Just when you thought the culture wars over reproductive health had finally been settled with the enactment of the reproductive health (RH) law after decades of languishing in Congress and its subsequent constitutional affirmation by the Supreme Court, those opposed to it have found a way to reignite them.
Controversy over budget cuts to the reproductive health program in the General Appropriations Act of 2016 erupted after it was revealed that some senators in the bicameral conference committee sequestered one billion pesos from the items approved by both houses of congress. The Palace in its negotiations with congress opted to keep these cuts given the impending deadline for the passage of its last budget.
The following six charts demonstrate just how important it is for government to fund the reproductive health law’s implementation through other means in light of these recent events.
Chart 1: Adolescent fertility rate (births per 1,000 women ages 15-19)
President Cory Aquino’s reversal of the Marcos era policies on population and fertility management arrested the downward trend seen in the adolescent fertility rates from about 66 per 1,000 women aged 15-19 years in 1960 to 50 births in 1987.
President Ramos succeeded in lowering that rate from 51 in 1992 to 49 (the lowest point ever achieved) in 1997. The rate went back up in the years since he left office. By 2014, the adolescent fertility rate was just over 60 per 1,000 women, a level not seen since 1967.
Clearly the lack of commitment for reproductive health from each government since EDSA-1 (with the exception of the Ramos administration) is responsible for these results. The chart shows that since 2002 the adolescent fertility rate in the Philippines has exceeded the World average, which has declined to 45 in 2014.
Withholding modern methods of family planning from young, poor parents who cannot afford them would prevent many young mothers from completing their education, according to Health Sec. Garin. The RH law was meant to allow women from the poorest households to have access to contraceptives.
Chart 2: Contraceptive prevalence (% of women ages 15-49)
Contraceptive use among married women and their partners aged 15-49 years in the Philippines was on an upward trend nearly tripling from 15% in 1968 to 44% in 1986 when it began to decline under Pres. Cory Aquino (for the same reasons cited above) back to 36% in 1988. Pres. Ramos lifted it to 50% by 1995. It then plateaued in the high-40s to low-50s range until 2013 with the passage of the RH law when it rose to 55%.
Other ASEAN countries such as Thailand and Vietnam saw their contraceptive prevalence converge with the United States during this period, overtaking the Philippines, and settling in the high-70s percentile range by 2010. Indonesia has been able to lift its prevalence rate above 60% by that time, nearing the World average, having overtaken the Philippines by the late-80s.
Chart 3: Unmet need for contraception
The unmet need for contraception is the percentage of fertile, married women of reproductive age who no not want to become pregnant and are not using contraception. The unmeet need in the Philippines has been falling, from just over 30% in 1993 to just under 18% in 2013. The Philippines has a relatively high unmeet need compared to other ASEAN countries Indonesia, Thailand and Vietnam.
Chart 4: Fertility rate
The fertility rate is the average number of births per woman. The Philippine fertility rate more than halved from just over 7 births per woman in 1960 to just over 3 by 2013, which was above the World average of about 2.5. Our ASEAN neighbors, Indonesia, Vietnam and Thailand transitioned from above average fertility rates in the 1960s to below average by the early 2010s.
Chart 5: Mortality rate, neonatal
The likelihood of infant mortality increases with a higher birth rate. The Philippines had a mortality rate of 19.6 (out of every 1,000 live births) in 1990 and ended with 12.9 in 2014. Thailand and Vietnam started out with higher mortality rates in 1990 (20.4 and 23.9 respectively) but ended up with lower rates by 2014 (7 and 11.7 respectively). Indonesia was able to narrow its gap with the Philippines by lowering mortality from 30.3 to 14 within this period. The United States began with 5.8 and ended with 3.7, by comparison.
Chart 6: Lifetime risk of maternal death
Higher fertility rates increases the risk of death due to maternal causes to women during their lifetime. In 1990 1 out of every 200 women aged 15 and above were at risk of maternal death, while in 2013, 1 out of 250 women were at risk. The risk in Indonesia was 1 out of every 68 in 1990 and became 1 out of every 220 in 2013. In Vietnam and Thailand, the risk was 1 out of every 180 and 1,000 in 1990 respectively and was reduced to 1 out of every 1,100 and 2,900 in 2013, respectively.