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dispense <strong>and</strong> adm<strong>in</strong>ister all acceptable methods ofcontraception”; “utilize cl<strong>in</strong>ics, pharmacies as wellas o<strong>the</strong>r commercial channels of distribution for<strong>the</strong> distribution of family plann<strong>in</strong>g <strong>in</strong>formation<strong>and</strong> contraceptives”; <strong>and</strong> “call upon <strong>and</strong> utilize anydepartment, bureau, office, agency or <strong>in</strong>strumentalityof <strong>the</strong> Government for such assistance as itmay require”. <strong>Family</strong> plann<strong>in</strong>g became a verticalprogramme under POPCOM.1973: Catholic bishops started to label as abortion allartificial methods which act <strong>in</strong> <strong>the</strong> “<strong>in</strong>terval betweenfertilization <strong>and</strong> implantation of <strong>the</strong> embryo” 15<strong>and</strong> pa<strong>in</strong>ted <strong>the</strong> population programme as apart of martial law's violation of human rights, a“contraceptive mentality” movement that will turnfrom “<strong>the</strong> voluntary towards <strong>the</strong> compulsory”. 161978: The contraceptive prevalence rate (CPR) formodern methods rose to 17 per cent from 2.9per cent <strong>in</strong> 1968, <strong>the</strong> fastest pace of growth (20%annually) that would be achieved by <strong>the</strong> familyplann<strong>in</strong>g programme. From that po<strong>in</strong>t on, growthof CPR for modern methods slowed down to 2-3per cent annually. 171979: Card<strong>in</strong>al Jaime S<strong>in</strong>, <strong>the</strong> recognised leader of <strong>the</strong>Catholic hierarchy <strong>in</strong> <strong>the</strong> Philipp<strong>in</strong>es, steppedup criticism of martial law's human rightsviolations <strong>and</strong> “anti-life” record, which he said<strong>in</strong>clude <strong>the</strong> promotion of “abortifacient” IUDs <strong>and</strong><strong>in</strong>jectables. 181986: Marcos fled <strong>the</strong> country after massive “peoplepower” protests <strong>and</strong> military defections. CorazonAqu<strong>in</strong>o became <strong>the</strong> new President. Card<strong>in</strong>al S<strong>in</strong>played a key role <strong>in</strong> <strong>the</strong> ouster of Marcos.1987: A new Philipp<strong>in</strong>e Constitution was ratified. Aprovision <strong>in</strong> <strong>the</strong> martial law constitution thatjustified population control was removed (“Itshall be <strong>the</strong> responsibility of <strong>the</strong> State to achieve<strong>and</strong> ma<strong>in</strong>ta<strong>in</strong> population levels most conduciveto <strong>the</strong> national welfare”). In its place, <strong>the</strong> 1987Constitution now says that <strong>the</strong> State shall defend“<strong>the</strong> right of spouses to found a family <strong>in</strong> accordancewith <strong>the</strong>ir religious convictions <strong>and</strong> <strong>the</strong> dem<strong>and</strong>s ofresponsible parenthood”.Catholic bishops succeeded <strong>in</strong> <strong>the</strong> <strong>in</strong>clusion of thisprovision <strong>in</strong> <strong>the</strong> 1987 Constitution: “[<strong>the</strong> State]shall equally protect <strong>the</strong> life of <strong>the</strong> mo<strong>the</strong>r <strong>and</strong> <strong>the</strong>life of <strong>the</strong> unborn from conception”. The proponentof this provision now says that this was also meantto prohibit “abortifacient” methods of familyplann<strong>in</strong>g. 19The 1988 to 1991 period1988: The family plann<strong>in</strong>g programme was transferred to<strong>the</strong> Department of Health after an <strong>in</strong>tense debatewith<strong>in</strong> <strong>the</strong> new government on whe<strong>the</strong>r or not tocont<strong>in</strong>ue with it. The Secretary of Health managedto rescue <strong>the</strong> programme <strong>and</strong>, consistent with <strong>the</strong>ongo<strong>in</strong>g democratization processes, framed familyplann<strong>in</strong>g as a rights-based health programme toreduce maternal <strong>and</strong> child mortality <strong>and</strong> morbiditiesthat would lead to desirable demographic changesas a matter of course. 201990: Catholic bishops began campaign<strong>in</strong>g aga<strong>in</strong>stcontraceptives for be<strong>in</strong>g unsafe for both <strong>the</strong> mo<strong>the</strong>r<strong>and</strong> foetus. 211991: DOH Adm<strong>in</strong>istrative Order (AO) 114 codified<strong>the</strong> place of FP <strong>in</strong> its range of health programmesby classify<strong>in</strong>g family plann<strong>in</strong>g “accord<strong>in</strong>g to couple'schoice” as part of “services for <strong>the</strong> reproductivehealth of mo<strong>the</strong>rs” – a basic maternal <strong>and</strong> childhealth service to be delivered by all frontl<strong>in</strong>e healthunits1991: The Local Government Code, which <strong>in</strong>cludes <strong>the</strong>devolution of <strong>the</strong> health sector, was passed <strong>in</strong>tolaw.The 1992 to 2000 period1992-1994: Health services were devolved to more than1,600 local government units (LGUs). Prov<strong>in</strong>ces<strong>and</strong> big cities got control of hospitals. Municipalities<strong>and</strong> cities got health centres (rural health units)<strong>and</strong> health posts (barangay health stations). <strong>Family</strong>plann<strong>in</strong>g became <strong>the</strong> responsibility of LGUs. Thetransfer of personnel, facilities <strong>and</strong> resources was24, 23completed <strong>in</strong> 1994.1994: The agreement of <strong>the</strong> <strong>International</strong> Conferenceon Population <strong>and</strong> Development to move familyplann<strong>in</strong>g away from demographic targets <strong>and</strong>reframe it with<strong>in</strong> reproductive health <strong>and</strong> rights wasreadily accepted, s<strong>in</strong>ce this was <strong>the</strong> general directiontaken by <strong>the</strong> country's FP programme after martiallaw.1998: AO 1-A, “Creation of a Philipp<strong>in</strong>e ReproductiveHealth Program”. A reproductive health (RH)programme with 10 elements was created; a leadoffice for each element identified; <strong>and</strong> a coord<strong>in</strong>at<strong>in</strong>gmechanism was set up to run <strong>the</strong> programme.2000: AO 24-A, “Streng<strong>the</strong>n<strong>in</strong>g of <strong>the</strong> DOH ReproductiveHealth Program”. A regular structure for manag<strong>in</strong>g<strong>the</strong> RH programme was formed under <strong>the</strong> Centerfor <strong>Family</strong> Health. A Contraceptive IndependenceInitiative (CII) was established to <strong>in</strong>tegrate RH298
fund<strong>in</strong>g, <strong>in</strong>clud<strong>in</strong>g <strong>the</strong> purchase of contraceptives,<strong>in</strong>to <strong>the</strong> health f<strong>in</strong>anc<strong>in</strong>g <strong>and</strong> social <strong>in</strong>surance plans<strong>and</strong> programmes of <strong>the</strong> Department of Health.Funds to purchase contraceptives – a first for <strong>the</strong>country – were <strong>in</strong>cluded <strong>in</strong> <strong>the</strong> 2001 DOH budgetrequest. The RH programme was fur<strong>the</strong>r detailed<strong>in</strong> AO 43, “Reproductive Health Policy”.The 2001 to 2010 period2001: A new government headed by President GloriaMacapagal Arroyo came to power after massprotests triggered by events <strong>in</strong> a corruption trial ofPresident Joseph Ejercito Estrada forced him out ofoffice. The new President was a follower of CatholicChurch doctr<strong>in</strong>es on contraception, <strong>and</strong> would holdon to power for <strong>the</strong> next n<strong>in</strong>e years. The budget forcontraceptives <strong>and</strong> <strong>the</strong> CII were never implemented.Later, <strong>the</strong> national effort was shifted to promot<strong>in</strong>gNatural <strong>Family</strong> <strong>Plann<strong>in</strong>g</strong> (NFP).2001: AO 50-A, “National <strong>Family</strong> <strong>Plann<strong>in</strong>g</strong> Policy”. Astrong, detailed <strong>and</strong> comprehensive FP programmewas outl<strong>in</strong>ed <strong>in</strong> this AO, but <strong>the</strong> 2000 RHprogramme <strong>and</strong> structure was replaced. Nationalfund<strong>in</strong>g for <strong>the</strong> FP programme, <strong>in</strong>clud<strong>in</strong>g <strong>the</strong>purchase of contraceptives, was <strong>in</strong>cluded <strong>and</strong>framed as part of elim<strong>in</strong>at<strong>in</strong>g dependence on foreigndonors through CII. An ambitious target of 50 percent modern CPR by 2004 was set, from a basel<strong>in</strong>eof 28 per cent <strong>in</strong> 1998 (10% annual CPR growth,equivalent to 4-5 times <strong>the</strong> annual rate of growths<strong>in</strong>ce 1978). It is unclear why this AO – neverseriously implemented – was crafted at all.2001-2004: House Bill 4110, “The Reproductive HealthCare Agenda Act of 2001” was filed at <strong>the</strong> Houseof Representatives. The bill was passed by <strong>the</strong>Committee on Health after prolonged deliberations,but was not acted upon by <strong>the</strong> Committee onAppropriations.2002: AO 125, “National NFP Strategic Plan Year2002-2006”. This marked <strong>the</strong> shift of <strong>the</strong> nationalgovernment to focus almost exclusively on naturalfamily plann<strong>in</strong>g. An ambitious target was set toraise NFP use from a basel<strong>in</strong>e of less than 1 percent, to 20 per cent by 2006.2003: <strong>and</strong> later years: Legislators prod <strong>the</strong> Departmentof Health to purchase contraceptives by allocat<strong>in</strong>g<strong>the</strong>ir discretionary development funds <strong>and</strong> pass<strong>in</strong>gbudgets for this specific purpose. Most of <strong>the</strong> fundswere simply left unused by <strong>the</strong> Department. Thesmall proportion of funds utilized went to a fairlycomplex fund<strong>in</strong>g w<strong>in</strong>dow (established by DOHMemo 2008-0100) that LGUs must apply <strong>and</strong>qualify for.2004: AO 132, “Creat<strong>in</strong>g <strong>the</strong> DOH Natural <strong>Family</strong><strong>Plann<strong>in</strong>g</strong> Programme <strong>and</strong> its ProgrammeManagement”. The NFP programme was fur<strong>the</strong>renlarged by separat<strong>in</strong>g it from <strong>the</strong> regular FPprogramme, <strong>and</strong> its narrow focus was re<strong>in</strong>forcedby direct<strong>in</strong>g it to work more closely with groups“which want to promote NFP exclusively”. <strong>Family</strong>plann<strong>in</strong>g was now based on “four pillars: responsibleparenthood, birth spac<strong>in</strong>g, <strong>in</strong>formed choice <strong>and</strong>respect for life”, a phrase used by <strong>the</strong> President todistance herself from <strong>the</strong> ICPD language.2004: AO 158, “Guidel<strong>in</strong>es on <strong>the</strong> Management ofDonated Commodities under <strong>the</strong> ContraceptiveSelf-Reliance Strategy”. This marked <strong>the</strong> formalpass<strong>in</strong>g of responsibility for family plann<strong>in</strong>g fromDOH to LGUs. The health secretary clarifiedthat self-reliance is not <strong>in</strong>dicative of a need for <strong>the</strong>national government to beg<strong>in</strong> purchas<strong>in</strong>g its ownsupplies, but of “<strong>the</strong> end-users <strong>and</strong> <strong>the</strong> [LGUs]outgrow<strong>in</strong>g <strong>the</strong>ir dependence on <strong>the</strong> donors of<strong>the</strong>se contraceptives”. 242008: The CPR for modern methods was measured at 34per cent by <strong>the</strong> National Demographic <strong>and</strong> HealthSurvey. It took 30 years to double <strong>the</strong> 17 per centCPR <strong>in</strong> 1978, equivalent to a slow 2.3 per centannual growth rate.2008-2009: House Bill 5043, “An Act Provid<strong>in</strong>g for aNational Policy on Reproductive Health, ResponsibleParenthood <strong>and</strong> Population Development, <strong>and</strong> forO<strong>the</strong>r Purposes” 25 , reached plenary debates at <strong>the</strong>House of Representatives, <strong>the</strong> fur<strong>the</strong>st that a law onreproductive health or population had gone s<strong>in</strong>cevarious bills were filed after ICPD. The bill was notvoted upon due to lack of time, a result of delay<strong>in</strong>gtactics by those oppos<strong>in</strong>g it.2010: AO 2010-0027, “Amendment to Adm<strong>in</strong>istrativeOrder No. 158, Series of 2004 entitled Guidel<strong>in</strong>eson <strong>the</strong> Management of Donated Commoditiesunder <strong>the</strong> Contraceptive Self-Reliance Strategy”.This AO streng<strong>the</strong>ned <strong>the</strong> role <strong>and</strong> responsibilityof <strong>the</strong> national government <strong>in</strong> ensur<strong>in</strong>g <strong>the</strong>availability of <strong>and</strong> access to family plann<strong>in</strong>g <strong>and</strong>RH commodities. However, this was issued a weekbefore <strong>the</strong> scheduled change of government.Mid-2010 <strong>and</strong> beyond2010: Benigno Aqu<strong>in</strong>o III took over <strong>the</strong> presidency on 30June 2010. His term of office will last until 2016.The President has publicly announced a five-po<strong>in</strong>tposition on family plann<strong>in</strong>g:299
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Family Pla
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ForewordThe Asia <
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Part 1Part 1Asia <
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Ensuring that <str
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of methods for all, in</str
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and undertake <str
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Report on the Regi
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SESSION 1: Changin
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that improving <st
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at a hospital would be offered post
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Bounkoung Phichit, Deputy M
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medicines
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Thus, while knowledge of modern met
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Hon. Mr. Malakai Tabar, Chairman, P
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curricula. If the
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dialogue as well as regional <stron
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BackgroundGlobal development effort
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TableTable1EventNational policyYear
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A third observation is that reporte
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TableTable2Current Contraceptive Pr
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Figure(-1.2), Cook Island</
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FigureTableTable3Trends in<
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Nam. Nearly all economies i
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2008 2009% Bilateral % Multilateral
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family planning wi
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IntroductionFamily
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The advent of the
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FigureFigure1Oceania and</s
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next 25 years, however, TFR fluctua
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FigureFigureFigure2Total fertility
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family planning pr
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esponsible for the
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that estimates of CPR for earlier p
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Figuremarried at an older age compa
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As previously mentioned most <stron
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FigureFigure945Relationship between
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The concept of “unmet need” has
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TableTable8Percentage of th
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TableTable9Percentage of reasons fo
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family planning pr
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As far as the supp
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Socio-cultural challenges tofamily
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likely to use contraception than yo
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15 Tests of statistical significanc
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of the South <stro
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104
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Figurewill exceed the</stro
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in urban (67%) tha
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ased service delivery poin<
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Most FWAs who were recruited two to
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are considered, unmet need for effe
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Households pay the
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Effective public-private partnershi
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ConclusionThe Bangladesh Fa
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the Family
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National Institute for Population R
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IndiaIndiaFamily <
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IntroductionThe use of contraceptiv
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TableTable2Indicators of tra<strong
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FigureFigureFigure1Contraceptive pr
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TableTable5Indicators of contracept
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TableTable6Adjusted odds ratios for
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FigureFigure3Contraceptive prevalen
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TableTable7Adjusted and</st
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the north
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TableTable10Differences between nor
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TableTable11 Total fertility rate <
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End Note1The first camp was success
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152
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154
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Figure1980s and ex
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health care and ed
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assistance from UNFPA and</
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in CPR. Likewise,
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International supp
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in development has
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__________ (2007). Population <stro
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170
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TableTable2What has the</st
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174
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per cent of women reported us<stron
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is provider bias that such methods
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TableTable7skewed distribution of h
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TableTable8TableTable9182
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that of the nation
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TableTable12 7some policies that ex
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The system guides the</stro
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FigureFigure4Total donor expenditur
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FigureFigureagain
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Impact of family plannin</s
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marketing of contr
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United States Agency for In
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200
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acceptable. From an NGO perspective
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FigureThis trend of limited donor f
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Figureto have the
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FigureFigure5Percentage change <str
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FigureFigure6Desire to limit childb
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coordination betwe
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the 1980s
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Policy Management.__________ (n.d.,
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218
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Population Activities (UNFPA) for a
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where family plannin</stron
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Thus an objective assessment of <st
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226
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Figureeconomic growth durin
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TableTable1TableTable2For spac<stro
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eflect a provider bias (e.g., <stro
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The Indonesian delegation was very
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than in ensur<stro
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in-country <strong
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(Ministry of Healt
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242
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244
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FigureTrends and p
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Page 270 and 271: ReferencesAng, Eng Suan (2007). Stu
Page 272 and 273: Demographic data sheet: population
Page 274 and 275: population size, with just 336,000
Page 276 and 277: NuptialityIn Myanmar nuptiality is
Page 278 and 279: FigureIn Myanmar, birth-spac<strong
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Page 282 and 283: FigureIn Myanmar, out of six select
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Page 290 and 291: FigureHIV/AIDS. An HIV-positive wom
Page 292 and 293: National Population PolicyMyanmar i
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Page 300 and 301: Nay Pyi Taw, 26 October 2010.53 Sit
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Page 310 and 311: (1) I am against a
Page 312 and 313: FigureFigureFigure3Use of modern co
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Page 340 and 341: TableTable19Laws and</stron
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FigureThe existence of traditional
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Guinea case by <st
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The establishment of provin
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provide family plannin</str
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Figurelegal requirement nor a condi
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FigureTableTable5TableTable6Figure4
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modern method and
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married or in unio
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Figureolder. Both the</stro
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TableTable15The immediate past Nati
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out that the “ne
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Commodity securitySupply cha<strong
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is able to achieve. In Papua New Gu
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Qualitative assessments by a number
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increasin<
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service delivery poin</stro
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Population: Views from Men
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1545-1730Day 2: December 9Session 2
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Day 3, December 10Session 50830-100
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15Mr. Tong Sithen1
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54Ms. Shadiya IbrahimAssistant Repr
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93Mr. Melkie AntonProject OfficerUn
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131Dr. John P. SkibiakDirectorRepro
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International <str
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