The Philippines
The Philippines is an archipelago consisting of 7,107 islands with a population of 90,457,000. The populace is approximately 80% Roman Catholic, about 15% Muslim, with Buddhists and smaller Christian denominations comprising the rest of the population. Despite significant growth in the country’s per capita income, income distribution has remained uneven as evidenced by widespread poverty. Forty-four percent of Filipinos earn less than $2 USD per day and about two-thirds are engaged in activities that rely heavily on environmental and natural resources. Unemployment is a high 7.5% and underemployment is even higher at 18.8%.
Women have an elevated status in Filipino culture, manifested by the Philippines ranking 9th best of 134 countries in order of their 2009 Global Gender Gap. Additionally, more females aged 15 - 24 are literate compared to men in the same age range. Even though women hold a high place in society, other obstacles contribute to less than ideal health conditions.
Stagnant Reproductive Health Outcomes
Eleven women die giving birth every day in the Philippines. This translates to a maternal mortality rate (MMR) of 162 per 100,000 live births. Based on official figures from acknowledged government surveys, the country's MMR seems to have plateaued in the last three survey periods:
- 209 maternal deaths in 1993 (National Demographic Survey, 1993)
- 172 maternal deaths in 1998 (National Demographic Survey, 1998)
- 162 maternal deaths in 2006 (Family Planning Survey, 2006)
The government is hoping to achieve the target of 52 deaths per 100,000 by 2015, but experts from United Nation (UN) agencies and non-governmental organizations have expressed concern that this goal is unlikely to be met.
Most Filipino women have always wanted fewer children than what they are actually having, however, their contraceptive practice does not match their fertility desires and the contraceptive prevalence rate (CPR) of 51% has not changed much in the past decade. A Guttmacher Institute study estimated that in 2008, 3.4 million women got pregnant, half of which were unintended or unplanned, and that one out three of these unplanned pregnancies ended with an abortion.
Religion and Reproductive Health
One of the most influential voices in Philippine society is the institutional Roman Catholic Church. It has been very active in blocking any government support for legislative bills and funding that will promote use of artificial contraceptive methods since only natural family planning methods are acceptable to the Church. In the years of the previous administration under Gloria Macapagal Arroyo (February 2001-June 2010), the government’s policies were aligned with the Church’s position. Noteworthy government policies and programs along these lines include:
- Administrative Order 125 of the Department of Health issued in 2002, which mandates government health workers to promote natural family planning as the only acceptable mode of birth control.
- Responsible Parenting Movement (RPM) under the Philippine Commission on Population (Popcom) launched in December 2006, aimed to reach 4.2 million couples in 42,000 barangays (local administrative divisions) over a period of 3 years (2007-2010) to promote and practice Responsible Parenthood and Natural Family Planning.
In addition, President Arroyo repeatedly stated during her term in office that the national government will not give any money for contraceptive commodities, instead local government units should purchase these for their constituents.
With the inauguration into office of President Benigno “Noynoy” Aquino III, in June 2010, leaders and advocates are hopeful that the government’s position will be more supportive of progressive national policies and programs on reproductive health and population. The initial signs were encouraging as President Aquino has publicly stated that he supports responsible parenthood and that it is up to the couples to decide the family planning method that they would use.
Wide Support
Given that leadership at the national level has shown weak support for reproductive health, supporting a strong network of leaders in reproductive health and population is of critical importance. Expanding that group to include leaders from all sectors (from NGOs, governmental organizations, academe, media and the private sector) will ensure a wider base of support.
In addition to partnering with Leadership Fellows, it was also a priority of LDM to groom the next generation of leaders from grassroots and civil society organizations, especially those in the youth sector. More than their sheer number, this group is key, as future leaders of this country will come from their ranks. Therefore, the LDM program gave attention to nurturing young and emerging leaders who will continue challenging the status quo and demand needed change and transformation in society.
Another key strategy was to support initiatives to institutionalize leadership, reproductive health, and population programs. An example of this strategy was the support and assistance LDM provided in establishing a course on Population, Reproductive Health and Environment, at the University of the Philippines, a course on Population and Development Policy Advocacy Leadership, at the Philippine Legislative Committee on Population and Development, and a Training of Trainers for NGO officers and staff on Monitoring and Evaluation with emphasis on the use of the Evalulead framework.
Promoting Improved Policies
Leadership Fellows worked to educate the public and policymakers about the importance of improved reproductive health access and services for women and their families. There have been some achievements on this front as the latest mapping (July 2009) showed that local government units across the country (6 provinces, 7 cities and 22 municipalities) have passed resolutions and ordinances to address reproductive health and population concerns. Still, Leadership Fellows remain concerned that there is no national reproductive health policy that protects Filipino families.
2008 marked a milestone year as a reproductive health bill reached plenary deliberations in congress - almost a decade after it was first proposed. With this development, reproductive health concerns have received considerable national attention; both positive and negative. Other “non-traditional” supporters, from the academe to the private sector, have come out in support of the proposed bill. It is also heartening to note that national and community surveys done by reputable polling organizations have largely been in favor of proposals for government to support family planning and reproductive health related concerns. The May 2010 national elections ended the plenary debates in congress, but the fervor of the RH champions in congress have again picked up in the 15th Congress. Six versions of the RH Bill were filed in congress and were eventually consolidated to House Bill 4244 (An Act Providing for a National Policy on Reproductive Health, Responsible Parenthood and Population Development and for other purposes). As of March 2011, the bill is once more up for plenary debates in congress. Meanwhile, in the Senate, a version of the RH bill has also been filed and similarly will be up for plenary debates in the coming months ahead.
RH leaders and advocates are also cognizant that despite the growing support for a national RH bill, there are still major opposition groups that are also zealously against the RH bill. In fact, the Roman Catholic Church and its allies have stepped up their campaign against the bill. The Church used significant events such as the 40th anniversary of Humanae Vitae in 2008 to hold a rally and speak out against the reproductive health bill. During the height of the 2010 presidential elections, the Catholic Bishops’ Conference of the Philippines issued a guideline called, “A Catechism on Family and Life for the 2010 Elections”, which explicitly stressed that “it would not be morally permissible to vote for candidates who support anti-family policies, including reproductive health” (www.cbcponline.net/documents). This was widely circulated in all parishes across the country at that time. Even after the elections, the Catholic Church has continued to put pressure to the new president to tow the official Catholic line. As such, the challenge remains for Leadership Fellows to build on the momentum for improved reproductive health policies through continued public education on the importance of reproductive health not only for the country to achieve its development goals but for families to have an improved quality of life. LDM is proud to have initiated the formation of Catholics for Reproductive Health in 2008, members of which are individual Catholics who believe that reproductive health is a right for all Filipinos even for those who belong to the Catholic faith. The group which started as a loose network of 7 individuals from several non-governmental organizations has expanded to include more than 500 members from key areas of the country.
Sources:
- The World Bank (2009)
- Population Reference Bureau (2009)
- Wikipedia (2009)
- UNICEF (2009)
- National Statistics Office, Press Release of Labor Force Survey, April 2009 released June 2009
- Meeting Contraceptive Needs in the Philippines, 2009, Guttmacher Institute with Linangan ng Kababaihan Incorporated (Likhaan) and University of the Philippines Population Institute (UPPI)
- State of the Philippine Environment: A Progress Report, February 2006
- National Demographic Survey (2003)
- Family Planning Survey (2006)