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REPRODUCTIVE HEALTH IN THE PHILIPPINES: RESPONSIBILITIES AND REALITIES Written by: Elizabeth Angsioco, National Chair, DSWP for the

forum “The Reproductive Health Bill & Its Relevance to Filipino Workers” 11 September 2008, Adarna Food & Culture, Quezon City - 1 -

REPRODUCTIVE HEALTH IN THE PHILIPPINES: RESPONSIBILITIES AND REALITIES
Elizabeth Angsioco National Chairperson Democratic Socialist Women of the Philippines (DSWP)

REPRODUCTIVE HEALTH (RH)
- is a state of complete physical, mental & social well-being & not merely the absence of disease or infirmity, in all matters relating to the reproductive system & to its functions and processes. (WHO & ICPD) RH implies that:    People are able to have a satisfying and safe sex life; & They have the capability to reproduce; & The freedom to decide if, when & how often to do so.

Therefore, RH necessitates the following:  Rights of women & men to be informed & to have access to safe, effective, affordable & acceptable family planning methods of their choice, as well as other methods for regulation of fertility WHICH ARE NOT AGAINST THE LAW; The right to access to appropriate health care services that will enable women to go safely through pregnancy & childbirth & provide couples with the best chance of having a healthy infant.

REPRODUCTIVE HEALTH CARE
  the constellation of methods, techniques & services that contribute to reproductive health & well-being by preventing & solving RH problems; also includes sexual health, the purpose of which is the enhancement of life & personal relations, & not merely counseling & care related to reproduction & STDs.

REPRODUCTIVE HEALTH IN THE PHILIPPINES: RESPONSIBILITIES AND REALITIES Written by: Elizabeth Angsioco, National Chair, DSWP for the forum “The Reproductive Health Bill & Its Relevance to Filipino Workers” 11 September 2008, Adarna Food & Culture, Quezon City - 2 -

PHILIPPINE RH PROGRAM 10 ELEMENTS (DOH AO 1-A s. 1998)
          Family Planning Maternal & Child Health & Nutrition Prevention & Management of Abortion Complications Prevention & Treatment of RTIs including STIs & HIV & AIDS Education & Counseling on Sexuality & Sexual Health Breast & Reproductive Tract Cancers & other Gynecologic Conditions Men’s Role & Participation Adolescent RH VAW Prevention & Treatment of Infertility & Sexual Disorders

PHILIPPINE CONSTITUTION’S PROVISIONS ON RH:
Art. II. Sec. 12. - … The State shall equally protect the life of the mother & the life of the unborn from conception… Art. II. Sec. 15. – The State shall protect & promote the right to health of the people and instill health consciousness among them. Art. XIII. Sec. 11. – The State shall adopt an integrated & comprehensive approach to health development which shall endeavor to make essential goods, health & other social services available to all the people at affordable cost. There shall be priority for the needs of the underprivileged, sick, elderly, disabled, women & children. The State shall endeavor to provide free medical care to paupers. Art. XV. Sec. 3. [1] – The State shall defend the right of spouses to found a family in accordance with their religious convictions and the demands of responsible parenthood.

RH REALITIES IN THE PHILIPPINES:
1. MARRIAGE, PREGNANCY & CHILD BIRTH .1. .2. .3. Mean age at marriage for males is 20 & 19 for females. (YAFS3, 2002) At age 19, 1 of every 5 young women is already married & 90% of those married have already given birth. (DOH, 1999) Mean age at having 1st child is 19. (YAFS3, 2002)

REPRODUCTIVE HEALTH IN THE PHILIPPINES: RESPONSIBILITIES AND REALITIES Written by: Elizabeth Angsioco, National Chair, DSWP for the forum “The Reproductive Health Bill & Its Relevance to Filipino Workers” 11 September 2008, Adarna Food & Culture, Quezon City - 3 -

.4. .5. .6. .7. .8. .9. .10. .11. .12.

Almost 10% of young Filipino women aged 15-19 has already given birth. (NDHS, 1998) Adolescent pregnancy is 30% of all annual births. (DOH/WHO/UNFPA Training Manual) Poor and uneducated women marry & give birth earlier in life, & have more children than women with higher education. (NDHS, 1998) More than 60% of all pregnancies in the Philippines is classified as high-risk. (NHDS, 2003) More than 10 Filipino women die daily due to pregnancy & childbirthrelated complications (UNFPA, 2007) & over half (56%) of yearly maternal deaths are unreported. The WHO indicates that 99% of women who die from pregnancy & childbirth complications comes from developing countries. Only about 25% of the poorest women is attended by skilled attendants upon delivery. (NDHS, 2003) The desired fertility rate of Filipino women in 2.5 per woman. However, actual total fertility rate is 3.5 or a difference of 1 child. (NDHS, 2003) Poor women have 3 times more children than the rich. CLASS Lowest (Poorest) Second Middle Fourth Highest (Richest) Desired Actual Fertility Fertility 3.8 5.9 3.1 2.6 2.2 1.7 4.6 3.5 2.8 2.0

.13. .14.

Population growth rate (PGR) is pegged at 2.04% which translates to about 2 million new Filipinos yearly. Poverty incidence is higher among big families. Family size Phils. 1 2 3 4 5 POVERTY INCIDENCE 1997 2000 2003 28.1 8.36 11.76 15.86 20.44 27.38 27.5 7.57 11.74 14.52 19.62 27.14 24.4 4.44 7.81 11.45 17.05 24.31

REPRODUCTIVE HEALTH IN THE PHILIPPINES: RESPONSIBILITIES AND REALITIES Written by: Elizabeth Angsioco, National Chair, DSWP for the forum “The Reproductive Health Bill & Its Relevance to Filipino Workers” 11 September 2008, Adarna Food & Culture, Quezon City - 4 -

6 7 8 9 10 > 10

35.59 41.22 47.81 52.41 48.99 43.35

37.00 45.62 52.70 55.42 54.44 50.74

33.48 41.44 46.55 52.27 50.63 52.96

2. FAMILY PLANNING (FP):
2.1. 2.2. 2.3. 2.4. 2.5. 2.6. 2.7. 2.8. Mean age at first sex for males is 17 & 18 for females. (YAFS 3, 2002) 16% of youth had first sex before age 15. (SPPR2, 2002) 31.2% of males & 15.9% of females had premarital sex. (YAFS 3, 2002) 27% of males & 14.5% of females used contraception during first premarital sex (YAFS 3, 2002) The lowest rate of contraceptive use is among the 15-19 years age bracket (NDHS, 1998) The majority of women practicing family planning uses modern instead of traditional (calendar, rhythm, abstinence & withdrawal) methods. (FPS, 2006) Only 0.4% of women uses natural family planning (NFP) methods (Mucus/Billings/Ovulation, Standard Days, LAM) & only 13.2% uses traditional methods. (FPS, 2005) Contraceptive Prevalence Rate (CPR) SURVEY 1968 Nat’l Demographic & Health Survey (NDHS) 1973 NDHS 1983 NDHS 1988 NDHS 1993 NDHS 1995 Family Planning Survey (FPS) 1996 FPS 1997 FPS 1998 FPS 2000 FPS 2001 FPS 2002 FPS 2003 FPS 2004 FPS 2005 FPS 2006 FPS Total (%) 15.4 17.4 32.0 36.1 40.0 50.7 48.1 47.0 46.6 47.0 49.5 48.8 48.9 49.3 49.3 50.6 Modern Traditional Methods Methods 2.9 12.5 10.7 18.9 21.6 24.9 25.5 30.2 30.9 28.2 32.3 33.1 35.1 33.4 35.1 36.0 35.9 6.7 13.3 14.5 15.1 25.2 17.9 16.1 18.3 14.7 16.4 13.8 15.5 14.2 13.2 14.8

REPRODUCTIVE HEALTH IN THE PHILIPPINES: RESPONSIBILITIES AND REALITIES Written by: Elizabeth Angsioco, National Chair, DSWP for the forum “The Reproductive Health Bill & Its Relevance to Filipino Workers” 11 September 2008, Adarna Food & Culture, Quezon City - 5 -

2.9.

2.10. 2.11. 2.12. 2.13. 2.14.

Almost 60% of women source their supply of FP services & supplies from the public sector. The government has been dependent on outside donors for its contraceptive commodities. USAID has completely phased out its donations this year. 61% of currently married women does not want additional children anymore. (NDHS, 2003) 50.6% of the youth wants to have only 2 children. (YAFS 3, 2002) The unmet need for contraceptives is 23.15% for poor women & 13.6 for women who are not poor. (NDHS, 2003) 97% of all Filipinos believe it is important to have the ability to control one’s fertility or to plan one’s family. 87% of total respondents is Roman Catholic. (Pulse Asia Survey, February 2004) FP can reduce maternal deaths by 32%. (DOH)

3. ABORTION
3.1. 3.2. 3.3. 3.4. 3.5. 3.6. Unwanted pregnancy causes over 400,000 induced abortions every year. (UPPU-AGI, 2006) It is estimated that 16 out of every 100 pregnancies end in abortion. (Perez, Aurora et al. 1997) The big majority of women having induced abortion are poor (68%), married (91%), with more than 3 children (57%), and Catholic (87%). (UPPU-AGI, 2006) By age groups, 27.9% of women who had induced abortion was aged 2024, 26.5% aged 25-29, and 19.3% was aged 30-34. (Raymundo, Corazon. 1998) Over 78,000 women were hospitalized for complications of induced abortion. (UPPU-AGI, 2006) Some reasons why women have abortions:  Too many children  Birth spacing  Poverty  Rape/incest  Unstable relationship  Too young (Safe Motherhood Fact Sheet: Unsafe Abortion, 1999)

WHAT FILIPINOS SAY:
About family planning:

REPRODUCTIVE HEALTH IN THE PHILIPPINES: RESPONSIBILITIES AND REALITIES Written by: Elizabeth Angsioco, National Chair, DSWP for the forum “The Reproductive Health Bill & Its Relevance to Filipino Workers” 11 September 2008, Adarna Food & Culture, Quezon City - 6 -

 

92% of Filipinos considers FP important. (Ulat ng Bayan, Pulse Asia Survey, 2007) 89% of Filipinos thinks that government should provide budgetary support for modern methods of FP including modern contraceptives. (Ulat ng Bayan, Pulse Asia Survey, 2007)

About pro-RH politicians:     86% says that candidates for elective positions who advocate a program for women’s health should be supported; 82% of the population says that candidates in favor of couples’ free choice of FP should be supported; 82% considers candidates supporting a law on population issues worthy of their votes; and 83% says that they are in favor of candidates who support the allocation of government funds for FP.

Source: Pulse Asia Survey, 2004