Who’s using it?

Star: BASED on the latest Malaysian Population and Family Survey, only around 52% of couples in Malaysia are using at least one form of contraception, whether natural or artificial.
The 2004 survey conducted by the National Population and Family Development Board (better known by its Malay acronym, LPPKN), spoke to a sampling of married women aged between 15-49, and were either currently using, or whose spouse was using, at least one form of contraception.
This included artificial methods like hormone pills, condoms, and intra-uterine devices (IUDs), as well as natural methods like periodic abstinence using the rhythm method, withdrawal, lactational amenorrhea method (using breastfeeding and the absence of periods as an indication of non-fertility) and folk methods.
The percentage of these women is considered the contraceptive prevalence rate (CPR).
The surveys, which are carried out every 10 years, show that the CPR in the country has been holding relatively steady around 50% ever since 1984. Ten years before that, it was 36%.
The survey reports that for the major ethnic groups, 64.3% of Chinese couples practise some form of contraception; followed by couples of other races, 59.3%; Indian couples, 51% and Malay couples, 39.3%.
And while urbanisation and education has increased the CPR, LPPKN Human Reproduction Division director Dr Norliza Ahmad says that “the differentials between urban (50.7%) and rural couples (43.3%), and across education categories (primary or no schooling 46.5%; secondary 48.6%; and post-secondary 49.3%) are much less pronounced than ethnic differentials”.
The most popular method of contraception is the oral contraceptive pill (14%), while the rhythm method is the most used among the natural, or non-modern, methods (9.3%).

The survey also showed that around one quarter of married couples wanted to stop or delay having children, but were not using any contraceptive methods for various reasons. This “unmet need for contraception” was highest among women in their 40s (64.4%).
Dr Norliza says that this could be due to a couple of factors.
“Number one is they might think that they are not fertile, This perception is partly true because at this age, there is a natural decline in fertility. However, the chance of getting pregnant is still there.”
Currently, women less than 50 years old are advised to continue using contraception until they have had no periods for two years, and women above 50 to continue for 12 months after their last period.
“Secondly may be because they are unaware of the contraceptive choices available. This could be due to inadequate advice by healthcare providers.” She adds that education and awareness is a very important part of LPPKN’s work as many women are afraid of the side effects of artificial, or modern, contraceptive methods.
In addition, Dr Norliza says that a wider range of contraceptive methods, such as low-dose oestrogen and long-acting formulations need to be made widely available to the community, and that effective counselling is a priority.
“More concentrated efforts are also needed to encourage and facilitate active male participation, and to reduce their objection to family planning practice.
“Nevertheless, women’s rights to decide on contraception and fertility will not be neglected.”
According to Dr Norliza, future areas of research for LPPKN include emergency contraception, unmet needs, and family planning usage among singles.