog
4
10
Address
Buyagan
16
40
Poblacion
5
10
Puguis
4
5
Betag
4
10
Pico
3
2.5
24
Table 1. continued…
Bineng
2
2.5
Balili
2
2.5
Alno
1
7.5
Ambiong
1
2.5
Wangal
1
5
Shilan
1
12.5
Religion
Roman Catholic
21
52.5
Born Again
9
22.5
Anglican
5
12.5
UCCP
2
5
Lutheran
2
5
INC
1
2.5
Address.
Most of the clients (17) were residents of Buyagan. The rest of the
clients were distributed to the other barangays.
This implies that clients near MHO were the ones regularly coming in the center
for check- ups.
Occupation. Majority of the respondents (25) were housewives. This implies that
women were the ones actively attending counseling in the MHO because men were the
ones working for the family.
Educational
attainment. Among the 40 respondents, (14) finished college and
(11) of them reached college level. This implies that most of the clients were able to read
and write.
Religion. As to the religion of the 40 respondents, majority (52.5%) belonged to
the denomination of Roman Catholic (RC).
Significantly, most of the respondents were RC and using family planning
contraceptives or methods.
25
Number of children. As to the number of children of the 40 respondents, (13) of
them have one child.
Based on the results of the study, it shows that most Catholic members were the
active participants of family planning using contraceptive methods. The same
respondents noted that using contraceptives has a good effect because they only have one
child. Therefore, religion for them is not a reason not to use contraceptive.
This is in contrast with the study of Lugue and De Leon (2001), that in the
teachings of the RC church, it is sinful to attempt to control or regulate the generative
process of child- bearing and aided by the influences of family mores and traditions in the
rural areas. Children are considered signs of God’s blessing.
Evaluation of the Respondents on the Flipchart
Comprehensibility.
Based from the results of the study, there were no words or
sentences that were not understood. All of them understood all the words used in the
content of the flipchart. The respondents even commented that some terms used like
“vomiting and nausea” were easily understood because there were pictures that supported
the texts. The respondents said that graphics and illustrations used helped portray the
message of the flipchart. This implies that there were no problems with regards to the
comprehensibility aspect of the respondents in the material.
The researcher believes that pictures are very important in a certain medium to
achieve effective and a more comprehensive communication. However, words that are
being used in the material should always be visible through the use of pictures and
illustrations to show the appearance of one thing.
26
This was supported by the website saying that every graphic should have a
purpose. Graphics and photographs are very important components of a material because
they add interesting visuals to the material, helping the audience to get the message
across (Hess et al., n.d).
Attractiveness.
Table 2 shows that great majority (92.5%) of the respondents find
the decision- making flipchart attractive. Table 3 supports this result in terms of the
reasons for attraction of the flipchart. Among the 40 respondents, 19 (47.5%) of them
said that with the presence of illustrations or the pictures, it made them perceived the
flipchart to be attractive because the material has simple and visible illustrations. Eleven
(27.5%) of them were attracted with the font style and font size used because according
to the respondents letters used are clear and easily read. Nine (22.5%) said that the colors
of the material are pleasing to the eyes and 5 (12.5%) of them said that they perceived the
layout to be attractive because according to the respondents, the arrangement or
alignment of the pictures were well organized and well presented.
The respondents perceived the material to be attractive because of the pictures,
colors, font styles and layout. This means that the respondents were dependent enough to
the given designs of the material. What they see in the material is not always what they
perceived to be attracted with because all the elements enumerated by the respondents
were presented in the flipchart regardless to their knowledge in flipchart design.
On the other hand, there were some of the respondents who perceived the material
to be not attractive. According to one respondent, the picture in the flipchart like
“implants” was not familiar to her. This can be reflected in the flipchart that “implants”
did not have a page in the flipchart and so it was not well explained to the clients.
27
Another respondent commented that she did not appreciate the pictures in the material
because according to her, they were not eye catching.
Table 2. Evaluation of the respondents on the effectiveness to the flipchart
EFFECTIVENESS
FREQUENCY (n=40) PERCENTAGE (%)
Attractiveness
Material was attractive
37
92.5
Material was not attractive
3
7.5
Acceptability
Elements are annoying/offensive
2
5
Elements are not offensive
38
95
Content
Believed in the flipchart
38
95
Did not believe in the flipchart
2
5
Self-Involvement
Flipchart was written for them
40
100
Persuasion
Try the recommended FP method
35
87.5
Will not try the recommended
5
12.5
method
TOTAL 40
100
Table 3. Respondents’ perceived reasons for attraction to the flipchart
REASONS
FREQUENCY (n=40) PERCENTAGE (%)
Illustrations/pictures are simple and
19
47.5
visible
Font styles and size used are easily read
11
27.5
Colors used are pleasing to the eyes
9
22.5
Well organized presentation of elements
5
12.5
* Multiple answers
28
In general, the flipchart for the respondents was attractive because it has all the
necessary elements needed as Cadiz mentioned.
According to Cadiz (1991), an important tip in using words in the visual media
pertains to their appearance: words must be legible or readable and legibility is
determined by several factors like size which based on letter height, width and thickness.
As general rule, the shorter, narrower and lighter letterings are less legible. However,
letter size should also be determined by the importance that a word plays in the visual
medium.
center of interest; follows normal left to right and top to bottom reading/ viewing
directions or patterns; balance and blend the different elements; simple and with empty
breathing spaces.
Type of illustrations according to Mindanao training Resource Center (n.d) must
be big and bold with minimum of details. Illustration must depict the idea or message;
and select the best types of line or stick figure, cartoons, stylized drawings and
photographs.
Acceptability. The result of the study on the respondents’ evaluation on the
acceptability aspects shows that great majority (95%) perceived the material inoffensive
as shown earlier in Table 2. This includes the evaluation of the respondents in the content
of the flipchart.
Table 4 shows that majority (85%) of the respondents said that words/pictures
used in the flipchart were normally and plainly used for educational purposes. According
to the respondents, the family planning methods were all common to them regardless of
their exposure to the material because they were using some of the methods. In addition,
29
Table 4. Respondents’ perceived reason for the acceptability to the flipchart
REASONS
FREQUENCY (n=40) PERCENTAGE
(%)
Words/pictures were used for
34
85
educational purposes
Illustrations were relevant to the topic
10
25
Attitudinal basis of acceptance
3
7.5
*Multiple response
respondents said that it is better for them to see the appearance of all these methods rather
than being ignorant about it. Ten (25%) of the respondents said that illustrations
specifically the expressions of the people in the pictures support the information in the
flipchart. Based also on the data, there were 3 (7.5%) respondents who perceived the
material to be inoffensive because of their attitudinal basis of acceptance. The basis of the
researcher was according to the respondents statements also. They said that it depends on
how the person consider all these things like being open- minded with regards to this
issue and also in the practicality of life nowadays. The respondent further noted, “Wala
na aarte- arte ngayon”.
This may imply that all pictures used in the flipchart provided impact to the
respondents. The two respondents, who said that they were annoyed in some of the
pictures in the flipchart, identified the pictures of the pregnant and breastfeeding mothers
to be offensive because they were not use to see them in the picture.
Content. As to the content of the material, nearly all (95%) of the respondents
believed the flipchart.
This implies that the flipchart was a credible source of information about family
planning. The two who did not believe the content of the material argued that it rested
30
upon the married couple’s decision whether or not to practice family planning and
acknowledged that the method did not work all the time.
This shows that the respondents had a parameter in believing the content of the
flipchart and this was shown in the result that they must prove it their selves first.
Flipchart as visual aids according to Brown (1985), the amount of information or
the content intended to be communicated in the material should be brief and should
highlight only the salient words or phrases necessary to make a point.
Self- involvement. As seen in Table 2, all of the respondents perceived that the
content of the material was written for them.
Hence, the self- involvement aspect of this flipchart succeeded. As reflected in the
results, the flipchart was effective in making the respondents more involved in the family
planning counseling. The BHWs validated these findings when all of them said that
during the presentation their clients often ask questions regarding the content of the
flipchart which they also tried to explain. Moreover the BHWs also added that when their
clients ask questions regarding family planning methods they observed that the interest of
the clients regarding the topic increases and that the clients were able to voice out their
insights regarding the problems that family planning is trying to address. This finding
supports the idea of Cadiz (1991) where she stated that in order to encourage more
participation of learners the presentor should allow learners to reflect on the given
problems in order to let the learners realize by themselves the solutions to such problems
instead of directly telling the learners the solution. This further encourages learners to
reflect, raise questions, and think of solutions creatively, not just remain as passive
learners.
31
Persuasion. As seen in Table 2, results show that that majority of the respondents
(87.5%) stated that they will try the recommended family planning method. However,
there were five who said that they will not try the recommended family planning method
because the contraceptive methods have side effects.
Based on the result of the study, this implies that almost all respondents felt right
to be part of the family planning practice and they were willing to alter from the
traditional family planning because they were now open for contraceptive methods and
even natural methods knowing their advantages and benefits from it.
This supports the study of Cadiz (1991) stating to adequately arrest learners’
attention, arouse and sustain the interest of the audience; presenters must explain why the
information they share is important by relating it to learners’ needs, problems or future
situations that they may encounter. This is part of applying the basic communication
principle “know your audience” and the concept of empathy. To be an effective presenter
must be learner- oriented. In the case of the La Trinidad MHO the respondents said that
they were persuaded by the explanation of the BHWs because as the respondents read the
content of the flipchart the BHWs coupled the content of the flipchart with oral
explanations wherein they related the content of the flipchart to the situation of the
respondents.
General Evaluation. Multiple answers were gathered in the general evaluation to
the flipchart. Table 5 shows that among the 40 respondents, there were twenty- one of
them who said that it was good because it helps married couples in choosing what family
planning method to use, eleven (27.5%) of the respondents said that it was good for
educational purposes. Nine (22.5%) of them said that the flipchart was simple and the
32
content was easily understood, four (10%) of them said that it was satisfactory and
informative. Respondents were satisfied because the flipchart helped and taught them
how to do family planning and lastly, only one said that the flipchart has well laid- out.
Table 5. General evaluation of the respondents to the flipchart
GENERAL EVALUATION
FREQUENCY PERCENTAGE
(%)
It helps married in FP decision-making
21
52.5
It
is
purposeful
educationally
11
27.5
Flipchart was simple and
easily
understood
9 22.5
Flipchart was satisfactory
and
informative 4 10
*Multiple answers
All the general evaluations of the respondents were positive. Thus, the flipchart
used in the MHO were very useful and effective in counseling about family planning.
The researcher generally rated the flipchart good as it satisfied almost all the basic
elements in designing a material. Although the material violated the criteria mentioned by
Cadiz (1991) regarding the maximum of colors for every page, still, it was effective as
supported by the evaluation of the respondents. The respondents said that it would have
been better if they used photographs of the artificial method and not just graphics.
Problems Encountered by the BHWs
Some clients are not attentive during the counseling. According to the key
informants, they made sure that they explained well the content of the flipchart but their
33
clients tend to forget the following instructions and the process being instructed them so
they ended up not continuing what is advised to them.
Financial capability of the clients. The BHWs may explain well the family
planning method and clients may easily accept what method they wanted to use but they
can only use what is available to them or what they can afford. In situations like these,
there must be a continuous in taking of pill tablet and it should be completed to be
effective, but the problem arises to the clients. Clients would say to the midwife what
other method they can suggest due to financial constraint.
This implies that the decision- making tool flipchart remained to be a tool as
stated in the study’s rationale where it seeks to guide the providers’ response to the
client’s acclaim and preferences at each step in the counseling process.
The study found out that financial reason was also a factor why such family
planning contraceptives were disregarded by some respondents to go on family planning.
Moreover, the midwife found it difficult to explain the tool to the respondent because of
this factor. She gave recommendation of a good method for a client’s situation but she
cannot do anything about it but to really help the clients give appropriate points regarding
family planning.
Client’s attitude toward the method. According to the midwife, the agreement
between married couples depends on the acquisition of a certain method. For the
midwife, it is hard for her to insist what is good for the clients because often times it is
unacceptable to the couples or offensive to the other and accordingly, this is only a guide
for decision- making. On the other hand, clients also consider the health risks that will
34
cause them if they chose to use the method. Otherwise, clients insist what they like and
the midwife cannot do anything.
The result of the study showed that majority of the female participants was the
ones active in family planning; this did not mean that the absence of males in family
planning is the reason. This means that male partners were the ones working because
most female were housewives and it did not mean that they were not active participants
in family planning. It can be implied that the conversation of the couple during bedtime
were also considered as part of the planning decision- making.
In line with this, the researcher suggests that there should be more motivation
done on the part of BHWs to motivate both couples attends family planning counseling.
Clients’ belief system. According to the key informant, older clients were hardly
convinced in terms of explaining a certain method because for some they still believe in
their own beliefs and that the midwife found it hard to convince them. It shows that
clients’ belief system was also a factor which made the midwife difficult to explain the
flipchart. Such belief system included: Social environment, Culture, and Religion.
Social environment. A person’s social environment usually has more influence on
family planning decisions than the attributes of specific contraceptives. When clients
were asked to give reason for their choice of a specific family planning method, most of
them cited the attitudes of their spouse and their neighbors. People chose contraceptive
methods that are commonly used in their community because of its social acceptability
and they claimed to know more about these methods.
Culture. Household and community influences can be so powerful that they can
obscure the line between individual desires and community norms. For instance, in some
35
culture, according to David (2008), many women reject contraception because bearing
and raising children is the path to respect and dignity in the society. This can be reflected
from the result of the study that most women use contraception because having small
families is the norm.
Religion. According to the BHWs they observed that the religious beliefs of their
clients often limit the full participation of the clients in family planning. This supports the
findings of Dixon-Meuller (1999) as cited by David (2008) that religious beliefs accord
their preferences about family size, family pressures to have children and whether to have
family planning in their customs.
The researcher observed that the BHWs who were the providers were subjecting
to the choice of the clients. In a way, it was good because the flipchart encourages only
the providers to give accurate, relevant and up-to-date technical information at
appropriate points and not to force the clients to follow their recommendations.
Suggestions of the Respondents for the Improvement of the Flipchart
The clients were asked to suggest for the improvement of the flipchart. According
to them, the BHWs should think of other ways on how to promote educational family
planning. Also, they suggested that texts in the flipchart should be lessened into a shorter
one. Information should go straight to the point as they were also requesting a handy one
so that they could always read it at home.
In addition, clients suggested that the flipchart must be written in multiple
language translations especially in vernacular so that they may understand it more easily.
The clients also suggested lectures to be done in groups rather than one on one so that
36
they could help each other in following the instructions in using a method. Finally, the
clients said that it is best if the providers show actual samples during counseling.
37
SUMMARY, CONCLUSIONS AND RECOMMENDATIONS
Summary
The study on the evaluation of the decision- making tool flipchart (DMT) in
promoting family planning in Poblacion, La Trinidad, Benguet was conducted from
December 2011 to February 2012. Generally it evaluated the effectiveness of the DMT
Flipchart in promoting Family Planning. Specifically it identified the socio- demographic
profile of the respondents; determined the effectiveness of the Decision-making Tool
Flipchart in terms of Comprehensibility, Attractiveness, Acceptability, Self involvement
and Persuasion; determined the problems encountered by the BHWs in explaining the
tool; and determined the suggestions of the respondents for the improvement of the
Decision-making Tool.
An interview schedule was used in obtaining data from the respondents in
Municipal Health Office. Also, guide questions were used in obtaining data from the
Barangay Health Workers.
The respondents of the study were three Barangay Health Workers which include
one midwife and two health care volunteers. These three BHWs have seen and used the
flipchart in counseling.
Also, 40 respondents who were practicing family planning were chosen through
purposive sampling. These respondents have undergone counseling in the Municipal
Health Office.
Majority of the respondents interviewed were female and there were only two
male. On the comprehension, all of them claimed that words were easily understood. It
appeared to be comprehensible enough to the respondents while majority found the
38
decision- making flipchart attractive. In terms of acceptability, majority perceived that
there were no annoying words about the flipchart.
Further, majority of the respondents believed in the content of the material and
was written for them. Lastly, majority responded that they will try the recommended
family planning method.
As to their general evaluation, they said that it was good because it helps the
married couples in choosing what they wanted to use for family planning, it was also
good for educational purposes, simple and easily understood, and was satisfactory and
informative. The respondents were satisfied of knowing some information on DMT for
them to be aware on how to do family planning and lastly, it was lay- outed well.
The following were the problems encountered by the BHWs in explaining the
tool: respondents were not attentive during the counseling, financial capability of the
clients, client’s attitude towards the method and clients are hard to persuade due to belief
system.
Finally, the respondents suggested that there must be other ways in promoting
educational family planning. Clients suggested lessening the information into a shorter
one and getting straight to the point. It must be written in multiple language translations
especially in vernacular ones, lectures must be done in groups aside from one on one, and
show actual samples of the artificial family planning method during the counseling.
Conclusions
Based on the results of the study, the following conclusions were derived:
1. The effectiveness of the Decision- making Tool Flipchart does not only depend
on the colors, graphics and texts but also on the effective delivery of the one explaining
39
the flipchart.
2. The flipchart is an effective medium in helping people make choices and
decisions.
3. Clients’ decision in choosing a family planning method does not rely only on
the flipchart but could be affected by their personal circumstances like their attitudes,
financial status and belief system.
Recommendations
Based from the conclusions, the following recommendations were derived:
1. The flipchart should be retained as a medium of instruction and it needs to be
promoted more not only in the Health Center but also in the community at large.
2. The use of alternative medium like audio- visuals or recorders for more
interactive discussions between clients and providers may be considered by the DOH.
3. It is recommended that BHWs should strategize other ways on how they can
motivate both couples attend family planning counseling.
40
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100-146.
LUGUE, Q. L. and M. F. DE LEON. 2001. Textbook on Family Planning: with an
overview of population trends, problems and policies. REX Book Store, Manila,
Philippines.
Pp.
90-138.
MINDANAO TRAINING RESOURCE CENTER. n. d. A training manual on
Development Communication. Davao City. Mindanao Training Resource Center
Institute of Primary Health Care- Davao Medical School Foundation. Pp. 109-
112.
POPULATION INFORMATION PROGRAM, CENTER FOR COMMUNICATION
PROGRAMS. 1994. Population Reports. The Johns
Hopkins School of Public
Health, 22,2. Population reports Articles database. Retrieved October 18, 2011
from http://info.k4health.org/pr/j40/j40chap6.shtml.
41
QUINTONG, J. 1994. Healh Benefits of Family Planning. In: Cabanos, C., F. Cawaon,
E. Dela Cruz, J. Lalo, O. Medrano and J. Pantig. 1994. Family Planning in the
Philippine Setting: An Anthropology. University of the Philippines: Manila. Pp.1-
10.
REGIONAL INFORMATION TRAINING CENTER. n.d. Pretesting Instructional
Materials. Benguet State University Pp. 1, 17-19.
TIWARI, M. 2010. Family Planning Methods. [Electronic version]. Journal of
Bibliographic
Research. Retrieved October 10, 2011 from
http://www.buzzle.com/articles/family
planning-methods.html.
WORLD HEALTH ORGANIZATION-DEPARTMENT OF REPRODUCTIVE
HEALTH AND RESEARCH. 2005. Decision-making tool for family planning
Clients and providers.
Retrieved October 18, 2011 from
http://www.who.int/reproductivehealth/publications/family_planning/9241593229
index/en/index.html.
APPENDIX A
Study on the Effectiveness of the Decision Making Flipchart
(Interview Schedule for Respondents)
Respondent No. ___
I. Socio- Demographic Profile
Name (Optional): __________________________
Sex: ______Male
Age: __________________
______Female
Address:_________________________________
Civil Status:_____________
Language Spoken: _________________________ Religion: _______________
Occupation: ______________________________
No. of Children: __________
Educational Attainment: Please Put a check ( √ ) on the space provided for.
_________Elementary Level
_________ Elementary Graduate
_________High School Level
_________ High School Graduate
_________College Level
_________College Graduate
II. Effectiveness of the Decision- Making Flipchart
The following questions measure the effectiveness of the flipchart. Please fill up
the needed information.
a. Comprehension
a. Please go through the material page by page. Are there any words or sentences
that you don’t understand? Kindly check the page number and list down the words or
sentences that you don’t understand.
Page Number
Vague words/Sentences
b. Attraction
43
1. Do you find the Decision- Making Flipchart attractive?
a.
Yes
b. No, Why Not? ___________________________________________________
2. If yes, what makes you perceive the flipchart to be attractive?
a. layout
b. type of letter
c. others (Please Specify)
3. Why do you perceive the material to be attractive?
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
4. If no, what makes you perceive the flipchart to be not attractive?
a. layout
b. type of letter
c. others (Please Specify)
5. Why do you perceive that the flipchart is not attractive?
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
c. Acceptability
1. Do you perceive that there is anything annoying or offensive about the flipchart?
a.
Yes
b. No, Why Not? __________________________________________________
2. If yes, please identify them _________________________________________
__________________________________________________________________
44
3. Do you believe in the content of the flipchart?
a.
Yes
b.
No
4. If no, why not? ___________________________________________________
__________________________________________________________________
d. Self Involvement
1. Do you perceive that this flipchart is written for you?
a.
Yes
b.
No
2. If no, why not? ___________________________________________________
__________________________________________________________________
e. Persuasion
1. Will you try the recommended Family planning method?
a.
Yes
b.
No
2. If no, why not? ___________________________________________________
__________________________________________________________________
f. General Evaluation of the Flipchart
1. What can you say about the flipchart? _________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
III. SUGGESTIONS FOR THE IMPROVEMENT
Please write your suggestions for the improvement of the Decision- Making Tool.
________________________________________________________________________
________________________________________________________________________
45
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
46
APPENDIX B
Study on the Effectiveness of the Decision Making Flipchart
(Guide Questions for Key Informants)
I. Socio- Demographic Profile
Name (Optional): ___________________________
Sex: ______Male
Age: _____________________________________
______ Female
Address: __________________________________
Civil
Status:___________
Language Spoken: __________________________
1. In promoting family planning, what are the communication strategies you
employ?
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
2. What materials are you using in promoting family planning?
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
3. Is the Decision-Making Tool for family planning effective?
____
Yes
____No
If Yes, Why? ______________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
If No, Why Not? ___________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
47
4. What do you think are the factors affecting the clients’ preference in choosing
certain family planning method
_____________________________________________________________________
____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
5. What are the common problems that you encounter in explaining the tool?
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
6. What are your suggestions for the improvement of the Decision- Making Tool
Flipchart?
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
SORIANO, JUNELYN T. MARCH 2012. Evaluation of the Decision- making Tool
Flipchart in Promoting Family Planning in Barangay Poblacion, La Trinidad,
Benguet.Benguet State University, La Trinidad, Benguet.
Adviser: Igrelyn P. Pinos- an, BSc.
ABSTRACT
The study on the evaluation of the decision- making tool flipchart (DMT) in
promoting family planning in Barangay Poblacion, La Trinidad, Benguet was conducted
from December 2011 to February 2012. Generally, it evaluated the effectiveness of the
DMT Flipchart in promoting Family Planning. Specifically, it identified the socio-
demographic profile of the respondents; determined the effectiveness of the
Decision-making Tool Flipchart in terms of Comprehensibility, Attractiveness,
Acceptability, Self involvement and Persuasion; determined the problems encountered by
the midwife in explaining the tool; and determined the suggestions of the respondents for
the improvement of the Decision-making Tool.
An interview schedule was used in obtaining data from the 40 respondents
practicing family planning in Municipal Health Office. Also, These were chosen through
purposive sampling.Guide questions were used in obtaining data from the three Barangay
Health Workers.
Results show that, all of the respondents claimed to have comprehended and easily
understood the words. Majority of them also find the decision- making flipchart attractive
while rest thought otherwise. Likewise,majority of them accepted the words used in the
Evaluation of the Decision- making Tool Flipchart in Promoting Family Planning in
Barangay Poblacion, La Trinidad, Benguet / Junelyn T. Soriano. 2012
material and believed in its content.Most of the respondents alsoperceived that the material
was written for them and were persuaded enough to give the recommended family
planning method try.
The BHWs stated that the following problems they have encountered when it comes
to communicating the tool:clients are not attentive during the counseling; were not
financial capable;and were hard to be persuaded due to their different belief system.
The researcher recommends that the flipchart should be encouraged as a medium of
instruction not only in the Health Centers but also at the community at large. The use of
audio- visuals or recorders for more practice discussions between clients and providers
may be considered by the DOH. It is also recommended that BHWs find ways on how they
can motivate both couples or help each other attend family planning counseling.
Evaluation of the Decision- making Tool Flipchart in Promoting Family Planning in
Barangay Poblacion, La Trinidad, Benguet / Junelyn T. Soriano. 2012
TABLE OF CONTENTS
Page
Bibliography. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i
Abstract . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . .
i
Table of Contents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .iii
INTRODUCTION . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . .
1
Rationale . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1
Statement of the Problem. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3
Objectives of the Study . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3
Importance of the Study . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4
Scope and Limitation. . . . . . . . . . . . . . . .. . . . . . . . . . . . .. . . . . . . . . .
4
REVIEW OFLITERATURE . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . .
6
Family Planning . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . .
6
Communication Campaigns . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . .
6
Potentials and Limitations of Flipchart . . . . . . . . . . . . . . . . . . . . . . . . . .
7
Components of Effectiveness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
7
Evaluation of Campaign Effectiveness. . . . . . . . . . . . . . . . . . . . . . . . . . .7
Flipchart Design . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Flipchart Utilization Techniques.. .. . . . . . . . . . . . . . . . . . . . . . . ... . . . 9
Presentation Tips for Effective Communication . . . . . . . . . . . . . . . . .
9
Flipchart as an Effective Trainer- Learner Aid . . . . . . . . . . . . . . . . . .
11
Factors to Consider in Using Flipchart . . . . . . . . . . . . . . . . . . . . . . . .12
Family Planning Methods for Women . . . . . . . . . . . . . . . . . . . . . . . . .
12
v
Family Planning Methods for Men . . . .. . . . . . . . . . . . . . . . . . . . . . . .
13
Natural Family Planning Methods . . .. . . . . . . . . . . . . . . . . . . . . . . . .
14
Permanent Family Planning Method. . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Operational Definition of Terms. . . . . . . . . . . . . . . . . . . . . . . . . . . . .16
METHODOLOGY. . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . .
17
Locale and Time of the Study. . . . . . . . . . . . . . . . . . .. . . . . . . . . . .. .
17
Respondents of the Study . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . .
17
Subject of the Study. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
18
Data Collection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . .
21
Data to be Gathered. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
21
Data Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
21
RESULTS AND DISCUSSIONS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . .
24
Socio-demographic Profile. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
Evaluation of the Respondent
on the Comprehensibility of the Flipchart. . . . . . . . . . . . . . . . . . . . . . . . . . 25
Evaluation of the Respondents
on the Attractiveness of the Flipchart . . . . . . . . . . . . . . . . . . . . . . . . . . .
26
Evaluation of the Respondents
on the Acceptability of the Flipchart . . . . . . . . . . . . . . . . . . . . . . . . . . . .
28
Evaluation of the Respondents
on the Self- involvement of the Flipchart . . . . . . . . . . . . . . . . . . . . . . . .
30
Evaluation of the Respondents
on the Persuasion of the Flipchart . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
31
General Evaluation of Flipchart. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
31
Problems Encountered . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
32
Suggestions of the Respondents. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
SUMMARY, CONCLUSIONS AND RECOMMENDATIONS . . . . . . . . . . . . . 37
Summary . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . 37
Conclusions . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
Recommendations . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
LITERATURE CITED. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40
APPENDICES
A. Communication Letter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42
B. Interview Schedule for the Respondents . .. . . . .. . . . . . . . . . . . . . .
43
C. Guide Questions for Key Informants . . . . . . . . . . . . . . . . . . . . . . . . . . 47
LIST OF TABLES
Table No.
Page
1
Socio- demographic Profile of
the Respondents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
23
2
Respondents Evaluation on the Effectiveness
to the Flipchart. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . 27
3
Respondents Perceived Reasons
for Attraction to the Flipchart. . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . 27
4
Respondents perceived reasons
for Acceptability to the Flipchart. . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . 29
5
General Evaluation of the Respondents
to the Flipchart . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
LIST OF FIGURE
Figure
No.
Page
1
Map of La Trinidad Benguet
showing the locale of the study . . . . . . . . . . . . . . . . . . . . . . . . . 19
2 Map of Barangay Poblacion, La Trinidad, Benguet
showing the locale of the study . . . . . . . . . . . . . . . . . . . . . . . . . 20
1
INTRODUCTION
Rationale
Information, Education and Communication (IEC) materials are needed for
effective information dissemination. According to PIPCCP (1994), IEC activities bring
people and family planning programs together. Communication activities give people the
information they need to make informed choices about using contraception and other
aspects of reproductive health. In family planning as in many other development
activities including health and agriculture, communication campaigns create awareness,
increase knowledge, and build public approval of new ideas and practices.
The World Health Organization (WHO) is the directing and coordinating
authority for health within the United Nations system. It is working with the Department
of Reproductive Health and Research (DRHR) to achieve access to sexual and
reproductive health in order to meet the needs of diverse populations, particularly the
most vulnerable ones. Their principal function is to support the institutions in diffusing
information to the public and creating awareness of their activities (WHO- DRHR, 2005).
In the Philippines, the Department of Health (DOH) is the principal health agency
responsible for ensuring access to basic public health services to all Filipinos. Working
under this agency are the Barangay Health Workers (BHWs). They are health care
providers who have undergone basic training program under any accredited government
or non- government organization and who render primary health care services in the
community.
Among the recipients of the reproductive programs of DOH is Municipal Health
Office (MHO) of La Trinidad. This is the center-most Health Center in the Municipality.
Evaluation of the Decision- making Tool Flipchart in Promoting Family Planning in
Barangay Poblacion, La Trinidad, Benguet / Junelyn T. Soriano. 2012
2
It has only one midwife in- charge and seven Barangay Health Workers (BHWs). They
function to provide the needs of the people especially in family planning program in the
said community.
In promoting this practice, the health care provider specifically the midwife is
using the Decision-making tool Flipchart. This tool for family planning clients and
providers is a new counseling resource developed by the World Health Organization and
the INFO Project at John Hopkins Bloomberg School of Public Health Center for
Communication Programs and was adopted by the Department of Health in our country
as one of the aid material in their promotion of family planning.
The flipchart is a decision-making aid for clients and a reference manual for the
providers. It is a training resource with one page for the client and a corresponding page
for provider. It has helpful pictures, key points and detailed reference information
covering 14 family planning methods. The tool promotes high quality family planning
counseling.
Moreover, the flipchart seeks to improve the quality of family planning
counseling by helping providers apply best practices in client-provider interactions. Also,
it guides providers to respond to the client's expressed wishes and preferences at each
step in the counseling process. Further, this tool encourages providers to give accurate,
relevant and up-to-date technical information at appropriate points. Lastly, it promotes
participation by the clients (Kim et al., 2005).
Thus, this Decision-making Tool Flipchart is an example of an IEC material that
has been used by family planning providers for the past years. However, this flipchart is
seldom used as informational material nowadays because of the emergence of other
3
media used in promoting family planning. Considering its advantages and benefits, there
is a need to evaluate the effectiveness of this medium in promoting family planning to
clients and knowing its importance as a guide to providers.
Statement of the Problem
The study generally evaluated the effectiveness of the Decision-making Tool
Flipchart in promoting Family Planning in Barangay Poblacion, La Trinidad, Benguet.
Specifically, it answered the following questions:
1. What is the socio- demographic profile of the respondents?
2. What is the effectiveness of the Decision- Making Tool Flipchart in terms of?
a.
Comprehensibility
b.
Attractiveness
c.
Acceptability
d. Self involvement
e.
Persuasion
3. What are the problems encountered by the midwife in explaining the tool?
4. What are the suggestions of the respondents for the improvement of the
Decision-making Tool?
Objective of the Study
The study generally evaluated the effectiveness of the Decision-making Tool
Flipchart in promoting Family Planning.
Specifically
it:
1. Identified the socio- demographic profile of the respondents;
4
2. Determined the effectiveness of the Decision-making Tool Flipchart in terms
of:
a.
Comprehensibility
b.
Attractiveness
c.
Acceptability
d. Self involvement
e.
Persuasion
3. Determined the problems encountered by the BHW in explaining the tool;
4. Determined the suggestions of the respondents for the improvement of the
Decision-making Tool
Importance of the Study
The result of this study may help the Municipal Health Office improve their
family planning program through the use of effective IEC materials. In addition, this may
also help the provider improve their interpersonal communication and counseling skills to
their clients. Also, it may be used as a guide to visual designers for lay outing effective
Instructional material. It may also be a help to determine whether flipchart is still
effective and can still be recommended as instructional material for family planning or
can be recommended as minor medium and needs to be supported with other instructional
media.
Scope and Limitations
This study focused on the effectiveness of the Decision-making Tool as a
Communication Information material for promoting family Planning. Also, the factors
5
affecting the clients’ preference in choosing a family planning method after being
exposed with the Decision-making Tool, the problems encountered by the providers in
using the tool and the suggestions of the respondents for the improvement of the
Decision-making Tool were determined.
6
REVIEW OF LITERATURE
Family Planning
Family Planning has been defined as rational, voluntary and moral management
of all the processes of family life including human production. This means that it must be
dictated by reasons and intelligence. It must be a free choice, a practice of man’s God-
given will or violation. And it must be moral so as not to allow doubt and anxiety in
man’s conscience (Lugue and De Leon, 1989).
Family planning use depends on people's private decisions and actions. These
decisions involve individuals, couples, families, and even peer groups. It is not enough
for service providers to know about family planning; rather, all of the people involved in
making family planning decisions, and especially women, need accurate and full
understanding (PIPCCP, 1994).
Family planning according to Quintong (1994) is the conscious efforts of
individuals and couples of reproductive age to regulate/ limit their fertility through the
use of the medically and legally accepted methods of contraception (natural or artificial
means) according to their beliefs, cultural, religious, economic and health circumstances.
This encompasses a responsible attitude among men and women for the outcome
or result of the sexual union such that children are born “not by chance, but by choice”
and that the children are planned, wanted, loved and provided for with the basic human
needs.
Communication Campaigns
According to the Population Information Program, Center for Communication
Programs (PIPCCP, 1994), in family planning programs, communication campaigns play
7
many roles. They make people aware of modern contraception, its proper use, and where
to find services. They counter myths, dispel rumors, and correct misinformation about
modern contraceptives and family planning. They also help link family planning to other
reproductive health care and to broader roles for women. They raise the quality of
services by improving the interpersonal relations skills of providers and by providing
informational materials for clients and providers.
Potentials and Limitations of Flipchart
Non- electronic presentation media or those that are directly shown to an audience
without having to use electronic equipment are relatively cheap and easy to produce.
Many of these media may not last long especially with repeated use (Cadiz, 1991).
Components of Effectiveness
The production of instructional materials according to RITC (n.d.) includes the
following components of effectiveness.
Attraction. It is interesting enough to attract or hold attentions.
Comprehension. It is clear and easily understood.
Acceptability. It does not contain annoying elements, offensive and irritating.
Self- involvement. The message is directed to the target audience.
Persuasion. It is convicting enough to the audience.
Evaluation of Campaign Effectiveness
The effectiveness of the information campaign according to Lugue and De Leon,
(2001) should be evaluated in terms of the meeting the objectives. It can be measured in
terms of four dimensions:
8
a. Audience Coverage
b. Audience Response
c. Communication’s impact
d. Channels of influence and Persuasion
Flipchart Design
In designing flipchart, there are factors to be considered in order to achieve an
organized presentation and enhance the effectiveness of the medium. According to
MTRC (n. d.) these factors must be considered in flipchart design.
Size of page. It must follow “one idea, one visual” principle. It must be easily flip
and handle and it is better if the flipchart is big than small.
Type of illustration. Illustrations must be big and bold with minimum of details.
Illustration must depict the idea or message; and select the best types of line or stick
figure, cartoons, stylized drawings and photographs.
Lettering style and size. Headings, headlines/captions and labels should be at least
1-2 inches high. It is best to use simple lettering style like gothic or block letters. It is also
appropriate to use capital letters for headings/headlines and combine capital and small
letters for caption and labels.
Language levels. Always consider the common language spoken and understood
by audience. Headlines/headings should not be more than seven words. Prefer short,
simple words and be concise.
Layout. Arrange headlines, illustrations, texts or captions in proper sequence or
order. Always aim for simplicity and provide enough space in each flipchart page.
9
Consider dominant areas of the page where you can place the important parts of
the visual.
Color. Use color for contrast and emphasis. Also, use color sparingly; two or
three colors are enough for one single page.
Simplicity and clarity as basic principle.
Flipchart Utilization Techniques
To use the flipchart, there are some of the practical utilization techniques that
providers can use to enhance the flipchart medium. According to MTRC (n. d.), these
techniques must be considered in flipchart utilization.
Keeping the presentation simple and not including too much detail is one.
Secondly, keeping the lettering and visuals simple but large enough for everyone in the
audience to see should also be considered. Third, to place the flipchart where it can be
seen by all its viewers will be good. Fourth, always be sure that the materials or pages are
in their proper sequence and are securely fastened. Fifth, face and talk to the audience,
not to the flipchart. Never block the audience’s view of the flipchart. Sixth, reveal
information only when you are ready to discuss them. And lastly, put summary points on
the separate sheet rather than turning the pages back as you conclude your presentation
(MTRC, n. d.).
Presentation Tips for Effective Communication
According to Cadiz (1991) enhancing and inducing effective learning process, the
educational communicator must be an effective presenter. This means that he must be
adequately arrest learners’ attention, arouse their interest and sustain so that they can
process information presented to them. The following tips must be practiced.
10
a. The presentation must be well- organized, possessing clear transitions to
understand than an unorganized one.
b. Learner participation may be enhanced if the presenter states problem and
guidelines instead of plain solutions. This is to encourage learners to reflect, raise
questions, and think of solutions creatively, not just remain as passive listeners.
c. Presenters must explain why the information they share is important by relating
it to learners’ needs, problems or future situations that they may encounter. This is part of
applying the basic communication principle “know your audience” and the concept of
empathy. To be an effective presenter must be learner- oriented.
d. Presenter must let their communication or learning objectives closely guide
them. Being goal- oriented helps lessen fear among less experienced presenters because it
helps them take their minds from making the right or wrong impressions. Before facing
an audience, he must clarify his mind what his purposes are in meeting them.
e. The proper use of gestures and facial expressions enhances presentation.
f. Humor can spice a presentation and keep the mood right and relaxed. However,
humor must be apt and must not offend learners’ sensibilities. Simply responding to one’s
and learners’ human nature is one way of injecting humor.
g. Surprises can keep learners on their toes. A presenter can maintain learner
interest and stimulate thought by raising controversial issues, drawing unexpected
conclusions, initiating uncontroversial learning activities, showing unusual visual
examples.
h. One paradox in the effective presentation or performance is that of a need to
concentrate and ignore as the same time. The presenter needs to concentrate on his
11
communication objectives and tasks. He must also ignore distractions, such as outside
activities, visible or heard from inside training room. However, they should not be
allowed to keep the presentation off tract in reaching its objectives.
i. The conduct of the presentation cannot be standardized in a rigid manner.
However, certain situation may demand or allow breaking certain pointers in effective
presentation to meet specific learner and presenters’ needs.
Flipchart as an Effective Trainer- Learner Aid
The educational values of the flipchart according to Brown (1985) as cited by
Amadeo (2004) are as follows:
To help concepts. Visual aids can serve as bridges between the concrete and
abstract. Though these qualities, relationships and processes represented symbolically by
words, it helps students to form mental pictures of the realities that they represent.
To arouse and sustain learners’ interest. To help learners experience things
through sensory ways like novelty and variety. Thus, it minimizes monotony and
boredom.
Selecting the materials. This is according to the group’s age, level, intelligence
and experience. Likewise, the legal and ethical aspects, they must be free from bias,
prejudice, distortion, anti-social, attitudes and untruthfulness.
Preparing the group for the visual experience. Motivation should accompany the
preparation. The trainer should discuss the purpose of the activity and suggest points that
will direct attention to key ideas during the activity.
12
Guiding the group through it. This serves as a guide to more fruitful learning. The
trainer can stop at certain points during the presentation to ask questions or to explain to
them what they are experiencing.
Factors to Consider in Using Flipchart
Factors to consider in using flipchart as a visual aids compared with use of a
poster as a teaching material according to Brown (1985) are as follows:
Logistic Problems. Maintain a smooth transition between the presentation and
alternative means for communicating the material.
Setting arrangement. The limitations and the ability of all audience to see the
material.
Time available to cover the material. Time is critical, so the materials should be
developed prior to the actual session.
Amount of information intended to be communicated in the material. The
displayed information should be brief and should highlight only the salient words or
phrases necessary to make a point.
Complexities of the material. Note extensive information during training session
itself.
Family Planning Methods for Women
According to Tiwari (2010), these were the popular family planning methods
which are used by the people practicing family planning and accordingly, it is always
advised to consult a specialist before adopting any of these because of so many side
effects associated to them.
13
Birth control pills. Out of the different family planning methods, this is the most
common and popular artificial method of family planning. This oral contraceptive
restricts the development of the egg and increases the thickness of the uterus cervical
muscles and stops the sperm from reaching the egg. If the regular course of birth control
pills fails, then emergency contraceptive pills can be taken during unsafe sex to minimize
the chances of pregnancy.
Intrauterine device (IUD). This device is commonly known as Copper T. This
method does not demand to follow any regular routine like taking pills. It is a small
device made of metal, plastic or copper that is inserted in the uterus of a woman who
does not plan an increase in her family for some time. It prevents fertilization by
restricting the sperm to enter the vagina, and thus prevents pregnancy for five to ten
years. This device should be used under the guidance of a medical practitioner only.
Cervical cap. It is a cup-shaped rubber device that is flexible enough to fit over
the cervix that prevents the sperms from entering the uterus. Spermicidal are used with it
that make the sperms inactive before they enter the uterus in any case.
Family Planning Methods for Men
According to Tiwari (2010), these were the popular family planning methods
which are used by the people practicing family planning and accordingly, it is always
advised to consult a specialist before adopting any of these because of so many side
effects associated to them.
Condoms. This birth control option is for men, but now female condoms are also
available. When used by males, this contraceptive method acts as a wall between the
sperms and the egg. It does not allow the sperms to establish a contact with the egg and
14
thus, prevents pregnancy. Apart from being one of the effective methods of birth control,
it also prevents many sexually transmitted diseases (STD).
The pills. This contraceptive pill for men involves synthetic hormone gestate or
desogestrel along with the other hormone, testosterone. It is one of the most effective and
promising family planning method and the studies have proved that the sperm count is
dropped to zero when pills are consumed daily. The reverse effect may take few weeks to
be more effective. But, this too has its own side effects like weight gain and shrinking of
testicles.
Chemical sterilization. In chemical sterilization, a chemical through injection is
introduced in the body. In this mild invasive procedure the resultant scarring prevent the
sperms to pass out from the body. This method might take a long time to be effective and
has some side effects associated too because of the chemicals.
Natural Family Planning Methods
According to Tiwari (2010), these are the natural family planning that still exists
nowadays. It is done by the couples to prevent pregnancy but it is not as effective as the
contraceptive methods.
Withdrawal. This is a natural birth control method where the male partner
withdraws the penis the moment before the ejaculation during the process of sexual
intercourse. But, this method does not prevent pregnancy because the liquid secreted
before the ejaculation also contains sperms in little quantity that are more than enough to
fertilize the ovum.
Abstinence. As the name suggests, this method requires the couple to refrain from
intercourse during the ovulation or the fertility period of the female partner. For this the
15
woman has to note down her dates of menstrual cycles and keep a track of the period
when the chances of getting pregnant are the most.
Permanent Family Planning Method
According to Tiwari (2010), these are the examples of permanent family planning
methods.
Vasectomy. This method is for the males who do not plan to have child any more.
This is a simple surgical procedure that requires minor surgery of the tube that carries
sperms to the ejaculatory duct. Vasectomy procedure prevents the sperm from entering
the seminal fluid and thus, prevents pregnancy. But the testis will continue the production
of sperms which will be absorbed by the body itself.
Tubectomy. This method is also known as tubal sterilization which is a permanent
contraceptive method for females. This again is a surgical process like vasectomy in
males. The fallopian tubes that carry eggs from the ovary to the uterus are blocked. This
does not allow the eggs to enter the tubes and thus, inhibits pregnancy.
Operational Definition of Terms
Barangay Health Workers (BHWs). This refers to the midwife and her assistants
working in the Municipal Health Office.
Clients. This refers to the women who have undergone family planning
counseling.
Counseling. This refers to the process of providing family planning information.
16
Flipchart. This is a decision-making aid/tool for clients, a job-aid and reference
manual for providers. This is the one used by the midwife for family planning counseling
in the rural areas.
Providers. This refers to the BHWs who offer counseling to the women practicing
family planning.
Multi- lingual. This refers to the dominant languages used by the clients at home.
These were Kankanaey and Ilokano. Other languages used were Ibaloi and Filipino.
17
METHODOLOGY
Locale and Time of the Study
The study was conducted in Barangay Poblacion, La Trinidad, Benguet (Figs.
1&2). It is situated on the central part of the municipality of La Trinidad. The
municipality has a total population of 103, 367 as of 2011. In barangay Poblacion there
were 17, 228 total number of households. It is the second to the most densely populated
in the municipality and is considered an urban area in La Trinidad.
This barangay was chosen because it is where the Municipal Health Office
(MHO) is located. Ideally, the municipality has 16 Barangay Health Stations (BHSs) and
it handles all other Barangay Health Centers in the Municipality. According to the MHO,
this barangay has the major number of people practicing family planning. This
Community Health Center is a recipient of the reproductive programs of the DOH and is
using the Decision- Making tool Flipchart.
The study was conducted from December 2011 to February 2012.
Respondents of the Study
There were three Barangay Health Workers (BHWs) who served as the Key
Informants of the study. They were the midwife, Eufemia Guzman and two health care
volunteers, Thelma Pasi and Garell Olagat. Since they have been using the flipchart in
counseling, they were described as the Providers.
Also, 40 female respondents who were practicing family planning were chosen
through purposive sampling. The criterion in choosing the respondents was that they
should have undergone counseling in the Municipal Health Office with the use of the
flipchart by the Providers.
18
Subject of the Study
The flipchart is titled, “Decision- making Tool for Family Planning Clients and
Providers”. It is an aid for clients for it is a reference manual and a training resource for
providers. With one page for the client and a corresponding page for provider, it has
helpful pictures like the appearance of the different methods, and the side effects. It also
include key points for the provider that serves as guide to address the need of the clients,
and detailed reference information that covers 14 family planning methods. The methods
include Intraurine Device (IUD), Cervical cap, Chemical sterilization, Pills, Mini- pill,
Injectables, Implants, Vasectomy, Condoms, Vaginal Methods, Lactating Mothers
(LAM), Tubectomy, Withdrawal, and Abstinence .
Topics include were medical eligibility criteria, side-effects, when to start, and
how to use each family planning method.
The flipchart has 232 pages, landscape in its layout and with a size of 10.84” x
7.50”.
For the pages, they consistently used Arial font style with a size of 22 for its
descriptions. While the headline is double the size of the descriptions. Generally, there
were six colors in the flipchart. These are red, yellow, blue, green, violet, and pink.
Graphics were used to support the information in the flipchart.
Front cover included: WHO family planning cornerstone logo, DRHR- WHO
logo, and John Hopkins Bloomberg school of Public Health logo.
19
Figure 1. Map of Benguet showing the location of La Trinidad
20
Figure 2. Map of La Trinidad showing the location of the study
21
Data Collection
The study was conducted in Barangay Poblacion, La Trinidad, Benguet where the
Municipal Health Office (MHO) is located. Data were collected during the schedule of
family planning in the MHO scheduled every Tuesdays and Thursdays. Respondents
were asked by the researcher using Interview schedule. A print out copy of the flipchart
was shown to them as a reference in replace of the original flipchart. Also, Key
informants were interviewed using guide questions.
The researcher observed that there was great number of clients coming to the
center in the morning schedules of check- up than in the afternoon.
Data to be Gathered
The data gathered were the socio-demographic profile of the respondents which
were in terms of age, address, language spoken, occupation, sex, civil status, religion,
number of children and educational attainment; the effectiveness of Decision- Making
tool in terms of Comprehensibility, Attractiveness, Acceptability, Self involvement,
Persuasion; the common problems encountered by the provider in using the tool and, the
suggestions of the respondents for the improvement of the Decision- Making Tool.
Data Analysis
The data and information gathered were organized, tabulated using frequency
counts and percentages. Data were also summarized and were presented in a narrative
form. Key Informants voices towards the flipchart were also use in the results of the
study to validate the evaluation of the clients towards the material. Also, other researches
were also used to support and compare the result of the study.
22
RESULTS AND DISCUSSION
Socio- demographic Profile of the Respondents.
Table 1 shows the socio- demographic profile of the respondents. These were in
terms of age, address, language spoken, occupation, sex, civil status, religion, number of
children and educational attainment.
Age.
The data shows that majority (22) of the respondents was aged 26-35, 10
were aged 15-25 and 8 were aged 36-45.
This implies that among the respondents, those who were 30-35 years old were
more involved in practicing family planning in MHO.
Civil status and Sex. Results show that almost all of the respondents were married
(39) and were female (38). Only 2 of them were male. This implies that married couples,
especially the females were the most active participants in family planning counseling.
This supports Lugue and De Leon (2001) stating that at the most basic level,
family planning programs involved women more often than men as acceptors of
contraception. It is essential that women be involved not merely as acceptors of this or
that contraceptive device, but as makers of decisions and active participants on an equal
basis with men in the formulation of policies which will profoundly affect their lives.
As to the role of being wives and mothers, it is still very important that men
should be involved in the family planning programs because as married couples they do
not just desire for parenthood but also the responsibilities involved.
Languages spoken. Results show that the respondents were multi-lingual.
Majority (22) of the respondents knew how to speak Ilocano and Kankana-ey.
23
Table 1. Shows the Socio- demographic Profile of the Respondents
CHARACTERISTICS FREQUENCY
(n=40)
PERCENTAGE (%)
Age
15-25
10
25
26-35
22
55
36-45
8
20
Total 40
100
Sex
Female
38
95
Male
2
5
Total 40
100
Civil Status
Married
39
97.5
Single
1
2.5
Total 40
100
Educational Attainment
College Graduate
14
35
College Level
11
27.5
High School Graduate
7
17.5
High School Level
4
10
Elementary Graduate
4
10
Total 40
100
Occupation
House wife
25
62.5
Self- employed
13
32.5
Government employed
2
5
Total 40
100
Language Spoken
Ilocano
22
55
Kankanaey
22
55
Ibaloi
12
30
Tagalog
4
10
Address
Buyagan
16
40
Poblacion
5
10
Puguis
4
5
Betag
4
10
Pico
3
2.5
24
Table 1. continued…
Bineng
2
2.5
Balili
2
2.5
Alno
1
7.5
Ambiong
1
2.5
Wangal
1
5
Shilan
1
12.5
Religion
Roman Catholic
21
52.5
Born Again
9
22.5
Anglican
5
12.5
UCCP
2
5
Lutheran
2
5
INC
1
2.5
Address.
Most of the clients (17) were residents of Buyagan. The rest of the
clients were distributed to the other barangays.
This implies that clients near MHO were the ones regularly coming in the center
for check- ups.
Occupation. Majority of the respondents (25) were housewives. This implies that
women were the ones actively attending counseling in the MHO because men were the
ones working for the family.
Educational
attainment. Among the 40 respondents, (14) finished college and
(11) of them reached college level. This implies that most of the clients were able to read
and write.
Religion. As to the religion of the 40 respondents, majority (52.5%) belonged to
the denomination of Roman Catholic (RC).
Significantly, most of the respondents were RC and using family planning
contraceptives or methods.
25
Number of children. As to the number of children of the 40 respondents, (13) of
them have one child.
Based on the results of the study, it shows that most Catholic members were the
active participants of family planning using contraceptive methods. The same
respondents noted that using contraceptives has a good effect because they only have one
child. Therefore, religion for them is not a reason not to use contraceptive.
This is in contrast with the study of Lugue and De Leon (2001), that in the
teachings of the RC church, it is sinful to attempt to control or regulate the generative
process of child- bearing and aided by the influences of family mores and traditions in the
rural areas. Children are considered signs of God’s blessing.
Evaluation of the Respondents on the Flipchart
Comprehensibility.
Based from the results of the study, there were no words or
sentences that were not understood. All of them understood all the words used in the
content of the flipchart. The respondents even commented that some terms used like
“vomiting and nausea” were easily understood because there were pictures that supported
the texts. The respondents said that graphics and illustrations used helped portray the
message of the flipchart. This implies that there were no problems with regards to the
comprehensibility aspect of the respondents in the material.
The researcher believes that pictures are very important in a certain medium to
achieve effective and a more comprehensive communication. However, words that are
being used in the material should always be visible through the use of pictures and
illustrations to show the appearance of one thing.
26
This was supported by the website saying that every graphic should have a
purpose. Graphics and photographs are very important components of a material because
they add interesting visuals to the material, helping the audience to get the message
across (Hess et al., n.d).
Attractiveness.
Table 2 shows that great majority (92.5%) of the respondents find
the decision- making flipchart attractive. Table 3 supports this result in terms of the
reasons for attraction of the flipchart. Among the 40 respondents, 19 (47.5%) of them
said that with the presence of illustrations or the pictures, it made them perceived the
flipchart to be attractive because the material has simple and visible illustrations. Eleven
(27.5%) of them were attracted with the font style and font size used because according
to the respondents letters used are clear and easily read. Nine (22.5%) said that the colors
of the material are pleasing to the eyes and 5 (12.5%) of them said that they perceived the
layout to be attractive because according to the respondents, the arrangement or
alignment of the pictures were well organized and well presented.
The respondents perceived the material to be attractive because of the pictures,
colors, font styles and layout. This means that the respondents were dependent enough to
the given designs of the material. What they see in the material is not always what they
perceived to be attracted with because all the elements enumerated by the respondents
were presented in the flipchart regardless to their knowledge in flipchart design.
On the other hand, there were some of the respondents who perceived the material
to be not attractive. According to one respondent, the picture in the flipchart like
“implants” was not familiar to her. This can be reflected in the flipchart that “implants”
did not have a page in the flipchart and so it was not well explained to the clients.
27
Another respondent commented that she did not appreciate the pictures in the material
because according to her, they were not eye catching.
Table 2. Evaluation of the respondents on the effectiveness to the flipchart
EFFECTIVENESS
FREQUENCY (n=40) PERCENTAGE (%)
Attractiveness
Material was attractive
37
92.5
Material was not attractive
3
7.5
Acceptability
Elements are annoying/offensive
2
5
Elements are not offensive
38
95
Content
Believed in the flipchart
38
95
Did not believe in the flipchart
2
5
Self-Involvement
Flipchart was written for them
40
100
Persuasion
Try the recommended FP method
35
87.5
Will not try the recommended
5
12.5
method
TOTAL 40
100
Table 3. Respondents’ perceived reasons for attraction to the flipchart
REASONS
FREQUENCY (n=40) PERCENTAGE (%)
Illustrations/pictures are simple and
19
47.5
visible
Font styles and size used are easily read
11
27.5
Colors used are pleasing to the eyes
9
22.5
Well organized presentation of elements
5
12.5
* Multiple answers
28
In general, the flipchart for the respondents was attractive because it has all the
necessary elements needed as Cadiz mentioned.
According to Cadiz (1991), an important tip in using words in the visual media
pertains to their appearance: words must be legible or readable and legibility is
determined by several factors like size which based on letter height, width and thickness.
As general rule, the shorter, narrower and lighter letterings are less legible. However,
letter size should also be determined by the importance that a word plays in the visual
medium.
center of interest; follows normal left to right and top to bottom reading/ viewing
directions or patterns; balance and blend the different elements; simple and with empty
breathing spaces.
Type of illustrations according to Mindanao training Resource Center (n.d) must
be big and bold with minimum of details. Illustration must depict the idea or message;
and select the best types of line or stick figure, cartoons, stylized drawings and
photographs.
Acceptability. The result of the study on the respondents’ evaluation on the
acceptability aspects shows that great majority (95%) perceived the material inoffensive
as shown earlier in Table 2. This includes the evaluation of the respondents in the content
of the flipchart.
Table 4 shows that majority (85%) of the respondents said that words/pictures
used in the flipchart were normally and plainly used for educational purposes. According
to the respondents, the family planning methods were all common to them regardless of
their exposure to the material because they were using some of the methods. In addition,
29
Table 4. Respondents’ perceived reason for the acceptability to the flipchart
REASONS
FREQUENCY (n=40) PERCENTAGE
(%)
Words/pictures were used for
34
85
educational purposes
Illustrations were relevant to the topic
10
25
Attitudinal basis of acceptance
3
7.5
*Multiple response
respondents said that it is better for them to see the appearance of all these methods rather
than being ignorant about it. Ten (25%) of the respondents said that illustrations
specifically the expressions of the people in the pictures support the information in the
flipchart. Based also on the data, there were 3 (7.5%) respondents who perceived the
material to be inoffensive because of their attitudinal basis of acceptance. The basis of the
researcher was according to the respondents statements also. They said that it depends on
how the person consider all these things like being open- minded with regards to this
issue and also in the practicality of life nowadays. The respondent further noted, “Wala
na aarte- arte ngayon”.
This may imply that all pictures used in the flipchart provided impact to the
respondents. The two respondents, who said that they were annoyed in some of the
pictures in the flipchart, identified the pictures of the pregnant and breastfeeding mothers
to be offensive because they were not use to see them in the picture.
Content. As to the content of the material, nearly all (95%) of the respondents
believed the flipchart.
This implies that the flipchart was a credible source of information about family
planning. The two who did not believe the content of the material argued that it rested
30
upon the married couple’s decision whether or not to practice family planning and
acknowledged that the method did not work all the time.
This shows that the respondents had a parameter in believing the content of the
flipchart and this was shown in the result that they must prove it their selves first.
Flipchart as visual aids according to Brown (1985), the amount of information or
the content intended to be communicated in the material should be brief and should
highlight only the salient words or phrases necessary to make a point.
Self- involvement. As seen in Table 2, all of the respondents perceived that the
content of the material was written for them.
Hence, the self- involvement aspect of this flipchart succeeded. As reflected in the
results, the flipchart was effective in making the respondents more involved in the family
planning counseling. The BHWs validated these findings when all of them said that
during the presentation their clients often ask questions regarding the content of the
flipchart which they also tried to explain. Moreover the BHWs also added that when their
clients ask questions regarding family planning methods they observed that the interest of
the clients regarding the topic increases and that the clients were able to voice out their
insights regarding the problems that family planning is trying to address. This finding
supports the idea of Cadiz (1991) where she stated that in order to encourage more
participation of learners the presentor should allow learners to reflect on the given
problems in order to let the learners realize by themselves the solutions to such problems
instead of directly telling the learners the solution. This further encourages learners to
reflect, raise questions, and think of solutions creatively, not just remain as passive
learners.
31
Persuasion. As seen in Table 2, results show that that majority of the respondents
(87.5%) stated that they will try the recommended family planning method. However,
there were five who said that they will not try the recommended family planning method
because the contraceptive methods have side effects.
Based on the result of the study, this implies that almost all respondents felt right
to be part of the family planning practice and they were willing to alter from the
traditional family planning because they were now open for contraceptive methods and
even natural methods knowing their advantages and benefits from it.
This supports the study of Cadiz (1991) stating to adequately arrest learners’
attention, arouse and sustain the interest of the audience; presenters must explain why the
information they share is important by relating it to learners’ needs, problems or future
situations that they may encounter. This is part of applying the basic communication
principle “know your audience” and the concept of empathy. To be an effective presenter
must be learner- oriented. In the case of the La Trinidad MHO the respondents said that
they were persuaded by the explanation of the BHWs because as the respondents read the
content of the flipchart the BHWs coupled the content of the flipchart with oral
explanations wherein they related the content of the flipchart to the situation of the
respondents.
General Evaluation. Multiple answers were gathered in the general evaluation to
the flipchart. Table 5 shows that among the 40 respondents, there were twenty- one of
them who said that it was good because it helps married couples in choosing what family
planning method to use, eleven (27.5%) of the respondents said that it was good for
educational purposes. Nine (22.5%) of them said that the flipchart was simple and the
32
content was easily understood, four (10%) of them said that it was satisfactory and
informative. Respondents were satisfied because the flipchart helped and taught them
how to do family planning and lastly, only one said that the flipchart has well laid- out.
Table 5. General evaluation of the respondents to the flipchart
GENERAL EVALUATION
FREQUENCY PERCENTAGE
(%)
It helps married in FP decision-making
21
52.5
It
is
purposeful
educationally
11
27.5
Flipchart was simple and
easily
understood
9 22.5
Flipchart was satisfactory
and
informative 4 10
*Multiple answers
All the general evaluations of the respondents were positive. Thus, the flipchart
used in the MHO were very useful and effective in counseling about family planning.
The researcher generally rated the flipchart good as it satisfied almost all the basic
elements in designing a material. Although the material violated the criteria mentioned by
Cadiz (1991) regarding the maximum of colors for every page, still, it was effective as
supported by the evaluation of the respondents. The respondents said that it would have
been better if they used photographs of the artificial method and not just graphics.
Problems Encountered by the BHWs
Some clients are not attentive during the counseling. According to the key
informants, they made sure that they explained well the content of the flipchart but their
33
clients tend to forget the following instructions and the process being instructed them so
they ended up not continuing what is advised to them.
Financial capability of the clients. The BHWs may explain well the family
planning method and clients may easily accept what method they wanted to use but they
can only use what is available to them or what they can afford. In situations like these,
there must be a continuous in taking of pill tablet and it should be completed to be
effective, but the problem arises to the clients. Clients would say to the midwife what
other method they can suggest due to financial constraint.
This implies that the decision- making tool flipchart remained to be a tool as
stated in the study’s rationale where it seeks to guide the providers’ response to the
client’s acclaim and preferences at each step in the counseling process.
The study found out that financial reason was also a factor why such family
planning contraceptives were disregarded by some respondents to go on family planning.
Moreover, the midwife found it difficult to explain the tool to the respondent because of
this factor. She gave recommendation of a good method for a client’s situation but she
cannot do anything about it but to really help the clients give appropriate points regarding
family planning.
Client’s attitude toward the method. According to the midwife, the agreement
between married couples depends on the acquisition of a certain method. For the
midwife, it is hard for her to insist what is good for the clients because often times it is
unacceptable to the couples or offensive to the other and accordingly, this is only a guide
for decision- making. On the other hand, clients also consider the health risks that will
34
cause them if they chose to use the method. Otherwise, clients insist what they like and
the midwife cannot do anything.
The result of the study showed that majority of the female participants was the
ones active in family planning; this did not mean that the absence of males in family
planning is the reason. This means that male partners were the ones working because
most female were housewives and it did not mean that they were not active participants
in family planning. It can be implied that the conversation of the couple during bedtime
were also considered as part of the planning decision- making.
In line with this, the researcher suggests that there should be more motivation
done on the part of BHWs to motivate both couples attends family planning counseling.
Clients’ belief system. According to the key informant, older clients were hardly
convinced in terms of explaining a certain method because for some they still believe in
their own beliefs and that the midwife found it hard to convince them. It shows that
clients’ belief system was also a factor which made the midwife difficult to explain the
flipchart. Such belief system included: Social environment, Culture, and Religion.
Social environment. A person’s social environment usually has more influence on
family planning decisions than the attributes of specific contraceptives. When clients
were asked to give reason for their choice of a specific family planning method, most of
them cited the attitudes of their spouse and their neighbors. People chose contraceptive
methods that are commonly used in their community because of its social acceptability
and they claimed to know more about these methods.
Culture. Household and community influences can be so powerful that they can
obscure the line between individual desires and community norms. For instance, in some
35
culture, according to David (2008), many women reject contraception because bearing
and raising children is the path to respect and dignity in the society. This can be reflected
from the result of the study that most women use contraception because having small
families is the norm.
Religion. According to the BHWs they observed that the religious beliefs of their
clients often limit the full participation of the clients in family planning. This supports the
findings of Dixon-Meuller (1999) as cited by David (2008) that religious beliefs accord
their preferences about family size, family pressures to have children and whether to have
family planning in their customs.
The researcher observed that the BHWs who were the providers were subjecting
to the choice of the clients. In a way, it was good because the flipchart encourages only
the providers to give accurate, relevant and up-to-date technical information at
appropriate points and not to force the clients to follow their recommendations.
Suggestions of the Respondents for the Improvement of the Flipchart
The clients were asked to suggest for the improvement of the flipchart. According
to them, the BHWs should think of other ways on how to promote educational family
planning. Also, they suggested that texts in the flipchart should be lessened into a shorter
one. Information should go straight to the point as they were also requesting a handy one
so that they could always read it at home.
In addition, clients suggested that the flipchart must be written in multiple
language translations especially in vernacular so that they may understand it more easily.
The clients also suggested lectures to be done in groups rather than one on one so that
36
they could help each other in following the instructions in using a method. Finally, the
clients said that it is best if the providers show actual samples during counseling.
37
SUMMARY, CONCLUSIONS AND RECOMMENDATIONS
Summary
The study on the evaluation of the decision- making tool flipchart (DMT) in
promoting family planning in Poblacion, La Trinidad, Benguet was conducted from
December 2011 to February 2012. Generally it evaluated the effectiveness of the DMT
Flipchart in promoting Family Planning. Specifically it identified the socio- demographic
profile of the respondents; determined the effectiveness of the Decision-making Tool
Flipchart in terms of Comprehensibility, Attractiveness, Acceptability, Self involvement
and Persuasion; determined the problems encountered by the BHWs in explaining the
tool; and determined the suggestions of the respondents for the improvement of the
Decision-making Tool.
An interview schedule was used in obtaining data from the respondents in
Municipal Health Office. Also, guide questions were used in obtaining data from the
Barangay Health Workers.
The respondents of the study were three Barangay Health Workers which include
one midwife and two health care volunteers. These three BHWs have seen and used the
flipchart in counseling.
Also, 40 respondents who were practicing family planning were chosen through
purposive sampling. These respondents have undergone counseling in the Municipal
Health Office.
Majority of the respondents interviewed were female and there were only two
male. On the comprehension, all of them claimed that words were easily understood. It
appeared to be comprehensible enough to the respondents while majority found the
38
decision- making flipchart attractive. In terms of acceptability, majority perceived that
there were no annoying words about the flipchart.
Further, majority of the respondents believed in the content of the material and
was written for them. Lastly, majority responded that they will try the recommended
family planning method.
As to their general evaluation, they said that it was good because it helps the
married couples in choosing what they wanted to use for family planning, it was also
good for educational purposes, simple and easily understood, and was satisfactory and
informative. The respondents were satisfied of knowing some information on DMT for
them to be aware on how to do family planning and lastly, it was lay- outed well.
The following were the problems encountered by the BHWs in explaining the
tool: respondents were not attentive during the counseling, financial capability of the
clients, client’s attitude towards the method and clients are hard to persuade due to belief
system.
Finally, the respondents suggested that there must be other ways in promoting
educational family planning. Clients suggested lessening the information into a shorter
one and getting straight to the point. It must be written in multiple language translations
especially in vernacular ones, lectures must be done in groups aside from one on one, and
show actual samples of the artificial family planning method during the counseling.
Conclusions
Based on the results of the study, the following conclusions were derived:
1. The effectiveness of the Decision- making Tool Flipchart does not only depend
on the colors, graphics and texts but also on the effective delivery of the one explaining
39
the flipchart.
2. The flipchart is an effective medium in helping people make choices and
decisions.
3. Clients’ decision in choosing a family planning method does not rely only on
the flipchart but could be affected by their personal circumstances like their attitudes,
financial status and belief system.
Recommendations
Based from the conclusions, the following recommendations were derived:
1. The flipchart should be retained as a medium of instruction and it needs to be
promoted more not only in the Health Center but also in the community at large.
2. The use of alternative medium like audio- visuals or recorders for more
interactive discussions between clients and providers may be considered by the DOH.
3. It is recommended that BHWs should strategize other ways on how they can
motivate both couples attend family planning counseling.
40
LITERATURE CITED
AMADEO, J. 2004. The effect of using flipchart in learning agricultural technology in
Benguet. MS Thesis. Benguet State University- Open University La Trinidad,
Benguet. Pp. 15-37, 138-150.
BROWN, J. 1985. Audio Visual Instruction Technology and Methods; 6th Edition. New
York. Mc Graw Hill Book Company.
CADIZ, M. H. 1991. Educational Communication for Development: basic concepts,
theories and know-how. CA Publications Program, UPLB, Laguna. Pp. 39-67.
DAVID, O. 2008. European Journal of Scientific Research. EuroJournals Publishing, Inc.
Olabisi Onabanjo University, Ago-Iwoye, Nigeria. Vol.23 No.2. Pp. 212-218.
Retrieved March 17, 2012 from http://www.eurojournals.com/ejsr.htm.
HESS, G., TOSNEY, K. and LIEGEL, L. n.d. Creating Effective Poster Presentations:
Create Your Poster: Text. Retrieved February 3, 2012 from CreatePosterText.html
KIM, Y. M. , A. KOLS, A. MARTIN, D. SILVA, W. RINEHART, S. PRAMM WAT,
S. JOHNSON and K. CHURCH. 2005. Promoting Informed Choice:
Evaluating a Decision-Making Tool for Family Planning Clients and Providers
in
Mexico.
International
Family Planning Perspectives, 31, 4.
Retrieved October 12,
2011 from Guttmacher Institute Research
database.
LUGUE, Q. L. and M. F. DE LEON. 1989. Textbook on Family Planning: with an
overview of population trends, problems and policies. REX Book Store, Manila,
Philippines.
Pp.
100-146.
LUGUE, Q. L. and M. F. DE LEON. 2001. Textbook on Family Planning: with an
overview of population trends, problems and policies. REX Book Store, Manila,
Philippines.
Pp.
90-138.
MINDANAO TRAINING RESOURCE CENTER. n. d. A training manual on
Development Communication. Davao City. Mindanao Training Resource Center
Institute of Primary Health Care- Davao Medical School Foundation. Pp. 109-
112.
POPULATION INFORMATION PROGRAM, CENTER FOR COMMUNICATION
PROGRAMS. 1994. Population Reports. The Johns
Hopkins School of Public
Health, 22,2. Population reports Articles database. Retrieved October 18, 2011
from http://info.k4health.org/pr/j40/j40chap6.shtml.
41
QUINTONG, J. 1994. Healh Benefits of Family Planning. In: Cabanos, C., F. Cawaon,
E. Dela Cruz, J. Lalo, O. Medrano and J. Pantig. 1994. Family Planning in the
Philippine Setting: An Anthropology. University of the Philippines: Manila. Pp.1-
10.
REGIONAL INFORMATION TRAINING CENTER. n.d. Pretesting Instructional
Materials. Benguet State University Pp. 1, 17-19.
TIWARI, M. 2010. Family Planning Methods. [Electronic version]. Journal of
Bibliographic
Research. Retrieved October 10, 2011 from
http://www.buzzle.com/articles/family
planning-methods.html.
WORLD HEALTH ORGANIZATION-DEPARTMENT OF REPRODUCTIVE
HEALTH AND RESEARCH. 2005. Decision-making tool for family planning
Clients and providers.
Retrieved October 18, 2011 from
http://www.who.int/reproductivehealth/publications/family_planning/9241593229
index/en/index.html.
APPENDIX A
Study on the Effectiveness of the Decision Making Flipchart
(Interview Schedule for Respondents)
Respondent No. ___
I. Socio- Demographic Profile
Name (Optional): __________________________
Sex: ______Male
Age: __________________
______Female
Address:_________________________________
Civil Status:_____________
Language Spoken: _________________________ Religion: _______________
Occupation: ______________________________
No. of Children: __________
Educational Attainment: Please Put a check ( √ ) on the space provided for.
_________Elementary Level
_________ Elementary Graduate
_________High School Level
_________ High School Graduate
_________College Level
_________College Graduate
II. Effectiveness of the Decision- Making Flipchart
The following questions measure the effectiveness of the flipchart. Please fill up
the needed information.
a. Comprehension
a. Please go through the material page by page. Are there any words or sentences
that you don’t understand? Kindly check the page number and list down the words or
sentences that you don’t understand.
Page Number
Vague words/Sentences
b. Attraction
43
1. Do you find the Decision- Making Flipchart attractive?
a.
Yes
b. No, Why Not? ___________________________________________________
2. If yes, what makes you perceive the flipchart to be attractive?
a. layout
b. type of letter
c. others (Please Specify)
3. Why do you perceive the material to be attractive?
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
4. If no, what makes you perceive the flipchart to be not attractive?
a. layout
b. type of letter
c. others (Please Specify)
5. Why do you perceive that the flipchart is not attractive?
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
c. Acceptability
1. Do you perceive that there is anything annoying or offensive about the flipchart?
a.
Yes
b. No, Why Not? __________________________________________________
2. If yes, please identify them _________________________________________
__________________________________________________________________
44
3. Do you believe in the content of the flipchart?
a.
Yes
b.
No
4. If no, why not? ___________________________________________________
__________________________________________________________________
d. Self Involvement
1. Do you perceive that this flipchart is written for you?
a.
Yes
b.
No
2. If no, why not? ___________________________________________________
__________________________________________________________________
e. Persuasion
1. Will you try the recommended Family planning method?
a.
Yes
b.
No
2. If no, why not? ___________________________________________________
__________________________________________________________________
f. General Evaluation of the Flipchart
1. What can you say about the flipchart? _________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
III. SUGGESTIONS FOR THE IMPROVEMENT
Please write your suggestions for the improvement of the Decision- Making Tool.
________________________________________________________________________
________________________________________________________________________
45
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
46
APPENDIX B
Study on the Effectiveness of the Decision Making Flipchart
(Guide Questions for Key Informants)
I. Socio- Demographic Profile
Name (Optional): ___________________________
Sex: ______Male
Age: _____________________________________
______ Female
Address: __________________________________
Civil
Status:___________
Language Spoken: __________________________
1. In promoting family planning, what are the communication strategies you
employ?
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
2. What materials are you using in promoting family planning?
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
3. Is the Decision-Making Tool for family planning effective?
____
Yes
____No
If Yes, Why? ______________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
If No, Why Not? ___________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
47
4. What do you think are the factors affecting the clients’ preference in choosing
certain family planning method
_____________________________________________________________________
____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
5. What are the common problems that you encounter in explaining the tool?
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
6. What are your suggestions for the improvement of the Decision- Making Tool
Flipchart?
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
Document Outline
- Evaluation of the Decision- making ToolFlipchart in Promoting Family Planning in Barangay Poblacion, La Trinidad,Benguet
- BIBLIOGRAPHY
- TABLE OF CONTENTS
- INTRODUCTION
- REVIEW OF LITERATURE
- METHODOLOGY
- RESULTS AND DISCUSSION
- SUMMARY, CONCLUSIONS AND RECOMMENDATIONS
- LITERATURE CITED
- APPENDICES