birth control, contraception, contraceptives, family planning, population, RH law, vasectomy, condom, pills

In December 2012, Republic Act No. 10354 on Responsible Parenthood and Reproductive Health was signed into law. Also known as the RH Law, it was a major step towards the country’s effort to provide universal and free access to nearly all forms of modern contraceptives for its citizens, especially to marginalized groups, via public health facilities. Other elements of the law include promotion of health education and counselling, elimination of violence and sexual assault against women and children, and treatment of reproductive health-related diseases. An executive order was signed in 2017 to finally implement the RH Law into the Constitution, despite objections from the Catholic Church about the law being “anti-life” (and thus unconstitutional).

But did the RH Law truly help give Filipinos better choices in child-rearing? And perhaps more importantly, how exactly can we measure this initative’s success in the Philippines, a country with an estimated population of over 117 million?

RH Law: Current outcomes

“Three variables could evaluate the current progress of the RH Law : the number of family planning (FP) users, total fertility rate (TFR), and modern contraceptive prevalence rate (mCPR),” said Dr. Alex Legarda, a family physician who worked for the Commission on Population and Development’s (POPCOM) Family Wellness Clinic as clinic manager. TFR refers to the ratio of annual births to women of different age groups, while mCPR is the rate at which modern contraceptives (such as condoms, OC pills, implants and IUDs) are being used.

Based on the 2021 RPRH Annual Report, the total number of FP users has risen from 6.83 million in 2017 to 7.54 million in 2021. The mCPR of the recorded FP users also increased from 24.9% in 2017 to 26.4% in 2021. The country’s target was an mCPR of 30%.

As for the total fertility rate, the National Demographic and Health Survey (NDHS) released results showing that the TFR had declined from 2.7 per woman in 2017 to a somewhat surprising 1.9 per woman in 2022. “The sudden decline of the fertility rate in 2022 could be attributed to the pandemic, physically restricting people to interact with each other. The real fertility rate would reflect this post pandemic if the 1.9 rate could be sustained,” Dr. Legarda said. “One of the main goals of implementing the RH Law was providing awareness and resources to the public to avoid unplanned pregnancies, especially among adolescents and young adults.”

Thus, if we were to look at the given numbers, it can be said that indeed, many have benefitted from the RH Law. However, there are still certain caveats to consider.

Men should share the load

The 2021 RPRH Annual Report indicates that almost 95% of the contraceptives being used were for women. On the other hand, male contraceptives made up only 5% of the mix. According to Dr. Legarda, this was due to a mix of systematic, cultural, and economic factors.

“Most of the time, men who go out to get condoms usually buy from nearby drugstores, convenience stores and even supermarkets. The commercialization of the product has made it less likely for men to get it from public health facilities. This has hindered collecting data to accurately report the number of men using condoms in our country.”

While condoms have become more accessible, the other method of male contraception, vasectomy, is still viewed as taboo. “Most of the family planning initiatives available are mostly for women. There is little budgeting or limited access for the vasectomy procedure. There are those who are interested to undergo, but don’t know where to apply,” said Dr. Legarda.

“Prevalence of misinformation and machismo culture among Filipino men has also made it difficult to promote the benefits of undergoing the procedure.”

To combat this issue, Dr. Legarda said that POPCOM continuously urges local government units to adapt the Kalalakihang Tapat sa Responsibilidad at Obligasyon sa Pamilya (KATROPA) program to help empower and convince men to develop a healthier perspective on family planning methods, especially towards non-scalpel vasectomy. The program was launched in 1999, but its promotion to the public has been a constant struggle.

Fortunately, the number of men opting to undergo vasectomy is steadily increasing. PhilHealth has reported 69 vasectomy claims in 2021, compared to 27 claims in 2020. In 2021, the Katropa program was incorporated in the International Men’s Day and World Vasectomy Day to raise awareness, convincing 82 males from Baguio City and Benguet to undergo the no-scalpel vasectomy procedure.

The road ahead

The driving force behind the creation of the RH Law was the need to give Filipinos ample support in planning the type of family they want to build. With the current state of the economy and a noticeable trend of people considering their emotional capacity for child-rearing, it’s unsurprising that many prefer to delay having children of their own or opt out of it entirely.

But as more Filipinos are enjoying the perks of having different family planning programs, more work still needs to be done in terms of increasing awareness of the law and its importance. Two government agencies that could significantly help in this endeavor are the Department of Education (DepEd) and local government units.

Per a 2022 report, POPCOM stated that teenage pregnancies in the Philippines may be considered a “national social emergency,” based on recent statistics. “One of the best ways to help reduce teenage pregnancies in our country is to implement sex education into all levels of basic education, with varying levels appropriate to the age of the students,” said Dr. Legarda.

“The LGUs also have a huge role in providing family planning services and trainings to their respective communities, as they will be the ones to allocate the funds needed for such services.”—MF



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Author: Lester Veras