Friday, July 13, 2012

Fight for Reproductive Health Bill grows in the Philippines

The Lancet, Volume 380, Issue 9837, Page 98, 14 July 2012

Citing recent government statistics, which show that the maternal mortality rate (MMR) in the Philippines is increasing, groups in support of a long-awaited Reproductive Health Bill are calling for it to become law as the new Congress session starts on July 23.
In late June, senators in favour of the bill, which covers the allocation of funds for contraceptives and the introduction of better sex education for children, reiterated the urgency to pass this legislation. Senator Pia Cayetano, principal sponsor of Senate Bill 2865, the Senate's version of the measure, said the Philippines might fail to reach the Millennium Development Goal (MDG) for maternal health by 2015, citing the results of the 2011 Family Health Survey. “During the past decade that the bill has been stalled in Congress, our MMR has not declined. In fact it has increased to 221 deaths per 100 000 livebirths from 162 deaths from the period 2000—2005”, Cayetano said in a statement, adding that the country's target is to reduce the rate to 52 per 100 000 livebirths by 2015.
Put simply, the results of the Family Health Survey mean that an estimated 11 women die every day in the Philippines from preventable complications arising from pregnancy and childbirth. During the launch of the survey on June 19, Health Secretary Enrique Ona, said: “The number of maternal deaths being reported today also gives us the much needed push to pass critical legislation in support of reproductive health, [and] the amendment of the midwifery and other health professions laws that will allow the provision of critical maternal health services to be provided by other health workers…”.
To reduce the maternal mortality rate, the government has allocated 500 million pesos (US$12 million) out of its 2012 $990 million general budget for purchasing family planning commodities and supplies, such as condoms, intrauterine devices, birth control pills, and other contraceptives. These supplies will be distributed nationwide for the first time. The policy, however, has been severely criticised by the Roman Catholic Church.
Honorata Catibog, Director of the National Center for Disease Prevention and Control, told The Lancet that the budget allocation for contraceptives will be increasing in the years to come to improve family planning. In the Philippines, access for women with financial difficulties in rural areas to modern maternal health-care systems remains insufficient.
In response to the urgent need to pass the bill, Catibog says, “it will really help us achieve the reduction of maternal mortality”. However, she says, it remains uncertain that the target set under the MDGs will be met.
In the Senate, the period of the interpellations on the bill has finished and the bill will proceed to the period of amendment when the new session starts. Meanwhile, at the House of Representatives, the measure remains in the period of interpellation.
Romeo Dongeto, Executive Director of the Philippine Legislators Committee on Population and Development Foundation (PLCPD), said that there is no reason for the House of Representatives to keep delaying the voting because the debate has gone on for more than 10 years and all related issues have been discussed. “Now we're planning our next move to keep on putting the pressure on the House of Representatives and make them really work on the bill”, he said.
According to PLCPD, the Philippines' population growth rate of 1·9%, which is one of the highest in Asia, can be attributed to the absence of a comprehensive reproductive health policy and lack of access to family planning education and services. Dongeto says that, after the bill is passed, the national law will mandate all local government units to allocate money for better health services and prioritise population management programmes on reproductive health.
Arabella Servas, a senior obstetrician and gynaecologist at Manila-based Mary Chiles General Hospital, told The Lancet that, based on her decades-long experience, with more pregnancies, patients are more prone to complications. She said that she had dealt with many cases involving the death of not only mothers but also babies. “If a patient comes to you with eight children, she wants to ask for pills or she wants to have ligation, why can't I give it to her?”
“I'm Catholic. I'm pro the bill…People should open their minds about these things. Like ligation, we're not killing anyone…We're just preventing future pregnancy…”, she added.
Meanwhile, the Episcopal Commission on Family and Life is trying to convince legislators to reject the bill and will hold a 4-day conference in late July focusing on it and other bills that the Church regards as “antilife” and “antifamily”.