SRH and HIV/AIDS Linkages at Policies, Programmes and Service ...
SRH and HIV/AIDS Linkages at Policies, Programmes and Service ... SRH and HIV/AIDS Linkages at Policies, Programmes and Service ...
BANGLADESHCAMBODIANEPALBackgroundThe policy support for strengtheninglinkages between HIV/AIDS andsexual reproductive health on theinternational stage has grown beginningwith the International Conferenceon Population and DevelopmentProgramme (ICPD) for Action(UN, 1994). There are now at leastnine different international policystatements calling for stronger linkagesbetween HIV/AIDS and sexual andreproductive health fields. Globalstatements such as these strengthenthe advocacy calls for establishing and/or strengthening the linkages betweensexual and reproductive health andHIV/AIDS in terms of policies,funding mechanisms, programmes andservices.This report is prepared as part of theInternational Council on Managementof Population Programmes’ (ICOMP)activity to assess HIV and SRH bidirectionallinkages at the policy,systems and service delivery levelsin selected countries, including thePhilippines. Through case studiessuch as this, ICOMP hopes toidentify gaps in policy, systems andservices to ultimately contribute to thedevelopment of country-specific actionplans to forge and strengthen theselinkages. The case study attempts tospecifically address three importantareas:i. the level and effectiveness, if any, oflinkages between SRH and HIVrelated policies, national laws, andconsequent operational plans andguidelines;ii. the extent to which the systemsupports these linkages; andiii. the extent to which HIV services areintegrated into SRH services, andSRH services into HIV services.The information included in this reportwas obtained through the review ofSRH and HIV policies at the nationallevel and, where applicable, a review ofoperational plans and guidelines forprogrammes and delivery of services.The proposed and enacted bills in bothHouses of Congress were revisited todetermine the existence of provisionsrelated to sexual and reproductivehealth and HIV and to identifyinitiatives to integrate the two. Thedirector of the Family Health Officeof the National Center for DiseasePrevention, Department of Health wasalso interviewed. This office is in chargeof family planning at the DOH.An electronic search for relevantinformation on the internet was alsodone for supplemental informationon the topic. The website of theDepartment of Education was checkedfor developments on the proposedintegration of sexual and reproductivehealth education in mainstreamcurriculum at elementary and highschool levels. Similarly, the PhilHealthwebsite was also checked for circularson the provision of service packagesrelated to SRH and HIV. Documentsregarding the provision of SRH andHIV-related services in the workplacewere also located.PHILIPPINES98
Demographic, Sexual andReproductive Health, andHIV Status of FilipinosFour out of the seven MillenniumDevelopment Goals (MDGs) are onsexual and reproductive health. It isheartening to note that the Philippinesis likely to achieve two out of these fourgoals. The country is likely to achievegender equality and empowermentof women. In fact, the gender gap ineducation is in favour of girls; moregirls than boys are enrolled in bothelementary and secondary levels. Infant,(under-five) and neonatal mortalitycontinues to decrease and there is alsothe likelihood that MDG 4, on reducingchild mortality, will be achieved.In 2003 there were 29 infant deaths per1000 live births and 40 deaths per 1000children under the age of five.This decreased to 25 and 34 deathsper 1000 children respectively in 2008.Considerable success has been madein combating malaria (Goal 6) but thegrowing number of HIV and AIDScases suggests that the infection hasnot been halted. As of the end of 2010,the cumulative number of reportedHIV positive individuals has alreadyreached 6,015 of which 78% are males.Unprotected sex was identified as theprimary mode of transmission.However, the goal of improving maternalhealth significantly lags behind the otherthree in terms of the likelihood of beingachieved at the end of 2015. The 2008National Demographic and HealthSurvey (NDHS) showed that whilethe total fertility rate (TFR) decreasedfrom 6.0 children per woman in 1970to 3.5, it is still high compared withneighbouring countries like Thailandand Singapore where the TFR is below2.0 children per woman. This is despitethe desire of most Filipino womento have a smaller family with 82 percent of women wishing to either spacebirths or limit childbearing altogether.Women in urban and rural areas have,on the average, 2.8 and 3.8 children,respectively. Around 26 per cent ofwomen age 15-24 years old have begunchild bearing. The level of fertility isinversely proportional to the women’slevel of education and householdwealth. It is ironic that those whoare in a better position to provide fortheir children are the ones with fewerchildren. This probably could be tracedto the sad state of the reproductivehealth programme in the country.The contraceptive prevalence rate islow. At present, only 51 per cent ofmarried women use contraceptives.The most common modern methodsused are the pill (16 per cent) followedby female sterilisation (9 per cent). Inthe 1970s and early 1980s because ofthe government’s support for familyplanning, the contraceptive prevalencerate (CPR) increased from 17 per centin 1973 to 40 per cent in 1993. However,these gains were not sustained in thesucceeding years. Since then, the CPRincreased gradually to the 51 per centthat is currently reported.Despite numerous legislations passedand still being proposed aimed atimproving sexual and reproductivehealth, the Philippines is still, at itsbest, in the infancy stage. Decades ofdisagreement between the Catholic99
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BANGLADESHCAMBODIANEPALBackgroundThe policy support for strengtheninglinkages between <strong>HIV</strong>/<strong>AIDS</strong> <strong>and</strong>sexual reproductive health on theintern<strong>at</strong>ional stage has grown beginningwith the Intern<strong>at</strong>ional Conferenceon Popul<strong>at</strong>ion <strong>and</strong> DevelopmentProgramme (ICPD) for Action(UN, 1994). There are now <strong>at</strong> leastnine different intern<strong>at</strong>ional policyst<strong>at</strong>ements calling for stronger linkagesbetween <strong>HIV</strong>/<strong>AIDS</strong> <strong>and</strong> sexual <strong>and</strong>reproductive health fields. Globalst<strong>at</strong>ements such as these strengthenthe advocacy calls for establishing <strong>and</strong>/or strengthening the linkages betweensexual <strong>and</strong> reproductive health <strong>and</strong><strong>HIV</strong>/<strong>AIDS</strong> in terms of policies,funding mechanisms, programmes <strong>and</strong>services.This report is prepared as part of theIntern<strong>at</strong>ional Council on Managementof Popul<strong>at</strong>ion <strong>Programmes</strong>’ (ICOMP)activity to assess <strong>HIV</strong> <strong>and</strong> <strong>SRH</strong> bidirectionallinkages <strong>at</strong> the policy,systems <strong>and</strong> service delivery levelsin selected countries, including thePhilippines. Through case studiessuch as this, ICOMP hopes toidentify gaps in policy, systems <strong>and</strong>services to ultim<strong>at</strong>ely contribute to thedevelopment of country-specific actionplans to forge <strong>and</strong> strengthen theselinkages. The case study <strong>at</strong>tempts tospecifically address three importantareas:i. the level <strong>and</strong> effectiveness, if any, oflinkages between <strong>SRH</strong> <strong>and</strong> <strong>HIV</strong>rel<strong>at</strong>ed policies, n<strong>at</strong>ional laws, <strong>and</strong>consequent oper<strong>at</strong>ional plans <strong>and</strong>guidelines;ii. the extent to which the systemsupports these linkages; <strong>and</strong>iii. the extent to which <strong>HIV</strong> services areintegr<strong>at</strong>ed into <strong>SRH</strong> services, <strong>and</strong><strong>SRH</strong> services into <strong>HIV</strong> services.The inform<strong>at</strong>ion included in this reportwas obtained through the review of<strong>SRH</strong> <strong>and</strong> <strong>HIV</strong> policies <strong>at</strong> the n<strong>at</strong>ionallevel <strong>and</strong>, where applicable, a review ofoper<strong>at</strong>ional plans <strong>and</strong> guidelines forprogrammes <strong>and</strong> delivery of services.The proposed <strong>and</strong> enacted bills in bothHouses of Congress were revisited todetermine the existence of provisionsrel<strong>at</strong>ed to sexual <strong>and</strong> reproductivehealth <strong>and</strong> <strong>HIV</strong> <strong>and</strong> to identifyiniti<strong>at</strong>ives to integr<strong>at</strong>e the two. Thedirector of the Family Health Officeof the N<strong>at</strong>ional Center for DiseasePrevention, Department of Health wasalso interviewed. This office is in chargeof family planning <strong>at</strong> the DOH.An electronic search for relevantinform<strong>at</strong>ion on the internet was alsodone for supplemental inform<strong>at</strong>ionon the topic. The website of theDepartment of Educ<strong>at</strong>ion was checkedfor developments on the proposedintegr<strong>at</strong>ion of sexual <strong>and</strong> reproductivehealth educ<strong>at</strong>ion in mainstreamcurriculum <strong>at</strong> elementary <strong>and</strong> highschool levels. Similarly, the PhilHealthwebsite was also checked for circularson the provision of service packagesrel<strong>at</strong>ed to <strong>SRH</strong> <strong>and</strong> <strong>HIV</strong>. Documentsregarding the provision of <strong>SRH</strong> <strong>and</strong><strong>HIV</strong>-rel<strong>at</strong>ed services in the workplacewere also loc<strong>at</strong>ed.PHILIPPINES98
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