Reproductive Health Bill in the Philippines (Part 1): Facts and Salient Features

One of the hottest topics one of these days is on the issue of the Reproductive Health Bill. With that you’ve got to agree that it’s bringing the country to a square off. But of course, it became more controversial and provocative when political affairs such as this are mixed with the Roman Catholic Church.
Family "Planting".

Before we go to crunch time, before I disclose my view on this, let us first examine our national policy on population vis-à-vis the current Reproductive Health Bill (which, the one most noteworthy was that bill authored by Rep. Edcel Lagman). I will give my opinion in the second part of this series.

House Bill No. 5043 authored by Albay Rep. Edcel Lagman has yet to be approved on second reading and is currently under interpellation in the chamber. Also known as the proposed Reproductive Health, Responsible Parenthood and Population Development Act of 2008, the bill promotes the use of both artificial and natural means of family planning.

History buff as I am, let us first look into its brief history. As what is stated by the Senate Policy Brief Promoting Reproductive Health, the issue on reproductive health dates back to 1967 when the Philippine Government signed the United Nations Declaration on Population by which countries agreed that the population problem be considered as the principal element for long-term economic development. Therefore, the Population Commission (Popcom) was created to push for a lower family size norm and provide information and services to lower fertility rates. Starting in 1967, the USAID started shouldering 80% of the total family planning commodities (contraceptives) of the country, which amounted to US$ 3 Million annually.



Our population problem has been aggravated by the fact that across various administrations since 1969, the government’s population control thrusts have been inconsistent. This was noted by the study of Dr. Alejandro N. Herrin, an Economics Professor at the University of the Philippines who specializes in demographic economics and population and developmental issues.

In the study entitled, “A Review of Population Policy and Program in the Philippines, 1969-2002,” he noted that the administration of Ferdinand Marcos (1965-1986) emphasized the negative consequences of rapid population growth, and saw the need for government intervention to manage it through information, services, and advocacy. In 1973 FPOP( Family Planning Office of the Philippines) freely gave out contraceptive pills and condoms, they also performed IUD insertions, performed vasectomies and tubal ligations even to far-flung rural areas to control population explosion.

But the succeeding government of Pres. Cory Aquino (1986-1992), did not prioritize population issues. It has also placed more emphasis on couple’s right to determine the number of children, and a family planning program that focused on maternal and child health.

The Ramos administration (1992-1998), meanwhile, renewed efforts to address rapid population growth. The government also promoted family planning in the context of reproductive health by shifting from population control to population management. I remember Sen. Juan Flavier’s “Family Planning” efforts.

On the following administration of President Joseph Estrada (1998-2001), efforts to promote reproductive health were recognized. But greater emphasis was placed on assisting couples achieve their desired family size, as well as introducing a mix of contraceptives.

Under the Arroyo administration, Mr. Herrin noted that the Department of Health had spelled out a national family planning policy. “In this policy statement, family planning was seeing mainly as a health intervention, specifically as an element of reproductive health. In implementing the program, emphasis was placed on the promotion of the natural family planning method,” he said.

In 2000, the Philippines signed the Millennium Declaration and committed to attain the MDG goals by 2015, including promoting gender equality and health. Three years after, USAID started its phase out of a 33 year old program by which the free contraceptives where given to the country. Aid recipients such as the Philippines faced the challenge to fund its own contraception program.

Mr. Herrin, on his paper, said that the President had been quoted as saying that if foreign donors stopped funding the purchase of contraceptive supplies for distribution to public health centers, she expected local private groups – and not the government – to continue the financing.

With various administrations having pushed different policies, Mr. Herrin said it was about time the present government clearly stated its position on a long-term population management program.

“The family planning program has been characterized by shifting objectives of fertility reduction, upholding reproductive rights, and promoting maternal health. In more recent policy statements, it appears that the fertility reduction objective of family planning has been downplayed, if not rejected,” he said.

Aiming for improved quality of life through a “consistent and coherent national population policy”, this is where the current RH bill comes to play.

Reproductive Health is espoused to guarantee universal access to reproductive health care services, supplies and information. There are four bills relating to RH. These are: the House Bill No. 17 authored by Rep. Edcel Lagman, House Bill No. 812 authored by Rep. Janette Garin, Senate Bill No. 40 authored by Sen. Rodolfo Biazon and Senate Bill No. 43 authored by Sen. Panfilo Lacson.

Reproductive Health, as defined by the World Health Organization (WHO) is a state of physical, mental, and social well-being in all matters relating to the reproductive system at all stages of life. Reproductive health 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 definition are the rights of men and women to be informed and to have access to safe, effective, affordable, and acceptable methods of family planning of their choice, and the right to appropriate health-care services that enable women to safely go through pregnancy and childbirth.

Reproductive health care is the constellation of information and services designed to help individuals attain and maintain the state of reproductive health by preventing and solving reproductive health problems. Reproductive health care includes a variety of prevention, wellness and family planning services as well as diagnosis and treatment of reproductive health concerns.

Positive reproductive health means that individuals can manage their own sexuality and have unrestricted access to the full range of reproductive health care options. Implicit in this understanding of reproductive health is the right of all women and men to be informed, to have access to safe, effective, affordable, and acceptable methods of family planning of their choice, and to have access to appropriate health care services that enable women to safely go through pregnancy and childbirth.

Reproductive health is a critical component of women’s general health. Reproductive health care is a prerequisite for women’s social, economic and human development. When women lack access to safe, comprehensive reproductive health care, the consequences can be damaging.

For more information, please take a jiffy to read the full bill (Click here):

Rep. Lagman enumerated some facts (as well as fallacies on his column LINK). Here are the bill’s salient features. Firstly, the bill is national in scope (Sec. 3,d.; Sec. 21) and therefore, comprehensive, rights-based and provides adequate funding to the population program. It is a departure from the present setup in which the provision for reproductive health services is devolved to local government units, and consequently, subjected to the varying strategies of local government executives and suffers from a dearth of funding.

The reproductive health (RH) bill promotes information on and access to both natural and modern family planning methods (Sec. 10; Sec. 11,f; ), which are medically safe and legally permissible. It assures an enabling environment where women and couples have the freedom of informed choice on the mode of family planning they want to adopt based on their needs, personal convictions and religious beliefs. The bill does not have any bias for or against either natural or modern family planning. Both modes are contraceptive methods. Their common purpose is to prevent unwanted pregnancies.

Promotes sustainable human development (Sec. 2; Sec. 3;k; Sec. 5;l; Sec. 6 and 8)

The UN stated in 2002 that “family planning and reproductive health are essential to reducing poverty.” The Unicef also asserts that “family planning could bring more benefits to more people at less cost than any other single technology now available to the human race.”

Strengthening of Popcom (Sec. 5)

The existing Population Commission shall be reoriented to promote both natural and modern family planning methods. It shall serve as the central planning, coordinating, implementing and monitoring body for the comprehensive and integrated policy on reproductive health and population development.

Capability building of community-based volunteer workers (Sec. 12)

The workers shall undergo additional and updated training on the delivery of reproductive healthcare services and shall receive not less than 10-percent increase in honoraria upon successful completion of training.

Midwives for skilled birth attendance

Every city and municipality shall endeavor to employ an adequate number of midwives and other skilled attendants.

Emergency obstetrics care (Sec. 16)

Each province and city shall endeavor to ensure the establishment and operation of hospitals with adequate and qualified personnel that provide emergency obstetrics care.

Hospital-based family planning (Sec. 13; Sec. 4,e,2; Sec. 4,g.; Sec. 6,d.; )

Family planning methods requiring hospital services like ligation, vasectomy and IUD insertion shall be available in all national and local government hospitals.

Contraceptives as essential medicines (Sec. 11,g.; Sec. 19,c.; )

Reproductive health products shall be considered essential medicines and supplies and shall form part of the National Drug Formulary considering that family planning reduces the incidence of maternal and infant mortality.

Reproductive health education (Sec. 4,e,7.; Sec. 4,i.; Sec. 6,e,1., Sec. 10; Sec. 11; )

RH education in an age-appropriate manner shall be taught by adequately trained teachers from Grade 5 to 4th year high school. As proposed in the bill, core subjects include responsible parenthood, natural and modern family planning, proscription and hazards of abortion, reproductive health and sexual rights, abstinence before marriage, and responsible sexuality.

Certificate of compliance

No marriage license shall be issued by the Local Civil Registrar unless the applicants present a Certificate of Compliance issued for free by the local Family Planning Office. The document should certify that they had duly received adequate instructions and information on family planning, responsible parenthood, breast feeding and infant nutrition.

Ideal family size (Sec. 13)

The State shall encourage two children as the ideal family size. This is neither mandatory nor compulsory and no punitive action may be imposed on couples having more than two children.

Employers’ responsibilities
(Sec. 15; Sec. 19,c)

Employers shall respect the reproductive health rights of all their workers. Women shall not be discriminated against in the matter of hiring, regularization of employment status or selection for retrenchment. Employers shall provide free reproductive health services and commodities to workers, whether unionized or unorganized.

Multimedia campaign (Sec. 17)

Popcom shall initiate and sustain an intensified nationwide multimedia campaign to raise the level of public awareness on the urgent need to protect and promote reproductive health and rights.

To sum it up, the Lagman-authored House Bill No. 17, also known as the proposed "Reproductive Health and Population Development Act of 2008," covers the following areas:

    * information and access to natural and modern family planning;
    * maternal, infant and child health and nutrition;
    * promotion of breast feeding;
    * prevention of abortion and management of post-abortion complications;
    * adolescent and youth health;
    * prevention and management of reproductive tract infections, HIV/AIDS and sexually transmitted diseases (STDs);
    * elimination of violence against women;
    * education and counseling on sexuality and sexual and reproductive health;
    * treatment of breast, gynecological disorders, and reproductive tract cancers;
    * male reproductive health;
    * male involvement and participation in reproductive health
    * prevention and treatment of infertility and sexual disorders;
    * and adolescent reproductive health.





Picture Credits:
http://archive.wn.com/2009/10/04/1400/globalwarm/

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