TREDFOR C33

Final Paper: The RH Bill

Submitted to: Sir Amado Galo Estodillo

Submitted by: Group 7: Dineros Lino Mallari Mariano

Pantino Sapungan I. History of the Bill/ Reproductive Health in the Philippines The history of reproductive health in the Philippines dates back to 1967. In 1967, leaders of different nations, including the former President Ferdinand Marcos signed the United Nations Declaration on Population that emphasized that the problem on population should be recognized and considered as the principal element for long-term economic development. RA 6365 or Population Act of the Philippines was enacted under the Marcos Administration and the Commission on Population (POPCOM), a commission in charge of studying and evaluating the population problem and proposing solutions for the problem, was created under the law. In 1970, National Population Program was officially launched, upon the recommendation of POPCOM, which advocated a small family size norm and provided information and services to reduce fertility rate. In 1988, POPCOM transferred the institutional and operational responsibility of the family planning program to the Department of Health (DOH) and was made to focus on population and development activities. Family planning became a component of the total health program under the DOH making the improvement of maternal and child health the primary concern. In 1989, the Philippine Legislators Committee on Population and Development was created and was responsible in the formulation of feasible public policies requiring legislation on population management and socio-economic development. Points of emphasis varied from different administrations. During the term of Marcos, there was a systematic distribution of contraceptives all over the Philippines while the Aquino administration concentrated in giving couples the right to have their preferred number of children. The Ramos administration redefined the population program from population control to population management. Estrada administration used mixed methods of reducing fertility rates while Arroyo administration solely focused on promoting natural family planning. In, 2000, the Philippines, together with other member states of the United Nations, signed the Millennium Declaration and committed to raise the quality of life of individuals and to promote human development by achieving the Millennium Development Goals by 2015. Chronology of RH Bills: 1995- 1998 1998- 2001 2001- 2004 2004- 2007 House Bill 120 Establishing a Population Policy House Bill 8110 Integrated Population and Development Act of 1999 House Bill 4110 The Reproductive Health Care Agenda Act of 2001 House Bill 16 Reproductive Health Act of 2004

House Bill 3773 Responsible Parenthood And Population Management Act of 2005 2007- 2010 House Bill 17 House Bill 5043 Reproductive Health and Population Development Act of 2008 Senate Bill 3122 An Act Providing for a National Policy on Reproductive Health and For Other Purposes 2010- 2013 House Bill 4244 The Responsible Parenthood, Reproductive Health, and Population and Development Act of 2011 Senate Bill 2865 The Reproductive Health Act of 2011 A. Reasons for the Bill According to the explanatory note by Representative Edcel C. Lagman, the principal author of the Reproductive Health Bill, one of the main and primary reasons behind the making of the bill is that there is a need to address the issue on rapid population growth in the Philippines that causes other issues to arise. Today, the Philippines is the 12th most populated country in the world and there is a high chance that population will continue to increase if the issue is not addressed. Based on studies, rapid population growth and high fertility rates aggravate poverty and poverty contributes in rapid population growth. Furthermore, according to Representative Lagman, the bill is not a population control measure solely focused on the objective on limiting population growth. The bill provides for population development that would aim to first, help couples or parents in achieving their desired fertility size in the context of responsible parenthood. Second, improve reproductive health of individuals and contribute to decreased maternal mortality rate, infant mortality and early child mortality. Third, reduce incidents of pregnancy among teenagers and other reproductive health problems and lastly, contribute to policies that will assist the government in achieving a favorable balance between population and distribution, economic activities and the environment. It was recommended that a consistent and coherent national population policy is needed, together with monetary and fiscal policies and good governance, in order to achieve the goal of improving the quality of life of Filipinos. B. Proponents Edcel C. Lagman was the principal proponent of the Reproductive Health Bill.

II. The RH Bill A. Guiding Principles The RH Bill was formulated in order to promote freedom of choice. Through the RH Bill, families get to exercise their right to make their own decisions. Also, the RH Bill helps protect the reproductive health of couples, adult individuals, women and adolescents. Through the RH Bill, the rights for reproductive health of the above mentioned people are protected. The RH Bill also answers the needs of the underprivileged citizens. The stipulation of medically safe, legal, accessible, affordable and effective reproductive health care services and supplies is important in encouraging the peoples right to health. Through the RH Bill, the state will be able to promote effective and natural and modern ways of family planning, which are medically safe and legal for the poor. The state shall also promote programs which will aid couples, individuals and women to have the number and age spacing of children that they wish which is applicable to the health of women and resources available to them. Also, they will put up programs which will help achieve the equal division and utilization of resources. Moreover, these programs will guarantee effective relationship among national government, local government units and private sector in the implementation of people-centered programs to enhance quality of life and environmental protection. Studies will also be conducted to analyze demographic trends towards sustainable human development, and to determine safety of alternative medicines and methods for reproductive health care development. The RH Bill also makes sure that the poor beneficiaries will be able to be supplied with proper reproductive health information and care. Non-government, womens peoples and other organizations and community will participate actively to guarantee that reproductive health and population policies, plans, and programs will address the priority needs of the poor, especially women. Also, while this act identifies the illegality of abortion, the government shall ensure that women in need of care for post-abortion complications shall be treated and counseled in a just and compassionate way. The reproductive health revolves on gender equality and women empowerment. The resources of the country will be used to answer the needs of the entire population. Programs will be held to amplify the quality of life of the people, especially those of the poor, needy and marginalized. Most importantly, the comprehensive reproductive health program addresses the needs of the people throughout their life cycle.

B. Family Planning Family Planning is one of the teachings encouraged by the Catholic Church, aside from responsible parenthood. Family Planning is having one child at a time depending on ones situation. The RH Bill provides health facilities, which will provide a full range of modern family planning methods. For patients who are not able to shoulder expenses, their liabilities will be fully covered by PhilHealth Insurance. PhilHealth shall pay for the full cost of family planning. One of the main concerns of advocates of RH Bill is the lack of access to family planning devices (contraceptives and sterilization) of families. The bill will provide universal access through government funding. Through the help of government fund, all the citizens of the Philippines, regardless of their social class will be able to be supported by this act. The DOH shall lead the professional usage monitoring of family planning supplies for the whole country. The supply and budget allotments will be based on the number of women of reproductive age and couples who want to limit their children; cost of family planning supplies and contraceptive occurrence rate by type of method used. The Catholic Church promotes natural family planning or fertility awareness, as opposed to the artificial way, which is through the use of contraceptives and abortion. The natural family planning consists in abstinence during period of fertility and having sex during the period of infertility. However, this method have is yet to be proven as reliable as artificial means of birth control. C. Maternal and Newborn Health According to the Womens Health Organization, maternal deaths in the Philippines amount to 5-6 per day. Through the RH Bill, these women will be be educated with information and access regarding natural and modern family planning. The Department of Health states that through family planning, the maternal mortality will be reduced by around 32 percent. As Clara Padilla reported, the bill is made to prevent maternal death in the Philippines. These deaths can be avoided if more Filipino women have access to reproductive health information and healthcare. Also, child deaths will also be reduced through proper education regarding reproductive health. The RH Bill will answer these issues, through ensuring that the minimum initial service package for reproductive health will be given proper attention, and that facilities will be equipped to respond to the special needs of pregnant women.

D. Responsible Parenthood Responsible parenthood is being associated to the RH Bill. President Noynoy Aquino, even renamed the RH Bill to Responsible Parenthood Bill. Through the RH Bill, poverty is also prevented, because of the proper planning of the number of children a family will have. Programs will be implemented to ensure the full access of poor and marginalized women to reproductive health care, services, products and programs. On the other hand, other people disregard responsible parenthood as equivalent to reproductive health bill. Responsible parenthood means being able to have a large family, and still being suitable in raising their children well. E. Roles and Duties of the Local Government (in relation to the RH Bill) On Section 16 of the Local Government Code of the Philippines, the following are the duties of the local government in relation to the social welfare: Ensure support, among other things, the preservation and enrichment of culture Promote health and safety Enhance the right of the people to a balanced ecology Encourage and support the development of appropriate and selt-reliant scientific and technological capabilities Improve public morals, enhance economic prosperity and social justice Promote full employment among their residents Maintain peace and order and preserve the comfort and convenience of their inhabitants Section 13 of the RH Bill states the Roles of the Local Government in Family Planning Programs: The LGUs shall ensure that poor families receive preferential access to services, commodities and programs for family planning. The role of Population Officers at municipal, city and barangay levels in the family planning effort shall be strengthened. The Barangay Health Workers and Volunteers shall be capacitated to help implement this Act. F. Mobile Health Care Services Section 15 states the Mobile Health Care Services: Each Congressional District may be provided with at least one (1) Mobile Health Care Service (MHCS) in the form of a van or other means of transportation appropriate to coastal or mountainous areas, the procurement and operation of which shall be funded by the National Government. The MHCS shall deliver health care supplies and services to constituents, more particularly to the poor and needy, and shall be used to disseminate knowledge and information on reproductive health. [The purchase of the MHCS shall be funded from the Priority Development Assistance Fund (PDAF) of each Congressional District.] The operation and maintenance of the MHCS shall be operated
6

by skilled health providers adequately equipped with an equipment, the latter including, but not limited to, a television set for audio-visual presentations. All MHCS shall be operated by a focal city or municipality within a congressional district. G. Application of the Law/Bill People who will be affected by the RH Bill: Families Families are affected in such a way that contraceptives will be freely available to the people. Youth Children from 10 to 17 will be taught about sexual rights and the means of satisfying safe sex as part of their school curriculum (Section 16, Mandatory Age-Appropriate Health and Sexual Education). Parents The parents are usually the ones responsible for the education of the children about sex. With the RH Bill, as stated above, sex education become part of the school curriculum thus making the parents lose control over such matter. The parents also lose parental authority over a minor child who was raped and found pregnant. H. Compliance Section 18: - from the local family planning office -will certify the Couple's attendance on instructions and information on responsible parenthood, family planning, breastfeeding and infant nutrition. I. Ideal Family Size Section 20: - state will assists couples, parents or any individual -family size will vary on the ability of the parent to provide -encourages 2 children per family -not mandatory nor compulsory -no punishment if children goes beyond the count of 2

J. Classification of persons being addressed or affected (Indigent Woman, PWD) Section 22: - Private and non-government reproductive health care service providers are required to have at least 48-hours yearly service in relation to reproductive health -covers providing information and education to rendering medical services free of charge to indigent and low income patients, especially to pregnant adolescents -the 48-hours is a ore-requisite for accreditation in PhilHealth Section 23: -municipalities and cities are responsible for allowing PWDs reproductive health services - ensuring equality with PWDs "(a) providing physical access, and resolving transportation and proximity issues to clinics, hospitals and places where public health education is provided, contraceptives are sold or distributed or other places where reproductive health services are provided; (b) adapting examination tables and other laboratory procedures to the needs and conditions of persons with disabilities; (c) increasing access to information and communication materials on sexual and reproductive health in braille, large print, simple language, and pictures; (d) providing continuing education and inclusion rights of persons with disabilities among health-care providers; and (e) undertaking activities to raise awareness and address misconceptions among the general public on the stigma and their lack of knowledge on the sexual and reproductive health needs and rights of persons with disabilities." K. Right to Information

Section 24: -the right to provide and recieveing right information about the reproductive health care services, including family planning, and prenatal care - the DOH and the Philippine Information Agency (PIA) will initiate and sustain Section 25: -the DOH and the Local Health Units in cities and municipalities shall serve as the lead agencies for the implementation of this Act and must/will integrate in their regular operations specific and necessary functions - The Commission on Population (POPCOM), which is an attached agency of DOH, will be the coordinating body in the implementation of this Act with specific and necessary actions

L.

Implementation

Section 23 of the RH Bill states that the DOH, and the Local Health Units in cities and municipalities, will be reliable for the implementation of this act among poor households, and shall integrate regular operations. This operation shall include the following: guarantee full and efficient implementation of the Reproductive Health Care Program accessible reproductive health supplies and services which are medically safe, legal, effective, quality and affordable ensure that reproductive health services are delivered with complete supplies, facilities and equipment and that service providers are sufficiently trained for such reproductive health care delivery take active steps to widen the coverage of the National Health Insurance Program, focusing on the poor and marginalized women strengthen the capacities of health regulatory agencies to ensure safe, legal, effective, quality, accessible and affordable health services Promulgate minimum reproductive health standards for public health facilities Facilitate the involvement and participation of non-government organizations Equip local government units with appropriate information and resources to keep them updated on information regarding reproductive health Perform other functions necessary to attain the purposed of this Act. o Integrate on a continuous basis the interrelated reproductive health and population development agenda o Provide the mechanism to ensure active and full participation of the private sector and citizens o Conduct sustained and effective information drives on sustainable human development and on all methods of family planning to prevent unintended, unplanned and mistimed pregnancies. M. COC (Congressional Oversight Committee) Composed of five members each from the Senate and the House of Representatives (to be appointed by the Senate President and the Speaker, respectively) At least one member must be representing the Minority It shall be headed by the respective chairs of the Committee on Youth, Women and Family Relations of the Senate and the Committee on Population and Family Relations of the House of Representatives The Secretariat of the COC shall come from the existing Secretariat personnel of the Senates and the HORs committees concerned

Job of the Congressional Oversight Committee: To monitor and ensure the effective implementation the Act To determine the inherent weaknesses and loopholes in the law To recommend the necessary remedial legislator or administrative measures To perform such other duties and functions which will be necessary to attain the objectives of this Act Prohibited Acts

N.

The following acts are prohibited: (a) Any healthcare service provider, whether public or private, who shall: (1) Knowingly withhold information or restrict the dissemination thereof, or intentionally provide incorrect information regarding programs and services on reproductive health, including the right to informed choice and access to a full range of legal, medically-safe and effective family planning methods; (2) Refuse to perform legal and medically-safe reproductive health procedures on any person of legal age on the ground of lack of third party consent or authorization. In case of married persons, the mutual consent of the spouses shall be preferred. However in case of disagreement, the decision of the one undergoing the procedure shall prevail. In the case of abused minors where parents or other family members are the respondent, accused or convicted perpetrators as certified by the proper prosecutorial office or court, no prior parental consent shall be necessary; and (3) Refuse to extend health care services and information on account of the persons marital status, gender, sexual orientation, age, religion, personal circumstances, or nature of work; Provided, That, the conscientious objection of a healthcare service provider based on his/her ethical or religious beliefs shall be respected; however, the conscientious objector shall immediately refer the person seeking such care and services to another healthcare service provider within the same facility or one which is conveniently accessible who is willing to provide the requisite information and services; Provided, further, That the person is not in an emergency condition or serious case as defined in RA 8344 otherwise known as "An Act Penalizing the Refusal of Hospitals and Medical Clinics to Administer Appropriate Initial Medical Treatment and Support in Emergency and Serious Cases". (b) Any public official who, personally or through a subordinate, prohibits or restricts the delivery of legal and medically-safe reproductive health care services, including family planning; or forces, coerces or induces any person to use such services.

10

(c) Any employer or his representative who shall require an employee or applicant, as a condition for employment or continued employment, to undergo sterilization or use or not use any family planning method; neither shall pregnancy be a ground for non-hiring or termination of employment. (d) Any person who shall falsify a certificate of compliance as required in Section 15 of this Act; and (e) Any person who maliciously engages in disinformation about the intent or provisions of this Act. O. Penalties Imprisonment ranging from one month to six months Fine of ten thousand pesos (P10,000) to fifty thousand pesos (P50,000) Both imprisonment and fine (at the discretion of the competent court) If the offender is a public official/employee, he/she shall suffer the accessory penalty of dismissal from the government service + forfeiture of retirement benefits If the offender is a juridical person, the penalty shall be imposed upon the president or any responsible officer. An offender who is an alien shall, after service of sentence, be deported immediately without further proceedings by the Bureau of Immigration. P. Effectivity

This Act shall take effect fifteen (15) days after its publication in at least two (2) newspapers of general circulation. III. Effects of the bill to the society

The RH bill remains to be a debate in our society, probably because of the considerations of people when it comes to the effects of it. Various communities have expressed their opinions on what the positive and negative effects are for the society. It is because of this debate that the Philippines is having a hard time do decide whether or not to implement it. Various communities are against it due to its moral implications and while most are for the RH bill for a more practical reason. Likhaan.com, a website dedicated to help protect women, shares its views on the positive effects of the RH Bill for the society, and most importantly for women. The first reason stated as a positive effect is that the bill can help protect the lives of mothers. According to World Health Organization (WHO), it estimates that 15% of complications arise from pregnancies, which causes women to be hospitalized. The Second reason is that it will help save babies and reduce infant deaths, because of the
11

proper birth spacing the RH bills uses. Third reason is to prevent unintended pregnancies which lead to induced abortions. Finally, the Bill can reduce the number of cancer deaths, because of how condoms can prevent HPV infections which can lead to cervical cancer. An article on inquirer.net written by David Balangue discusses how the RH bill is pro-development for our society. It states the poor are denied access contraceptives, simply because of their incapability financially. Through the RH bill, it can provide better and easier access to contraceptives, also to push for a more responsible parenthood. Balangue states Access to a better life is a paramount right of every individual, and it is the governments duty to make this possible. Although the practical reasons of the RH Bill seem to be able to help the country, there are still those who oppose the Bill because of how it will affect the behavior of people. In contrast to what the positive effects are, the RH bill will stand for anti-life, because of the contraceptives that people are using. It is also said that contraceptives are hazardous which will in effect lead to cancer for women. Also, contraceptives are not a guarantee for preventing HIV/AIDS. Primarily, the concern of those against the RH bill is the non-consideration of moral principles in passing the law. Finally, the RH bill is a choice greatly related to the conscience of people and also their faith. IV. Points of view from different agencies or people Professors from Ateneo de Manila University

People have various points of views regarding the issue of the implementation of the RH Bill. Because of the strong opinions each sector has, it is harder for legislation to pass the Bill. Various sectors have expressed their opinion on why the bill should be and should not be passed. An article on Inquirer.net discusses the stand of 192 Atenan professors, on why they think the RH Bill should be passed. First and foremost, the article shows their support for the RH bill because it promotes human rights. The article discusses how the bill supports the obligation of the state to promote health, responsible parenthood, reproductive health and population. In all, the article discusses the states obligation to provide information and access to family planning services for women, men and women couples, and poor. More than just the obligation of the state, it supports the constitutional provision in terms of fulfilling the countrys obligation under the international human rights It gives people access to medically safe, legal and effective family planning methods and to make informed choices. The heart of the bill is about providing people with a choice that is legally permissible and safe. Doctors

It is also important that doctors opinions on the RH Bill are recognized, for they handle real life scenarios that might have resulted to pregnancy problems. A decision is yet to be made by doctors, most especially because of the contradicting beliefs they

12

have in their profession and the bill. Dr. Sylvia Carnero, President of Obstetrical and Gynelogical society of the Philippine Medical Association (PMA) , shares her opinion and stand of PMA regarding the RH Bill. She shares that life begins at fertilization, and how PMA together with CBCP are against the idea f abortion. PMAs executive director also shares the same beliefs that of Carnero. He believes that, although the RH bill has some good pints, it violates doctors oath to save and protect human life. He clarifies that abortion is the only reason which stops them from supporting the bill. In contrary to what PMA believes, the Philippine College of Physicians one of the largest specialty division in PMA, strongly believes on the importance of the RH Bill. They believe that the importance of the bill is through the alleviation of suffering and reducing the number of deaths, due to past abortions and no access to proper care. Just like PMAs stand in saving the unborn child, they also believe in saving the mother who carries the unborn child. They believe that the RH bill can give access to proper material care and proper education through an informed choice. Economist

Economist in UP are for the RH Bill, because they believe that it is an integral part of development and a way to reduce poverty in the country. One reason why they think that the RH Bill is necessary is because, as a developing county, it is crucial that the government spends its money on what can help the country in the long run. In addition, large family size is associated to poverty incidence, in which majority of those who have a lot of kids are from the poorer side. A reason for this is that contraceptives are not yet introduced to poor couples, and because of their lack of education. Due to lack of information in terms of prevention, health risks are observed and an increasing number of deaths are being recognized caused by unwanted pregnancies and complications. It is for this reason the economists believe that unwanted costs for families are being made, because the RH Bill has not yet been approved. More importantly, proper education is not yet given to poorer families. V. Conclusion

Despite the practical effects of the RH bill to society, people see it as a threat to life and families here in the Philippines. 81% of Filipinos are Catholics and pro-life, in which some of those in the 81% are against the RH Bill. What is seen as solution for the population problems in the country now becomes a test of peoples values. Although other institutions take their stand on the RH Bill, some have chosen to clarify first operative terms in the Bill, which has become controversial to all. An example institution who has clarified terms regarding the RH Bill is the Philippine Obstetrical and Gynecological society. They defined first the meaning of their operational definitions before making a stand. Such clarifications on definition include Contraceptives and abortion.

13

References: http://www.likhaan.org/content/ten-good-reasons-pass-rh-bill-now http://opinion.inquirer.net/36716/the-rh-bill-is-pro-development http://cbcponline.net/v2/?p=1151 http://opinion.inquirer.net/35892/rh-bill-promotes-human-rights http://mysite.dlsu.edu.ph/student/10933417/final/css3.html http://www.slideshare.net/HarveyDiaz/philippine-college-of-physicians-support-rh-bill http://jlp-law.com/blog/reproductive-health-bill-fact-sheet-and-explanatory-note/ http://www.scribd.com/doc/72327047/RH-Bill https://docs.google.com/viewer? a=v&q=cache:Wezps1ZzD9QJ:www.congress.gov.ph/download/14th/hb05043.pdf+rh+b ill+5043+pdf&hl=en&gl=ph&pid=bl&srcid=ADGEEShkz-QAZkYgVpwCqiAtCp3ZwpgoCoF4Mhe8MjNVrQiTcEy2_pU45tazmal99RkX_FwvCCaKNkYSgCt Gsgw-hueB8W6ZNmUxmvQyqeR4PeUcfqyxywXMnbUJKOkNadVYsnSS3H&sig=AHIEtbQWtl-PqPbK283w8978Xg3Z3eHWXg http://www.abs-cbnnews.com/insights/08/16/10/reasons-why-we-need-rh-law https://docs.google.com/viewer?a=v&q=cache:65quf03jDikJ:law.upd.edu.ph/files/pdf/rhprimeronline.pdf+hb+4244+sb+2865+pdf&hl=en&gl=ph&pid=bl&srcid=ADGEESgKNPt51vcVT 9lKFcz-pyW2VKrXxi4VTOCZbObd2OlmP6vOKc766MB1p2Wuvc3AcULximC1KUGuoOU98Phue2sk3_5MCxymB3xRUlH T8Hov9F8GVjP9FdciZoZGxp8FCC2HLys&sig=AHIEtbRVbNZ6CX5aP1QX6TpTJebLh1ntw http://dswp.org.ph/2012/08/16/3028/ http://www.scribd.com/doc/72327047/RH-Bill

14