Not just doleouts but real reforms

Editor’s note: The second part of this series discussed why the government’s anti-poverty program has been not effective in some way because of its basic design or politics.

Third of Five Parts

When he was still a local official, Interior Government Secretary Jesse Robredo had commented that while the local school board (LSB) “seems well-represented” on paper, “in reality, most of them are not functioning well.” He said that this was because in most cases, the local chief executive overpowered the rest of the board, thereby ensuring things went his or her way.

Another Education department staff member commented that oftentimes, the LSB members are mere signatories of resolutions formulated by the mayor.

Secretary Robredo blames the lack of regulation in the utilization of the Special Education Fund (SEF). “[The SEF] is beyond the oversight of the Sanggunian,” as it is solely in the hands of the LSB, he said.

The SEF comes from the local government’s collection of an additional 1-percent tax on real property.

Robredo has issued a memo circular requiring local governments to have full public disclosure of how they used their SEF, among other items in their annual budget. The Department of Budget and Management is also busy formulating the guidelines for SEF use. This, Robredo said, will hopefully minimize the debate on SEF priorities.

No leg up for NGOs KALINGA’s

Gloria Santos, president of the community-based association KALINGA, has been left grumbling over her experience of trying to get a leg up from SEF, but the good news is she has no plans of giving up her organization’s projects. KALINGA has also worked out a memorandum with the Department of Education (DepEd) national office.

Santos said that she expects DepEd to issue a resolution that would instruct the local government to recognize KALINGA as a bona fide educational organization, thereby qualifying it for funding support.

Among KALINGA’S beneficiaries are Mona Geronimo and Mary Joy Racines, who have taken it upon themselves to look for other ways to secure high school diplomas. Since they both lack the means to go back to school, the teenagers have decided to take a crack at the Education department’s high-school equivalency exam.

To prepare themselves for the test, Mona and Mary Joy have joined an alternative learning program being provided for free by KALINGA, which also runs a daycare in Barangay Pinagbuhatan in Pasig City, where both girls reside.

Eventually, Mona wants to enroll in a business course because she wants to be an entrepreneur. Mary Joy wants to be a teacher someday.

She explained why: “Para ako na rin ‘yung magtuturo sa mga kapatid ko . . . para matuto naman silang bumasa, sumulat, umintindi. Kasi wala namang magpapaaral sa kanila, e. [That way, I will be the one to teach my siblings . . . so that they can learn to read, write, comprehend. Nobody will finance their schooling, anyway].”

Better programs needed

In his message that accompanies the proposed government budget for next year, President Benigno Aquino 3rd notes that the allocation for health is 13.6 percent higher than 2010’s P29.3 billion (According to the 2010 General Appropriations Act though, only P28.7 billion was allocated to the Department of Health).

Yet if one were to compare health’s share of the budget for this year and what the corresponding figure could be in the next, the difference isn’t much.

For 2010, the health allocation is 1.8 percent of the P1.54-trillion national purse. For 2011, the Aquino administration is proposing P32.62 billion for health –as indicated in the proposed National Expenditure Program — which is 1.9 percent of the P1.64-trillion national budget. The increase in terms of share in the total budget then would amount to just a tenth of a percentage point.

But that isn’t all. When he was still on the campaign trail, President Aquino had promised that health would take a five-percent share of the national budget. It would seem now that he is off by at least 3.1 percentage points from what he had pledged, and short by almost P50 billion in peso terms.

Aquino, however, appears to have an ally in Dr. Esperanza Cabral, who was the last secretary of the Department of Health (DOH) in the previous administration.

According to Cabral, the promised increase should not all happen in one year. “Because if you throw P80 billion to the [Health] department, but the department is not ready to spend it, sayang naman [it would just be a waste],” she said. The increase, she added, should be incremental according to the “absorptive capacity” of the DOH.

“The spending should be programmed because the accomplishments are also programmed,” Cabral said. “Hindi naman matatapos lahat ng health care problems natin sa isang taon [Our health care problems won’t be solved in just one year anyway].”

That’s putting it mildly. As it is, the Philippines is already unlikely to attain the Millennium Development Goal (MDG) No. 5 by the 2015 deadline – to reduce by three-fourths the number of mothers dying from child-birth complications, and to assure greater access to contraceptives.

Feeble, infirm

The National Economic and Development Authority (NEDA), which put together the latest Philippine Progress Report on the MDGs that will be out this week, does say that the country may have a medium to high probability of meeting other health-related MDG targets. But development and health experts would probably agree that “feeble and infirm” are apt descriptions for the delivery of health services in this country, especially to the poor.

And yet the Aquino administration is poised to maintain several key health programs of its predecessor, even though these had been plagued by inefficiency and political interference, among other things. These include health subsidies under the conditional cash transfer program and Philhealth’s sponsored program, which is co-financed by national and local government agencies.

One major point of divergence it has with the previous government regarding public health, though, is in the area of reproductive health.

President Aquino had some quarters worried that he was about to renege on another campaign promise when he reportedly said he needed to review the reproductive health bill and rename it the “responsible parenthood bill.”

But statements made just last week by Health Secretary Enrique Ona assured most of the Aquino government’s support for artificial contraceptives, which would be among the range of choices to be offered to couples.

The support would include funds for the availability of contraceptives in government health centers. Ona also said that the government would support sex education, which had been strongly opposed by the local Roman Catholic Church hierarchy and lay groups.

Arroyo’s failure

Aquino’s immediate predecessor, Rep. Gloria Arroyo of Pampanga, was known to frown on government programs that incorporated artificial contraceptives, including initiatives promoting maternal health, as well as those aimed at preventing HIV/AIDS or the human immunodeficiency virus and acquired immune deficiency syndrome.

In large part, saiddevelopment and health experts – and even Cabral – this is why the Philippines will be unable to achieve MDG No. 5.

In 1990, the Philippine maternal mortality rate (the number of women dying from pregnancy or childbirth-related complications for every 100,000 live births) stood at 290. This figure was supposed to be reduced to 52 by 2015.

But the current maternal mortality rate is 162, which translates to about 12 women dying each day while giving birth.

Most of these women are poor. After all, according to the 2008 National Demographic and Health Survey (NDHS), a woman in the lowest wealth quintile will bear an average of 5.2 children in her lifetime, compared to an average of 1.9 children for a woman in the highest wealth quintile.

In general, this is because the poor have less access to more family planning methods, even though they may want to space or limit their childbearing.

Income divide

For sure, proper medical attention and hygienic conditions during delivery are crucial in lowering the risks of women dying during childbirth. But in this area, there appears to be a huge divide between rich and poor women, between the educated and uneducated, and between urban and rural residents, according to the United Nations Population Fund (UNFPA).

In the National Capital Region (NCR), for instance, almost nine in 10 deliveries are attended by skilled health professionals, versus only two out of 10 in the Autonomous Region in Muslim Mindanao (ARMM), 2008 NDHS data show.

Indeed, the fact that she lives in Metro Manila may be why Claire Briones has yet to encounter any real problem while giving birth. Still, she says she dreads having any other medical emergency. At 35, Briones has four children; she is a single parent.

In theory, Briones’s family may qualify as one of the beneficiaries of the Conditional Cash Transfer (CCT) scheme that was the flagship anti-poverty program of the Arroyo administration and which is being continued by President Aquino.

To be continued –Che De Los Reyes, Philippine Center For Investigative Journalism