Barrameda Saquido, Arra

Gepte, Francesca

Guadalupe, Angeli

Higuchi, Asaka

Morita, Tomohiro

Ozaki, Akihiko

Tanimoto, Tetsuya

Simorgh Research Repository

Family Planning as a Possible Measure to Alleviate Poverty in the Philippines – Beyond Sociocultural Norms and Pervasive Opposition  Akihiko Ozaki1,2*, Angeli Guadalupe3, Arra Barrameda Saquido4, Diana Francesca Gepte5, Asaka Higuchi6, Tomohiro Morita7, Tetsuya Tanimoto8Letter to EditorFull list of authors’ affiliations is available at the end of the article.http://ijhpm.comInt J Health Policy Manag 2017, 6(11), 683–684 doi 10.15171/ijhpm.2017.57*Correspondence to: Akihiko Ozaki, Email: ozakiakihiko@gmail.comCopyright: © 2017 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Citation: Ozaki A, Guadalupe A, Saquido AB, et al. Family planning as a possible measure to alleviate poverty in the Philippines – beyond sociocultural norms and pervasive opposition. Int J Health Policy Manag. 2017;6(11):683–684.  doi:10.15171/ijhpm.2017.57Received: 4 March 2017; Accepted: 6 May 2017; ePublished: 16 May 2017Dear Editor,The 16th and current President of the Philippines, Rodrigo Duterte, aims to resolve poverty as a critical agenda. Although annual growth rate of the Philippine gross domestic product exceeded 5% since 2012, the estimated proportion of people living below the poverty threshold (2015) was 21.6% (22 million out of 100 million). Indeed, a significant economic disparity exists as demonstrated in its GINI index of 43.0 in 2013, a level higher than most Southeast Asian countries. Additionally, although the average total fertility rate in 2008 was 3.3 in the Philippines, its number reaches as high as 5.2 in the poorest household that is estimated to spend only around 2% of their total income on education.1 Actually, the children aged 6-17 in poorest households were less likely to attend school compared to those in richest households in 2011 (85.6% vs. 97.2%).2 As such, it has been hypothesized that there may be strong links among high fertility rate, poverty and limited opportunities of education in the country.Given these speculations, President Duterte highlights the importance of population control using modern family planning measures in his war on poverty. However, the inadequate sexual health education and conservative sociocultural norms prove to be significant obstacles, as methods of contraception are widely disrespected by the general population. The Philippines is predominantly Catholic, whereby 80% of the local population subscribes to the teachings of the Church. Although constitutionally there is a separation of the Church and State, the Church remains influential in defining policies particularly in areas of reproductive health. Presently, abortion is prohibited in their constitution except for cases conducted to protect mothers’ health. However, in reality, abortifacient agents are illegally sold in stalls adjacent to several Catholic cathedrals in Manila. Additionally, the lowest rate of condom use in Southeast Asia and increasing rate of casual sex contribute a considerable burden of sexually transmitted diseases, including human immunodeficiency virus (HIV).3 The reported number of HIV infections is currently 30 000, 80% of which have been newly registered since 2010.3 Further, the emerging risk of Zika virus infection or rubella would present a challenging situation to pregnant women.4Under such conditions, there is a growing need that policymakers and public health professionals take into account the changing attitudes towards sexual intercourses among the general population in the country.In 2012, Responsible Parenthood and Reproductive Health Act, also known as Reproductive Health Law, was enacted in the Philippines to improve an access to birth control measures after years of struggle.5 Although its constitutionality was questioned by the Supreme Court in 2013, the court finally declared that the law was constitutional in 2014.5 However, Temporary Restraining Order, which was subsequently issued by the Supreme Court, has restricted (1) the registration of new contraceptives and the re-registration of currently sold contraceptives when their permits expire, and (2) the purchase, distribution and use of subdermal implants by the Department of Health, eventually hampering the full implementation of the law until now.6 It is obvious that the current situation necessitates an early resolution, considering that there will be limited contraceptive measures available in the Philippines, such as tubal ligation, vasectomy and natural family planning methods, if the restraining order is not lifted and the current registration of contraceptives expire.6 We urge President Duterte to achieve a historic step to further improve healthcare in the Philippines – the full implementation of the Reproductive Health Law.Ethical issues Not applicable.Competing interests Authors declare that they have no competing interests. Authors’ contributions AO wrote the manuscript. All authors conceptualized and designed the study, and revised the paper.Ozaki et alInternational Journal of Health Policy and Management, 2017, 6(11), 683–684684Authors’ affiliations 1Department of Surgery, Minamisoma Municipal General Hospital, Fukushima, Japan. 2Graduate School of Public Health, Teikyo University, Tokyo, Japan. 3Department of Pediatrics, Brokenshire Memorial Hospital, Davao City, Philippines. 4Department of Environmental and Occupational Health, University of the Philippines Manila, Malate Manila, Philippines. 5College of Medicine, Pamantasan ng Lungsod ng Maynila, Metro Manila, Philippines. 6Department of Hematology, Toranomon Hospital, Tokyo, Japan. 7Department of Internal Medicine, Soma Central Hospital, Fukushima, Japan. 8Department of Internal Medicine, Jyoban Hospital of Tokiwa Foundation, Fukushima, Japan.References1. Philippine Commission on women. Population, families and household statistics. Web site. http://pcw.gov.ph/statistics/201405/population-families-and-household-statistics. Accessed March 3, 2017. Published 2014.2. Philippine Statistics Authority. Child poverty in the Philippines. https://www.unicef.org/philippines/ChildPovertyinthePhilip-pines_web.pdf. Accessed March 3, 2017. Published 2015.3. Philippine epidemic calls for urgent action on HIV. Lancet HIV. 2016;3(3):e105. doi:10.1016/S2352-3018(16)00021-74. Zhang S. Zika virus may push South America to loosen abortion bans. https://www.wired.com/2016/01/abortion-and-zika-south-america/. Accessed March 3, 2017. Published 2016.5. Responsible Parenthood and Reproductive Health Law. Commission on Population, Department of Health, Republic of the Philippines website. http://www.popcom.gov.ph/62-press-releases/rp-rh-law/rp-rh-law-introduction/329-responsible-parenthood-and-reproductive-health-rp-rh-law. Accessed April 29, 2017.6. Duterte presses Supreme Court on Reproductive Health law. ABC-CNB News. 2017. http://news.abs-cbn.com/news/01/11/17/duterte-presses-supreme-court-on-reproductive-health-law. Accessed April 29, 2017.

Family Planning as a Possible Measure to Alleviate Poverty in

the Philippines – Beyond Sociocultural Norms and Pervasive

Opposition

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Family Planning as a Possible Measure to Alleviate Poverty in the Philippines – Beyond Sociocultural Norms and Pervasive Opposition

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