Promoting RH

It’s not true that whatever Rodrigo Duterte wants, he gets.

It’s been three years, for example – the first half of his term – since Duterte included the full implementation of the Responsible Parenthood and Reproductive Health Act of 2012 in his 10-point socioeconomic planning agenda. Today, his government is just gearing up for the full implementation of Republic Act 10354.

Officials in charge of population-related programs say the challenge remains formidable in promoting RH in this predominantly Catholic country, where a male macho culture puts the burden of birth control mostly on the women. But there have been some improvements.

With the approach of World Population Day tomorrow, we’ve discussed the issue on Cignal TV/One News’ “The Chiefs” with several officials. We were told that from four children per family 25 years ago, the average Filipino family size has gone down to 2.5.

The population growth rate, however, remains one of the highest in Southeast Asia, behind only Myanmar and Cambodia. This is according to Socioeconomic Planning Secretary Ernesto Pernia, who maintains that there is a real link between population and economic growth.

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It’s surely not just coincidence that in terms of indicators such as per capita income and gross domestic production, we have been left behind by the four other founding members of the Association of Southeast Asian Nations, where the population growth rate is slower.

Opponents of birth control point out that a country’s population fuels demand and contributes to national production, stimulating economic growth. Limited resources must be factored in, however, and at a certain point, population growth can become unsustainable, affecting everyone’s quality of life.

How can you tell when the level of unsustainability has been reached? In the cities, you can look around you and see urban blight. There are simply too many people competing for limited resources, from decent shelter to road space to jobs and the most basic necessities for survival, water and food.

True, the country still has vast open spaces for human settlement, as some opponents of family planning argue. But this isn’t the age of the frontiersman. It isn’t the age of Adam and Eve, when it made sense to be fruitful and multiply.

The typical poor Filipino isn’t looking to become an American-type colonist, developing a homestead and eking out a living in the hinterlands. The typical poor Filipino is waiting for the government to develop areas for modern human settlement, with roads and utility services, with economic and livelihood opportunities, a school, a health center and a place of worship, with an armed security team to keep the community safe.

Developing countries, however, have limited resources for this, often compounded by the lack of political will and bad governance.

Lacking in the basic services and opportunities in underdeveloped rural communities, urban migration becomes attractive – especially for families with many mouths to feed and not enough food to go around. In crowded cities, urban blight is inevitable.

It’s also a question of quality of life. Women with the education and the means to have access to RH services have the choice of spacing childbirth and planning the size of their families. Why should poor women be deprived of that choice?

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In September 1994 at the International Conference on Population and Development in Cairo, Egypt, the Philippines committed to a program of action to achieve certain population management goals. 

Dr. Juan Antonio Perez III, socioeconomic planning undersecretary for population and executive director of the Commission on Population (Popcom) says none of the goals has been achieved so far.

Efforts to pass an RH law were initiated during the presidency of Fidel Ramos, whose health chief Dr. Juan Flavier also launched an aggressive program to promote family planning and safe sex.

Flavier proved so effective that he attracted intense heat from the Catholic Church. Even the Protestant FVR caved in to pressure and persuaded the country’s version of Mr. Condom to make a career change. Fortunately for Flavier, he never lost an election bid.

The push for the RH law was much less successful for FVR. The passage of RA 10354 was one of the legislative achievements of the Noynoy Aquino presidency, but it took about five more years before all the legal challenges were finally resolved.

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Now the National Economic and Development Authority (NEDA), mother unit of Popcom, has taken over the implementation of the RH program from the Department of Health and is gearing up for a stronger push for RA 10354.

Among the first steps taken by NEDA and Popcom is to get the Catholic Church on board. Perez met last week with several bishops as well as representatives of Protestant churches and Islam to discuss the RH program.

Some of the agreements: NEDA will be ramping up efforts to raise public awareness of the natural method of avoiding pregnancy even as it promotes artificial contraception. As a compromise, the Catholic Church will not actively campaign against birth control. I hope Perez was not just hearing what he wanted to hear from the bishops.

Regardless of religious beliefs, Perez noted that attitudes in Philippine society in fact posed major hurdles in the RH program. In rural areas for example, parents want many children so they can have help in farming or other livelihood activities. But Perez said this mindset is gradually changing.

There is also the Pinoy male’s attitude that continues to place the burden of spacing childbirth on the woman. The typical Pinoy male dislikes using condoms, thinks vasectomy will rob him of his virility, and is cool to coitus interruptus – the reason the natural method can be unreliable. Perez said they were still discussing ways of promoting changes in the Pinoy male mindset.

There is also the compromise provision in the RH law that allows public health workers to refuse to participate in the program because of religious or personal beliefs.

Such a worker, however, must register with the government as a so-called conscientious objector. So far, the government has not had even one person registering as such, Perez said. 

With the forthcoming push for RH, President Duterte might yet see progress in this socioeconomic goal by the end of his term.