Implementing a Natural Family Planning Program: The Case of The Metropolitan Archdiocese of Cagayan De Oro
Authors: Asiones Noel 
Published: October 2022

This single and critical case study evaluated a faith-based natural family planning program's salient features using a framework on implementation fidelity. Multiple focus group discussions were conducted, with three groups of stakeholders (n=100), to gather qualitative data on their knowledge and experience of the program. Overall, the findings showed that the program primarily adhered to the essential elements of implementation fidelity, such as content, frequency, duration, and coverage prescribed by its designers. Three lessons were drawn to address some issues that have influenced the degree of fidelity in which the program was implemented. The first is the need to secure adequate and sustained human and financial resources. The second is the need to strengthen its partnership with government and non-government organizations that have provided them with much-needed assistance. Finally, there is also the need to provide extensive training, materials, and support to its service providers to preserve their morale and interest. Other faith-based organizations may hold this case as an indicator of how and why an NFP program works and the extent to which the need for family planning can be met adapted to their local conditions and needs.
References
Arbuckle, Gerald A. Refounding the Church: Dissent for Leadership. Quezon City: Claretian Publications. 1993. Arevalo, Marcos. "Expanding the Availability and improving the delivery of natural family planning services and fertility awareness education: providers' perspectives. Adv Contracept. Jun-Sep 1997; 13(2-3):275-81.
Arévalo, Marcos, Victoria Jennings, and Irit Sinai. "Efficacy of a new method of family planning: the Standard Days Method." Contraception 65, no. 5 (2002): 333-338.Arévalo, Marcos, Irit Sinai, and Victoria Jennings. "A fixed formula to define the fertile window of the menstrual cycle as the basis of a simple method of natural family planning." Contraception 60, no. 6 (1999): 357-360.
Atun, Jenna (2013). Religiosity and Contraceptive Use among Filipino Youth. Philippine Center for Population and Development. (2013) Accessed April 15, 2019, from http://www.pcpd.ph/.../religiosity-and-contraceptive-use-
Authority, P. S. ICF Philippines national demographic and health survey 2017. Quezon City, Philippines, and Rockville, Maryland, USA: PSA and ICF, 2018.
Authority, Philippine Statistics. "Philippine statistics authority." Accessed from Philippine Statistics Authority Web site: https://psa. gov. ph/vegetable-root-crops-main/tomato (2018).
Authority, P. S. “Philippine statistics authority.” Accessed July 20, 2019, from Philippine Statistics Authority Web site: https://psa. gov. ph/vegetable-root-crops-main/tomato.(2016)
Authority, P. S. “ICF Philippines national demographic and health survey.” Quezon City, Philippines, and Rockville, Maryland, USA: PSA and ICF, 2017.
Bamber, John, Stella Owens, Heino Schonfeld, Deborah Ghate, and Deirdre Fullerton. "Effective Community Development Programmes: a review of the international evidence base." (2010).
Barden-O'Fallon, Janine. "Availability of family planning services and quality of counseling by faith-based organizations: a three-country comparative analysis." Reproductive health, 14, no. 1 (2017): 57.
Baskarada, Sasa. "Qualitative case study guidelines." The Qualitative Report 19, no. 40 (2014): 1-25. Accessed July 25, 2019, from http://www.nova.edu/ssss/QR/QR19/baskarada24.pdf
Beaubien, Louis, and Daphne Rixon. "Key performance indicators in co-operatives: directions and principles." Journal of Co-operative Studies 45, no. 2 (2012): 5-15.
Booker, Victoria K., June Grube Robinson, Bonnie J. Kay, Lourdes Gutierrez Najera, and Genevieve Stewart. "Changes in empowerment: Effects of participation in a lay health promotion program." Health Education & Behavior 24, no. 4 (1997): 452-464.
Breitenstein, Susan M., Deborah Gross, Christine A. Garvey, Carri Hill, Louis Fogg, and Barbara Resnick. "Implementation fidelity in community‐based interventions." Research in nursing & health 33, no. 2 (2010): 164-173.
Carroll, Christopher, Malcolm Patterson, Stephen Wood, Andrew Booth, Jo Rick, and Shashi Balain. "A conceptual framework for implementation fidelity." Implementation Science 2, no. 1 (2007): 40.
Casterline, J.B., A.E. Perez & A.E. Biddlecom. “Factors Affecting Unmet Need for FP in the Philippines," “Studies in Family Planning, (1997). (3):173-191. Accessed November 02, 2019, from http://www.jstor.org/stable/2137886.
Catholic Bishops' Conference of the Philippines. (2011). Guiding Principles of Population Control. Accessed September 27, 2019, from www.cbcponline.net/
Catholic Church. Bishops' Conference of the Philippines. (1992). Acts and Decrees of the Second Plenary Council of the Philippines. Catholic Bishops' Conference of the Philippines.
Catholic Bishops' Conference of the Philippines. (1990). A Pastoral Letter on the Population Control Activities of the Philippine Government and Planned Parenthood Association. Accessed November 24, 2019, from cbcponline.net/v2/?p=324.
Cleland, John, and Kazuyo Machiyama. "Unmet need for family planning: past achievements and remaining challenges." In Seminars in reproductive medicine, vol. 33, no. 01, pp. 011-016. Thieme Medical Publishers, 2015.
Costello, Marilou P., and John B. Casterline. "Fertility decline in the Philippines: current status, prospects." asdf (2009): 479.
Creel, Liz C., Justine V. Sass, and Nancy V. Yinger. "Overview of quality of care in reproductive health: definitions and measurements of quality." New Perspectives on Quality of Care 1 (2002): 1-8.
Cronin Jr, J. Joseph, Michael K. Brady, and G. Tomas M. Hult. "Assessing the effects of quality, value, and customer satisfaction on consumer behavioral intentions in service environments." Journal of retailing 76, no. 2 (2000): 193-218.
Crous, M. "Quality service delivery through customer satisfaction." (2006).
D’Arcy, Catherine, Ann Taket, and Lisa Hanna. "Implementing empowerment-based Lay Health Worker programs: a preliminary study." Health promotion international 34, no. 4 (2019): 726-734.
Dane, Andrew V., and Barry H. Schneider. "Program integrity in primary and early secondary prevention: are implementation effects out of control?" Clinical psychology review 18, no. 1 (1998): 23-45.
David, Clarissa C., and Jenna Mae L. Atun. "Factors affecting fertility desires in the Philippines." Social Science Diliman 10, no. 2 (2014).Accessed August 12, 2019, from jounals.upd.edu.ph/index.php/socialsciencediliman/article/viewFile/4407/3999.
Ewerling, F., Victora, C. G., Raj, A., Coll, C. V., Hellwig, F., & Barros, A. J. (2018). Demand for family planning satisfied with modern methods among sexually active women in low-and middle-income countries: who is lagging? Reproductive health, 15(1). (2018): 42.
Francisco, J.M. “Letting the Texts of RH Speak for themselves: (Dis) continuity andCounterpoint in CBCP Statements.” Philippine Studies: Historical and Ethnographic Viewpoints, 223. (2015). Accessed October 17, 2019, from www.philippinestudies.net.
Franta, Benjamin, Hilly Ann Roa-Quiaoit, Dexter Lo, and Gemma Narisma. "Climate Disasters in the Philippines." (2016).
Fehring, Richard Jerome, Mary Schneider, and Kathleen Raviele. "Pilot evaluation of an Internet‐based natural family planning education and service program." Journal of Obstetric, Gynecologic & Neonatal Nursing 40, no. 3 (2011): 281-291.
Glickman, Norman J., and Lisa J. Servon. "More than bricks and sticks: Five components of community development corporation capacity." Housing Policy Debate 9, no. 3 (1998): 497-539.
Gomez, Fausto, B., OP. “The Role of Priests in Natural Family Planning." Boletin Ecclesiastico de Filipinas, LXXII, (1996): 163.
Gribble, James N. "The standard days' method of family planning: a response to Cairo." International family planning perspectives 29, no. 4 (2003): 188-191.
Guida, Maurizio, Giovanni A. Tommaselli, Massimiliano Pellicano, Stefano Palomba, and Carmine Nappi. "An overview on the effectiveness of natural family planning." Gynecological Endocrinology 11, no. 3 (1997): 203-219.Hasson, Henna. "Systematic evaluation of implementation fidelity of complex interventions in health and social care." Implementation Science 5, no. 1 (2010): 67.
Infantado, R. B. "Main-streaming NFP into the Philippines' Department of Health: opportunities and challenges." Advances in Contraception 13, no. 2-3 (1997): 249-254.
Institute for Reproductive Health. Faith-based organizations as partners in family planning: Working together to improve family well-being. Washington, DC: Georgetown University. (2011). Accessed February 11, 2019, from http://www.ccih.org/FBOs_as_Partners_in_FP_Report.pdf.
Ledesma, Antonio. J. “All-NFP: A Way Forward.” Philippine Daily Inquirer (2012). Accessed August 04, 2019, from https://opinion.inquirer.net/35848/all-nfp-a-way-forward#ixzz5zAroo0oo
Ledesma, Antonio. J. “Al-Natural Family Planning: Going beyond the RH Bill.” Accessed April 15, 2019, from https://archcdo.wordpress.com/
Lundgren, Rebecka, Jeannette Cachan, and Victoria Jennings. "Engaging men in family planning services delivery: experiences introducing the Standard Days Method® in four countries." World health & population 14, no. 1 (2012): 44.
Lundgren, Rebecka I., Mihira V. Karra, and Eileen A. Yam. "The role of the Standard Days Method in modern family planning services in developing countries." The European Journal of Contraception & Reproductive Health Care 17, no. 4 (2012): 254-259.Mikolajczyk, Rafael T., Joseph B. Stanford, and Martina Rauchfuss. "Factors influencing the choice to use modern natural family planning." Contraception 67, no. 4 (2003): 253-258.
Orbeta, Aniceto., Jr. “Poverty, Fertility Preferences, and Family Planning Practice in the Philippines.” Philippine Journal of Development, 129. (2006). Accessed October 25, 2019, from https://ideas.repec.org/p/phd/dpaper/dp_2005-22.html.July
Orbeta, Aniceto Jr. “Poverty, vulnerability, and family size: evidence from the Philippines (No. 68). (2005). Asian Development Bank.
Orbeta Jr, Aniceto, and Ernesto M. Pernia. Population Growth and Economic Development in the Philippines: What Has Been the Experience and What Must Be Done? No. 1999-22. PIDS Discussion Paper Series, 1999.
Rufo, Aries. “The church pays lip service to natural family planning.” Rappler (2011). Accessed October 01, 2019, from https://news.abs-cbn.com/-depth/12/04/11/church-pays-lip-service-natural-family-planning.
Schivone, Gillian B., and Paul D. Blumenthal. "Contraception in the developing world: special considerations." In Seminars in reproductive medicine, vol. 34, no. 03, pp. 168-174. Thieme Medical Publishers, 2016.
Seidman, M. "Requirements for NFP service delivery: an overview." Advances in Contraception 13, no. 2-3 (1997): 241-247.
Selak, Anne. “What the Church Owes Families.” La Croix International (2020) Accessed October 24, 2020, from https://www.commonwealmagazine.org/what-church-owes-families.
Sinai, Irit, Rebecka Lundgren, Marcos Arévalo, and Victoria Jennings. "Fertility awareness-based methods of family planning: predictors of correct use." International family planning perspectives (2006): 94-100.
Smoley, Brian A., and Christa M. Robinson. "Natural family planning." American family physician 86, no. 10 (2012): 924-928.
Stanford, Joseph B., Janis C. Lemaire, and Poppy B. Thurman. "Women's interest in natural family planning." Journal of Family Practice 46 (1998): 65-72.
Tommaselli, G. A., M. Guida, S. Palomba, M. Pellicano, and C. Nappi. "The importance of user compliance on the effectiveness of natural family planning programs." Gynecological endocrinology 14, no. 2 (2000): 81-89.
Van de Vusse, Leona, Lisa Hanson, Richard J. Fehring, Amy Newman, and Jaime Fox. "Couples' views on the effects of natural family planning on marital dynamics." Journal of Nursing Scholarship 35, no. 2 (2003): 171-176.
Vidal, Avis C. “Faith-based organizations in Community Development. (2001) Accessed January 28, 2020, from www.huduser.org/publications/pdf/faith-based.pdf.
Walker, Christopher, and Mark Weinheimer. "The performance of community development systems: A report to the National Community Development Initiative." Washington, DC: Urban Institute (1996).
Weldon, Elizabeth, Karen A. Jehn, and Priti Pradhan. "Processes that mediate the relationship between a group goal and improved group performance." Journal of personality and social psychology 61, no. 4 (1991): 555.
World Health Organization, "Family Planning Contraception Methods," June 22, 2020. Accessed August 08, 2020, from https://www.who.int/news-room/fact-sheets/detail/family-planning-contraception.
World Health Organization. "Building from common foundations: the World Health Organization and faith-based organizations in primary healthcare." (2008).
World Health Organization. “Health topics: family planning.” (1988). Accessed September 24, 2020, from http://www.who.int/topics/family_planning/en/.
World Health Organization. (1988). Natural family planning: a guide to the provision of services. Accessed August 27, 2019, from https://apps.who.int/iris/handle/10665/39322.Yin, Robert K. "Case study research: Design and methods 4th edition." In the United States: Library of Congress Cataloguing-in-Publication Data. 2009.