On Reproductive Health & RH Bill 4244 Prepared by Pinay sa Holland-GABRIELA & IBON Europe For the Philippinenburo Forum on Reproductive
Discussion Framework I. Context-Setting: Reproductive Health and Reproductive Health Care II. Government Responsibility & Accountability in Health Care III. Current State of Reproductive Health in the Philippines IV. RH Bill: History, Authors, Status V. The Debate: Players and Perspectives VI. Calls and Campaigns of the
Reproductive Health is the condition of complete physical, mental and social wellbeing and not only the absence of disease or weakness, in all things related to the reproductive system, its functions and processes.
Reproductive Health Care refers to the availability of and access to various methods, supplies and services for reproductive and sexual health and well-being by means of preventing or solving problems related to reproductive health.
Elements of Reproductive Health Care 1. Maternal, infant and child health and nutrition; 2. Promotion of breastfeeding; 3. Information and services related to fertility management; 4. Prevention of abortion and management of post-abortion complications; 5. Prevention and management of reproductive tract infections (RTIs), HIV/AIDS and other sexually transmittable infections (STIs); 6. Elimination of violence against women;
Elements of Reproductive Health Care 7. Education and counseling on sexuality and sexual and reproductive health; 8. Treatment of breast and reproductive tract cancers and other gynecological conditions; 9. Male involvement and participation in reproductive health; 10. Prevention and treatment of infertility and sexual dysfunction; 11. Reproductive health education for the girl child, adolescent and youth; and 12. Health education and health care services for menopausal and post - menopausal women
Government Responsibility & Accountability for People s Health & Well-being including Reproductive Health It is the right of every person to enjoy good health. The government needs to recognize, uphold and ensure the basic and fundamental right of its citizens to health. Reproductive health, which particularly addresses women s needs, is integral to general health and wellbeing. This concern is enshrined in national laws and international instruments to which the Philippines is signatory.
Some national laws and international instruments on health and reproductive health: 1. 1987 Philippine Constitution. The State shall protect working women by providing safe and healthful working conditions, taking into account their maternal functions, and such facilities and opportunities that will enhance their welfare and enable them to realize their full potential in the service of the nation. (Article 13 Sec. 14) 2. Magna Carta of Women. (a) Comprehensive Health Services. - The State shall, at all times, provide for a comprehensive, culture-sensitive, and gender-responsive health services and programs covering all stages of a woman's life cycle and which addresses the major causes of women's mortality and morbidity (Chapter 4 Sec. 17) 3. Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW). States Parties shall take all appropriate measures to eliminate discrimination against women in the field of health care in order to ensure, on a basis of equality of men and women, access to health care services, including those related to family planning. (Article 12) 4. Convention on the Rights of Persons with Disabilities. Provide persons with disabilities with the same range, quality and standard of free or affordable health care and programmes as provided to other persons, including in the area of sexual and reproductive health and population-based public health programmes. (Article 25)
Current State of Reproductive Health in the Philippines: The Facts Only 2.6% of the national budget for 2011 was allocated for health care and all related services for 94 million Filipinos. Per person, this translates to P351.00 per year or 96 cents a day. Current information and services on reproductive health focus mainly on family planning which aims to control pregnancies. According to the DOH, the aim of the 2004 Family Planning Program was to reduce the Fertility Rate Target from 3.7 children in 1998 to 2.7 per woman. In addition, maternity clinics were transferred to the management of local governments and private corporations. There is only one maternity hospital (Fabella Hospital) in the country that is under national government administration.
As a result 1. The Philippines has the highest maternal mortality rate in Asia. For every 100,000 deliveries, 230 women die during childbirth as compared to 110 in Thailand, 62 in Malaysia and 14 in Singapore. 2. Despite research showing that more than 60% of pregnancies in the Philippines is high-risk (2003 National Demographic and Health Survey), facilities and access to skilled birth attendants is direly lacking. 3. Inaccessibility of services and lack of accurate information on family planning methods remain as obstacles for women to make informed choices regarding these matters. 4. There is an 18% -23% increase in pre-marital sexual activity among 15-19 year olds from 1994-2002, reflecting a lack of responsible information on sex education for young people. 5. Every hour, 1 woman falls victim to violence according to 2009 surveys. 24% of women between 15-19 years old are victims of physical or sexual violence.
The main causes of maternal mortality are: These causes are preventable if women have access to adequate and appropriate health care and adequate information on how to plan their pregnancies.
THE REPRODUCTIVE HEALTH BILL History & Status On 29 September 2010, Gabriela Women s Party (GWP) authored and submitted House Bill 3387 ( A Comprehensive Reproductive Health Bill). The bill contains the demands of women for access to affordable, quality and comprehensive health care services and programs. Currently, HB 4244 has been submitted to the House of Representatives as a consolidated bill which contains many positive provisions based on HB 3387 submitted by GWP and additional bills (Nos. 96,101,513,1160,5120) submitted by other representatives. Authors: Congress House Bill No 4244 An Act Providing for a Comprehensive Policy ational Policy on Responsible Parenthood, Reproductive Health, and Population and Development and for Other Purposes Submitted By: Representatives Espina, Lagman, Garin (J), Bag-ao, Bello, Biazon, Syjuco, Ilagan and De Jesus Senate Bill 2865: An Act Providing for a National Policy on Reproductive Health and Population and Development Submitted By: Senators Defensor-Santiago, Lacson, Cayetona (P)
THE DEBATE: PLAYERS & PERSPECTIVES 1. The Population Control & Responsible Parenthood Framework...... Promoted and supported by the government. Concerned with control of women s fertility in order to address overpopulation which is seen as the root cause of poverty. Population control programs offered as panacea that will alleviate poverty and mitigate the impact of the economic crisis. Ensures a big and ready market for contraceptive products sold by foreign pharmaceutical companies. Promotes family planning as fertility and pregnancy control instead of planned pregnancies based on informed and healthy choices for women. Does not give importance to the issues of access to information, sufficient facilities and services, quality health service providers that promote women s right to choose and takes into account their health, safety and well-being.
2. Contraceptives as Abortifacients Framework Promoted and supported by the church. Asserts that all contraceptives are abortifacients because it stops the fertilization process which is where the life of a fetus starts. For the church life begins at the conception or fertilization stage. To prevent this from taking place is to kill life. This belief cannot be imposed on everyone and should not be the basis for national policies which should take into consideration respect for different beliefs and choices among the population.
Women claiming their right to comprehensive health care and reproductive health A national reproductive health policy that will guarantee marginalized women s full access to comprehensive maternal and reproductive healthcare. RH Bill provisions that address this advocacy: The consolidated RH bill currently contains several provisions that will help ensure poor women and children s access to healthcare, such as the following: Mobile health clinics that will ensure the delivery of health services to far-flung communities and barangays (villages). Improvement and upgrade of equipment available in public health care facilities, including barangay health centers to ensure that they are able to conduct basic reproductive health care procedures such as pap smears. Pro-bono reproductive health care services for indigent women by making it mandatory for all health care workers to provide at least 48 hours annually of reproductive health services free of charge to indigent patients, especially pregnant adolescents.
However The RH Bill currently contains 3 provisions pertaining to population control that will overshadow its pro-poor provisions and threatens to effectively confine the delivery of reproductive and maternal health care services to the implementation of population control programs, the distribution of contraceptives and population control mechanisms. Moreover, the population control aspects of the RH bill conveniently blame poverty on women s bodies, fertility and population while disregarding the impact of social inequities and neo-liberal policies on the country s growing hunger and poverty.
The 3 provisions: Section 2, Guiding Principles, (l): The limited resources of the country cannot be suffered to be spread so thinly to service a burgeoning multitude that makes the allocations grossly inadequate and effectively meaningless; Section 12, Integration of Responsible Parenthood and Family Planning Component in Anti-Poverty Programs; and Section 25, Implementing Mechanism, where the Population Commission, rather than the DOH per se, is mandated to serve as the coordinating body in the implementation of this bill.
Voices of Progressive Women Gabriela Women s Party and its constituency from among grassroots and community-based women s organizations and networks remain firm in its position against population control. It will continue to push for amendments to the bill, including the removal of provisions pertaining to population control. It will continue to actively organize and mobilize to campaign and lobby for full women s access to healthcare and not just for the retention of the pro-poor provisions in the RH bill but also for increased budgetary allocation for healthcare as well as the granting of increased maternity benefits for women workers, among others. It will continue to work through various ways and in complimentary fields, including actively campaigning to pass a comprehensive national policy on RH. National legislation on RH will ensure recognition of and responsibility by the government for implementing related programs and allocating the necessary budget for it.
CHALLENGES AHEAD 1. Maximize the current public attention on the RH debate to raise awareness among the general public in order to: Ø assert rights to health care and reproductive health care Ø take the government to task to provide appropriate programs and sufficient budgetary allocations for related services and information. Ø Introduce alternative perspectives and influence the current discourse on RH that blames women for the poverty caused by overpopulation and that the ultimate solution to poverty, therefore, is population control and control of women fertility. Ø Advocate recognition of women s rights, including the right to choose and enjoy full access to comprehensive health services and reproductive health care. Ø Expose the population control framework and increase understanding and awareness on the real causes of poverty. 2. Towards educating the general population, increase the participation and provide opportunities for engaging all interested sectors in the debates and campaigns by building multisectoral and cross-networking alliances that will include organizations, institutions and individuals from grassroots communities, professionals, and the youth.
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