Responsive and Progressive, Responsibilities and Realities (The RH Bill)

     The Reproductive Health Bill and Population Development Act of 2008 (hereafter RH Bill) is an act providing for a national policy on reproductive health, responsible parenthood and population development, and for other purposes. It was primarily authored by Albay First District Representative Edcel Lagman and is now co-authored by about 130 more lawmakers. The bill covers the following aspects: "information and access to natural and modern family planning; maternal, infant and child health and nutrition; promotion of breast feeding; prevention of abortion and management of post-abortion complications; adolescent and youth health; prevention and management of reproductive tract infections, HIV/AIDS and sexually transmitted diseases; elimination of violence against women; counseling on sexuality and sexual and reproductive health; treatment of breast and reproductive tract cancers; male involvement and participation in reproductive health; prevention and treatment of infertility; and reproductive health education for the youth." (House Bill No. 5043 Sections I-III, 2008) More than a year has passed since the bill's original authorship, but it still remains a controversial issue in the legislative assembly. Consequently, it has also sparked debates among economists, sociologists, health experts, religious organizations and ordinary members of the community. This is why it is only appropriate for me, a concerned student and Filipino citizen, to offer my assessment. After reading the full text of the bill and the opposing arguments among different sectors, I am now brought to an unwavering stand. The RH Bill must be immediately legislated because as clearly stated in its policies and objectives, it promotes awareness and education, ensures public health and disease prevention and enables the government to play its role in the overall welfare of the citizens.
     Obviously, sick and uneducated humans are not the resources we would like to have. They cannot be dynamic if they are devoid of information, inflicted with diseases that can be prevented and treated, or worried about a family of ten that they cannot support. These can all be avoided upon the approval of the RH Bill, which, as we will soon after see, is not just pro-life but pro-quality life.
     RH Bill promotes awareness and education, which are the initial steps to creating a well-founded society.
     Another objective of this bill is to ensure public health and disease prevention.
     The third and most time-appropriate advantage of the RH Bill is the fact that it enables the government to play its role in the overall welfare of the citizens. This is the reality today, and we must soon take action.

The Health Benefits of Family Planning and Reproductive Health

  • More than 400,000 women suffer from maternal morbidities every year.
  • Women suffer more from maternal morbidities than any other illness.
  • Around 200,000 maternal morbidities—up to half the total— can be prevented through effective family planning.
  • Eleven women die each day from pregnancy and birth complications. Most of these deaths are preventable.
  • Proper birth spacing reduces by half the risk of death for newborns and infants. More than 7,800 infant deaths can be prevented yearly through family planning.
  • Poor women and infants carry the most risk of death and disability from lack of access to reproductive health services.
  • For every peso spent in family planning, around 3 to 100 pesos will be saved in maternal care costs for unintended pregnancies.
  • At least 5.5 B (billion) pesos are spent each year in health care costs for managing unintended pregnancies and its complications. An annual budget of 2 to 3 B pesos for FP is a cost-effective public health measure.
Population Policies and Programs from 1968-2010
A part of Atty. Pangalangan’s lecture included a brief review of how previous administrations dealt with the issues of population growth and reproductive health through government policies and programs. A similar and more detailed analysis conducted by Alejandro N. Herrin was featured in the Philippine Institute for Development Studies Discussion Paper Series.
  • It was during the Marcos administration (1967-1986) that RA 6365 or the Population Act of the Philippines was established. This was later revised by PD No. 79 for the purposes of “national development…[and] meeting the grave social challenge of high rate of population growth.” From these statements, it is clear that the administration’s population policies emphasized the negative consequences of rapid population growth on social and economic progress.
  • During the Aquino administration, POPCOM issued the “Policy Statement on the Philippine Population Program” that regards family planning as a “vital component of comprehensive maternal and child health.” Its basic principles also include “respect for the rights of couples to determine the size of their family.”
  • The Ramos administration (1993-1998) recognized the role of rapid population growth in hampering socioeconomic program. In 1997, POPCOM completed the Philippine Population Management Program (PPMP) Directional Plan. Part of this was the Philippine Family Planning Program (PFPP), which adopted a “reproductive health orientation to family planning.” The Department of Health (DOH) soon issued Administrative Order No. 1-A, which created the Reproductive Health Program.
  • The Philippine Population Management Program of the Estrada administration (1998-2001) adopted a strategy that aims to “assist couples to achieve their desired family size” and promotes the couple’s health and well-being. To achieve replacement fertility by the year 2004, the DOH considered a shift from the current contraceptive method mix to more modern methods.
  • The Arroyo administration (2001-May 2010) emphasized Natural Family Planning, as Arroyo herself prefers natural family planning over artificial methods. According to her, she expects non-government organizations, rather than the government, to fund the purchase of contraceptives for distribution to public health facilities in the event that bilateral and multilateral donors stop doing so.
As for the new Aquino administration, the stand of President Noynoy Aquino on the RH Bill is still not clearly defined.

10 Reasons to pass the RH bill now

1. RH will: Protect the health & lives of mothers

The WHO (World Health Organization) estimates that complications arise in 15% of pregnancies, bad enough to hospitalize or kill women. From the 2 million plus live births alone, some 300,000 maternal complications occur yearly. This is 7 times the DOH’s annual count for TB, 19 times for heart diseases and 20 times for malaria in women. As a result, more than 11 women die needlessly each day.
Enough skilled birth attendants and prompt referral to hospitals with emergency obstetric care are proven curative solutions to maternal complications. For women who wish to stop childbearing, family planning (FP) is the best preventive measure. All these are part of RH.

2. Save babies

Proper birth spacing reduces infant deaths. The WHO says at least 2 years should pass between a birth and the next pregnancy. In our country, the infant mortality rate of those with less than 2 years birth interval is twice those with 3. The more effective and user-friendly the FP method, the greater the chances of the next child to survive.

3. Respond to the majority who want smaller families

Times have changed and people want smaller families. When surveyed about their ideal number of children, women in their 40s want slightly more than 3, while those in their teens and early 20s want just slightly more than 2.
Moreover, couples end up with families larger than what they planned. On average, Filipino women want close to 2 children but end up with 3. This gap is unequal, but shows up in all social classes and regions. RH education and services will help couples fulfill their hopes for their families.

4. Promote equity for poor families

RH indicators show severe inequities between the rich and poor. For example, 94% of women in the richest quintile have a skilled attendant at birth, while only 26% of the poorest can do so. The richest have 3 times higher tubal ligation rates. This partly explains why the wealthy hardly exceed their planned number of children, while the poorest get an extra 2. Infant deaths among the poorest are almost 3 times that of the richest, which in a way explains why the poor plan for more children. An RH law will help in attaining equity in health through stronger public health services.

5. Prevent induced abortions

Unintended pregnancies precede almost all induced abortions. Of all unintended pregnancies, 68% occur in women without any FP method, and 24% happen to those using traditional FP like withdrawal or calendar-abstinence.
If all those who want to space or stop childbearing would use modern FP, abortions would fall by some 500,000. In our country where abortion is strictly criminalized, and where 90,000 women are hospitalizedyearly for complications, it would be reckless and heartless not to ensure prevention through FP.

6. Support and deploy more public midwives, nurses and doctors

RH health services are needed wherever people are establishing their families. For example, a report by the MDG Task Force points out the need for 1 fulltime midwife to attend to every 100 to 200 annual live births. Other health staff are needed for the millions who need prenatal and postpartum care, infant care and family planning. Investing in these core public health staff will serve the basic needs of many communities.

7. Guarantee funding for & equal access to health facilities

RH will need and therefore support many levels of health facilities. These range from health stations that can do basic prenatal, infant and FP care; health centers for safe birthing, more difficult FP services like IUD insertions, and management of sexually transmitted infections; and hospitals for emergency obstetric and newborn care and surgical contraception. Strong RH facilities can be the backbone of a strong and fairly distributed public health facility system.

8. Give accurate & positive sexuality education to young people

Currently, most young people enter relationships and even married life without the benefit of systematic inputs by any of our social institutions. We insist on young voters’ education for events that occur once every few years, but do nothing guiding the young in new relationships they face daily. The RH bill mandates the education and health departments to fill this serious gap.

9. Reduce cancer deaths

Delaying sex, avoiding multiple partners or using condoms prevent HPV infections that cause cervical cancers. Self breast exams and Pap smears can detect early signs of cancers which can be cured if treated early. All these are part of RH education and care. Contraceptives do not heighten cancer risks; combined pills actually reduce the risk of endometrial and ovarian cancers.

10. Save money that can be used for even more social spending

Ensuring modern FP for all who need it would increase spending from P1.9 B to P4.0 B, but the medical costs for unintended pregnancies would fall from P3.5 B to P0.6 B, resulting in a net savings of P0.8 B. There is evidence that families with fewer children do spend more for health and education.

This is a compilation of the RH Bill advantages and its good side.
The sources of this post are Live Journal, Philippine Online Chronicles, Likhaan and Filipino Free Thinkers. What are the disadvantages and the bad side of the RH Bill? Click this  



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