Almost six million Filipino women of reproductive age who either want to space their pregnancies or stop having babies do not have the means to do so. Of the six million, two million are poor. The Department of Health (DOH) calls this data the “unmet need” for any method family planning.

The data on the needs that are not met are also translated into women aged 15 to 49 whose rights to some form of contraception and family planning of their choice are not granted because of policy and legal obstructions caused by the Supreme Court’s Temporary Restraining Order  to the DOH in June 2015 from “procuring, selling, distributing, dispensing or administering, advertising and promoting the hormonal contraceptives, “Implanon” and “Implanon NXT.”

Following this decision, the DOH immediately stopped providing implants and implant services to women.

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First six months

A year after the High Court’s TRO, the government of President Rodrigo Duterte announced its policy of embarking on a robust campaign to strictly implement the family planning program through the Responsible Parenthood and Reproductive Health (RH) Law in the Philippines, while advocating for the three-child policy.

Health Secretary Paulyn Jean Rosell-Ubial looked at the first six months of the Duterte administration from July 2016 to January 2017 as the period to provide the family planning needs of couples to help them achieve the desired average number of children and the proper spacing of births.

Along with the National Economic and Development Authority (NEDA), the plan involved local governments to go out in the field, do house-to-house visits, identify those in need of family planning, and work with related agencies to properly implement the RH Law which is one of the 10-point socioeconomic agenda to reduce poverty by 13% in 2022.

“Women in this country are having more children than they want,” Dr. Ubial told journalists in one of her initial press conferences. “So in terms of implementing the law, we will ensure that the unmet need for family planning becomes zero,” she said.

She said the President’s suggestion of three children as the ideal number of offspring for a couple is not a hard target because it is based on official statistics, as Filipino women of reproductive age want 2.7 children. “Three is the desired number of children, the average number of children that women of reproductive age want. It is actually 2.7, so 3 is the round-off number,” she explained.

Duterte also signed Executive Order No.12, providing funds and support for making modern family planning available and to intensify critical actions necessary to attain and sustain “zero unmet need for modern family planning”for all poor households by 2018.

Ubial added that the government wants to make sure women and their partners are able to space the births and plan the number of children they want to have, to afford and to provide for by taking care of their health and of their children and families, and this is optimized if the spacing of births is three to five years.

Wasted plans

The six-month period has lapsed since the DOH had its family planning program,anchored on the strict implementation of the RH Law, was planned and laid down.

Secretary Ubial said “government investments such as the procured sub-dermal implants that are now on stock in the DOH warehouses and will be expiring by 2018 will all go to waste.” Aside from the procured implants, she said investments made in the training of health practitioners are also wasted because of the TRO.

The SC issued twin TROs in June last year, the first of which stops the DOH from distributing, selling, and administering contraceptive implants; and the other prevents the Food and Drug Administration (FDA) from acting on all applications for reproductive products and supplies, including contraceptive drugs and devices, such as Implanon.

Implants such as Implanon, also called subdermal implants, are hormone implants placed underneath the skin of the upper arm through insertion. They release hormones that prevent pregnancy for three years.

Ubial joined hands with Dr. Juan Antonio Perez III, executive director of the Commission on Population (POPCOM), in meeting with health workers, stakeholder and even faith-based organizations to calls on the Supreme Court to uphold women’s rights in planning their families by lifting the TRO on FP commodities.

“We need to exert greater efforts to reduce the unmet need for family planning and reproductive health services by four to five million women and individuals who want the services to limit, space or stop pregnancies,” Perez III said.

One million signatures

In November 2016, the DOH, POPCOM and the Forum for Family Planning and Development, Inc. held the first National Family Planning Conference and initiated the One Million Signatures campaign for the Supreme Court to lift the TRO.

Ubial told the gathering the TRO is one the roadblocks to achieving the critical changes envisioned for women and their families. “We have a fragmented health care delivery system, lack of general political commitment, dearth of skilled manpower and no sustainable budget and funding, to name a few,” she said.

For 2017, the DOH estimates to reach 28% of the population of women of reproductive age who want to delay childbearing. As of 2016, they were about 5.5 million women. Currently, 49 out of 100 women use a modern method of family planning such as pills, IUDs, DMPA injectables and implants and permanent methods BTL (bilateral tubal ligation)and NSV (non-scalpel vasectomy).

Perez said in two and a half years’ time, as 90% of the contraceptive brands will no longer be available, Filipino women will be left with a limited number of expensive products because the more affordable ones will lose their certificates in 2017. Restrictions in the TRO will eventually lead to the expiration of registrations of currently available contraceptives, leaving a supply shortage by 2018. If not addressed, couples will eventually be able to choose only among tubal ligation, vasectomy, and natural family planning methods by 2018.

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“This situation will make the most important elements of the RH Law ineffective and deprive women and men of their reproductive health and rights,” he said.

Ubial said reaching the proportion of women with an unmet need for family planning will improve the goals of enhancing maternal and child health and nutrition, so the existence of the TRO should not stop stakeholders and advocates from continuing the services.

“We already fought a good fight but it doesn’t stop there,” she said. In the many years to come, she said advocates must not lose their sight on the reality that women have to fully exercise their reproductive rights.

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