Last updated: October 15, 2012 12:46 pm

Philippines debates free contraception

Children play on a congested street in Manila, Philippines©Getty

Cornelia Tumale knows that the one tiny room she occupies in an abandoned government housing project in Manila is no place to raise six children.

“I wanted just one more child since moving to this place after having three children in the province,” says Ms Tumale, sitting outside the cramped quarters which are no bigger than a large car.

The 46-year-old mother ended up having three more children instead of one. She had used intrauterine devices to space her pregnancies before moving to Manila, and was shocked to discover that government doctors in the capital refused to fit her with one after she gave birth to her fourth child in 2002.

The city’s then mayor had banned the distribution of contraceptives in government hospitals because he considered them immoral. That belief is actively promoted by the powerful Catholic church. It is also widely held by many Filipino politicians who dare not offend influential priests and bishops because they fear losing the votes of Filipino Catholics, who make up more than 90 per cent of the population.

But the House and Senate are now debating a reproductive health bill that could help women like Ms Tumale by requiring government hospitals to provide free contraceptives. It would also force schools to teach sex education to help reduce teenage pregnancies.

“Women everywhere will have better information and have greater access to contraceptives that work best for them,” said Magdalena Macalambo, a community health worker who works at a women’s health clinic. “Right now, it pretty much depends on whether their local mayor supports or opposes contraceptives.”

A government survey last year found that a quarter of low-income married women in the Philippines indicated their family planning needs were not being met. Unplanned pregnancies contribute to high levels of maternal deaths in the nation of 95m people. The reported figure of 160 maternal deaths per 100,000 live births is almost twice the average of other large southeast Asian countries, according to the World Bank.

In August, the 285-member House of Representatives voted to end prolonged debates that have condemned previous versions of the bill to oblivion. The unprecedented vote came after President Benigno “Noynoy” Aquino endorsed the measure in defiance of Catholic bishops who warn that the use of contraceptives will weaken morals and eventually lead to the legalisation of abortion and divorce.

“We are at the threshold of passing this bill finally,” said Edcel Lagman, a House member and one of the authors of the proposed reproductive health law.

Mr Lagman said the president’s support encouraged a majority of lawmakers to vote to end debate on the bill. Still, final approval of the bill is not certain. Though outnumbered, the bill’s opponents have blocked further progress of the proposed law by using parliamentary delaying tactics, leaving less time for the approval of the bill before Congress breaks up in February ahead of the May 2013 polls.

If Congress fails to approve the bill during its current session, which ends in June 2013, the process will start from scratch. That would be a big setback for Ms Tumale and millions of other poor women who need government subsidies for contraceptives to prevent or space pregnancies.

Failure to pass the bill also has broader consequences. Economic planners are hoping for early passage so that the Philippines can start enjoying faster economic growth triggered by the so-called demographic transition. The shift happens after fertility rates drop to a replacement ratio of 2.1 births per woman, resulting in a sharp rise in the proportion of working age people to total population.

Economists say that demographic transition accounted for about a third of the economic growth spurt experienced by east Asia’s economic “tigers” from 1965 to 1995.

The Philippines’ fertility rate, which stands at 3.1 births per woman – double Thailand’s 1.5 – is expected to fall to 2.1 by 2020 if the reproductive health bill is passed and demand for 90 per cent of Filipino women’s family planning needs are met, according to a study done by a group of economists, including Arsenio Balisacan, the new economic planning secretary.

Without the measure, the fertility rate is only expected to fall to 2.1 by 2030, delaying by a decade the benefits from demographic transition.

“The sooner the reproductive health bill is passed and implemented, the faster the economy can hit the ‘sweet spot’,” said Ernesto Pernia, a former Asian Development Bank economist, in August.

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