Noynoy for reproductive health

We got a glimpse into the reproductive health concerns of president-elect Noynoy Aquino, which concerns are the needed shot in the arm in the long-festering issue of lack of a national population policy. During the campaign period, Aquino had expressed favoring reproductive health, a position that was perceived to not sit well with the Roman Catholic bishops, particularly because he is a Catholic.

Reproductive health advocates hold on to the promise Aquino made in his platform, titled, “A Social Contract with the Filipino People.” In the section “Commitment to a Transformational Leadership,” he underscored “responsible parenthood,” and said that the advancement and protection of public health are key measures of good governance.”

Former Health Secretary Jaime Galvez Tan, Aquino’s consultant on health during these policy planning days, and who is likely to be the next Department of Health head, told reproductive health advocates attending a forum sponsored by the Likhaan Center for Women’s Health yesterday that the president-elect expressed a resolution for a universal health care system.

“I have never seen a president who has placed health as No. 1 in his agenda,” said Tan. Aquino, he said, expressed that the country can’t afford to continue its high birth rate, and that under his administration, the Medium Development Goal 5 of reducing maternal mortality rate would be reduced early in his term.

Aquino’s marching orders, said Tan, included seeing a program to cut down poverty.

Those are heartening words from Aquino, indeed. We look forward to reading the dynamics of his population policy. As to the question of whether it would favor the “cafeteria” approach of making available to everyone all family planning methods, it possibly will. After the forum, Tan told me that before the May election, Aquino told him, “I don’t care if the church hates me for my position on reproductive health. “

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Another cause for celebration was the pronouncement of Rep. Edcel Lagman that the 15th Congress will vigorously push for the approval of the Reproductive Health bill, of which he was the principal author at the 14th Congress, and earlier congresses. Reelected in the May election to represent the first district of Albay, he said much effort must be made to convince his colleagues to get the bill passed. Those opposed to the bill were noisy, and so should advocates make noise, he said. But the prospect of passage is bright, as 75 percent of the bill’s co-authors have been reelected, 69 percent of party-list groups are co-authors of the bill, and “staunch supporters” of the bill are back in the House. “Some of those who strongly opposed the bill lost in the May election.”

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Other speakers at the forum – Health Secretary Esperanza Cabral, former Health Secretary Alberto Romualdez, United Nations Population Fund (UNFPA) country representative Suneeta Mukherjee, senior country adviser of the David and Lucille Packard Foundation Michael Tan, and Likhaan executive director Janice L.D. Melgar, presented statistics and observations on the poor state of reproductive health among Filipino women.

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The high birth and maternal mortality rates were presented at the forum as due to barriers to contraceptive use in the country. According to Likhaan’s brief, contraceptive use has hardly increased in the Philippines over the past decade. Yet women are having, on average, about one more child than they would like. More than a fifth of married women do not want to have a child soon or at all, but are not using a contraceptive method.

Cutbacks in publicly funded contraceptive service and supplies since 2004 have reduced women’s and couples’ access to contraceptives, according to Likhaan. National surveys from 1998 to 2008 show that women have relied increasingly on pharmacies for contraceptive services. This switch to private sector suppliers is likely to involve higher costs and lead to reduced access, particularly for low-income women and couples.

“Family planning services should be a major public health priority for the incoming administration,” Janice Melgar said at the forum and press statements. “The government must ensure that the rapid fall in access to contraception, especially among poor women, is halted. Family planning services must be restored as a key strategy to help reduce maternal deaths and pregnancy complications.”

Melgar noted that on overall contraceptive use among married women has increased very slowly in the past 10 years, from 47 percent in 1998 to 51 percent in 2008. Modern contraceptive use has not increased in recent years, remaining at 33-34 percent between 2003 and 2008. Meanwhile, women are having, on average, one more child than they want.

As a result, said Melgar, 22 percent of married women have an unmet need for contraception. The proportion is higher among the poorest married women (28 percent) and among sexually active unmarried women aged 15-29 (24 per percent) and lowest among the richest married women (20 percent). –Domini M. Torrevillas (The Philippine Star)