Philippines RH Act: Rx for controversy
Diatribe by Philippines' President turns back the clock
Appendix "A"
Philippines population control and management
policies
In 1967, President Ferdinand Marcos joined other
world leaders in adding his signature to a Declaration on Population that had been made
the previous year by representatives of 12 countries
(often incorrectly cited in Philippines government
documents as "the UN Declaration on Population").1
Two years later, Executive Order 171 established the
Commission on
Population (POPCOM), and in 1970 Executive Order
233 empowered POPCOM to direct a national population
programme.2
The Population Act [RA 6365] passed in
1971 made family planning part of a strategy for
national development.
Subsequent Presidential Decrees required increased
participation of public and private sectors, private
organizations and individuals in the population
programme.3
Under President Corazon Aquino (1986 to 1992) the
family planning element of the programme was
transferred to the Department of Health, where it
became part of a five year health plan for
improvements in health, nutrition and family
planning. According to the Philippines National
Statistics Office, the strong influence of the
Catholic Church undermined political and financial
support for family planning, so that the focus of
the health policy was on maternal and child health,
not on fertility reduction.4
The Ramos administration launched the
Philippine Population Management Program
(PPMP) in 1993. This was modified in 1999, incorporating "responsible parenthood" as a central theme.3
During the Philippines 12th Congress (2001-2004)
policymakers and politicians began to focus on
"reproductive health."5
In 2006 the President ordered the Department of
Health, POPCOM and local governments to direct and
implement the Responsible Parenthood and Family
Planning Program.
The Responsible Parenthood and
Natural Family Planning Program's primary policy
objective is to promote natural family planning,
birth spacing (three years birth spacing) and
breastfeeding which are good for the health of the
mother, child, family, and community. While LGUs can
promote artificial family planning because of local
autonomy, the national government advocates natural
family planning.3
The population of the Philippines grew steadily
from about 27million in 1960 to over 100 million in
2018. Starting from similar populations in 1960,
Thailand, Myanmar and South Korea now have much lower
populations (Figure 1).
However, from about 1984, the rate
of population growth in the Philippines and
these countries decreased (See Figure 2). Moreover, the decrease in the
Philippines growth rate remained comparatively
steady, and was consistent with the decrease in
population growth rate worldwide (See
Figure 3).
From 2000 to 2017 the Philippines' birth rate (per 1,000 people) remained consistently higher than that of Thailand, Myanmar and South Korea, but maintained a downward trend consistent with those countries until 2008, when it returned to a level slightly higher than five years earlier (Figure 4).
The downward trend resumed, so that by 2017 the Philippines' birth rate had fallen about 15% in 17 years (Figure 5). This was only about half the reduction reported in Myanmar and Thailand over the same period; the drop in South Korea's birth rate was far more dramatic. However, the 17 year reduction in the Philippines' birth rate was actually higher than the reduction in the global birthrate .
A paper published in 2003 claimed that the population program was "ineffectual," the result of "inadequate institutional and financial support."6
Nonetheless, the fertility rate in the Philippines was halved between 1973 and 2013.7
If the Philippines population management policies
and programmes have had no measurable impact on
population growth, they have produced one notable
outcome. The notion that the government should
manage population growth and instruct the population
in fertility control and "responsible parenthood"
has become part of the normal social, political and
health care landscape in the Philippines. Moreover,
an infrastructure of familiar government ministries,
offices and officials has been established
throughout the country to give effect to government
policies.
Over 80% of Filipinos are Catholic, so it is not
surprising to encounter assertions that population
management infrastructure and operations "largely
reflect the Catholic Church's position on family
planning which emphasizes responsible parenting,
informed choice, respect for life and birth
spacing."8 The
Catholic bishops of the country have been accused of
opposing and hampering population management and
fertility reduction policies.9 On the other hand, Church officials have sometimes suggested or encouraged "Church-government collaborative partnerships" involving "principled collaboration" by the Church.10 One such partnership was formalized.11
Certainly, the Catholic bishops have forbidden Catholic hospitals
to "provide facilities and services for induced
abortion, contraceptive sterilization, or the
administration of artificial contraceptives," and
insisted that admitting privileges are conditional
on adherence to this policy. Members of Catholic
religious orders may administer or work in
non-Catholic hospitals where such services are
provided only if their presence is not exploited to
create a public impression that they approve of
them, and they do not participate in them. The
bishops have advised Catholics working in hospitals
where contraceptive sterilization is offered to
notify management in writing "of their conscientious
refusal to directly participate in such procedures."12
However, this is not the whole story.
Surgical sterilization excepted, the forms of birth control that are legal in the Philippines do not have to be provided through hospitals. Government health care facilities (including hospitals) outnumber privately controlled facilities (including hospitals) by a 10-1 margin.13 This enormous practical advantage appears to be reflected in statistics about birth control practices.
Over 25 years ago a survey of women aged 15 to 49
found that over 96% were familiar with one or more
methods of family planning, including modern
contraceptive methods, and that over 90 percent knew
where to obtain the pill, 80 percent the IUD, condom
and female sterilization, and 70 percent male
sterilization. Of the married women surveyed, 40%
were practising some form of birth control, most
often dispensed by government sources. Only 7% were
using methods accepted by Catholic teaching,14
and of the non-users, less than 5% were "opposed to
family planning or cited religion as a reason for
not using contraception."15
From 1992 to 2003, 70% of contraceptives used
were obtained from government sources.16
In 2002 over 57% of those using birth control were
using modern contraceptives.17
By 2017, about 67% of Filipinos using some form of birth control were using modern methods disapproved by the Catholic Church.18
Ten years ago, a prominent Filipino politician offered the
following summary of the political relevance of
Catholic teaching on contraception even then:
He cites recent surveys
showing majority of Catholics favoring a
reproductive health law, requiring government to
teach family planning to the youth, and the
government distributing legal contraceptives like
condoms, pills and IUDs. Religion, says Lagman,
ranks only 9th out of 10 reasons why women do not
use contraception. That a Catholic can still be a
good Catholic and use family planning methods
outside the only church-approved natural family
planning methods has been expressed by a number of
faculty and staff members of the Catholic
institution Ateneo de Manila University, a position
also held by University of the Philippines
academicians. Lagman is himself a Catholic, and goes
to mass when he can.18
If the Catholic Church has enjoyed a privileged position with respect to Philippines government policies in family planning, and if the Church has hampered government efforts to control fertility and reduce the population, it seems, nonetheless, to have been ineffective in convincing most Filipinos to adhere to Church teaching on contraception and sterilization, and it has not prevented a reduction in the Philippines' population growth or birth rate over time.
Notes
1. Ayala T, Caradon L. Declaration on Population: The World Leaders
Statement. Studies in Family Planning [Internet]. 1968 Jan;1(26): 1-3. DOI: <10.2307/1965194>. (Cited 2019 Sep 14).
2. National Statistics Office (NSO) [Philippines] and Macro International Inc. (MI).
National Demographic Survey, 1993 [Internet]. 1994, May. 300 p. [NDS 1993] (Cited 2019 Sep 14).
3. Commission on Population Pilippines, POPCOM: About Us: History [Internet]. [POPCOM] (Cited 2019 Sep 14).
4. NDS 1993, supra note 2 at p. 5-6.
5. Republic of the Philippines, Senate Economic Planning
Office Policy Brief,
Promoting Reproductive Health: A Unified Strategy to
Achieve the MDGs [Internet]. (2009 Jul) [Senate Brief 229] at p. 6. (Cited 2019 Sep 14).
6. Herrin A, Orbeta Jr A, Acejo I, Cuenca J, del Prado
F.
An Evaluation of the Philippine Population Management Program (PPMP) [Internet]. Makati City: Philippine Institute for Development Studies; Discussion Papers Series No. 2003-18. 2003 Dec. 59 p. [Herrin et al] at p. 4. (Cited 2019 Sep 14).
7. Republic of the Philippines, Commission on Population Philippines, The Philippine Population Management Program Directional Plan 2017-2022 [Internet] (Mandaluyong City, Philippines) [PPM 2017] at p. 17, Figure 8. (Cited 2019-09-14)
8. Senate Brief 2009, supra note 5 at p. 3.
9. Herrin A. Lack
of Consensus Characterizes Philippine Population
Policy [Internet]. Makati City: Philippine Institute for Development Studies; Policy Notes, No. 2003-03 2003 Jun. 4 p.
[Herrin] at p. 4. (Cited 2019 Sep 14).
10. Ledesma AJ.
Natural Family Planning- A Pastoral Approach [Internet]. Landas. 2003;17(1) 126-133. (Cited 2019 Sep 14).
11. Memorandum of Agreement among the Family Life Apostolate of the Lingayen-Dagupan Archdiocese, the Kapihan sa Kumbento, and the Province of Pangasinan, with the concurrence of Archbishop Oscar V. Cruz of the Lingayen-Dagupan Archdiocese. Cited in Herrin, supra note 8.
12. Alberto TV.
Moral Norms for Catholic Hospitals and Catholics
in Health Services [Internet]. 1973 Dec 8. CBCP Online Manila, Philippines: Catholic Bishops Conference of the Philippines. (Cited 2019 Sep 14).
A section of the posted
document appears to be missing. According to a copy formerly posted at
Moral Norms <https://www.bukal.com/pdfs/moral%20norms-b.rtf> the full text about religious orders working in non-Catholic hospitals should read: "Religious may not continue to administer and/or work in a hospital which exploits their presence to create in the mind of the public the impression that they approve of immoral procedures being followed in the hospital. If this impression can be
avoided, they may continue in the hospital,
but they may not be directly involved in any of
those procedures. "
13. Republic of the Philippines, Department of Health, National Health Facility Registry v2.0: Philippine Health Facility Status [Internet]. (Cited 2019 Sep 14).
14. NDS 1993, supra note 2 at p. 39-43.
15. NDS 1993, supra note 2 at p. 54.
16. Herrin et al, supra note 6 at p. 7.
17. Herrin et al, supra note 6 at p. 8
18. PPMP 2017, supra note 7 at p. 32, Table 15. According to the table, 54.9% of Filipinos were using some form of birth control 36.8% were using modern birth control methods clearly disapproved of by the Catholic Church. The "traditional" methods include both coitus interruptus and periodic abstinence, but the table does not distinguish between the former (disapproved by the Catholic Church) and the latter.
19. Torrevilas DM.
Lagman's commitment to reproductive health. [Internet] The Philippine Star (philstarGlobal). 2009 Feb 28. (Cited 2019 Sep 14).
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