The RH Law – Coming to a Clinic Near You

Categories: Business Updates

Date: 08 Jul 2014

The Supreme Court on July 1 upheld its previous ruling that the controversial reproductive health law is constitutional except for a few key provisions. The law, which seeks to give poor women in the Philippines greater access to contraception, was passed in 2012 and challenged in 2013.

Now that the law has overcome the judicial hurdle, the government faces the challenges of implementation. The Philippine government has never attempted to bring modern family planning and contraceptive practices to the most remote communities and poorest slums in the country. This new law requires that the Department of Health take on new, complex tasks with some of the most difficult-to-reach populations in the country.

The law has been in the works for decades, with dozens of drafts sitting idle in congress. The Philippines has one of the highest birth rates in Asia and proponents of the law say allowing poor women to have access to family planning, and have less children, will decrease poverty in the country. This has been the case in some neighboring countries, including Thailand, where prosperity increased after population growth was brought under control.

The administration of President Benigno S. Aquino III has stressed the reproductive health law is not a population control measure. It does not mandate the use of contraception, it simply makes it more available — and provides greater information — to poor people who want it. The unspoken logic of course is that most poor women who already have children they cannot feed are not looking to have more. These women will jump at a chance to stop getting pregnant.

The Catholic Church of the Philippines has for decades fought the measure and its political clout in the country has been one of the key reasons that the bill languished for years in congress. The Catholic Church opposes what it terms as artificial contraceptive measures, such as condoms.

While upholding the vast majority of the law, the Supreme Court struck down two key provisions. One provision that was disallowed was an aspect of the law that would have punished health workers who refuse to distribute contraceptives or provide family planning information based on their personal religious views. The high court ruled that government health workers could not be punished for refusing to do these activities.

A senior Department of Health official, who is helping to oversee the implementation of the law, said that the department has devised a fairly simple “work around” for this. The department will mandate that local health clinics provide the full range of contraceptive services and family planning information or they risk the loss of their accreditation and the funding that goes along with it.

The key point is that the Department of Health will focus on the facilities, not on the individual health workers. In short, the local clinic will need to find staff members willing to do this work related to contraception distribution or lose funding. They cannot force one worker to do it, but they must find someone who is willing. The Department of Health officials said this should not be difficult since most health workers who work with poor women are eager to get them help with family planning because they are sympathetic to their plight.

The Supreme Court also voided a provision that would allow minors who are pregnant, or who already have a child, to receive contraceptives and family planning information without parental consent. The thinking of the proponents of this measure was that if a child or teenager is pregnant, their situation is a clear indicator that they urgently need help with family planning.

The senior Department of Health official noted that this is a particularly unfortunate action by the Supreme Court because many of the young girls who get pregnant are from homes where parents are absent. These are the girls most at risk, who need the help the most and they are also the ones who will have the most difficulty getting parental consent.

The “work around” on this provision is still being debated within the Department of Health, but the official noted that one likely solution is that when young pregnant girls need help, assistance can be provided to establish an adult — usually a relative — as their legal guardian with authorization to give parental consent. This official said that if a pregnant minor shows up at a government clinic, she will not be refused access to the reproductive health care that she needs. She will be helped, one way or another.

One of the most powerful aspects of the law is that it establishes a legally-mandated budgeting mechanism for reproductive health and contraception. Previously, local officials — such as a mayor — could ban the sale of condoms and other forms of contraception in their cities by executive order. On a national level, the Secretary of Health, acting on the orders of the president, could refuse to fund government contraception programs — as was the case with President Gloria Arroyo.

Under this law, a budgetary calculation will be based on the number of women of reproductive age living below the poverty line nationwide. Money will be allocated to reproductive health, including all forms of contraception, based on this calculation and must be available in every big city and small town, including teeming slum areas and remote rural communities. This is legally mandated under the new law.

Moral and religious concerns regarding contraceptive use are deeply held by some people, and this is of course their right. But it is hard for anyone who has ever been to the poorest communities in the Philippines to not see the need for this long-overdue legislation.

 

Source: Pacific Strategies & Assessments Weekly Report, July 7, 2014

 

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