Philippine law
The Responsible Parenthood and Reproductive Health Act of 2012, also known as the Reproductive Health Law or RH Law, and officially designated as Republic Act No. 10354, is a Philippine law that provides universal access to methods of contraception, fertility control, sexual education, and maternal care.
While there is agreement about its provisions on maternal and child health, there is debate on its mandate that the government and private sector will fund, and undertake widespread distribution of family planning devices such as condoms, birth control pills, and IUDs, as the government continues to disseminate information on their use, through health care centers.
The passage of the legislation was controversial and divisive, with academics, religious institutions, and politicians declaring their support or opposition while it was pending in the legislature. Heated debates and rallies supporting and opposing the Bill took place nationwide. The Supreme Court of the Philippines delayed the implementation of the law in March 2013 in response to challenges. In April 2014, the Court ruled the law was "not unconstitutional" but struck down eight provisions partially or in full.
The history of reproductive health law in the Philippines dates back to 1967 when President Ferdinand Marcos was among the heads of state who signed the Declaration on Population. The 30 countries who participated in the signing of the declaration were acknowledged by U.N. Secretary-General U Thant during a United Nations ceremony on December 11, 1967, a day after Human Rights Day. The Philippines agreed the population problem should be considered as the principal element for long-term economic development. Thus, the Population Commission was created to push for a lower family size norm and provide information and services to lower fertility rates.
Starting in 1967, the United States Agency for International Development (USAID) began shouldering 80% of the total family planning commodities (contraceptives) of the country, which amounted to $3 million annually. In 1975, the U.S. adopted as its policy the National Security Study Memorandum 200: Implications of Worldwide Population Growth for U.S. Security and Overseas Interests (NSSM200). The policy gives "paramount importance" to population control measures and the promotion of contraception among 13 populous countries, including the Philippines, to control rapid population growth which they deem to be inimical to the sociopolitical national interests of the U.S., since the "U.S. economy will require large and increasing amounts of minerals from abroad", and these countries can produce destabilizing opposition forces against the U.S. It recommended the U.S. leadership to "influence national leaders" and that "improved world-wide support for population-related efforts should be sought through increased emphasis on mass media and other population education and motivation programs by the UN, USIA, and USAID."
Different presidents had different points of emphasis. President Marcos pushed for a systematic distribution of contraceptives all over the country, a policy that was called "coercive", by its leading administrator. The Corazon Aquino administration focused on giving couples the right to have the number of children they prefer, while Fidel V. Ramos shifted from population control to management. Joseph Estrada used mixed methods of reducing fertility rates, focusing on mainstreaming natural family planning.
In 1989, the Philippine Legislators' Committee on Population and Development (PLCPD) was established, "dedicated to the formulation of viable public policies requiring legislation on population management and socio-economic development". In 2000, the Philippines signed the Millennium Declaration and committed to attaining the Millennium Declaration Goals by 2015, which include promoting gender equality and health. In 2003, USAID started its phase out of a 33-year-old program by which free contraceptives were given to the country. Aid recipients such as the Philippines, faced the challenge to fund its own contraception program. In 2004, the Department of Health (DOH) introduced the Philippines Contraceptive Self-Reliance Strategy, arranging for the replacement of these donations with domestically provided contraceptives. In August 2010, the government announced collaborative work with the USAID in implementing a comprehensive marketing and communications strategy in favor of family planning called "They Have a Plan".
Content.
Sections.
The basic content of the Consolidated Reproductive Health Bill is divided into the following sections.
SEC. 1. The Responsible Parenthood and Reproductive Health Act of 2012
SEC. 2. Declaration of Policy
SEC. 3. Guiding Principles
SEC. 4. Definition of Terms
SEC. 5. Midwives for Skilled Attendance
SEC. 6. Emergency Obstetric Care
SEC. 7. Access to Family Planning
SEC. 8. Maternal and Newborn Health Care in Crisis Situations
SEC. 9. Maternal Death Review
SEC. 10. Role of the Food and Drug Administration
SEC. 11. Procurement and Distribution of Family Planning Supplies
SEC. 12. Integration of Family Planning and Responsible Parenthood Component in Anti-Poverty Programs
SEC. 13. Roles of Local Government in Family Planning Programs
SEC. 14. Benefits for Serious and Life-Threatening Reproductive Health Conditions
SEC. 15. Mobile Health Care Service
SEC. 16. Mandatory Age-Appropriate Reproductive Health and Sexuality Education
SEC. 17. Additional duty of the local population officer .
SEC. 18. Certificate of Compliance
SEC. 19. Capability Building of Barangay Health Workers
SEC. 20. Pro Bono Services for Indigent Women
SEC. 21. Sexual and Reproductive health
SEC. 22. Right to Reproductive Health Care Information
SEC. 23. Implementing Mechanisms
SEC. 24. Reporting Requirements
SEC. 25. Congressional Committee
SEC. 26. Prohibited Acts
SEC. 27. Penalties
SEC. 28. Appropriations
SEC. 29. Implementing Rules and Regulations
SEC. 30–32. Separability Clause, Repealing Clause, Effectivity
Summary of major provisions.
The bill mandates the government to "promote, without biases, all effective natural and modern methods of family planning that are medically safe and legal."
Although abortion is recognized as illegal and punishable by law, the bill states that "the government shall ensure that all women needing care for post-abortion complications shall be treated and counseled in a humane, non-judgmental and compassionate manner".
The bill calls for a "multi-dimensional approach" integrates a component of family planning and responsible parenthood into all government anti-poverty programs. Age-appropriate reproductive health and sexuality education is required from grade five to fourth year high school using "life-skills and other approaches."
The bill also mandates the Department of Labor and Employment to guarantee the reproductive health rights of its female employees. Companies with fewer than 200 workers are required to enter into partnership with health care providers in their area for the delivery of reproductive health services.
Employers with more than 200 employees shall provide reproductive health services to all employees in their own respective health facilities. Those with fewer than 200 workers shall enter into partnerships with health professionals for the delivery of reproductive health services. Employers shall inform employees of the availability of family planning. They are also obliged to monitor pregnant working employees among their workforce and ensure they are provided paid half-day prenatal medical leaves for each month of the pregnancy period that they are employed.
The national government and local governments will ensure the availability of reproductive health care services like family planning and prenatal care.
Any person or public official who prohibits or restricts the delivery of legal and medically safe reproductive health care services will be meted penalty by imprisonment or a fine.
Support.
Free choice regarding reproductive health enables people, especially the poor, to have the number of children they want and can feasibly care and provide for. There are several studies cited by those who support the bill:
Criticism.
Opponents of the bill argue that:
President Aquino stated he was not an author of the bill. He also stated that he gives full support to a firm population policy, educating parents to be responsible, providing contraceptives to those who ask for them, but he refuses to promote contraceptive use. He said that his position "is more aptly called responsible parenthood rather than reproductive health".
Economic and demographic premises.
The Philippines is the 39th most densely populated country, with a density over 335 per square kilometer, and the population growth rate is 1.9% (2010 Census), 1.957% (2010 est. by CIA World Factbook), or 1.85% (2005–2010 high variant estimate by the UN Population Division, "World Population Prospects: The 2008 Revision") coming from 3.1 in 1960.
The 2013 total fertility rate (TFR) is 3.20 births per woman, from a TFR of 7 in 1960. In addition, the total fertility rate for the richest quintile of the population is 2.0, which is about one third the TFR of the poorest quintile (5.9 children per woman). The TFR for women with college education is 2.3, about half that of women with only an elementary education (4.5 children per woman).
Congressman Lagman states that the bill "recognizes the verifiable link between a huge population and poverty. Unbridled population growth stunts socioeconomic development and aggravates poverty".
The University of the Philippines School of Economics presented two papers in support of the bill: "Population and Poverty: the Real Score" (2004), and "Population, Poverty, Politics and the Reproductive Health Bill" (2008). According to these economists, which include Solita Monsod, Gerardo Sicat, Cayetano Paderanga, Ernesto M. Pernia, and Stella Alabastro-Quimbo, "rapid population growth and high fertility rates, especially among the poor, do exacerbate poverty and make it harder for the government to address it", while at the same time clarifying that it would be "extreme" to view "population growth as the principal cause of poverty that would justify the government resorting to draconian and coercive measures to deal with the problem (e.g., denial of basic services and subsidies to families with more than two children)". They illustrate the connection between rapid population growth and poverty by comparing the economic growth and population growth rates of Thailand, Indonesia, and the Philippines, wherein the first two grew more rapidly than the Philippines due to lower population growth rates. They stressed that "the experience from across Asia indicates that a population policy cum government-funded [family planning] program has been a critical complement to sound economic policy and poverty reduction".
In "Population and Poverty", Aniceto Orbeta, Jr., showed that poverty incidence is higher among big families: 57.3% of Filipino families with seven children are in poverty while only 23.8% of families who have two children live below the poverty threshold.
Proponents argue that smaller families and wider birth intervals resulting from the use of contraceptives allow families to invest more in each child's education, health, nutrition and eventually reduce poverty and hunger at the household level. At the national level, fertility reduction cuts the cost of social services with fewer people attending school or seeking medical care and as demand eases for housing, transportation, jobs, water, food, and other natural resources. The Asian Development Bank in 2004 also listed a large population as one of the major causes of poverty in the country, together with weak macroeconomic management, employment issues, an underperforming agricultural sector and an unfinished land reform agenda, governance issues including corruption.
Criticism of premises.
Opponents refer to a 2003 study of Rand Corporation, which concluded that "there is little cross-country evidence that population growth impedes or promotes economic growth...population neutralism has in fact been the predominant school in thinking among academics about population growth for the last half-century". For example, the 1992 study of Ross Levine and David Renelt, which covered 119 countries over 30 years (versus a University of the Philippines study of 3 countries over a few years). The RAND study also said that a large population can promote growth given the right fundamentals. Thus, they refer to the HSBC 2012 projection for 2050 that the Philippines will be 16th largest economy due to its large growing population, and those whose populations are decreasing will suffer decline.
In a recent development, two authors of the Reproductive Health Bill changed their stand on the provisions of the bill regarding population and development. Reps. Emerciana de Jesus and Luzviminda Ilagan wanted to delete three provisions which state that "gender equality and women empowerment are central elements of reproductive health and population and development", which integrate responsible parenthood and family planning programs into anti-poverty initiatives, and which name the Commission on Population and Development or POPCOM as a coordinating body. The two party-list representatives strongly state that poverty is not due to over-population but because of inequality and corruption.
The "Wall Street Journal" in July 2012 said that Aquino's "promotion of a 'reproductive health' bill is jarring" since it could lead to "a demographic trap of too few workers. The Philippines doesn't have too many people, it has too few pro-growth policies".
Opposing the bill, Former Finance Secretary Roberto de Ocampo wrote that it is "truly disingenuous for anyone to proceed on the premise that the poor are to blame for the nation's poverty:. He emphasized that the government should apply the principle of first things first and focus on the root causes of the poverty (e.g., poor governance, corruption) and apply many other alternatives to solve the problem (e.g., giving