Reproductive health bill

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Reproductive health bill

  1. 1. Reproductive Health Bill
  2. 2. What is RH (Reproductive Health) Bill? • are proposed laws in the Philippines aiming to guarantee universal access to methods on: Contraception Abortion Fertility Control Sexual Education Maternal Care
  3. 3. There are presently two bills with the same intended goals: • House Bill # 4244 ─ An Act Providing for a Comprehensive Policy on Responsible Parenthood, Reproductive Health, and Population and Development, and For Other Purposes • Senate Bill # 2378 ─ An Act Providing For a National Policy on Reproductive Health and Population and Development
  4. 4. Maternal Care Child Health Condoms Birth control Pills (BCP) Intrauterine Device (IUD)
  5. 5. • October 2012 - the bill was renamed and revised because of the overwhelming opposition, especially from the Catholic Bishops' Conference of the Philippines (CBCP) • The bill is highly opposed by many people. Debates and rallies against the bill by many people, particularly the Roman Catholic Church.
  6. 6. Purpose for improved quality of life through a “consistent and coherent national population policy
  7. 7. Key Definitions • Senate Bill 2378 defines the term "reproductive health care" as follows: Reproductive Health Care – refers to the state of complete physical, mental and social well-being and not merely the absence of disease or infirmity, in all matters relating to the reproductive system and to its functions and processes. This implies that people are able to have a satisfying and safe sex life, that they have the capability to reproduce and the freedom to decide if, when and how often to do so, provided that these are not against the law. This further implies that women and men attain equal relationships in matters related to sexual relations and reproduction.
  8. 8. Key Definitions • Reproductive Rights is defined by Senate Bill 2378 as follows: the rights of individuals and couples, to decide freely and responsibly whether or not to have children; the number, spacing and timing of their children; to make other decisions concerning reproduction free of discrimination, coercion and violence; to have the information and means to do so; and to attain the highest standard of sexual and reproductive health.
  9. 9. Key Definitions • the country will guarantee this same right to unmarried children and teenagers, since they are "people." • this will lead to promiscuity among the young, as they will be granted the right to "decide if, when and how often to reproduce".
  10. 10. Bill content Sections 1. Philippine Population Density Map. Darker areas mean more population. 2. The basic content of the Consolidated Reproductive Health Bill is divided into the following sections. 3. Title 4. Declaration of Policy 5. Guiding Principles 6. Definition of Terms 7. Midwives for Skilled Attendance 8. Emergency Obstetric Care 9. Access to Family Planning 10. Maternal and Newborn Health Care in Crisis Situations 11. Maternal Death Review 12. Family Planning Supplies as Essential Medicines 13. Procurement and Distribution of Family Planning Supplies 14. Integration of Family Planning and Responsible Parenthood Component in Anti-Poverty Programs 15. Roles of Local Government in Family Planning Programs 16. Benefits for Serious and Life- Threatening Reproductive Health Conditions 17. Mobile Health Care Service 18. Mandatory Age-Appropriate Reproductive Health and Sexuality Education 19. Additional Duty of the Local Population Officer 20. Certificate of Compliance 21. Capability Building of Barangay Health Workers 22. Ideal Family Size 23. Employers’ Responsibilities 24. Pro Bono Services for Indigent Women 25. Sexual And Reproductive Health Programs For Persons With Disabilities (PWDs) 26. Right to Reproductive Health Care Information 27. Implementing Mechanisms 28. Reporting Requirements 29. Congressional Oversight Committee 30. Prohibited Acts 31. Penalties 32. Appropriations 33. Implementing Rules and Regulations 34. Separability Clause 35. Repealing Clause 36. Effectivity
  11. 11. Summary of major provisions • The bill mandates the government to “promote, without bias, all effective natural and modern methods of family planning that are medically safe and legal.” • Although abortion is recognized as illegal, 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.
  12. 12. Summary of major provisions • Under the bill, 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 less than 200 workers are required to enter into partnership with health care providers in their area for the delivery of reproductive health services.
  13. 13. Summary of major provisions • Employers with more than 200 employees shall provide reproductive health services to all employees in their own respective health facilities. Those with less 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 services. 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, including 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.
  14. 14. Summary of major provisions • Employers with more than 200 employees shall provide reproductive health services to all employees in their own respective health facilities. Those with less 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 services. 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, including 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.
  15. 15. Summary of support • (1) Economic studies, especially the experience in Asia,show that rapid population growth and high fertility rates, especially among the poor, exacerbate poverty and make it harder for the government to address it. • (2) Empirical studies show that poverty incidence is higher among big families. Smaller families and wider birth intervals could allow families to invest more in each child’s education, health, nutrition and eventually reduce poverty and hunger at the household level.
  16. 16. Summary of support • (3) Ten to eleven maternal deaths daily could be reduced if they had access to basic healthcare and essential minerals like iron and calcium, according to the DOH; • (4) Studies show that 44% of the pregnancies in the poorest quintile are unanticipated, and among the poorest women who would like to avoid pregnancy, at least 41% do not use any contraceptive method because of lack of information or access.
  17. 17. Summary of support • (5) use of contraception, which the World Health Organization has listed as essential medicines, will lower the rate of abortions as it has done in other parts of the world, according to the Guttmacher Institute. • (6) An SWS survey of 2008 showed that 71% of the respondents are in favor of the bill, • (7) at the heart of the bill is the free choice given to people on the use of reproductive health, enabling the people, especially the poor to have the number of children they want and can care for.
  18. 18. Summary of criticism • (1) "The world's leading scientific experts" have resolved the issues related to the bill and show that the "RH Bill is based on wrong economics" as the 2003 Rand Corporation study shows that "there is little cross-country evidence that population growth impedes or promotes economic growth“ • (2) The bill takes away limited government funds from treating many high priority medical and food needs and transfers them to fund objectively harmful and deadly devices. The latest studies in scientific journals and organizations show that the ordinary birth control pill, and the IUD are abortifacient to 100-celled human embryos: they kill the embryonic human, who as such are human beings equally worthy of respect, making the bill unconstitutional.
  19. 19. Summary of criticism • (3) US National Defense Consultant, Lionel Tiger, has shown empirical evidence that contraceptives have deleterious social effects (abortion, premarital sex, female impoverishment, fatherless children, teenage pregnancies, and poverty).Harvard School of Public Health scientist Edward Green observes that 'when people think they're made safe by using condoms at least some of the time, they actually engage in riskier sex', in the phenomenon called "risk compensation". There is evidence for increased risk of cancer (breast, cervical, liver)as well as significant increase of risk for heart attack and stroke for current users of oral contraceptives. The increased usage of contraceptives, which implies that some babies are unwanted, will eventually lead to more abortion; the correlation was shown in a scientific journal and acknowledged by pro-RH leaders,
  20. 20. Summary of criticism • (4) People's freedom to access contraceptives is not restricted by any opposing law, being available in family planning NGOs, stores, etc. The country is not a welfare state: taxpayer's money should not be used for personal practices that are harmful and immoral; it can be used to inform people of the harm of BCPs. • The penal provisions constitute a violation of free choice and conscience, and establishes religious persecution. 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."
  21. 21. Economic and demographic premises • The Philippines is the 39th most densely populated country, with a density over 335 per squared kilometer • The 2010 total fertility rate (TFR) is 3.23 births per woman, from a TFR of 7 in 1960. (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)
  22. 22. Economic and demographic premises • 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.“
  23. 23. Economic and demographic premises • 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 "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)."
  24. 24. Economic and demographic premises • In Population and Poverty, Aniceto Orbeta, Jr, showed that poverty incidence is higher among big families. • 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.
  25. 25. Maternal health and deaths • Maternal deaths in the Philippines, according to the WHO, is at 5.7 per day, not 10-11 deaths a day, as per the proponents who repeated these numbers "to drive home the point.“
  26. 26. Maternal health and deaths The proponents state that RH will mean: • (1) Information and access to natural and modern family planning • (2) Maternal, infant and child health and nutrition • (3) Promotion of breast feeding • (4) Prevention of abortion and management of post-abortion complications • (5) Adolescent and youth health
  27. 27. Maternal health and deaths • (6) Prevention and management of reproductive tract infections, HIV/AIDS and STDs • (7) Elimination of violence against women • (8) Counseling on sexuality and sexual and reproductive health • (9) Treatment of breast and reproductive tract cancers • (10) Male involvement and participation in RH; • (11) Prevention and treatment of infertility and • (12) RH education for the youth.
  28. 28. Family planning • Unmet need • Twenty-two percent of married Filipino women have an unmet need for family planning services, an increase by more than one- third since the 2003 National Demographic and Housing Survey. • women are having more children than they desire, as seen in the gap between desired fertility (2.5 children) and actual fertility (3.5 children), implying a significant unmet need for reproductive health services
  29. 29. Family planning • common reasons why women with unmet need in the Philippines do not practice contraception are health concerns about contraceptive methods, including a fear of side effects
  30. 30. Family Planning • Access • main concerns of the proponents is the perceived lack of access to family planning devices (e.g. contraceptives and sterilization) • The bill intends to provide universal access through government funding
  31. 31. Family Planning • Natural family planning • Pro-life groups and the Catholic Church are in favor of NFP or natural family planning or fertility awareness as a moral way of regulating child births. • abstinence during period of fertility and having sex during period of infertility, does not abuse nor trivialize the natural processes • By respecting sexuality, it does not "use" the spouse as an object for mere pleasure, nor is there a directly willed prevention of human life
  32. 32. Family Planning • Natural family planning • On the other hand, proponents contend that "natural family planning methods have not proven to be as reliable as artificial means of birth control.“ • Pro-life groups counter this by saying that high-level scientific studies show that when fertility awareness is used correctly and consistently with ongoing coaching, it is 99% effective.
  33. 33. Abortion • Abortifacient issue • According to the RH bill, one of its components is "prevention of abortion and management of post-abortion complications.“
  34. 34. Abortion • It provides 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.“ • It also states that "abortion remains a crime and is punishable," as the Constitution declares that “the State shall equally protect the life of the mother and the life of the unborn from conception.”
  35. 35. Abortion • Opposing the bill, the Faculty of Medicine of the catholic University of Santo Tomas, the Philippine Nurses Association, the Bioethics Society of the Philippines, Catholic Physicians’ Guild of the Philippines stated that “the antiabortion stance of the bill is contradicted by the promotion of contraceptive agents which actually act after fertilization and are potentially abortifacient agents.”
  36. 36. Abortion • when a common birth control pill fails to prevent ovulation, "postfertilization effects are operative to prevent clinically recognized pregnancy.“ • the IUD brings about the "destruction of the early embryo,“ thus is deemed to kill five-day old babies.
  37. 37. Contraceptives • Morality and social effects • contraception is evil because it desecrates sex which is intrinsically linked to new sacred human beings, it makes spouses lie about their total self gift to their spouse, by not surrendering their personal fertility, and is an abuse of the function of reproductive organs
  38. 38. Contraceptives • HIV/AIDS • The RH bill provides for "prevention and treatment of HIV/AIDS and other, STIs/STDs, • Lagman explained that "Globally, the new number of reported cases of HIV infections and deaths has dropped by nearly 20 percent. It is therefore both ironic and tragic that the Philippines’ trajectory is towards the other direction. Our country’s HIV/AIDS statistics have increased by 30 percent!"
  39. 39. Sex Education • the bill provides for mandatory reproductive health education and that it be taught in "an age-appropriate manner... by adequately trained teachers starting from Grade 5 up to Fourth Year High School. • Opposition to the bill is concerned about early sexualization of the youth and say that sexuality education promoters themselves state that it has led to more teenage pregnancies and illegitimacy
  40. 40. Sex Education • They stressed that what is needed is chastity education, especially taught by their parents, rather than sex education in school • Proponents refer to the latest UNESCO study dated December 2009 which concluded that sexuality education did not encourage early initiation into sex, but actually increased the age at which people first engage in sexual activity
  41. 41. Penalties • There is mandatory sexuality education starting grade 5, and "malicious disinformation" is penalized. • All health care service providers which provide reproductive health services, including faith-based hospital administrators, may be imprisoned or fined if they refuse to provide family planning services such as tubal ligation and vasectomy.
  42. 42. Penalties • The same may happen to employers who do not provide free services to employees. • Imprisonment ranges from (1) month to six (6) months or a fine ranging from Ten Thousand Pesos (P10,000.00) to Fifty Thousand Pesos (P50,000.00)
  43. 43. Financials • Department of Health is proposing 13.7 Billion Pesos to be fund the RH Bill if it is passed in 2012, according to Senator Pia Cayetano. • The Filipinos for Life issued a statement with online copies of documents which according to TV5 News, "revealed the following financial grants for RH lobby groups."
  44. 44. Financials • $90,000 to the Reproductive Health Advocacy Network (RHAN) for promotion, from the UN Population Fund or UNFPA (2011); • $6.6 million to Planned Parenthood arm Family Planning Organization of the Philippines (FPOP) from UNFPA (2009);
  45. 45. Financials • $1.6 million to FPOP from IPPF for the years 2005, 2009, and 2010; • $1.2 million to PSPI from Marie Stopes (2009); • $39,000 to Likhaan from Planned Parenthood (2007); • $88,000 to FPOP in 2009 from Marie Stopes for RH kits; and • $75,000 to “Catholics” for Choice to promote RH, from the Wallace Global Fund (2009)
  46. 46. References • The general overview of the Reproductive Health bill cites fertility control among both men and women, the extensive usage of contraceptive services either through artificial methods and natural family planning, sexual education among pre-teens and adults, as well as supplemental maternal care for expectant mothers. • ^ http://newsinfo.inquirer.net/300440/rh-foes-still-oppose- watered-down-version-of-bill • ^ http://www.gmanetwork.com/news/story/279400/news/nati on/copy-of-new-rh-bill-version-filed-at-the-house-of- representatives • ^ a b "HB4244". Republic of the Philippines House of Representatives. Retrieved September 2, 2012.
  47. 47. References • ^ 12 World Leaders (January 1968). "Declaration on Population". Studies in Family Planning. JSTOR 1965194. • ^ a b Antonio de los Reyes (2002). "Coercive Population Ploys in the Philippines". Population Research Institute. • ^ a b c d e f (PDF) Promoting Reproductive Health: A Unified Strategy to Achieve the MDGs. Senate of the Philippines Economic Planning Office. July 2009. PB-09-03. • ^ US Department of National Security (1974). "National Security Study Memorandum 200: Implications of Worldwide Population Growth for U.S. Security and Overseas Interests (NSSM 200)". USAID. • ^ February 22, 2011 (2011-02-22). "RH Bills – A Primer – by Rev. Fr. Gregory D. Gaston, STD". 2010.alfi.org.ph. Retrieved 2012-08-20.
  48. 48. References • ^ Lexicon, Human Life International, Front Royal, 2006 • ^ a b c d e f g h i Francisco Tatad (2008-09-14). "Procreative Rights and Reproductive Wrongs". Scribd. • ^ a b c d e f g h Dalangin-Fernandez, Lira (1 February 2011). "RH bill OK’d at House committee level". politics.inquirer.net. Philippine Daily Inquirer. Retrieved 1 February 2011. • ^ a b c d e f g h i j Ernesto M. Pernia, Stella Alabastro-Quimbo, Maria Joy V. Abrenica, Ruperto P. Alonzo, Agustin L. Arcenas, Arsenio M. Balisacan, Dante B. Canlas, Joseph J. Capuno, Ramon L. Clarete, Rolando A. Danao, Emmanuel S. de Dios, Aleli dela Paz-Kraft, Benjamin E. Diokno, Emmanuel F. Esguerra, Raul V. Fabella, Maria Socorro Gochoco-Bautista, Teresa J. Ho, Dennis Claire S. Mapa, Felipe M. Medalla, Maria Nimfa F. Mendoza, Solita C. Monsod, Toby Melissa C. Monsod, Fidelina Natividad-Carlos, Cayetano W. Paderanga, Gerardo P. Sicat, Orville C. Solon, Edita A. Tan, and Gwendolyn R. Tecson (2008-08-11). "Population, Poverty, Politics and the Reproductive Health Bill". 2010 Presidentiables.
  49. 49. References • ^ a b c d e f Ruperto P. Alonzo, Arsenio M. Balisacan, Dante B. Canlas, Joseph J. Capuno, Ramon L. Clarete, Rolando A. Danao, Emmanuel S. de Dios, Benjamin E. Diokno, Emmanuel F. Esguerra, Raul V. Fabella, Ma. Socorro Gochoco-Bautista, Aleli P. Kraft, Felipe M. Medalla, Nimfa F. Mendoza, Solita C. Monsod, Cayetano W. Paderanga, Jr., Ernesto M. Pernia, Stella A. Quimbo, Gerardo P. Sicat, Orville C. Solon, Edita A. Tan, and Gwendolyn R. Tecson (December 2004) (PDF). Population and Poverty: the Real Score. University of the Philippines School of Economics. DP2004-15. • ^ a b ADB (2004). "Poverty in the Philippines". Asian Development Bank. • ^ a b Aniceto Orbeta, Jr. (2003). "Population and Poverty: A Review of the Evidence, Links, Implications for the Philippines". Philippine Journal of Development (Philippine Institute for Development Studies) XXX (56): 198–227. • ^ a b c Elizabeth Angsioco (2008-10-08). "Arguments for the Reproductive Health Bill". The Manila Times (The Manila Times Publishing Corp.). • ^ a b c "WHO Model List of Essential Medicines". World Health Organization. 2008 March.
  50. 50. References • ^ a b c d Edcel Lagman (2008-08-03). "Facts and Fallacies on the Reproductive Health Bill". Philippine Daily Inquirer. • ^ a b Mahar Mangahas (2008-10-18). "New polls on reproductive health". Philippine Daily Inquirer. • ^ a b c "The Demographic Dividend: A New Perspective on the Economic Consequences of Population Change". Rand Corporation. 2003. • ^ a b c d Raul Nidoy (2010-11-07). "Science Facts on the RH Bills". Scribd. • ^ a b c d Angelita Miguel-Aguirre (2008-08-11). "Medical Issues in the Reproductive Health Bill". The Truths and Half Truths about Reproductive Health, The Bishops-Legislators Caucus of the Philippines. • ^ a b Larimore WL, Stanford JB (2000). "Postfertilization effects of oral contraceptives and their relationship to informed consent" (PDF). Arch Fam Med 9 (2): 126–33. doi:10.1001/archfami.9.2.126. PMID 10693729. Retrieved 2010-10-05. • ^ a b c d Joseph B. Stanford and Rafael T. Mikolajczyk (2005). "Mechanisms of action of intrauterine devices: Update and estimation of postfertilization effects". American Journal of Obstetrics and Gynecology (W.B. Saunders Comp) 187: 1699–1708. doi:10.1067/mob.2002.128091. PMID 12501086. • ^ a b Peter Kreeft. "Human Personhood Begins at Conception". Medical Ethics Policy Monograph. Stafford, Virginia: Castello Institute. • ^ a b Ang Kapatiran Party (2010-11-15). "A Position Paper on the Reproductive Health Bills". Phnix.
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