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Family Planning in the Philippines: A Global Wake-Up Call

for Policymakers
By

Tod Preston
on April 24, 2008 10:21 AM | Permalink | Comments (2) | TrackBacks (0)

“Birthrates Help Keep Filipinos in Poverty” – that’s the headline of an April 21, 2008
Washington Post article highlighting the plight of a growing number of poor women
in the Philippines who lack access to one of the most basic forms of health care:
family planning (FP) and reproductive health services. The article, which mentions
that the U.S. is scaling down its FP program in the Philippines, should be a wake-up
call for policymakers about the global impact of declining FP assistance on the lives
of hundreds of millions of men and women in the Philippines and other developing
nations.

U.S. investments in international family planning have been one of the most
successful and cost-effective ways to improve maternal and child health, ease
population pressures on the environment, and help countries fight poverty. But
despite the achievements of recent decades -- including an increase in use of
contraceptives among married women in the developing world from 10 percent to
60 percent since 1960 and a decline in average fertility rates from about six
children per woman to three children per woman -- significant needs remain. For
example, only one-third of married Filipino women use modern contraceptives.

The reality is that family planning remains out of reach for hundreds of millions of
women and men. In fact, more than 200 million women in the developing world
want to space or limit their childbearing but are not using modern contraception. In
some countries such as Haiti, Pakistan and Uganda, one-third or more of married
women have this “unmet need” for FP.

Nonetheless, in recent years funding from the U.S. -- a long-time leading donor of
FP/RH assistance -- has declined significantly when accounting for inflation and the
growing demographic demand. And FP/RH assistance from other donor nations has
also declined.

Current U.S. funding for int’l FP (about $460 million) represents a cut of $300 million
or 40 percent (adjusted for inflation) from what the U.S. provided for these
programs back in 1995. Had the Bush Administration gotten its way and Congress
not intervened in the past two years, U.S. funding for these programs would have
been reduced by an additional 25 percent. Making matters even worse, the Bush
Admin has withheld all U.S. funding (nearly $200 million) for the U.N. Population
Fund (UNFPA), which provides FP/RH assistance in more than double the number of
countries the U.S. does.

So what does this downward U.S. funding trend mean for a country like the
Philippines? As you’d probably suspect, it’s not good. In its budget request to
Congress last year, the Bush Administration proposed spending only $5.2 million for
FP/RH assistance in the Philippines -- less than 1/7 of what the U.S. spent in that
country in 1995 ($37 million in inflation-adjusted dollars). That’s despite the fact
that 25 percent of Filipinas ages 20-24 have an unmet need for family planning --
and these rates are even higher among uneducated women. So funding is going
down and contraceptive shipments are ending while the need and demand remain
high. And remember, the backdrop for all of this is a country in which more than 40
percent of its people live below the poverty line.

Ironically, this meager funding request for FP in the Philippines was proposed in the
same budget in which the Administration acknowledged to Congress the connection
between high birth rates and poverty in the country. In its FY 2008 foreign
assistance Congressional Budget Justification, the Administration stated that “[the]
Philippines struggles to provide sufficient jobs, infrastructure, health services, and
education for its rapidly growing population.” (PDF, p. 348)

Just how fast is the population of the Philippines growing? It’s doubled since the late
1970s and -- if access to family planning does not increase and current fertility rates
remain static -- it will double again from 86 million today to 170 million in the next
thirty years. That’s a lot of additional mouths to feed, especially in a nation that’s
recently acknowledged it has a serious shortage of rice and faces the threat of food
riots.

Make no mistake, because of declining funding USAID has had to make very difficult
choices of where it allocates its limited FP dollars. One of those choices is to scale
back its family planning program in the Philippines and to end shipments of
contraceptives -- contraceptives that we know many Filipinos desire. Tragically, this
story isn’t limited to the Philippines. The U.S. has scaled back FP assistance to a
number of countries, some with even higher unmet need than the Philippines.
Kenya is one example, with troubling implications for maternal and child health and
its development prospects.

The great tragedy in all of this -- “outrage” might be a more accurate term -- is that
the cuts in FP funding are depriving women and men, many of them impoverished,
of something they fundamentally want: that most basic ability to choose how many
children to have and when to have them. And by depriving them of this reproductive
right, we’re contributing to an increasingly unsustainable and impoverished world.

Update: Check out The Los Angeles Times article "Debate grows with Philippine
population."

Categories:

• U.S. Policies

Tags:

• Congress,
• family planning,
• News,
• Philippines,
• population,
• USAID,
• Viewpoint

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2 Comments
By Kathleen Mogelgaard on May 13, 2008 4:08 PM

Thanks, Tod, for this thoughtful yet troubling picture of the Philippines' demographic future, and
its resulting impacts on the health and well-being of Filipinos.

Having recently returned from a National Audubon Society study tour to the Philippines, I saw
first-hand how population growth is outpacing the country’s ability to provide sufficient food,
shelter and livelihood for its people.

I was in the Philippines with other members of the Audubon Society, as well as folks from the
Sierra Club and the Izaak Walton League of America. We had the opportunity to travel the
country and see some of the beautiful, remarkable, and globally unique species found there -
species like Philippine eagle (with a 7-foot wingspan, one of the world's largest eagles), and the
tarsier (standing about 7 inches tall, one of the world’s smallest primates).

Because of its remarkable wealth of biodiversity - hundreds of plant, animal and marine species
found nowhere else in the world - the Philippines has been designated by Conservation
International as one of the world’s top 25 “biodiversity hotspots.” This classification also signals
a high level of threat to biodiveristy, and in the Philippines, rapid population growth is a very
significant threat. The country has lost 80% of its forests over the last century, largely driven by
human activities. Its thriving and unique marine environment, whose fisheries supply much of
the population's protein, is also feeling the strain of population pressure. The current population
density in the Philippines is 296 people per square kilometer (compared to 31 people per square
kilometer in the US). In a country on track to double its population in the next 30 years, these
trends are alarming.

Historically, the U.S. has been a world leader in providing voluntary family planning programs
through the U.S. Agency for International Development, with a proven track record of reducing
fertility and slowing global population growth. As you have pointed out, U.S. funding for these
programs around the world has declined, and the U.S. trails most of the developed world in
supporting family planning. For these reasons, Audubon has joined with our friends and
colleagues in health, development, and faith-based groups to call on the US Congress to
significantly increase funding for these valuable programs that improve human and
environmental well-being, and help to put the Earth on a path to a more sustainable future.

Kathleen Mogelgaard
Assistant Director, Government Relations
National Audubon Society

By aditi on July 3, 2008 2:24 AM

Maternal and child Health is of utmost importance. Its startling to know that more than half a
million women die in pregnancy and childbirth every year -
that’s one death every minute.