Family Planning in Asia and the Pacific - International Council on ...

media to reach target groups; improv<strong>in</strong>g <strong>the</strong> quality ofcare; streng<strong>the</strong>n<strong>in</strong>g supply cha<strong>in</strong>s; tra<strong>in</strong><strong>in</strong>g of humanresources <strong>in</strong> RHCS; advocat<strong>in</strong>g all partners to considerquantity <strong>and</strong> quality for universal access; provid<strong>in</strong>gguidel<strong>in</strong>es for effective utilization of <strong>the</strong> country’s drugrevolv<strong>in</strong>g fund; actively engag<strong>in</strong>g <strong>the</strong> donor community;<strong>and</strong> streng<strong>the</strong>n<strong>in</strong>g <strong>the</strong> health system.Response from government:The national population policy had been drafted <strong>in</strong> 1992;family plann<strong>in</strong>g was highlighted <strong>in</strong> Myanmar based on<strong>the</strong> <strong>in</strong>creas<strong>in</strong>g trend of fertility levels. The ma<strong>in</strong> problem<strong>in</strong>cluded unmet need (17%). The government adopted anRH strategy <strong>and</strong> was <strong>in</strong>terested <strong>in</strong> regional collaborationto share experiences related to implementation of familyplann<strong>in</strong>g programmes.Discussion po<strong>in</strong>tsQuestion/issue:The Philipp<strong>in</strong>es was asked why it was challenged <strong>in</strong>implement<strong>in</strong>g broader development issues beyondpolitical tenure when many o<strong>the</strong>r countries could achievechanges <strong>in</strong> development <strong>and</strong> <strong>the</strong> macro environment.Response:In <strong>the</strong> Philipp<strong>in</strong>es, political tenure was important: <strong>the</strong>country depended on work with<strong>in</strong> sympa<strong>the</strong>tic prov<strong>in</strong>ces.However, <strong>the</strong>re was not enough support (political orphysical) to respond to <strong>the</strong> actual need. Pass<strong>in</strong>g lawsto <strong>in</strong>stitutionalize family plann<strong>in</strong>g programmes wasone political measure that could be taken to developprogrammes beyond political tenure. There wereattempts to <strong>in</strong>stitutionalize law while ma<strong>in</strong>ta<strong>in</strong><strong>in</strong>g ahealthy dialogue with <strong>the</strong> Church. The Philipp<strong>in</strong>eswas challenged by <strong>the</strong> f<strong>in</strong>e l<strong>in</strong>e between Church <strong>and</strong>State. It was a sectarian State <strong>and</strong> a Catholic country.The high levels of unmet need did push women to haveunsafe abortions. <strong>Family</strong> plann<strong>in</strong>g <strong>in</strong> <strong>the</strong> Philipp<strong>in</strong>es hadbecome a by-word. The current adm<strong>in</strong>istration wouldplay a role <strong>and</strong> efforts were be<strong>in</strong>g made to work towardsresponsible parenthood.Comments were made related to risk mitigation, as wellas <strong>the</strong> importance of analys<strong>in</strong>g actual spend<strong>in</strong>g versusbudgets. There were issues related to <strong>the</strong> cost of policy.If decentralization did not work, countries should movetowards centralization. Systems needed to be flexible toadapt to specific needs.Bhutan byDr. Sunun Gatsu, M<strong>in</strong>istry of HealthIn Bhutan, family plann<strong>in</strong>g was <strong>in</strong>tegrated <strong>in</strong>to <strong>the</strong>general health-care system <strong>in</strong> 1974 <strong>and</strong> featured <strong>the</strong><strong>in</strong>troduction of various methods (low-dose pills,<strong>in</strong>jectables <strong>and</strong> IUDs). Also, a nationwide campaign ofpopulation plann<strong>in</strong>g had been <strong>in</strong>itiated. The nationalpolicy on family plann<strong>in</strong>g focused on <strong>the</strong> voluntary basisof <strong>the</strong> programme; access to <strong>in</strong>formation <strong>and</strong> educationregard<strong>in</strong>g pregnancy; counsell<strong>in</strong>g on FP methods;surgical contraceptives as well as support to <strong>in</strong>fertilecouples were offered.TFR was 3 children per woman <strong>and</strong> <strong>the</strong> CPR trend was35 per cent. Teenage pregnancy was twice as common <strong>in</strong>rural areas compared with urban areas. Key issues fac<strong>in</strong>g<strong>the</strong> programme <strong>in</strong>cluded teenage pregnancies; unsafeabortion; limited access to services due to <strong>the</strong> shortageof tra<strong>in</strong>ed staff <strong>and</strong> <strong>the</strong> great distance to health centres.Currently, contraceptive commodities were be<strong>in</strong>gprovided by UNFPA.Nepal byMr. Naresh Pratap K.C., Director, <strong>Family</strong> Health Division,Department of Health ServicesNepal was currently draft<strong>in</strong>g a new constitution aftera decade-long armed conflict. The prelim<strong>in</strong>ary draftdid make reference to <strong>the</strong> right to equality, <strong>the</strong> rightto propriety <strong>and</strong> <strong>in</strong>heritance (which would have animpact on <strong>the</strong> role of women <strong>and</strong> could make womenmore <strong>in</strong>dependent), as well as women’s right to RH,free medical care <strong>and</strong> essential care services. Address<strong>in</strong>ggender-based violence was a priority for Nepal; <strong>the</strong>government had formed a special committee on <strong>the</strong> issue<strong>and</strong> declared 2010 “a year free of gender-based violence”.There was a commitment to address<strong>in</strong>g FP effectively. Theexpectation was that <strong>the</strong> new constitution would help <strong>in</strong><strong>the</strong> implementation of family plann<strong>in</strong>g <strong>in</strong>terventions.Cambodia byH.E. Ms. Lork Kheng, Member, National AssemblyCommissionHealth promotion for <strong>the</strong> people was one of <strong>the</strong> toppriorities of <strong>the</strong> government; it <strong>in</strong>volved address<strong>in</strong>greproductive health concerns, maternal mortality, HIV/AIDS <strong>and</strong> communicable diseases. A national strategyhad been adopted with a focus on family plann<strong>in</strong>g, birthspac<strong>in</strong>g, safe abortion, nutrition <strong>and</strong> maternal care.However, Cambodia still faced slow progress <strong>in</strong> <strong>the</strong> useof modern contraceptives (an <strong>in</strong>crease of only 1.5%) <strong>and</strong>CPR was 28 per cent. Evidence showed that campaignsdid not reach youth <strong>and</strong> rural areas.The annual budget allocated to <strong>the</strong> M<strong>in</strong>istry of Healthfor health promotion had been <strong>in</strong>creased by 19 percent, which reflected <strong>the</strong> government’s commitmentto achiev<strong>in</strong>g MDGs. Focus would be placed onreach<strong>in</strong>g young people through mass media techniques,establish<strong>in</strong>g private partnerships <strong>and</strong> adoption of fiveyearnational action plans.Lao People’s Democratic Republic by H.E. Dr.24