The government of the Philippines aims to drastically cut maternal
deaths by spending US$12 million on contraceptives in 2012, a move bitterly
opposed by the Catholic Church.
The government of the Philippines
is aiming to save its “failed” national family planning program and drastically
cut maternal deaths by spending 500 million pesos (almost US$12 million) on
contraceptives in 2012, a move bitterly opposed by the influential Roman
Catholic Church.
The Department of Health has said
it will use the money to purchase “family planning commodities and supplies” –
an official euphemism for condoms, intra-uterine devices (IUDs), birth control
pills and other contraceptives – and distribute them on a large scale for the
first time in largely underfunded community centers across the country.
It is a controversial decision
that even public health officials and family planning advocates admit may not
be carried out by local officials wary of angering the Church or losing the
votes of Catholic supporters.
The Church frowns on
contraceptives and discourages Filipinos from using them, so government support
for family planning programs has usually been limited. Earlier attempts to
boost family planning services failed when strict congressional vetting
scrapped any program that involved paying for and distributing
contraceptives.
The money for the new family
planning initiative will have to come from 2012 general budget allocations of
$990 million. 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.
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.
“The Philippines started its
family planning program in the 1970s, when we had a similar population to
Thailand of around 40 million. But now our population is roughly 95 million,
while Thailand only has 65 million,” said Esmeraldo Ilem, head of the Jose
Fabella Memorial Hospital, the national maternity facility in the capital,
Manila.
“This difference… is attributed
to Thailand’s very successful [family planning] program,” he said. “In other
words, ours has been unsuccessful.”
The hospital’s dark hallways and
perpetually overcrowded maternity wards could symbolize the country’s
inadequate health sector management.
A reproductive health bill that
includes allocating funds for contraceptives and introducing sex education for
primary school children has been bitterly debated in Congress for the past two
years, but there is little sign of it being passed anytime soon.
Foreign governments and NGOs have
so far filled the gap, but the global financial crisis and changing
geopolitical priorities have forced them to cut back on aid, say Philippine
government officials. 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. The International Planned Parenthood Federation, Marie
Stopes International – a global reproductive health NGO – and the UN Population
Fund (UNFPA) together provided $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 said as he made the rounds in Fabella’s crowded
wards.
The city government of Manila
hosts the national headquarters of the Catholic Church in a country where more
than 80 percent of the people identify themselves as members.
“In Manila, there is no health
center where you can find free contraceptives.” The city banned contraceptives
in government health centers about a decade ago.
President Benigno Aquino, elected
in 2010 on a promise to end poverty, initially voiced support for
the reproductive health bill, but intense lobbying by Church officials,
whose views on key issues often shape public opinion, has softened that
position.
“We will not meet the MDG
[Millennium Development Goal] on maternal health,” Ilem said. “But at the very
least the purpose of this spending is to help save our family planning program
by… mak[ing] contraceptives available to the public.”
The statistics and acronyms mean
little to women like Irish Gili, 31, a mother of eight who had just delivered
her latest baby at Fabella. She has never had access to family planning advice,
much less free contraceptives. She nearly died while delivering her seventh
child, but found herself pregnant again, barely a month after giving
birth.
“I have been advised to have a
[tubal] ligation already,” she said. “I suppose I need to that now. I have so
many mouths to feed, and my body can no longer handle another
childbirth.”
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Source: IRIN
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