Beruflich Dokumente
Kultur Dokumente
Alvin Concha, MD
MA Applied Social Research
Ateneo de Davao University
Introduction
Very recently, the Ligtas Buntis Campaign of the Department of Health (DOH)
rekindled an age-old debate between the government and the church around family
planning.1 By DOH definition, “Ligtas Buntis” has two complementing meanings
and scope of concerns. First, “Ligtas Buntis” can be short for “ligtas na
pagbubuntis” or safe pregnancy and childbirth. In this sense, the DOH is referring
to programs promoting regular prenatal check ups to detect high-risk pregnancies
and to facilitate deliveries that are safe for both mothers and babies. Second, and
more controversially, “Ligtas Buntis” may also be short for “ligtas sa pagbubuntis”
or “safety from (high-)risk or unwanted pregnancy.2 In this sense, the campaign is
meant to “to increase the visibility of family planning as an essential public health
service, and to dramatically improve the access of men, women and couples to
family planning.... services.”3 The DOH stresses that family planning as a health
intervention prevents high-risk pregnancies, reduces maternal deaths and prevents
abortion. Family planning also responds to the unmet needs of women (and men)
of reproductive age and could be viewed as a means to attain sustainable
development.4
The nomenclature, of course, carries with it a very wide space for doubts.5 Despite
being very clear about its definition and scope of the program, DOH received
accusations that it has been discretely promoting abortion and is not “pro-life.”
The adamant stand of the Catholic Church has always been against family
planning except by natural means, because it believes that “family planning by
artificial means” is a euphemism for abortion. Shortly after the campaign was
launched, the Catholic Bishops’ Conference of the Philippines issued a pastoral
letter branding Ligtas Buntis as an “assault to the family.”6 Father Roy Cimagala
has often been quoted for saying that “This Ligtas Buntis campaign, while heavily
sanitized and deodorized, continues to be afflicted with the basic sick idea that
contraception is just okay, especially given the poverty, ignorance, blah, blah, blah
of the people. When a basic moral issue is involved, the Church will not be
silenced, even if it has to be crucified in public opinion.”7
1
For the Catholic Church, any measures supporting family planning necessarily
supports abortion, as well.8 While many Philippine laws in the past have
provisions pertaining to family planning and abortion, no Republic Act on
reproductive health has yet been passed because of the Catholic Church’s efforts to
oppose it. The most controversial points around the reproductive health bills are
the provisions on family planning, because they are often (mis-)construed as
promoting abortion, so I would like to concentrate on this area in this policy
review. In this paper, I will review provisions on family planning in House Bill
No. 16 (HB16), the latest proposed law on reproductive health. Some of these
provisions in the bill necessarily cross-refer to those of abortion and reproductive
health, so I will also tackle on these latter areas.
2
Table 1. Family planning provisions in House Bill 16, or the “Responsible Parenthood and
Population Management Act of 2005.”
Section 3j. Guiding While the full range of family planning methods, techniques and
Principles devices shall be made available to couples and adults of reproductive
age, abortion shall remain to be penalized under the Revised Penal
Code and relevant jurisprudence...
Section 4a. Definition Responsible Parenthood - the will, ability, and commitment of parents
of Terms to respond to the needs and aspirations of the family and children more
particularly through family planning.
Section 4b. Definition Family Planning - a program which enables couples and individuals to
of Terms decide freely and responsibly the number and spacing of their children
and to have the information and means to carry out their decisions, and
to have informed choice and access to a full range of safe and effective
family planning methods, techniques and devices, excluding abortion
which is a crime.
Section 4g. Definition Reproductive Health Care - availability and access to a full range of
of Terms methods, techniques and services that contribute to reproductive and
sexual health and well-being by preventing and solving reproductive
health-related problems in order to achieve enhancement of life and
personal relations. The elements of reproductive health care include:
(among others) Family planning information and services; prevention
of abortion and management of post-abortion complications...
Section 5. Responsible Pursuant to the herein declared policy, there is hereby constituted
Parenthood and within thirty (30) days from the effectivity of this Act a multi-agency
Population body to be known as the Responsible Parenthood and Population
Management Council Management Council, hereinafter referred to as the Council. It shall be
composed of eighteen (18) members with the Director General of the
National Economic and Development Authority (NEDA) as
Chairperson and the Secretary of The Department of Health (DOH) as
Co-Chairperson....
Section 6d. Functions As the central advisory, planning and formulating body of the
of the Council comprehensive and integrated policy on reproductive health relative to
human development and population management, the Council shall
have the following functions: (among others) d. To facilitate the
involvement and participation of non-government organizations and
the private sector in reproductive health care service delivery and in
the production, distribution and delivery of quality reproductive health
and family planning supplies and commodities to make them
accessible and affordable to ordinary citizens....
Section 6e. Functions To fully implement the Reproductive Health Care Program with the
of the Council following components: (among others) Reproductive and sexual health
education including but not limited to counseling on the full range of
legal and medically-safe family planning methods including surgical
methods; Prevention of abortion and management of post-abortion
complications....
3
Section 9. Mobile Each Congressional District shall be provided with a van to be known
Health Care Service as the Mobile Health Care Service (MHCS) to deliver health care
goods and services to its constituents, more particularly to the poor and
needy, as well as disseminate knowledge and information on
reproductive health: Provided, That reproductive health and sexuality
education shall be conducted by competent and adequately trained
persons preferably reproductive health care providers: Provided,
further, That a wide range of family planning methods, both
natural/traditional and modern, shall be taught.
Section 10. Mandatory Reproductive Health and Sexuality Education in an age-appropriate
Reproductive Health manner shall be taught by adequately trained teachers starting from
and Sexuality Grade 5 up to Fourth Year High School. Reproductive Health and
Education Sexuality Education shall commence at the start of the school year
immediately following one year effectivity of this Act. The Council
shall formulate the Sexuality Education curriculum, which shall be
common to both public and private schools, based on the following
subjects and standards: (among others) reproductive health and sexual
rights; reproductive health care and services; attitudes, beliefs and
values on sexual development, sexual behavior and sexual health; d.
proscription and hazards of abortion and management of post-abortion
complications; natural and modern family planning to prevent
unwanted, unplanned and mistimed pregnancies; use and application of
natural family planning methods....
Section 16. Prohibited The following acts are prohibited: (among others) Any health care
Acts service provider, whether public or private, who shall: (among others)
knowingly withhold information, or restrict the dissemination thereof,
and/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; refuse to perform voluntary sterilization and
ligation and other legal and medically-safe reproductive health care
services on any person of legal age on the ground of lack of third party
consent or authorization: Provided, That in the case of abused minors
as certified to by the Department of Social Welfare and Development,
and pregnant minors, no prior parental consent shall be necessary...
4
Typological analysis
Below are provisions that describe HB16 and categorize proposed family planning
policies within it according to typology. For simplicity, only the section numbers
of the provisions mentioned in Table 1 are placed under the column “Provision” in
Tables 3a to 3d.
5
A. By intent Provision Description
6
B. By function Provision Description
Material policies Section 5 - provides for a multi-agency body that shall oversee the
implementation of the programs within the bill
Section 6e - provides for Reproductive and Sexual Health education
and 10 and specifications on how to carry it out
Section 9 - provides for Mobile Health Care Services to each
congressional district
Section 16 - restricts certain actions in relation to reproductive health
care service provision
Symbolic policies Section 3j - states the principles that guide legislators in making
further stipulations around family planning and abortion
Section 4a, 4b - delineates that scope of some concepts as they relate to
and 49 other stipulations within the bill
Local policy Section 9 - stipulates that provision of Mobile Health Care Service
is locally based at the congressional district
National policies Sections 3j, - there is an implied national scope of these provisions
4a, 4b, 4g, 5, because of the absence of clauses that limit the services
6d, 6e 10, 16 locally
Policy trail
7
Since 1970 up to the present, there have been one Republic Act, two Presidential
Decrees, one Executive Order, one Department of Health Circular, one
Department of Health Order, two Department of Interior and Local Government
Memoranda, one Board Resolution and four House Bills that refer to family
planning. HB 4110 was read twice (and therefore had two versions) within the
Twelfth Congress. Table 4 shows the laws and house bills according to
chronology.
8
Year Type of law and number Title or subject
9
created the Comprehensive Maternal and Child Health Family Planning Program
in 1970. During that time, family planning was seen solely as a health issue. The
policies in the Department of Health Circular No. 16 ordered for both the
provision of family planning services and family planning education by rural
health units, government hospitals and city health centers. Shortly thereafter, the
Population Act of 1971 (RA 6365) was passed, which started a long history of
family planning policies being subsumed under “population laws.” The Population
Commission was created by virtue of this Republic Act.
In 1995, during the Tenth Congress, House Bill No. 2136 was proposed as the
“New Population Act of 1995.” It was the first bill to mention the concept of
“reproductive health services.”
Purposes and Objectives. In the implementation of the
foregoing policy and in accordance with the provisions of
this Act, the government shall: (among others) invest in
programs specifically directed at women's increased access
to information, education, skills development, employment
opportunities, and high quality reproductive health
services in order to enable them to effectively contribute
to and benefit from economic growth and sustainable
development... (HB 2136, Section 3)
The phrase “family planning” was never mentioned in the draft, but the bill took
on the tradition of the population laws before it. “Reproductive health services”
remained a symbolic pronouncement in the bill and had no operationalized
provisions for it in other sections of the bill, save for the reiteration of the roles of
the Population Commission. What was remarkable, though, was the fact that
“reproductive health services,” along with employment opportunities, increased
access to education and skills development of women, started to be regarded as
necessary elements for “economic growth and sustainable development.” In this
regard, “family planning” (or “reproductive health services,” for that matter)
ceased to be viewed as solely a health issue or a means to control the population,
and came to carry more noble purposes of promoting not only “economic growth”
but, more importantly, “sustainable development” as well.
During the Eleventh Congress, HB 2136 was repackaged as the “Integrated
Population and Development Act of 1999,” or House Bill 8110. The latter bill was
not very different in concept from the previous one in the sense that it “integrated”
10
the principle of “population” with that of “development.” HB 8110 was, however,
elaborated “reproductive health services” by mentioning the components of the
services, which include family planning services.
The mention of abortion in HB 8110 was aimed to stress that it is something that
should be avoided, like unwanted pregnancy. There is an implied (but not explicit)
declaration that abortion is not a method of family planning, but rather, that it is
something that can be prevented through the employment of family planning
methods. In a way, this is an improved depiction of the relationship of family
planning and abortion, compared to that in PD 79.
In the succeeding congress, the Twelfth Congress, the “Integrated Population and
Development Act of 1999” underwent further repackaging and was now called
“The Reproductive Health Care Agenda Act of 2001.” During the second reading
of the bill, the title was shortened to “The Reproductive Health Care Act of 2002.”
At face value, the bill title again portrays a solely health perspective of the
subsumed policies. However, the Declaration of Principles within the bill stated
that reproductive health is actually regarded as a human right.
While the first draft of HB 4110 contextualized reproductive health and family
planning within the concepts of “population” and “development,” the second draft
was virtually silent about these concepts.
The policies in the latter draft of HB 4110 could therefore be taken as an aggregate
statement that reproductive health services, including family planning, should be
promoted “not for anything else” but by virtue of its being a human right.
11
Incidentally, it was around this time that the Catholic Church intensified its efforts
in opposing the bill.9, 10
This present repackaging of the reproductive health/family planning bill (HB 16)
really reflects full integration of the health, population, development and human
rights approach to the issue, and more. This time, the concept of “responsible
parenthood” is also capitalized, and could in fact be considered as the “priority”
point of view that the bill takes, as can be noticed in its long title: “An Act
Providing for an Integrated and Comprehensive National Policy on Responsible
Parenthood, Population Management and Human Development, Creating a
Responsible Parenthood and Population Management Council, and For Other
Purposes.” The bill declares that “responsible parenthood” can be obtained
through a family planning program that promotes “family planning methods,
techniques and devices.”
12
The family planning provisions in HB 16 could be summarized as follows: 1.
family planning methods, techniques and devices shall be made available; 2.
education about family planning shall be made available; 3. abortion is not a
family planning method; it is a crime; it should be avoided; should it happen, its
medical consequences must be effectively managed; 4. a Responsible Parenthood
and Population Management Council should be created; 5. locally, a Mobile
Health Care Service should be in-charge of the delivery of services within the
congressional district; and, 6. acts that prevent the attainment of a state of
reproductive health as a human right are prohibited.
A more extreme version of opposition to the bill by the church is the rejection of
any form of “artificial” methods of family planning, in support for the “natural”
ones. The reason for such opposition seems to be the fact that “artificial” methods
13
entail the use of devices which are not physically intrinsic, hence they are
unacceptable and consequently, sinful. This area is really problematic because of
lack of explanation from the church regarding the parallelism of “devices” and
“sin.” Is enjoying the pleasure of talking to a friend via cellular phones necessarily
sinful because it entails the use of “devices”?
Apart from minding the drafting of bills, it cannot be overemphasized that the
advocacy arm of a family planning bill holds a very crucial role in passing the bill
through the congress. There needs to be a body of lobbyists who are also capable
of forging alliance and effectively negotiating with those who oppose the bill.
While it is true that the bill needs to be drafted in a manner that ensures effective
implementation of the resulting law, the bill should also prepare the people for law
implementation through an advocacy campaign that highlights the intended
benefits of the proposed law. More importantly, the intended benefits should also
be presented to the people in a manner that espouses respect for cultural and
religious beliefs and personal conviction, as declared in the guiding principles of
the bill.
References
14
1
. Jimenez, C. (2005) Dayrit, the daunted. Internet. Accessed on 2 May 2005, available at
http://partners.inq7.net/newsbreak/istories/index.php?story_id=33567
2
. Department of Health. (2005). Ligtas buntis campaign 2005. Internet [lecture slides]. Accessed on 2 May 2005,
available at http://www.doh.gov.ph/ligtasbuntis/LBC_presentation_files/frame.htm
3
. Department of Health. (2005). Ligtas buntis 2005 campaign. Internet. Accessed on 2 May 2005, available at
http://www.doh.gov.ph/ligtasbuntis/about_LBC.htm
4
. Tan, ML. (2005). Language, context, politics and health. Internet. Accessed on 2 May 2005, available at
http://www.inq7.net/globalnation/col_pik/2005/mar21.htm
6
. Dalisay, B. (2005). Why I left the church. Internet. Accessed on 2 May 2005, available at
http://partners.inq7.net/newsbreak/common/printable.php?site_id=51&story_id=33565
8
. Betonio, TC. (2002). Family planning org urges congress to pass Reproductive Health Care Act. Internet.
Accessed on 23 April 2005, available at http://www.mindanews.com/2002/10/2nd/arn05bill.html
9
Catholic Bishops’ Conference of the Philippines. (2003). We must reject House Bill 4110. Internet. Accessed
on 15 December 2004, available at http://www.rcam.org/cbcp/hb4110statement.htm
10
Manar, MC. (2003). Catholics pray for rejection of HB 4110. Internet. Accessed on 23 April 2005, available at
http://www.mindanews.com/2003/10/07nws-candles.html
11
Department of Health. (2005). Family planning myths and misconceptions. Internet. Accessed on 2 May 2005,
available at http://www.doh.gov.ph/ligtasbuntis/myths.htm