How bad is the Philippine population problem?
The number of Filipinos is continuously growing by 2.36 percent annually. The latest population projection (mid-2006) reveals that we already number at an estimated 87 million. As the number of people increases, so do the demands. Every school year, we hear the same problems: textbook shortage, now pegged at 25 million; teacher shortage, with an estimated 50,000 more needed in public schools. Despite the government’s proclaimed economic gains, more than half of Filipinos (53%) rate themselves as poor (SWS first quarter 2007 survey).
Although some may argue that the population growth rate is below the national average at the provincial and municipal levels, especially in rural local governments, the capacity to provide basic services is severely constrained overall. Consider the following numbers:
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Forty-four percent (44%) of Filipinos still earn less than two dollars per day, and about two-thirds of them are engaged in activities that rely heavily on environmental and natural resources. (State of the Philippine Environment: A Progress Report, Feb. 2006).
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The number of unemployed rose from 2.91 million in 2005 to 2.93 in 2006, while labor force participation rate remained at 64.9 percent.
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Classroom shortage of 6,832 was addressed by creating two shifts of classes, resulting to a classroom-to-student ratio of 1:100.
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Our 2005 health budget amounting to P10.273 billion translates to a mere 35 centavos per Filipino daily, way below the per capita allocation for health in other Asian countries.
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There is only 1 doctor for every 27,842 Filipinos (2,969 doctors / 82,663,561 pop) as opposed to the ideal ratio of 1doctor for every 20,000 people (2004 Philippine Health Statistics Report).
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There is only 1 nurse for every 18,638 Filipinos (4,435 nurses / 82,663,561 pop), which falls extremely short of the ideal ratio of 1 nurse for every 5,000 people (2004 Philippine Health Statistics Report).
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Because of the mass exodus of doctors, nurses and caregivers, two hundred hospitals have already closed down since 2003 and eight hundred have partially closed due to the shortage of health workers. (Galvez-Tan, J. Z. Philippines: The Challenge of Managing Migration, Retention and Return of Health Professionals).
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How does our large and continuously growing population contribute to the country’s worsening poverty?
A study conducted by Aniceto Orbeta, Jr. (Poverty, Vulnerability and Family Size: Evidence from the Philippines, ADB Institute Discussion Paper No. 29, June 2005) shows the strong and enduring link between poverty incidence and vulnerability to poverty, and family size.
According to said study, only 23.8 percent of families with four members are poor, compared to 48.7 percent of families with seven members. Poverty gap and severity also worsens as one moves from a smaller to a bigger family size.
Evidence also shows that families are not able to maintain per capita income, per capita expenditures and per capita savings as their size increases. Incidence of child labor also rises as family size increases.
Similarly, data show that there are 11 dependents for every 6 working Filipinos, or almost two dependents per working Filipino.
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Why is it important to focus on reproductive health?
The results of the 2003 National Demographic and Health Survey (NDHS) show that Filipino women, especially among the ranks of the poor, still bear more children than they desire.
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Only half of married women practice family planning because of lack of information and proper knowledge of various family planning methods and services. The greater proportion of these women live in rural areas where there are few service providers and where services are scarce and inaccessible.
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Poor women have three times more children than the rich (5.9 children for the poor and 2.0 for the rich), give birth to their first child at a younger age, and have more problems spacing their children than wealthier women.
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Likewise, men who belong to the poorest segments of society have more children (5) compared to those who belong to the richest sectors (3).
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One in four pregnancies is mistimed and one in five is not wanted at all.
Meanwhile, despite the advances made in medicine, maternal health remains problematic in the country:
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Maternal mortality is pegged at a disturbing 162 for every 100,000 live births (2006 Family Planning Survey). The only exception are a handful of areas where there is an efficient program on maternal and child health, such as the municipality of Carmen, Bohol. The vast majority of local governments have yet to establish a system that would drastically reduce maternal mortality.
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Only 38 percent of deliveries have been found to be attended by skilled health professionals (2003 NDHS). Majority still seek the services of traditional hilots because they could not afford birthing in hospitals or because of lack of proper information.
Unless these people’s needs are addressed, Filipinos will keep on having more children than they want and can afford to have, and thousands of mothers will continue to die from causes that could have been prevented, were they only provided with complete information and services on reproductive health.
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Has the country’s population growth rate (PGR) really slowed down to 1.9 percent?
There is no truth to the claim that the country’s population growth rate (PGR) has slowed down to 1.9 percent annually. What the NSO data showed are mere projections derived from estimates of fertility and mortality, rather than on actual censuses. By contrast, the 2.36 percent PGR was derived from data of the 1995 and 2000 censuses – the most accurate method for computing PGR.
Moreover, so many assumptions are made when making population projections, making the figures less accurate. For example, projections may assume an increase in the use of contraceptives and a decline in fertility rate. But the past five years have shown a very slow increase in contraceptive use. The decline in fertility rate for the past 10 years has also been very slow. This is the reason why National Statistics Office (NSO) Director Carmencita Ericta recommends caution when interpreting data from population projections.
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Will the country experience a ‘demographic winter’ when a population and reproductive health policy is legislated?
Economists from the UP School of Economics believe that the threat of the so-called ‘demographic winter’ (birth dearth, aging, etc.) for the Philippines is greatly exaggerated, and using it as an argument against a sensible population policy is a plain and simple scare tactic. They also say population aging is as distant as about 100 years from today for the Philippines.
Projections indicate that if total fertility rate (TFR) continues to decline by 0.2 children every five years, replacement fertility of 2.1 children per woman would be reached only by 2040. However, the effects of population momentum would persist for another 60 years before population ceases to grow, by which time the Philippines’ total population would be 240 million.
Legislators from European Union countries, which are often cited as examples of countries facing demographic winter, have debunked the assumption that contraceptives are to blame for their situation. Hon. Anne Van Lancker, EU Parliamentarian from Belgium, cited the case of Scandinavian countries, particularly Norway, where contraceptives are widely accessible to the people, but are not experiencing the problem of an ageing population.
According to Hon. Kari Kjonaas Kjos of Norway, they were able to elude the problem of population ageing because they have learned to invest in their people. Specifically, Norway has ensured the establishment of mother-child facilities, economic incentives for fathers to take parental leave, and a pension system that covers everybody by the age of 67, employed or unemployed. This enabled mothers and couples to contribute significantly to the country’s economy and preserve their family life at the same time.
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Why is age-appropriate and mandatory sexuality education important?
Adolescent fertility has become a growing cause of concern as the results of the 2003 NDHS and the Young Adult Fertility and Sexuality Study (YAFSS) show.
The 2003 NDHS shows the following:
Meanwhile, the latest Young Adult Fertility and Sexuality Study conducted by the UP Population Institute (UPPI) in 2002 reveals the following:
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An estimated 4.9 million young adults (15-27 years old) have already engaged in premarital sex.
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Of the sexually active young Filipinos, an estimated 34 percent are having multiple partners.
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Majority of this group say that sex was something they did not plan but went with anyway.
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Only 19 percent used any contraception to protect themselves against pregnancy or sexually transmitted diseases the first time they had sex.
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Thirty-six percent (36%) of hospital cases of abortion belong to young women aged 15-24.
More and more of our youth are engaging in various forms of sexual activities. Without the proper education on their reproductive health and rights, these activities could lead to unwanted pregnancies or worse, abortion and abortion-related complications. An age-appropriate and mandatory sexuality education will equip our youth with the appropriate and relevant information and services on their reproductive health and rights, which they badly need.
The fear that sexuality education would lead to promiscuity among the youth is also unfounded. A study conducted by the Joint United Nations Programme on HIV/AIDS (UNAIDS) in October 1997 reveals that young people who were taught about their sexuality become more cautious in matters concerning sex. Similarly, a study by Grunseit and Kippax (1993) also found that sex education, in fact, delays the start of sexual activity and leads to protective behavior once sexual activity begins. In five Latin American cities, researchers found that young women who took a sex education course are more likely to delay having sex (Blaney, 1993).
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Why is there a need for a comprehensive legislation on population and reproductive health?
The Philippines’ policy on population and reproductive health (including family planning) has always been dependent on the incumbent. The late President Ferdinand Marcos instituted various commendable policies on said issues. However, President Corazon Aquino’s ambiguous stand on the role of family planning adversely affected the implementation of the national family planning program by the Commission on Population (POPCOM) and its partners.
Former President Fidel V. Ramos’ administration, in contrast, saw a strong support for family planning initiatives as it was sought in the context of sustainable development. When Joseph Estrada became President, enlightened officials in his Cabinet aggressively pursued and implemented family planning programs albeit the lack of any official pronouncement on population and family planning.
Estrada was replaced by President Gloria Macapagal-Arroyo, whose stand on the matter of population has been flip-flopping. She once acknowledged the need to reduce the country’s population growth rate to 1.9 percent, only to say in another statement that she is leaving the matter to local government units.
Relegating the responsibility of crafting and implementing policy interventions on population, reproductive health at the local level is not a viable option. This would lead to unsustainable and uneven programs across LGUs because of the relatively short term of LGU officials (3 years), disparities in internal revenue allotment (IRA), and the local official’s priorities, among others.
A number of progressive local government units like Aurora, Mountain Province, Ifugao, Marikina, and Davao City have already put in place family planning and reproductive health policies and programs in their respective areas. But what to do with a city as big as Manila, where any form of information and services related to family planning has been banned?
Unless a comprehensive national legislation on population and reproductive health is put in place, our people’s right to complete, accurate and comprehensible information, and comprehensive services on population and reproductive health will always remain dependent on the whim of whoever is in power.
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What is wrong with the government’s natural family planning-only (NFP-only) policy?
Universal access to a constellation of methods in family planning utilizing a principle of voluntary choice is founded on the 1987 Philippine Constitution, which guarantees for every human person full respect for human rights (Sec. 11, Art. 2,). Moreover, the fundamental law of the land gives due cognizance to the particular needs of women for gender equality (Sec. 14, Art. 2); of the youth to enjoy protection of their physical, moral, spiritual, intellectual, and social well-being (Sec. 13, Art. 2); and of spouses to found a family in accordance with their religious convictions and the demands of responsible parenthood (Sec. 3:1, Art. 15).
A policy focusing on natural family planning alone actually goes against these Constitutional principles. The government’s Natural Family Planning-only (NFP-only) policy will isolate the majority of women who prefer modern and artificial methods. Focusing only on natural methods is disempowering and discriminatory to women as it deprives them of universal access to the whole range of family planning methods so that they can choose what is most appropriate for their bodies, in accordance with their beliefs.
International and local studies have established that natural methods are not for everyone. For example, the standard days method is effective only for women whose menstrual cycles fall between 26-32 days and requires the unfailing cooperation by the husband as the couple must abstain from sex for 12 consecutive days during the woman’s fertile period.
Various national surveys of the National Statistics Office have also revealed that Filipinos prefer modern family planning methods, with pills as the consistent no. 1 method of choice.
The government’s NFP-only policy will also reverse the gains in lowering fertility and slowing down population growth to propel national development. It is impossible to achieve the government’s 1.9 percent population growth rate target if other legally permissible and medically-safe family planning methods are disregarded.
If government is really concerned about women’s fear of side effects and complications, and the general acceptability of modern methods, then, it should put its resources to programs for educating people on the pros and cons of all methods, rather than a policy imposing only one method.
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What hampers the establishment of a comprehensive legislated policy on population and reproductive health?
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Some leaders of the Catholic hierarchy and lay organizations have vigorously opposed reproductive health, family planning and population initiatives. While these groups have the right to stand for their religious beliefs, as guaranteed by the Constitution, the situation becomes problematic when they threaten and coerce those who believe otherwise, as what has been happening come election time. During the 2004 elections and in the 2007 elections, members of the Catholic hierarchy and lay organizations have been known to campaign against candidates supportive of policies and programs on population, reproductive health, and family planning. This is highly inappropriate as these candidates, when elected into office, will have the responsibility of crafting policies and implementing programs that will benefit all Filipinos, whether Catholic or otherwise. Moreover, data from the 2003 NDHS show that only 2.4 percent of married women cite religion as their reason for not using contraception.
Sadly, there are also leaders in government who choose not to recognize that the country’s population and reproductive health situation really needs to be addressed as it has serious negative impacts on our development as a nation. By turning a blind eye on the situation, they are failing to concretely address the people’s needs.
At the local government level, aside from the opposition mounted by the Catholic hierarchy, population and reproductive health policies are often not prioritized as these compete with other pressing issues. And when such policies do get enacted, they are often not implemented as most local governments, especially the 4th to 6th class LGUS, have barely enough funds, severely limiting their capacity in implementing mandated programs. These are structural and institutional constraints faced by local government units that need to be addressed as well.
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Do the people want reproductive health and population policies and programs?
The results of the Pulse Asia Ulat ng Bayan surveys on Family Planning done in 2000, 2004 and 2007 indicate the people’s consistent clamor for a comprehensive national policy on reproductive health and family planning.
In particular, the March 2007 Ulat ng Bayan findings reveal the following:
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Nine out of 10 Filipinos (92%) consider family planning important.
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Nearly 8 out of 10 Filipinos (76%) believe in the importance of including family planning in a candidate’s program of action.
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Three-quarters of the adult Filipino population (75%) will support candidates who are in favor of a government budget for family planning.
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About 9 in 10 Filipinos (89%) think it is important that government provide budgetary support for modern methods of family planning including the pill, intra-uterine devices (IUD), condoms, ligation and vasectomy.
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One in two Filipinos (50%) is of the opinion that rapid population growth hinders the country’s development.
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A larger proportion of Filipinos believe that the church (or religion) should not participate in the issue of what family planning methods couples should use (44% vs 33%).
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As a LEGISLATOR, what could you do to address this problem?
You can definitely do something to address the problem.
If you really want to serve the people by addressing their needs, you must know that sound population and reproductive health programs and services are among their basic rights and foremost needs. You must understand that these concerns have a direct impact on areas that are crucial to the people’s well-being such as income, education, health, and environment.
It would be better to institutionalize a sound population management policy and implement the necessary programs today than to simply cope with the problems of raising the resources for providing adequate social services and infrastructure to support a constantly growing and unmanaged population.
As a member of Congress can break the silence and apathy on these issues by including said concerns in your legislative agenda, by supporting the bills on reproductive health and population management currently filed in the 14th Congress (House Bills 17 and 182, and Senate Bills 40 and 43), by including said concerns in your discussions with your constituents and the media, and by initiating reproductive health and population management programs and services in your districts. You should also be willing to allocate and obtain resources for the institutionalization, implementation and sustainability of these programs.
As a local government official, you can initiate the crafting of local reproductive health and population policies and build a common agenda in your LGU. It is best to consult with the people to validate their needs and wants. This will also ensure their participation in the policymaking process.
While local policies do provide a solution to the various problems of population and reproductive health, local governance will work better in collaboration with national programs. However, in the absence of a comprehensive and sustainable national policy, LGUs may initiate support actions through resolutions and activities demonstrating their support for the passage of bills currently filed in the 14th Congress.
Reproductive health and population management are winning issues. By supporting said concerns, you will definitely win the hearts of your constituents and be remembered for years to come.
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