REPRODUCTIVE HEALTH BEHAVIOR AMONG OUT-OF-SCHOOL YOUTH

OF SELECTED BARANGAYS IN A FOURTH-CLASS MUNICIPALITY IN

NEGROS OCCIDENTAL

In Partial Fulfillment

of the Requirements in our Social Work Research

BY:

KIMBERLY D. APATAN

RICKY MAE B. REBATADO

ATHEL BELLIDO
 Chapter 1
Introduction

Background of the Study

In all matters relating to the reproductive system and its functions and processes,

reproductive health is a state of complete physical, mental, and social well-being, not just the

absence of disease or abnormality.. Reproductive health therefore implies that people are

able to have a satisfying and safe sex life and that they have the capability to reproduce

and the freedom to decide if, when and how often to do so. Implicit in this last condition

are the right of men and women to be informed and to have access to safe, effective,

affordable and acceptable methods of family planning of their choice (WHO, 2017).

According to (De Jose, 2013), one of the most controversial issues confronting the

Filipino youth today is about sexuality and reproductive health. Research shows that a

high percentage of both male and female adolescents still value virginity, and disclosed

disagreement with premarital sex. However, according to a study in a government

university in the Philippines, students reported having had early sexual experience and a

high number of them had it unplanned.

In a study conducted by Pastuszak et al., (2016) expalains that the young males

had low engagement and lack in knowledge of testicular health practices. On the side of

the female, conveyed that the college students of a certain Indian district had limited

knowledge of cancer screening. More so than most illnesses or disabilities, sexual and

reproductive health problems experienced by women and men—young and old—tend to

be cloaked in embarrassment, secrecy and shame. The Barriers to sexuality education

were perceived from 5 aspects: feasibility, acceptability, accountability, strategies and

community unawareness (Khalaf et al., 2014)

So many women suffer and die because of a lack of comprehensive reproductive care. The

majority of illnesses and fatalities triggered by reproductive issues might be prevented or treated

using tactics and technology that are well within the reach of even the lowest earners of selected

sexual and reproductive health problems across and within populations, additional

research is needed to make the invisible visible by filling gaps in our knowledge of such

problems as they are experienced physically and emotionally by men, women and

adolescent girls and boys through the life course. There is a dearth in the literature, most

of the studies conducted relative to this topic focuses on the reproductive health behavior

of youth in general but not specifically highlights OSY. Thus, this study purports to

assess the reproductive health behavior among out-of-school youth in a fourth class

municipality in negros occidental and to produce baseline information about the

reproductive health awareness. Hence, the finding of this research will be able create a

reproductive health advocacy program for OSY.

Statement of the Problem

This study seeks to determine the reproductive health behavior among out-of-

school youth in a fourth class Municipality in Negros Occidental for the Fiscal Year

2021-2022.

Specifically, it seeks to answer the following questions:

1. What is the level of reproductive health behavior among out-of-school youth in a

fourth class municipality in negros occidental when they are grouped according to:
 a. Sex

b. Monthly household income

c. Educational attainment

d. Religion?

2. What is the level of reproductive health behavior among out-of-school youth in a

fourth class municipality in negros occidental when taken as a whole and grouped

according to the following areas:

A. sex education

B. awareness on contraceptives

3. Is there a significant difference in the reproductive health behavior among out-of-

school youth in a fourth class municipality in negros occidental when taken as a

whole and grouped according to:

a. Sex

b. Monthly household income

c. Educational attainment

d. Religion?

Hypothesis
1. There is no significant difference in the reproductive health behavior among out-of-

school youth in a fourth class municipality in negros occidental when taken as a

whole and grouped according to:

a. Sex

b. Monthly household income

c. Educational attainment

d. Religion

Significance of the study

The findings of this study will be beneficial to the following:

Municipality of Don Salvador Benedicto.The findings of the study may give

timely awareness and and implement activities and program to strengthen and intensify

reproductive health awareness within its jurisdiction.

Out-of-school Youth. This study may give awareness to OSYs and help them

realize how important to have knowledge on reproductive health. It may also provide

information to refrain from doing uncessary things like

Social Workers. This study may enable them to evaluate and provide an

intervention program to address the crucial problem of tennage pregnancy in the

community.

Public Health Workers. The results of this study may provide them a situation

that affects the ramphant cases of sexual transmitted disceases, and thereby, they can
devise a program or strategy to overcome problem to become more competent conveyors

of reproductive health awareness .

Future Researchers. This study may provide them a specific situation of the

program implementation resulting to a positive if not negative output. Hence, they can be

more prepared to assimilate the ideas presented in a new dimension and emulate the

strategies to ensure the effectiveness program towards reproductive awareness.

Scope of the Study

This study focus on the reproductive health behavior among out-of-school youth

in a fourth class Municipality in Negros Occidental for the Fiscal Year 2021-2022 .The

variables under consideration are age, sex, religion and educational qualification.

The research covers selected out-of-school-youth in different barangay in

Municipality of Don Salvador Benidicto. The participants will be selected using stratefied

proportionate random sampling. Don Salvador Benidicto is the fourth class municipality

of Negros Occidental. It is located in the midle area of the province, it is also surrounded

by many mountains and hills.

The reproductive health behavior among out-of-school youth in a fourth class

Municipality in Negros Occidental according to age, sex, religion and educational

qualification will be determined using modified instrument. The over-all mean

interpreted using the scale for the researcher to establish if the out-of-school-youth are

emotionally stable and pyschollogiacally ready and upright towards sexual activities.

The statistical tools used in the study are mean, percentage, t-test, and ANOVA
Definition of terms

In order to better understand the context of the study, the following terms are

defined according to their operational definitions:

Reproductive Health. Conceptually, it refers to a state of complete physical, mental

and social well-being and not merely the absence of disease or infirmity, in all matters relating to

the reproductive system and to its functions and processes (WHO, 2009).

Operatioanlly, it refers to the condition in which the reproductive functions and complete

physical, mental and social well-being of the Out-of-School-Youth in Don Salvador Benedicto.

Reproductive Health Behavior. Conceptually, it refers to manifestation of

teenagesexual impulse, starting from a glance to pair’s sensual part of the body until sexual

intercourse (DOH, 2010).

Operationally, it refers to the behavior of Out-of-School-Youth in Don Salvador

Benedicto towards reproductive health and awareness.

Out-of-School Youth. This refers to persons aged 15 to 24 years who are not

attending school and not working.

As used in this study, it refers to the teenager who are not enrolled in an elementary or

secondary school or institution of higher education in Don Salvador Benedicto.

Monthly Household Income. Conceptually, this term refers to the monetary

payments received for goods or services, or from other sources as rents or investments

(Norico 2020).
 Operationally, this refers to the re-numeration that the parent-respondents

received from the their sources of income in daily and monthly basis for their services

rendered.

Educational Attainment. This refers to the level of education that an individual

has achieved. (Guevara, 2009).

The term denotes to the highest level of educational attainment, which categorized

into a elementary and high school graduate.

Religion. This term refers to a propitiation or conciliation of powers superior to

man which are believed to direct and control the course of Nature and of human life

(Frazer, 2017).

As used in this study, it refers to the religious denomination to which the Out-Of-

School youth belonged.

Theoretical Background

Poor reproductive health behavior among out-of-school youth will result to rapid

increase of teenage pregnancy and vulnerabilities of the youth to STI, HIV, and AIDS.

The vulnerability of young people to HIV and unintended pregnancy, and the choices

adolescents make that have critical implications for their sexual and reproductive health.

Most adolescents are aware that sexual activity puts them at risk of getting pregnant or

contracting HIV. Their knowledge is not detailed, however, and myths are common. For

example, many adolescents think that a young woman cannot get pregnant the first time

she has sexual intercourse or if she has sex standing up. Some adolescents believe they

can identify someone living with HIV by their outward physical appearance; others report
that HIV can be transmitted through a mosquito bite or that a man who is HIV-positive

can be cured by having sex with a virgin.

This study is anchored to the theory of Duval and Wicklund (1976) self-

awareness theory has shown that self-focused attention influences a wide range of

attitudes, attributions, and behavior. The cognitive processes that supposedly mediate

these effects have not been carefully explored, however. In order to discover whether

manipulation of self-awareness actually activates self-relevant thoughts, two studies were

conducted using the Stroop color-word measure of concept activation in memory. The

first revealed a pattern of differences between means that was consistent with the

hypothesis, although the expected interaction of word content and presence of mirror and

camera to produce longer color-naming latencies did not appear. Also, self-relevant

words were read faster than neutral words, even though they had been matched for

length, frequency, and part of speech. In the second study (a refinement of the first), the

expected interaction was significant. The results support one of the central claims of self-

awareness theory and suggest an alternative interpretation of classic findings concerning

anxiety and memory.

This study is also supported by the protection motivation theory of (Rogers, 1983),

which developed as a framework for understanding the effectiveness of health-related

persuasive communications, although more recently It’s also been used to forecast health-

promoting behavior. Its origin can be found in early research on the persuasive power of fear

appeals, which focused on the situations in which emotional appeals may influence attitudes

and behavior.
Conversely, on a study done by Ubalde et al. (2012) showed that the level of awareness

about the topical aspect of reproductive health was very high in school. Some of the

college students have already engaged in vaginal sex and awareness of contraception

among them is high . However, it was revealed that the youth lack sexual and

reproductive health knowledge and they engaged in risky sexual behavior.

These theories have significant factors why do people act the same way as they do.

Security motivation is a strong indicator of thoughts about intensity, fragility, and

reaction that emerges from either the two appraisal system.Views about the incentives

associated with the regressive reaction and the affect success of the response efficacy,

and a negatively effect of efficacy and self-efficacy. Furthermore, for protective

motivation to be evoked, the incentives associated with it must be present.With views of

severity and fragility outweighing the maladaptive reaction, and views of reaction

efficacy and self-efficacy outweighing the preventive behavior’s response costs.

Protection desire is thought to activate, guide, and maintain protective activity, as

evaluated by behavioral intentions

Moreover, the relationship self-awareness and protection motivation theories are

based on the premise that one's behavior traits are consistent with what one finds

gratifying in interpersonal relations and with concepts or beliefs one holds about how to

interact with others to achieve those gratifications . Although many personality theories

are about people, this theory was meant for people. It was intended to provide an

effective means for understanding one's self and for understanding others so that

interpersonal relationships could be mutually productive and gratifying. The theory was

planned to help people organize their concepts of themselves and their concepts of others
around three basic motivations: wanting to be of genuine help to others, wanting to be the

leader of others, and wanting to be self-reliant and self-dependent especially in

reproductive healht issue.

Conceptual Framework

This study is also anchored on the Responsible Parenthood and Reproductive

Health Act of 2012, known as the RH Law, is a groundbreaking law that guarantees

universal and free access to nearly all modern contraceptives for all citizens, even those

from disadvantaged areas. The legislation also establishes a prerequisite for sexual health

education in public schools and acknowledges a mother’s right to post-abortion treatment

as part of her entitlement to reproductive healthcare. The Reproductive Health Law is a

significant moment for all Filipino women, encouraged to make their own personal and

social decisions about issues more completely and fairly in society

To help visualize this framework, the schematic diagram is provided in the next

page.

The diagram shows of the study on the reproductive health behavior

among out-of-school youth in a fourth class municipality in negros occidental. The first

box presents the profile of the Participants in terms of their (sex), (age), (educational

attainment), (religion), and their level of reproductive health behavior on the succeeding

boxes. The study hopes to develop a strategic planning program..

v

Reproductive Health
Out-Of-School Youth Behavior

Basis for
Sex
sex education strategic planning
Age
Awareness on program..
contraceptives
Educational Attainment

Reigion

Figure 1. A schematic diagram illustrating the conceptual framework of the study

Review of Related Literature

Reproductive Health

The term “reproductive health” is frequently used interchangeably.Motherhood is

one component of a woman’s life. Difficulties resulting from a variety of maternal

problems indeed major contributors to poor reproductive health among millions of

women worldwide. Half of the world’s 2.6 billion women are now 15 – 49 years of age.

Without proper health care services, this group is highly vulnerable to problems related to

sexual intercourse, pregnancy, contraceptive side effects, etc. Death and illnesses from

reproductive causes are the highest among poor women everywhere. In societies where

women are disproportionately poor, illiterate, and politically powerless, high rates of

reproductive illnesses and deaths are the norm. Ethiopia is not an exception in this case.

Ethiopia has one of the highest maternal mortality in the world; it is estimated to be

between 566 – 1400 deaths per 100,000 live births. Ethiopian DHS survey of 2005

indicates that maternal mortality is 673per 100,000 live births. In Ethiopia, contraception

use in women is 14.7% and about 34% of women wantto use contraceptive, but have no

means to do so according to the Ethiopian Demographic and Health Survey (EDHS

2005).

Furthermore, the highest incidence of pregnancy difficulties, venereal diseases,

and reproductive malignancies are experienced by women in undeveloped countries and

underprivileged women in some industrialized areas. Many women starve and die due to

a lack of access to adequate reproductive healthcare. Most reproductive-related illnesses

and deaths might be prevented or treated using tactics and technology that are well only
within grasp of even the world's poorest. Men, too, have sexual health issues, the most

common of which are STIs. For women, however, the quantity and extent of dangers are

significantly greater Worldwide, it is estimated that 529,000 women die yearly from

complications of pregnancy and childbirth about one woman every minute. Some 99

percent of these deaths occur in developing countries, where a woman's lifetime risk of

dying from pregnancy-related complications is 45 times higher than that of her

counterparts in developed countries. The risk of dying from pregnancy-related

complications is highest in subSaharan Africa and in South-Central Asia, where in some

countries the maternal mortality ratios are more than 1,000 deaths per 100,000 live births.

Sixty to eighty percent of maternal deaths are due to obstetric hemorrhage, obstructed

labor, obstetric sepsis, hypertensive disorders of pregnancy, and complications of unsafe

abortion. These direct complications are unpredictable and most occur within hours or

days after delivery.

According to World Health Organization (2009), the establishment of a

reproductive health system provides not only a solution measure to the population

problem, but also contributes to the improvement of individual health1 , and it is based

on the definition of “health”2 as provided by the World Health Organization (WHO) in

its Constitution. However, the range of reproductive health is wide and the definition and

interpretation of its concept remain varied. Many people in the world have no chance to

enjoy reproductive health due to various causes. Such causes include insufficient

knowledge of human sexuality, inappropriate or low-quality information and service on

reproductive health, the spread of high-risk sexual behavior, discriminative social

customs, negative attitudes toward women and girls, and the limited empowerment of
women and girls in relation to sex and reproduction, etc. Adolescents are in an especially

vulnerable position. This is because there is little information available on reproductive

health and few related services in many of the countries in the world.

Reproductive health indicates life-long, wide ranging health not only limited to

the health of women of reproductive age groups from 15 to 49. It also points out the

importance of women being able to control their health from the perspective of the

human life cycle instead of being careful only during the period when they have children.

(1) Reproductive health targets a comprehensive approach which encompasses

family planning/maternal and child health and other health issues related to reproduction

including sexually transmitted infections including HIV/AIDS that had been treated in

isolation in conventional vertically separated administration systems.

(2) It is difficult to say whether conventional family planning programs have

dealt appropriately with the needs, roles and responsibilities of men and special needs of

adolescents. However, reproductive health activities require sufficient consideration of

these problems. It also refers to the roles and responsibilities of men in other reproductive

health fields (such as sexually transmitted infections including HIV/AIDS).

(3) Reproductive health calls for the rights of individuals and couples related to

family planning and especially the rights to select the method of family planning. At

present, many individuals and couples are not given any opportunity to choose the

method of family planning or the opportunity is insufficient or inappropriate even when

given. Reproductive health insists on the rights of individuals and couples to utilize

family planning and select the family planning method that seems appropriate for each
individual, and state the assurance to substantiate the health care and information which

will enable such rights.

(4) Reproductive health points out that violence against women creates large

health problems. In particular, rape, sexual abuse, human trafficking, forced prostitution,

and harmful traditional customs including female genital cutting constitute violence

against women which often occur within the framework of “sex and reproduction.” In

addition, it is also important to deal with violence that affects not only physical health,

but also the mental health of women.

Beijing (1995), elabotaed that it is important that RH interventions are not only

timely but also appropriate and consistent with national laws and development priorities.

RH programmes affect highly personal aspects of life, so programmes must be

particularly sensitive to religious and ethical values and cultural backgrounds of the

refugee population. It may not always be feasible for one organisation to implement the

full range of RH services. Providing comprehensive RH services may require cooperation

and coordination among agencies. The complexities of reproductive health were

discussed at the Fourth World Conference on Women. Participants listed the following as

some of the reasons why many of the world’s people do not benefit from reproductive

health: “... inadequate levels of knowledge about human sexuality; inappropriate or poor-

quality RH information and services; the prevalence of high-risk sexual behaviour;

discriminatory social practices; negative attitudes towards women and girls; and the

limited power many women and girls have over their sexual and reproductive lives.”
 Community participation is essential at all stages to ensure the acceptability,

appropriateness and sustainability of RH programmes. It is necessary for empowering

refugees, particularly women, to have greater control over their lives and over the

services that are provided to them.

Good communication among levels is essential to deal satisfactorily with issues

relating to support, supervision and training, all of which are essential in maintaining

quality. Specific training of personnel may be necessary to ensure that the designated

services can be provided at each level by appropriately skilled personnel. RH services

should be considered neither as optional nor as special projects. They should be

integrated in a timely fashion within PHC and community service activities. Even when

the delivery of RH services calls for special arrangements or resources, this cannot justify

their postponement or neglect

According to Lou, C. et al (2004) sex education the purpose of this study was to

see how effective a youth-friendly approach was at promoting one safe sex behavior—

contraception and condom use—among unaffiliated young people aged 15–24 years in

Shanghai, China. A holistic counseling program that provided knowledge and skills, as

well as counseling and assistance, seemed to have a favorable effect on contraceptive

practice and condom use among unmarried young girls and males in Shanghai's suburbs.

According to Braeken, D. et al (2008) several international statements have urged

for accessibility to sexuality education. This article examines why sexuality education is

the most successful in encouraging sexual health and how it should be structured in terms

of health, values, development, and rights. Two major problems for rights-based,
sexuality education are the absence of acknowledgement of young people as sexual

beings and the revival of abstinence-only sexuality education. To solve these issues,

greater international responses are required to make sexuality education a complete

endeavor supported by all, both locally and globally.

According to Coley, R. et al (2004) a developmental systems approach, this study

examined the long-term linkages between adolescents' out-of-school care experiences and

behavioral trajectories in a random sample of 819 adolescents aged 10 to 14 years old

from low-income, urban homes at Wave 1. The location, supervision, and structure of

teenagers' care arrangements, as well as parenting practices and perceived neighborhood

settings, were all taken into account. Out-of-home care, whether supervised or

unsupervised, was associated with higher rates of delinquency, drug and alcohol use, and

school issues, according to regression models. Out-of-home care was associated with

particularly negative outcomes for adolescents who had a history of behavior issues, had

inadequate parental monitoring, and had a low perception of neighborhood collective

efficacy.

According to Timæus, I. et al (2015) the correlation between adolescent

childbearing and school attainment is studied using nationally representative longitudinal

data from South Africa's National Income Dynamics Study. The study focuses on the

results of 673 young women aged 15–18 who were childless in 2008. Girls who went on

to have children had double the odds of dropping out of school by 2010 and nearly five

times the odds of failing to matriculate, even after controlling for other factors. Fewer

than 1% of girls in the highest-income quintile had children. Girls who attended schools
in higher-income areas and were behind in school were substantially more likely to have

children than those who were in the right grade for their age or attended no-fee schools.

According to Seifu, A. et al (2006) awareness on contraceptives in May 2001, a

cross-sectional, comparative study was done in the East Gojjam zone of northwest

Ethiopia. Twelve kebeles (the smallest social administrative units) were chosen at

random from four districts (one urban and three rural). To determine households in each

cluster, a modified random walk method was utilized. Knowledgeable 12th grade

students used pretested questionnaires to collect data. In data analysis, the x2 - test, the t-

test, and the Odds Ratio (OR) with 95 percent Confidence Interval (CI) were utilized. To

investigate the relative impact of factors on sexual activity and contraceptive use, a

multiple logistic regression analysis was done using the SPSS version 10 statistical

program.

In total, 1001 teenagers answered to the interview. Although knowledge of

reproductive issues appeared to be adequate, numerous misconceptions were detected.

Only 53% of survey participants were aware that a healthy-looking individual can have

HIV, while 40% were unaware that a person can catch HIV the first time, he or she had

sex. Approximately 10% of those polled thought they were at danger of contracting HIV

in the next 12 months, whereas more than 45 percent said they had sexual experience.

The average age of first sexual onset was determined to be 13.6 years. Significantly

greater proportions of rural teenagers were also found to be sexually active (OR = 3.0; 95

percent CI = 1.9, 6.2). Approximately 46% of sexually active rural teenagers had 2-5

lifetime sexual partners, compared to 35.4 percent of urban adolescents.

 Reproductive Health Behavior Among Youth

Behaviors that young people adopt during adolescence have critical implications

for future health and mortality. Indeed, the recent report of the US National Academies,

Growing Up Global, concluded that ―unprotected sex is one of the riskiest behaviors

that young people can undertake, particularly in settings where HIV/AIDS is widespread‖

(NRC/IOM 2005).

In sub-Saharan Africa, HIV/AIDS is now the leading cause of death among

young people (even more so for young women than young men); it is one of the least

important causes of death for young people in other regions. At the same time, in all

developing-country regions, mortality and morbidity related to pregnancy and childbirth,

7 including unsafe abortion, remain among the most significant risks to young women’s

health. While first sex is not necessarily occurring at earlier ages than in the past, in most

countries an increasing proportion of adolescents are experiencing first sex premaritally,

often as a result of later ages at marriage (NRC/IOM 2005).

The changing context of first sex has implications for certain reproductive health

outcomes, in particular the incidence of unwanted pregnancy. These trends could also

have implications for the incidence of unsafe abortions, given that the desire to stay in

school is a common reason cited by adolescent girls for having an induced abortion

(Bankole et al. 1998). Detailed cross-country analysis of sub-Saharan Africa, based on

surveys from 27 countries, sheds further light on trends in marriage and first sex

(Mensch, Grant, and Blanc 2006).

 Rates of early marriage have been falling, and in many African countries for

which recent data are available, these trends are being accompanied by rising proportions

of young people experiencing their first sex premaritally before age 18. In some cases

these trends can be explained by a longer period of exposure to the risk of premarital sex,

given delays in marriage with no change in rates of premarital sex; in other cases these

trends are due to a rise in the rate of premarital sex. At least in Africa, however, where

HIV among adolescents is most widespread, there is no evidence from these data of any

association between changes in the timing and context of sexual initiation and rates of

HIV among adolescents. What is not known is whether there has been a change relative

to the past in the extent to which these sexual transitions are occurring while adolescents

are still attending school and the extent to which these changes are occurring primarily

after adolescents leave school. Furthermore, it is not immediately obvious whether

students are more or less likely than their non-enrolled peers to engage in behaviors that

compromise reproductive health.

The transition from adolescence to adulthood involves adjusting to age-related

challenges and changes (UN 2018). Health-related behaviors that begin in adolescence,

such as smoking, drinking, and drug use, have effects in later life. For example, road

injuries, HIV, suicide, lower respiratory infections, and interpersonal violence are the

leading causes of death among adolescents globally (WHO 2014). These risk behaviors

are more common among young males than females. In the United States, for example,

young men are more likely than young women to act in potentially harmful ways, such as

driving without wearing a seat belt or under the influence of alcohol (Center for Disease

Control and Prevention 2018).

 Other behaviors, such as early sexual initiation and unprotected sex, can have

adverse social, health, and psychological consequences not only for the individuals but

also for their families and society in general (Ujano-Batangan 2012). Cultural and social

contexts play a role in determining the diverse pathways in the transition from

adolescence to adulthood. Across societies, young people are exposed to different

societal norms and are presented with different opportunities for risk-taking behaviors.

Strict societal norms, for example, may regulate the risk behaviors of adolescents, such as

those in most Asian societies (Hofstede 2011). In Filipino culture, religion influences the

construction and shaping of sexuality and sexual norms. Young males have greater sexual

freedom, while expectations of young females’ behavior tend to be conservative, with

virginity associated with virtue (Medina 2015; Upadhyay, et. al. 2006). Worldwide,

adolescents and young adults account for a substantial proportion of the total population.

There are an estimated 1.2 billion young people, age 15-24, which is 16% of the total

world population . In the Philippines, the 2015 Census found that this age group has

remained at 19% of the total population, while the absolute number of individuals in this

age group has doubled in 35 years, from 9.8 million in 1980 to 19.5 million in 2015, and

continues to increase (Ogena and Cruz 2016).

An exploratory study in 2002 of sexual risk-taking behaviors among Filipino

youth identified cyberspace as an alternative platform for casual and transactional sexual

partnerships (Ujano-Batangan 2012). A decade later, after considerable growth of the

telecommunication industry in the Philippines, the 2013 Young Adult Fertility and

Sexuality Study (YAFSS) found that 78% of Filipino youth own a cellular phone and

59% use the Internet, most commonly for social networking, checking emails, and
chatting (Laguna 2013). The Internet offers young people access to information that they

might feel too embarrassed to ask their parents or other adult members in their social

circles. In some contexts, there has been evidence of the feasibility and positive effect of

Internet-based sex education programs in increasing reproductive health knowledge

among students (Lou et al. 2006). An exploratory study of the Internet as a possible

source of information on sexual health among American school-based teenagers, for

example, found that a majority of the students were wary of the sexual health information

obtained online (Jones and Biddlecom 2011). Although the findings are still inconclusive

about the effect of the Internet on young people’s attitudes and behaviors, evidence

suggests that use of information technology will continue to be a ubiquitous element in

young people’s lives.

The Filipino terms, “pagdadalaga” and “pagbibinata,” capture the notion of

puberty as a transition stage from childhood to adulthood, or the process of becoming a

young (unmarried) woman or young man. This pubertal period of development includes

physical, biological, and psychosocial changes with important implications for young

people’s development into adults. In addition, during puberty, adolescents experience

growing awareness of sex differentiation and identity, romantic feelings, the increasing

influence of peers, and an urge to participate in new activities and practices (Raymundo

2004).

Young people in the Philippines have almost universal knowledge of the physical

changes that young men and women experience during adolescence. Among boys, these

changes include physical growth (height), appearance of underarm and pubic hair, and a
change in voice. Among girls, the physical changes include the onset of menstrual

periods and the development of breasts (Marquez and Ortega 2016).

Knowledge about sex, taken from the 2013 YAFSS, shows that only 27% of

Filipino youth considered themselves to have adequate knowledge of sex1 . Across

regions, young people from the National Capital Region (NCR) reported the highest

proportion with adequate knowledge of sex at 51% for males and 36% for females. The

Autonomous Region in Muslim Mindanao (ARMM) reported the lowest proportion at

16% for males and 13% for females. Moreover, the proportion with adequate knowledge

on sex has remained unchanged for 20 years. Based on the 1994 YAFSS, 27% of young

Filipinos reported an adequate knowledge of sex (Kabamalan 2016). This finding

validates an earlier observation from a literature review of sexual risks of Filipino

adolescents conducted in the 1990s, which noted that the majority of Filipino youth have

grown up believing that discussions about sex are “bastos,” or profane, and are something

that should be learned within the context of marriage (Ujano-Batangan 2003).

Reproductive Health Behavior Among Youth and the variables (sex,

educational attainment. Monthly household income, religion)

Given the low level of contraceptive use among young people, there is concern

that early sexual behavior heightens the risk of pregnancy. A report published by the

United Nations Population Fund (UNFPA) in 2015 found that, while adolescent fertility

rates have declined in many countries in the last two decades, little change in adolescent

fertility rates has been observed in the Philippines (UNFPA 2015). Compared with other

countries, teenage pregnancy rates (pregnancy among young women age 15-19) in the
Philippines have remained constant over the past four decades at 56 pregnancies per

1,000 women in 1973 and 57 per 1,000 in 2013 (UNFPA, UNESCO, and WHO 2015).

Based on the 2017 NDHS, one girl in every 10 age 15-19 is either a mother or is pregnant

with her first child (PSA and ICF 2018). Results from the 2013 YAFSS in the Philippines

also found that 14% of young women age 15-19 have ever been pregnant, which is twice

the 2002 rate of 7%. A slightly higher percentage of young women age 15-19 in urban

areas have begun childbearing when compared with young women in rural areas (15%

versus 13%) (Natividad and Marquez 2016).

Sex. Women, who account for almost half of the population of the Philippines,

play a vital role in national development. The 2009 passage of the Magna Carta of

Women, or RA 9710, signaled the Philippine government’s commitment to achieving

gender equality. As a comprehensive law, RA 9710 guarantees the rights of Filipino

women to economic opportunities, access to markets, and the opportunity to contribute to

policymaking. The law promotes gender equality as an important element in the fight

against poverty and the promotion of development. Substantial progress has been made in

closing the gender gap in education between women and men in the Philippines. These

achievements have not necessarily translated to economic gains, however, because

women continue to experience lower labor force participation rates than men. In the

January round of the 2019 Labor Force Survey, Filipino men accounted for 61% of the

employment force, while Filipino women were only 39% (PSA 2019). Women also bear

a greater burden of care and domestic work, which is often not remunerated (David et al.

2018). However, compared with other countries in Asia, there is greater visibility of

women in the Philippines in economic and political spheres. The country has had two
women presidents and a number of women legislators and justices. Gender relations,

however, may vary within households and families, as well as at the community and

policy levels.

Among young people, however, traditional gender roles that view women as

submissive can serve as barriers to exercising their power to decide on the timing of

sexual intercourse and negotiating for contraceptive use (Alesna-Llanto and Raymundo

2005). Most FP studies have highlighted the important role of men in decisions about

fertility intentions such as the number of children and use of contraceptive methods

(Kakoko 2013).

Gender inequality is also manifested in Filipinos’ view of sexuality. Greater

freedom is afforded to men than to women in almost all types of sexual behavior. Young

women bear the greater brunt of blame, as well as responsibility, for teenage pregnancy.

A study of women’s empowerment and IPV in Cebu found that women who

participate in decision-making have a lower risk of experiencing IPV. The greater

number of domains of decision-making that men dominate in the household, the more

likely they are to exercise power over their wives through physical abuse. In another

study however, it was found that there is higher risk of violence when women dominate

household decision making or when women participate in decision making (Rahman, et.

al. 2011).

Educational Attainment. In both waves of the NSAM, all respondents were

asked to report retrospectively on whether they had ever received "formal instruction in

school or in an organized program" in eight specific reproductive health topics, and if so,
the grade they first received this instruction. These topics are divided into five content

areas of reproductive health education based on previously used categorizations14: AIDS

(including how to prevent AIDS through safe sex); other STDs*; birth control (including

methods of birth control and where to obtain contraceptive methods); how to say no to

sex; and how to put on a condom (Lindberg, 1995).

According to Gupta (2003),Nearly twice the percentage of girls, 46.6 percent, are

illiterate compared with males (25.5 percent).7 The comparison of the results obtained

from the 1991 and 2001 censuses indicates that illiteracy has been declining among males

and females in most states. However, the situation is still critical in states where female

illiteracy is much higher than the national average.

More than one-quarter of girls’ lack of education was ascribed to their

responsibilities for caring for siblings at home and other household responsibilities.

Another quarter was ascribed to the cost of education.9 Among the boys, the main

reasons identified for not attending school were a lack of interest in studies and the cost

of education. Until quite recently, the approach of the family planning program has

focused on achieving demographic goals by increasing contraceptive use. Policymakers

and planners have now realized that the adolescent population group has specific health

and developmental needs. There is a growing understanding that adolescence is a bridge

between childhood and adulthood.

One of the most dramatic trends in developing countries over the last two to three

decades has been the rapid rise in both school participation and grade attainment,

particularly for girls. This has occurred in countries that have prospered economically
and in those that have not. Indeed, throughout the developing world the pace of change

has been more rapid than the pace of change that occurred during the transition to

universal schooling among today’s developed countries (Clemens 2004). These changes

have meant that an increasing percentage of adolescents in every country attend school

during their adolescent years, with growing numbers still attending beyond the age of 15.

Nonetheless, school participation and grade attainment rates lag for the poor, with poor

and ―excluded‖ girls at the greatest disadvantage (Lewis and Lockheed 2006).

Thus, we cannot necessarily assume that observed differences in behavior

between students and non-students are caused by differences in school exposure and

experience. Nonetheless, differences in the duration of school exposure and experience

between students and non-students are likely to be among the factors influencing the

behavior of adolescents during their teenage years. The mean grade levels attained by

students currently enrolled typically exceed the mean grades attained among the non-

enrolled by 50 percent or more, suggesting that differences in exposure to the school

environment, and by extension differences in academic skills, are important (Lloyd

2006).

These studies show that students who do better in school are less likely to initiate

sex, more likely to use a condom if sexually active, and, for girls, less likely to become

pregnant or drop out if pregnant. A comparative analysis of five West African countries

also showed that female students who progress through school at an appropriate age for

grade are less likely to drop out because of pregnancy or early marriage (Lloyd and

Mensch 2006). These relationships go both ways in that adolescents who have premarital
sex while in school are more likely to drop out, particularly girls; thus adolescent risk

behaviors can compromise school progress (Biddlecom et al. 2007)

Monthly Household Income. Poor health and puberty are the outcome of many

forces beyond a young person’s control, including the disease environment, family

circumstances, and personal vulnerability. However, individual behavior becomes a

factor of growing importance to health during adolescence. In particular, unprotected sex

and/or early marriage, which can lead to sexually transmitted infections, HIV/AIDS, and

pregnancy, carry many risks for young people, including most immediately the risk of

school dropout. Thus, we expect that students with better-off and more supportive

families, as well as students doing well academically and receiving encouragement from

their teachers, would be more likely than others to take steps to avoid the risk of dropout

by either avoiding sex, engaging in protected sex, terminating unwanted pregnancies

before detection, or negotiating with parents to refuse or delay early offers of marriage

(Grant and Hallman 2006).

Religion. Religion plays an integral role in life and health, especially for women

in the United States.1–4 For adolescents and young women who are at a critical point in

their social, psychologic, and physical development, religion may shape health decision

making and behavior.1 In regard to young women's sexual and reproductive health

(SRH), sex is often an issue of moral and religious values as much as it is a normal

developmental process that contributes to health and well-being.1 Approaches to sex,

including expectations learned before and after menarche, attitudes toward coitarche, and

views on relationships, childbearing, marriage, contraception, pregnancy, and abortion,

are often influenced by religious beliefs, dedication, and practices (Hall, 2012).
 According to Moreau (2012), religious young women indeed do have sexual

relations, and characteristics of religion, such as affiliation with a religious denomination,

religious service participation, or value attributed to religion in daily life, appear to

influence sexual behaviors.1,6–8 Research has examined the role of these religious

characteristics (as both protective and risk factors) for a variety of SRH outcomes,

including sexual initiation, sexual education, contraceptive use, unintended pregnancy,

and abortion.5–22 An analysis of 50 studies examining religiosity and sexual behavior

conducted as part of the National Campaign to Prevent Teen Pregnancy suggested that

religion might not always act as a gatekeeper to risky sex and related outcomes, as was

previously thought.18 Collectively, the comprehensive review found that many religious

characteristics were not associated with less frequency of sex, lower number of sexual

partners, increased contraceptive use, or lower pregnancy rates. Religious young women

who are sexually active and potentially at risk for poor reproductive outcomes may have

particular needs for SRH care. Inadequate SRH care is believed to be one of the many

complex reasons for poor SRH outcomes among adolescent and young adult women

more broadly, and religion may influence attitudes and behaviors around SRH care

seeking. Whether and how young women's religious characteristics relate to their use of

family planning, sexually transmitted infection (STI), and even routine gynecologic

healthcare services, however, is unknown

 Chapter II

Methodology

This chapter presents the research design, research locale, the Participants, the

sampling technique, the data gathering tools, administrations of the questionnaire and the

statistical treatment used in this research study.

Research Design

This study employs the descriptive-comparative research design in

determining the reproductive health behavior among out-of-school youth in a fourth

class Municipality in Negros Occidental.

 According to Calderon as cited by Alberto et al (2014), descriptive research

design is also known as statistical research, it describes data and characteristics about the

population or phenomenon being studied. This research method is used for frequencies,

averages and other statistical calculations. Often the best approach prior to writing

descriptive research, is conducting a survey investigation.

It is the nature of this study to determine the conditions of things in their present

state. It delves into the relationships and/or comparisons among variables that are

considered in the study as well as the influence of one variable on another. Based on this

premise, the researcher considered it most appropriate to use the descriptive-comparative

design.

Participants of the Study

The participants of the study are the selected out-of-school youth in the different

Barangays in Municipality of Don Salvador Benedicto. The Participants of the study will

be selected using stratefied proportionate random sampling technique due to the difficulty

of the situation associated with COVID-19 pandemic.

Table 1

Frequency Distribution of Participants According to Variables

BASI PWEDE NYO MAKWA ANG NUMBERS HERE PARA MABAL AN TA NA
KUNG ANO KADAMO SILA THEN FILL IN THE TABLE.
Variables f %
Entire Group
Sex
Male
 Female
Total

Age
Young(18-42)
Old(43 and above)
Total
Educational Attainment
Elementary Graduate
High School Graduate
Total
Household Monthly Income
5000 below
Above 5000
Religion
Catholic
Non-Catholic
Total

Data-Gathering Instrument

This study will be used modified instrument which focus on the reproductive

health behavior among out-of-school youth in a fourth class Municipality in Negros

Occidental for the Fiscal Year 2021-2022.

To gather the necessary data, the researchers used a survey instrument which the

validity and the reliability will be established.

The data-gathering instrument to be administered to the Participants are composed

of three (2) major parts. Part I is the respondent’s personal information which requires
them to supply or check the needed information concerning their sex, age, educational

attainment, religion and household monthly income.

Part II of the instrument is the questionnaire proper which gathers data necessary

for this investigation of the reproductive health behavior among out-of-school youth in a

fourth class Municipality in Negros Occidental.

The items found therein are answerable with a corresponding numerical value as

follows:

To measure the level of awareness.The 12 items are answerable of a 5 point scale:

5 (Always), 4 (Often), 3 (Sometimes), 2 (Seldom) and 1 (Never). The corresponding

numerical value were converted into scales on the next page..

Score Range Options/Responses

4.50-5.00 Very High

3.50-4.49 High

2.50-3.49 Moderately High

1.50-2.49 Low

1.00-1.49 Very Low

Validity of the Data-Gathering Instrument

 According to Shuttleworth (2015), validity encompasses the entire experimental

concept and establishes whether the results obtained meet all of the requirements of the

scientific research method.

To ensure its face validation, the questionnaires will be submitted to five (5)

authorities and/or people who are knowledgeable about the research topic. The

comments and suggestions of the validators will be considered in the final copy of the

said instrument. Using the Good and Scates Criteria for Validation of Instrument, the

content of the survey instrument was validated and rated by the jury of validators using

the following scale: 5 (excellent), 4 (very good), 3 (good), 2 (fair) and 1 (poor).

If the validation results show a total mean score higher than avarage it means that

the instrument is valid.

Reliability of the Instrument

Reliability or the accuracy of an instrument is the extent to which a research

instrument consistently has the same results if it is used in the same situation repeated

occasions (Heale & Twycross, 2015).

In addition, an instrument is said to be reliable when it has the capacity to gather

stable and consistent data that are needed for this investigation. To meet this

requirement, the researchers administered the questionnaires to thirty (40) participants

from the people in Victorias City.

 After the questionnaires will be retrieved, the data are reliability-tested wherein

the results showed a Cronbach’s Alpha reliability coefficient is above the 0.80, it

indicates that the instrument is reliable.

Data-Gathering Procedure

The researchers will seek permission from the Barangay. Captains to conduct the

survey and the administration of the questionnaire to the different barangays in

Municipality of Dpn Salvador Benedicto. After permission will be granted, the

researchers will personally distribute the questionnaires to the Participants. The

Participants will be oriented on the responses. The instruments gathered, tallied, and

interpreted according to the conceptual design and the specific objectives of the study.

Statistical Treatment

The following procedures will be adopted to analyze the data gathered for this

work:

For problem concerning the level eproductive health behavior among out-of-

school youth in a fourth class Municipality in Negros Occidental when taken as a whole

and grouped according to: sex, age, educational attainment, religion and household

monthlky income , mean will be utilized.

For problem concerning the significant difference on level of reproductive health

behavior among out-of-school youth in a fourth class Municipality in Negros Occidental

when taken as a whole and grouped according to: sex, age, educational attainment,

religion and household monthlky incomee, t-test and ANOVA will be used.

Ethical Considerations

In consideration of the ethics in research, the researchers dealt with the

participants’ profile with utmost confidentiality. Researchers also secured permission

from the proper authorities and participants concerned. They also took into consideration

the principles of secrecy, honesty, objectivity, intellectual property rights, legalities and

other ethical considerations.

The researchers also observed to the best of their knowledge and abilities the right

to patent, citation of significant information quoted in this research to give credits to the

original researcher/s or author/s. They further recognized the probable societal effects of

the result of their scholarly work especially in the event that the results of this research

will be utilized by means of presentation in conferences or summits, seminars or to any

publications.

References

LOU, C., WANG, B., SHEN, Y., & GAO, E. (2004). Effects of a community-based sex

education and reproductive health service program on contraceptive use of unmarried

youths in Shanghai. Journal of Adolescent Health, 34(5), 433–440.

 Seifu, A., Fantahun, M., & Worku, A. (2006). Reproductive health needs of out-

of-school adolescents: A cross-sectional. Ethiopian Journal of Health Development,

20(1). https://doi.org/10.4314/ejhd.v20i1.10006

Timaeus, I. M., & Moultrie, T. A. (2015). Teenage Childbearing and Educational

Attainment in South Africa. Studies in Family Planning, 46(2), 143–160.

https://doi.org/10.1111/j.1728-4465.2015.00021.x