Nearly two decades after the International Conference on Population Development in Cairo, the Philippines has still not laid out a clear national policy on reproductive health in line with its commitment to the ICPD Program. More than our failure to meet our commitment to the global community, this lack of action highlights the State’s failure to recognize reproductive rights of Filipinos.

Denial of these rights is reflected on the Philippines’ poor performance in the MDGs. Maternal mortality ratio is high and will not decrease to target levels by 2015. Infant mortality rate targets can be achieved but disparity exists among economic quintiles and regions. Women continue to be denied ability to exercise their rights over their bodies. A significant proportion of women desiring to use family planning are unable to access these services. Actual fertility rates overshoot desire fertility rates up to three kids in the poorest quintile.[i] On top of this, the Philippines faces an HIV/AIDS epidemic whose impact on health services and the economy we will be feeling in the future.

We already know the solutions to these problems. One is increasing birth intervals to at least three years would increase survival chances of children up to at least five years and the mother during childbirth.[ii] Achieving this would necessitate access to family planning services. We should avoid more “Manilas” where an oppressive policy resulted in women experiencing poorer lives and difficulty in getting ligations that would help prevent a future pregnancy that might well kill them.[iii]  Although it should be noted that based on the experience of other developing countries, increasing the number of contraceptive users may not necessarily translate to lower maternal deaths and policy should be accompanied by better implementation and a good health service delivery system.[iv]

Another solution is promoting better behavior. Sex education is a foundation for behavioral change. It can delay sexual initiation and promote safer sexual behavior. Contrary to what critics exclaim, these programs do not lead to earlier sexual behavior[v]. This is important as early sexual initiation is associated with risky behaviors and increased risk of HIV infection[vi] and safer practices would later translate to decreased HIV transmission. Aside from these the bill stipulates some other important thrusts such as provision of improved reproductive health services and protection for special populations such as the disabled and the indigent.

If the Philippines would like to improve the health of its people, the reproductive health bill should be passed. Although it is not the cure-all we want, it is certainly a necessary step towards better health for all.

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References:

[i] National Demographic and Health Survey 2008

[ii]Setty-Venugopal V, Upadhyay UD. Birth Spacing Three to Five Saves Lives. 2002. Population Reports, series I, no. 13. Baltimore: John Hopkins Bloomberg School of Public Health, Population Information Program. Available at http://main.jhuccp.org/pr/l13edsum.shtml.

[iii]Likhaan, ReproCen and Center for Reproductive Rights. Imposing Misery The Impact of Manila’s Ban on Contraception. 2007. Available at: http://www.likhaan.org/sites/default/files/pdf/2007_imposing_misery.pdf

[iv] Hardee K, Agarwal K, Luke N, Wilson E, Pendzich M, Farrell M, Cross H. “Reproductive Health Policies and Programs in Eight Countries: Progress since Cairo. 1999. International Family Planning Perspectives, 25 (Supplement): S2-S9.

[v] Kirby DB, Laris BA, Rolleri LA. Sex and HIV Eduation Programs: Their Impact on Sexual Behaviors of Young People Throughout the World. 2007. Journal of Adolescent Health 40: 206-207.

[vi] Preventing HIV/AIDS in Young People: A Systematic Review of the Evidence from Developing Countries.

notes: This is my output for my OB elective, I was limited to 500 words. Writing evidence-based position papers is fun but I got lucky that I've been following this issue for years. If I was a total newbie, it would have been torture. I was also limited to free full articles only and for the life of my I can't remember the sources we used for our effectiveness of HIV/AIDS education report.