Noynoy Aquino Seeks to Restart Birth Control

Philippine President Benigno S. Aquino III appears to be attempting to bypass the powerful Catholic Church by allocating P500 million (US$12.01 million) to the Department of Health "family planning commodities and supplies” -- birth control devices such as condoms, intra-uterine devices (IUDs) and birth control pills for large-scale distribution to community centers across the country.

The decision appears to be a route around the Philippine Catholic Bishops Conference, which bitterly opposes any attempts to deliver birth control devices to the country’s soaring population. The bishops have managed to keep a reproductive rights bill bottled up in the Philippine legislature for 15 years. The legislation is a package of measures aiming to provide universal access to women for birth control and for maternal care.

Aquino, when he was campaigning before he was elected to the Presidency in 2010, said he favored the reproductive rights measure. However, while publicly he says he remains committed to its passage, it was moved down the list of his priorities for passage in the legislature and remains stalled. The conference has threatened to excommunicate the president if he supports it.

The plan to go ahead with distribution of the funds is the latest in a series of actions by Aquino that appear to belie his reputation for indecision. He has sought to make real inroads on corruption, engineering the impeachment of the chief justice, Renato Corona, and seeking to put his predecessor, Gloria Macapagal Arroyo, in jail on charges of plunder and election fraud.

After cancelling several vitally important infrastructure projects because he wanted to ensure transparency in the bid process, the National Economic Development Authority announced in May that it had approved five infrastructure projects including two from the government’s priority project list and had upped the priority list of public-private projects from 16 to 22, including four rail projects, requiring expenditure of P352 billion (US$8.2 billion). The latest announcement involved projects worth P32.7 billion. Tender dates have been set for a further seven of the projects, a sign that maybe the country is going to do something about the woeful state of its infrastructure – and do it in a relatively transparent and honest process.

About 85 percent of Filipinos are Catholics, with 45 percent going to church weekly, behind only Ireland and Northern Ireland for fidelity to the church. Despite that, the fact is that Filipinas, like much of the rest of the world, are well ahead of their church when it comes to attitudes toward birth control. Some 34 percent have used birth control devices according to a study by an organization called Catholics for Free Choice. Currently 18 percent report using birth control pills and another 11 percent have been sterilized, both opposed by the church.

Those figures may well be out of date. Particularly among young, urban Filipinas, birth rates appear to be dropping markedly according to anecdotal evidence, with women opting to have only one or two babies. Even so, according to the Guttmacher Institute, which specializes in research on reproductive rights, the average Filipina has at least one more child than she wants.

Nonetheless, it is questionable whether the family planning allocations can actually be carried out in some provinces. Public health officials and family planning advocates told IRIN, a public information service of the United Nations Office for the Coordination of Humanitarian Affairs, that officials in the country’s local governments and politicians concerned about losing the votes of Catholic supporters may simply ignore the measure’s provisions. Getting aid to the poorest is crucial since it is they who have the highest fertility rates.

The money for the new family planning initiative will have to come from 2012 general budget allocations of US$990 million, IRIN said. Health department officials say the move is aimed at cutting maternal mortality rates, which went from just 162 deaths per 100,000 live births in 2006 to 221 in 2011 - a rise of 35 percent - according to the government’s 2011 Family Health Survey. Life expectancy is running well below East Asia as a whole, at 68 years in 2010 compared with 72 years for the rest of Asia.

Philippine population has been on an inexorable rise since the early 1960s. At that point, the country’s population was roughly the same size as Thailand’s, at about 40 million. However, there are now nearly 95 million Filipinos against 65 million Thais, testament to Thailand’s extremely successful birth control program. Health officials say at this pace the Philippines will likely miss the UN Millennium Development Goal (MDG) of reducing the 1990 maternal mortality ratio (MMR) by three-quarters by 2015.

“This difference… is attributed to Thailand's very successful [family planning] program, In other words, ours has been unsuccessful,” Esmeraldo Ilem, head of the Jose Fabella Memorial Hospital, the national maternity facility in the capital, Manila, told IRIN.

Under pressure from the church, the Philippine government discontinued its family planning programs during the administration of Aquino’s mother, Corazon. They were revived sporadically but opposed by Gloria Arroyo, who sought the help of the Catholic church in her fight to stay in office. Foreign governments and NGOs have so far filled the funding gap, but the global financial crisis and changing geopolitical priorities have forced them to cut back on aid, Philippine government officials told IRIN. In 2005 donors provided $4.4 million for contraceptives, with the US government contributing most of the money, according to the public-private Reproductive Health Supplies Coalition, which tracks shipments of reproductive health supplies.

Funding for contraception was half that amount in 2011 as the global financial crisis cut into spendng by philanthropical organizations. The International Planned Parenthood Federation, Marie Stopes International - a global reproductive health NGO - and the UN Population Fund (UNFPA) together provided US$2.2 million for contraceptives, with $836,000 coming from UNFPA.

As a result, some six million Filipina women reported an "unmet need" for modern family planning services, according to the health department.

"These are women who are too old or too young to give birth, or those who already have too many [children], yet still come here and bear babies because they do not have proper access to health services,” Ilem told IRIN as he made the rounds in Fabella's crowded wards.

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