A Comparative Study… 1

CHAPTER I

INTRODUCTION

Reproductive health is an important part of general health and an

essential feature of human development. Over the years, the significance of

human reproductive health has been explained and disseminated throughout the

world. According to the World Health Organization, good reproductive health

refers to a whole physical, mental and social well-being in all matters concerning

to the reproductive system (WHO, 2015).

Reproductive health problems usually occur due to the people’s lack of

knowledge about the issue and the absence of proper propagation of information

about effective, safe, affordable and acceptable contraception methods that are

available. On 2014, the United Nations Population Fund reported that 225 million

women in the developing countries are not using effectual contraceptive method

which resulted to 74 million unplanned pregnancies, 28 million unplanned births

and 36 million abortion cases every year (UNPF, 2014).

Reproductive health awareness must be taught especially to teenagers

since many changes in human body occur during the teenage years. This also

means that a teenager’s reproductive system becomes fully active during this

period (Klosterman, 2009).

One way of helping the teenagers understand the benefit of abstinence in

the early years which can also teach them how to be responsible sexually active
 A Comparative Study… 2

people in the future is through sex education. Sex education is a high-quality

teaching and learning about broad assortment of topics affiliated to sex and

sexuality, digging into the values and beliefs about those topics and gaining the

skills that are demanded to manage an individual’s sexual health and navigate

relationships (Planned Parenthood, 2012).

In the Philippines, the latest report on the implementation of the RH law

revealed that the minimum standards of comprehensive sexuality education

have not yet been developed by the Department of Education (Geronimo, 2016).

Given the information, the purpose of this study is to determine and compare the

reproductive health awareness of grade 11 students who came from public and

private junior high schools.

Review of Literature

Reproductive health addresses the processes of reproduction, functions

and systems at all stages of life. It indicates that people should have a

responsible, satisfying and safe sex life and that they can reproduce and have

the liberty to decide, when and how often to do so (WHO, 2015).

Reproductive health applies to disorders, diseases and conditions that

affects the functions of the male and female reproductive systems. Reproduction

disorders involve birth defects, developmental disorders, preterm birth, low birth

weight, impotence, reduced fertility, and menstrual disorders (NIEHS, 2017).

One of the significant parts of general health and is an essential feature of

human development is reproductive health. It reflects the health of a child, and is

 A Comparative Study… 3

important during adulthood, it sets the stage for health further the reproductive

years for both men and women and affects the health of the next generation.

The health of an infant is mostly a function of the mother’s health and nutrition

status and of her access to health care. Reproductive health is an all-around

concern but is most important for women specifically during reproductive years.

Men too have reproductive health concerns and needs though their health is

affected by reproductive health to a lesser extent than in the case of women

(POPIN, 2010).

Reproductive health implies that people have the capability to reproduce,

regulate their fertility practice and enjoy sexual relationships apart from the

absence of disease or infirmity. A broader concept of “reproductive health” offers

a comprehensive and integrated approach to the health needs in relation to

reproduction (Fathalia, 2011).

The Cairo definition of reproductive health is long and includes sexual

health. Inter alia, the HIV pandemic, increasing global rates of sexually

transmitted infections and the growing recognition of the public health

importance of issues such as violence against women and girls are later results

on giving emphasis on sexual health as a separate public health issue. In

addition, unsafe sex was identified by the World Health Organization as the

second most important risk factor for disease, disability, or death in the poorest

communities and the ninth in developed countries (Glassier et. al., 2006).

In function, dysfunction and disease, the reproductive system plays a

central role in a women’s health while in men, they have a different case. It is a
 A Comparative Study… 4

major burden in females to possess a disease related to their reproductive

function and reproductive system (Fathalla, 2011).

Impoverished women suffer disproportionately from unintended

pregnancies, unsafe abortion, maternal death and disability, sexually transmitted

infections (STIs), gender-based violence, and other related problems. The

leading cause of death for women of childbearing is reproductive health

problems that age worldwide. Family planning, maternal health care and HIV

prevention are some services that some women still have no access to. Every

year there are 287, 000 women die from complications during pregnancy or

childbirth and more than 225 million women want to avoid pregnancy but are not

using modern contraception.

Reproductive health is one issue that needs attention in our country. The

ones responsible for one third of health issues for women between the ages of

15 and 44 is sexual and reproductive health. In a developing country, like the

Philippines, unsafe sex is a huge risk factor especially for women. (PCHRD,

2008)

According to Medical Center Manila, reproductive health means ensuring

that a woman achieves a state of mental, physical, and social well-being during

all stages of her reproductive life. According to United Nations, some 114 Filipino

mothers die for every 100,000 live births. These deaths occur due to

complications related to pregnancy and giving birth.

CNN Philippines reported that several programs aim for the maintenance

of reproductive health in the Philippines. Ads on televisions about programs

 A Comparative Study… 5

promoting safe sexual habits and awareness about various sexually transmitted

diseases are some efforts of the Filipino government and NGOs to achieve a

reproductively healthy society. However, 28 percent in a population of 104

million, one in four pregnancies in this country is unwanted. Unintended

pregnancies may lead to maternal or prenatal deaths and unsafe abortions.

Almost two out of three Filipinas prevented to use any form of birth control and

one in four women gets pregnant within a year because they prefer using

traditional over modern contraception. Klaus Beck said that 78 percent among

the females who had their first sexual encounter is unprotected. Unfounded fear

of side effects, opposition from religious groups, lack of knowledge, and lightly

taking the risk of pregnancy are some reasons for some who does not choose

modern contraception that the World Health Organization cited. Medical facilities

must be provided to help deal with problems like infertility, STDs, and other

reproductive problems. However, there are still some practices that are related to

reproduction that is still prevalent in our society.

The Commission on Population XI stated that 44 percent of female youth

from Davao Region have experienced sexual intercourse. The percentage of

those who engaged in pre-marital sex increased from 15 percent in 2002 to 38

percent. In addition, 2 percent of female youth aged 15-24 have had sex before

age 15 and 30 percent in the 18-24 age brackets have had sex. Females had

their sexual debut at the age of 19 in 1994, but it has become younger today at

the age of 17. The region of Davao also placed as the third highest in the

number of youths who engage in pre-marital sex in 2013 with 38.5 percent or
 A Comparative Study… 6

370, 000, a figure higher by 15. 3 points from 23.2 percent in 2002. Moreover, 8

in 10 or 295, 000, participated in their first pre-marital sex encounter without any

form of protection against sexually transmitted infections (STIs) or unwanted

pregnancy (Clerigo, 2016).

Men are being encouraged by the city’s health officers in openness to

adapt to family planning methods and other reproductive health issues. Officer-

in-charge of the Population Division of the City Health Office (CHO), Jeff

Fuentes, said that in a male dominated society, a man’s openness in

participating in sexual and reproductive issues is a great factor in the

improvement of the situation of women’s reproductive areas (Saligumba, 2014).

Department of Health distributed condoms to high school students to

clarify that they are not promoting pre-marital sex or any form immoralities. This

is due to fact that Davao region ranks fifth in the highest number of HIV cases

nationwide. Davao Region had 475 cases of HIV-Aids that was recorder by the

Reproductive Health and Wellness Center from January to October 2016

(Revita, 2016).

World Health Organization’s 2014 fact sheet reported that about 16

million girls aged 15 to 19 and some 1 million girls under 15 give birth every

year. Childbirth and pregnancy complications are the second cause of death for

15—19-years old girls worldwide. 3 million girls aged 15 to 19 have undergone

unsafe abortions every year and babies born to teenage mothers face a greater

risk of dying than those born to women aged 20 to 24.

 A Comparative Study… 7

Human papillomavirus (HPV) is a group of viruses that are eminently

common worldwide. HPV has more than 100 types, at least 13 of which are

cancer-causing. It is mainly transmitted through sexual intercourse and it can

cause cervical cancer. Two HPV types causes 70% of cervical cancers and

precancerous cervical lesions. Evidences also links HPV with cancers of the

vulva, anus, penis and vagina (WHO, 2016).

A survey data from the 2013 Philippines National Demographic and

Health Survey show that 29% of married adolescent Filipinas have an unmet

need for contraception, which is higher than that among women in all other age-

groups. Furthermore, almost equivalent proportions of married adolescent

women depend on less-effective traditional methods and on modern methods.

Closely one-third of all births to women younger than 20 are unplanned. To

manage the high level of unmet need among Filipina adolescents, it is important

to develop access to family planning counseling and to provide the full range of

contraceptive methods (Guttmacher Institute, 2015).

In the past years, several school-based programs have been developed

for delaying the initiation of sexual activity. A school is the only institution in

regular connection with a fairly large proportion of the teenage population with all

youth attending it before they begin sexual risk-taking behavior. Programs that

raise abstinence have become popular with school systems in the US and with

the federal government. Other programs appointed in the literature as safer-sex,

comprehensive, secular or abstinence-plus programs further match the goal of

increasing usage of effective contraception. Abstinence-only and safer-sex

 A Comparative Study… 8

programs both strive to foster problem-solving and decision-making skills in the

belief that through sufficient instruction, adolescents will be more prepared to act

responsibly in the heat of the moment (Silva, 2009).

Sex education is likely one of the most sensitive topics in the Philippines.

It has been a subject of debate until now whether to incorporate this in the

school curriculum. The reason behind it is to address the problems of pre-marital

sex and teenage pregnancies among youths, and to check the dissemination of

sexually-transmitted diseases (STDs). Given the alarming number of

adolescents engaging in sexual activities, the government through the

Department of Education should include sex education in the curriculum of

schools, especially to middle school and high school students because they

belong to the age group that are considered vulnerable (Ronquillo, 2017).

The latest report on the implementation of the RH law on 2016 revealed

that the Department of Education has not yet developed the minimum standards

of comprehensive sexuality education that schools, and other learning facilities

should comply with. A report by UNESCO said that a scientifically-accurate,

culturally and age-appropriate, gender sensitive and life skills-based CSE

reduces risky behavior of young people who are sexually active (Geronimo,

2016).

Theoretical Framework

Andrew Tannahill (1980) made a health promotion model consisting of

three overlapping spheres of activity: health education, prevention, and health

 A Comparative Study… 9

protection. Health education is intended to change the knowledge, beliefs,

attitudes, and behavior in a way that facilitates health. Disease prevention aims

to lessen risk factors and the consequences of disease. Health protection

centers on legal controls and policies and voluntary codes of practice that

intends to prevent ill health and enhancing well-being (Jones and Bartlett, 2005).

This study used the Cognitive Development Theory (CDT) of Piaget,

which categorizes an individual’s development into four pre-determined stages.

This theory claims that a person become more aware and understanding of the

things and concepts more intricately and in a more developed way as they go

through the different stages of their development (La Bella, 2013).

This study also used Social Cognitive Theory (SCT) by Albert Bandura. It

states that, learning occurs in a social context with a dynamic and reciprocal

relation to the person, environment, and behavior. The unique feature of Social

Cognitive Theory (SCT) is its emphasis on social influence and on external and

internal social reinforcement. SCT considers the unique way in which individuals

acquire and maintain behavior, while also considering the social environment in

which individuals perform the behavior (Hurst, 2003).

Furthermore, many theories focused on initiating behavior used in health

promotion and did not consider maintenance of behavior. This is unfortunate as

maintenance of behavior, and not just initiation of behavior, is the true goal in

public health. The goal of SCT is to explain how people regulate their behavior

through control and reinforcement to achieve goal-directed behavior that can be

maintained over time (LaMorte, 2016).

 A Comparative Study… 10

Conceptual Framework

The level of awareness of

Grade 11 Senior High
School Students on
Reproductive Health

Grade 11 Senior High Grade 11 Senior High

School Students coming School Students coming
from Public Junior High from Private Junior High
School School

Figure 1. Conceptual Framework of the Study

Figure 1 shows the variables considered in the study. The Independent

variables are the Grade 11 Senior High School Students who came from Public

and Private Junior High School. The Dependent Variable is the level of

awareness on Reproductive Health of Grade 11 Senior High School Students

who came from both public and private Junior High School. These were

measured using closed ended questionnaire made by the researchers.

Statement of the Problem

The main objective of this study is to determine and compare the level of

awareness on reproductive health of the Grade 11 Senior high school students

coming from public and private Junior high schools who is currently enrolled in

San Pedro College.

Specifically, this paper sought to answer the following questions:

 A Comparative Study… 11

1. What is the profile of Grade 11 students based on the school they

graduated from?

2. What is the level of reproductive health awareness of students from public

school?

3. What is the level of reproductive health awareness of students from

private school?

4. Is there a significant difference on the level of reproductive health

awareness of students who came from public and private schools?

Hypothesis

H0: There is no significant difference on the students’ level of reproductive

health awareness among Grade 11 students who came from public and private

junior high schools.

 A Comparative Study… 12

CHAPTER II

METHOD

This chapter presents the research design, research locale, research

participants, research instruments, research procedures, statistical treatment,

and scope and limitation of the study.

Research Design

This study used the descriptive-comparative design of research.

Descriptive research is a study designed to describe the participants in an

accurate way. It exhibits relationships that are not existing, practices that are

present, attitudes and beliefs that are contrast, ways and methods that are

practiced (Kowalczyk, 2003). Descriptive method was used to identify the level of

awareness of the respondents.

Moreover, a Comparative method, an investigation based on comparison

was used to determine if there is a difference between the level of reproductive

health awareness of students from the public and private junior high schools.

Research Locale

This study was conducted at the Senior High School Department of San

Pedro College, wherein the respondents were the Grade 11 students enrolled in

the academic year 2017-2018.

 A Comparative Study… 13

Research Participants

The number of respondents were obtained through purposive sampling.

The total population of the respondents is 166. Eighty three (83) respondents are

from public schools and another eighty three (83) respondents are from private

schools. Both groups of participants were officially enrolled in the Senior High

School Department academic year 2017-2018.

Research Instruments

A standardized close-ended questionnaire was adopted from the level of

awareness questionnaire by Verma et. al. to identify the level of awareness on

reproductive health of Grade 11 STEM students. A cover letter was attached to

the questionnaire that explains the purpose of the study for ethical

considerations. The questionnaire is consisting of statements referring to

reproductive health awareness. The level of awareness assessment is divided

into: modes of transmission, and preventions wherein it is assessed using Likert

Scale with the scales 5- Extremely awareness, 4- Moderately aware, 3-

Somewhat aware, 2- Slightly aware, 1- Not at all aware. Ordered intervals of the

level of reproductive health awareness were utilized. Table 1 below is divided

into three parts: numerical value, descriptive equivalent and interpretation.

Table 1. Ordered Intervals for the Awareness level

Numerical Descriptive Interpretation
Value Equivalent
4.2-5.0 Extremely Aware Very aware of Reproductive Health and has
relevant knowledge about the matter
 A Comparative Study… 14

3.4-4.1 Moderately Aware Aware of Reproductive Health and has

relevant knowledge about the matter
2.6-3.3 Somewhat Aware Fairly aware of Reproductive Health and has
relevant knowledge about the matter
1.8-2.5 Slightly Aware Quite aware of Reproductive Health and has
relevant knowledge about the matter
1.0-1.7 Not at all aware Not aware of Reproductive Health and has
relevant knowledge about the matter.

Research Procedures

The following are the procedures that the researchers have followed to

get adequate information from the respondents regarding on their reproductive

health awareness.

The first step was asking of permission for the conduct of the study. The

researchers wrote a letter to the Department head of the Senior High School,

Professor Rosario M. Oconer, MATC, to allow us to conduct the study at San

Pedro College.

The second step the asking of permission from the author to use the

standardized test questionnaire from the study entitled “An Assessment of the

Level of Awareness, Attitudes, and Opinions of the Medical Students Concerning

HIV and AIDS in Malaysia.” by Verma, et., al. The researchers used a

standardized close-ended questionnaire to determine the respondent level of

awareness towards reproductive health.

The third step was asking permission to the respondents of the study

through distribution of the letter of consent.

The fourth step was the retrieving and the gathering of data. The

unchecked data of the respondents was handed by the researchers to the hired
 A Comparative Study… 15

statistician. The selected test questionnaires were checked, and the results were

tabulated by the researchers.

The last step was the analyzation and interpretation of data gathered.

After the tabulation and calculation of data, the researchers have deliberated,

analyzed and interpreted the results accordingly to come up with the conclusions

and recommendation.

Statistical Treatment

The following statistical tools were used in this study.

1. Population Mean

Mean could measure the best value that represents the whole population

or the sample under study. The mean or average that is used to derive the

central tendency of the data in question.

2. Independent Sample t-test

The independent sample t-test was used to measure significance

between two independent samples.

 A Comparative Study… 16

CHAPTER III

Results

Presented in this chapter are the results of the data gathered on the level

of reproductive health awareness of Grade 11 students coming from public and

private junior high schools.

Based on the data presented in Table 1, fifty percent (50%) of the

respondents are from public schools and another 50% are from private schools.

A total of 166 respondents participated in the study.

Table 1. Profile of Grade 11 students from public and private high schools
Count %
School Graduated Public 83 50.0%
From Private 83 50.0%

The results presented in Table 2 are the level of reproductive health

awareness of Grade 11 students coming from Public and Private junior high

schools. In obtaining the mean of the level of reproductive health awareness of

both public and private schools, this range was used; 1.0-1.7 not at all aware,

1.8-2.5 slightly aware, 2.6-3.3 somewhat aware, 3.4-4.1 moderately aware and

4.2-5.0 extremely aware. The mean of public junior high schools was 3.79 which

falls under moderately aware. Furthermore, the private junior high schools have

the mean of 3.78 which also falls under moderately aware. This shows that both
 A Comparative Study… 17

Grade 11 students coming from public and private junior high schools are both

moderately aware about reproductive health.

Table 2. Awareness level of Grade 11 Students from Public and Private Junior
high schools
School Graduated Mean Description Interpretations
From

Public 3.79 Moderately Aware Aware of Reproductive

Health and has relevant
knowledge about the matter
Private 3.78 Moderately Aware Aware of Reproductive
Health and has relevant
knowledge about the matter

As presented in Table 4, the p-value of 0.958, was greater than the level

of significance of 0.05. Therefore, the null hypothesis was accepted. There was

no significant difference on the level of reproductive health awareness of Grade

11 students who came from public and private junior high schools.

Table 3. Independent Sample t-test of Awareness level

Awareness p-value Decision
Level 0.958 Accept Ho
 A Comparative Study… 18

CHAPTER IV

DISCUSSIONS

In this chapter, the data are presented to answer the question posed in

the study. The data gathered were reproductive health awareness level of the

respondents from public and private schools.

The test results showed that Grade 11 students from public junior high

schools has a slightly greater mean than the students from private junior high

schools. This implies that Grade 11 students from public junior high schools are

slightly more aware of reproductive health than the students from private junior

high schools and both mean of the groups of respondents are described as

moderately aware. This supports what La Bella (2013) mentioned that there

should be implications of incorporating a sexuality education program in the

Filipino public-school system. The Reproductive Health bill in the Philippines was

passed in 2012 but apparently, on 2016 the Department of Education revealed

that the minimum standards of comprehensive sexuality education that schools

and other learning facilities should comply with has not yet developed

(Geronimo, 2016).

In relation to this, the Social Cognitive Theory (SCT) by Albert Bandura

states that learning occurs in a social context with a dynamic and reciprocal

relation of the person, environment, and behavior (Hurst, 2003). As stated by La

Bella (2013), Applying SLT is assumed that the more individuals change their
 A Comparative Study… 19

sexual behavior, the more people around them will also change their sexual

behavior. Thus, this may explain why the respondents were moderately aware

about the matter even though comprehensive sex education here in the

Philippines has not yet expounded.

Furthermore, there is no significant difference on the level of reproductive

health awareness of Grade 11 students coming from public and private junior

high schools. This implies that the level of reproductive health awareness among

Grade 11 students were close. According to Piaget (1955), Cognitive

Development Theory assumes that individuals become more aware and can

understand things and concepts in a more developed way as they go on different

stages of their development. Thus, this theory explains why both grade 11

students from public and private junior high school have close level of

awareness because they are in the stage of development wherein, they can

already fully understand how important reproductive health is.

Thus, the results can be related to Andrew Tannahill’s the Tannahill

Model, which states that health education is designed to change the knowledge,

beliefs, attitudes and behavior in a way that facilitates health which will lead to

disease prevention and health protection that aims to lessen risk factors and the

consequences of disease (Jones and Bartlett, 2005).

This study stressed that Grade 11 Students from public and private junior

high schools have adequate knowledge about reproductive health. Despite the

fact that the sexuality education which schools and other learning facilities
 A Comparative Study… 20

should comply with has not yet developed, the students have already acquired

sufficient information about the matter.

This study mainly focuses on determining and comparing the reproductive

health awareness of the Grade 11 Senior high school students from public and

private junior high schools who were officially enrolled in the academic year

2017-2018, at San Pedro College The results of this investigation may provide

information on the level of reproductive health awareness, which may also serve

as guide on their future researches.

 A Comparative Study… 21

CHAPTER V

SUMMARY, CONCLUSION, AND RECOMMENDATION

This chapter contains the summary, conclusion and recommendations of

the study which were drawn from the results gained.

Summary

The mean of the students from the public junior high schools was 3.79,

and the mean of private junior high schools’ students was 3.78. In addition, due

to their slight difference the results show that the students from public junior high

schools are more aware than those students from private junior high schools.

Moreover, the null hypothesis was accepted because the p-value of 0.958 is

greater than the level of significance of 0.05. The level of awareness regarding

reproductive health among grade 11 students who came from public and private

junior high schools has no significant difference.

Conclusion

Based on the findings of this research, the researchers conclude that the

mean of public junior high schools students was 3.79 and the mean of the

private junior high schools students was 3.78.The following ranges was used to

obtain the mean level of reproductive health awareness of both public and

private schools; 1.0-1.7 not at all aware, 1.8-2.5 slightly aware, 2.6-3.3
 A Comparative Study… 22

somewhat aware, 3.4-4.1 moderately aware and 4.2-5.0 extremely aware. In

addition, this concludes that the mean of both public and private junior high

schools falls under moderately aware. However, based on their slight difference

it only indicates that public junior high schools are more aware than private junior

high schools. Furthermore, the p-value of 0.958 is greater than the level of

significance of 0.05 therefore the null hypothesis was accepted.

In conclusion, the results show that there was no significant difference on

the level of reproductive health awareness among Grade 11 students who came

from public and private junior high schools.

Recommendations

Based on the findings and conclusions, the researchers recommended

that:

1. The administrators may provide seminars for students to improve their

level of reproductive health awareness.

2. A study be conducted about the level of reproductive health awareness of

students from different private and public schools in Davao City.

3. The future researchers can use age and gender as their basis for

determining the level of reproductive health awareness.

4. Specific reproductive health problems may be used as basis for further

research.
A Comparative Study… 23