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A Study on the Attitudes of the Female Residents of Pureza, Manila Towards the Reproductive Health Law

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Graduate School of Business
Pamantasan ng Lungsod ng Maynila

A Study on the Attitudes of the Female Residents of
Pureza, Manila towards the Reproductive Health Law

In Partial Fulfillment of the Requirements for
Research Methods and Case Writing

Submitted to
Dr. Dolores Garcia

Submitted by
Arien Marie A. Guda

I. Introduction

Population control or population management has been one of the rallying cries of Filipino economists since Pres. Ferdinand Marcos signed the United Nations Declaration on Population in 1967. With an estimated population of 92,337,852 in 2010 according to the National Statistics Office (National Statistics Office [Philippines]), and a land area of 300,000 sq. m., lawmakers and civic groups have been clamoring for a solution to address the constant growth rate vis a vis the dwindling natural resources in the country. While the population growth rate continues to hold steady(estimated to be at 2.36% per annum in 2008) (National Statistics Office [Philippines] and ICF Macro), the country’s resources, has suffered the same fate as that of the rest of the Asia Pacific region, which, the Asian Development Bank, in collaboration with the WWF, says is, “consuming more resources than its ecosystems can sustain, threatening the future of the region’s beleaguered forests, rivers, and oceans as well as the livelihoods of those who depend on them.”

In an effort to help address this issue, stakeholders have sought to offer various methods to stabilize, and even inhibit population growth. In 1971, the Population Act passed into law, whereupon family planning was seen as a strategy for national development. Under Corazon Aquino’s administration, the Department of Health assumed responsibility for introducing and supporting family planning methods for the general public. Then came the Philippine Population Management Program (PPMP) in 1993 under President Ramos. More recently, lawmakers authored a bill in Congress, called the RH Bill (House Bill No. 4244) or, “Reproductive Health, Responsible Parenthood and Population Development”, and a similar bill in the senate, Bill 2378, An Act Providing For a National Policy on Reproductive Health and Population and Development.

Over the past three decades, both support for and opposition to these population policies implemented or proposed by the government has existed. Currently, civic groups such as Likhaan, Gabriela and Akbayan are some of the more vocal supporters of the RH Bill. Prominent academicians from universities across the country have also backed the bill. On the other side of the spectrum, the Roman Catholic Church has been its most powerful and vociferous opponent.

The RH Bill has generated much controversy. The opposition has voiced out its concerns that the bill provides for the legalization of abortion and the dissemination of sex education among young children. They further contend that population control or management is not the solution to poverty, and should therefore be scrapped. Meanwhile, the proponents of the bill have focused on family planning as an integral part of poverty reduction efforts. The supporters also argue that the bill focuses not only on offering access to contraceptives to the general population; it will also provide free prenatal and postnatal care to both the mother and the child.

On December 21, 2012, Pres. Benigno Aquino Jr. signed Republic Act 10354, the Responsible Parenthood and Reproductive Health Act of 2012, amidst the heated debate. The signed law has taken effect fifteen days after its publication in the papers. (Patria)

In spite of this, the opponents of the RH Bill, now the RH Law, vow to pursue further action to nullify its enactment. According to the Philippine Daily Inquirer, “Catholic lawyers are preparing to question the constitutionality of RA 10354, or the Responsible Parenthood and Reproductive Health Act of 2012, in the Supreme Court even as the Philippine Palace called for reconciliation.” (Christian V. Esguerra)

The research shall then highlight the views of the target population in light of all this controversy.

II. Statement of the Problem

This study attempts to explore the attitudes of the female residents of Pureza, Sta. Mesa, Manila towards Republic Act 10354, or the Responsible Parenthood and Reproductive Health Act of 2012, here on out to be referred to as the RH Law.

The research seeks to answer the following questions:

1. What is the demographic constitution of the female residents of Pureza, Sta. Mesa (Age, civil status, economic status, educational attainment? 2. What do the respondents know about the RH Law in relation to their age, civil status, economic status and educational attainment? 3. Based on the demographic constitution of the respondents, what are their attitudes towards the enactment of the RH Bill into law? 4. What reasons account for their stance in relation to the passage of the RH Law, given their demographic constitution?

III. Significance of the Study

The subject of population control and management has always been a divisive issue in the country where over 80% of the population practices Roman Catholicism. The local Catholic Church has consistently opposed the all government proposals and policies that may go against the encyclical issued by Pope Paul VI called Humanae Vitae. Humanae Vitae “’condemned the use of artificial methods of contraception, including the pill.” On the other hand, proponents of the RH Bill have extolled what they believe to be the multitude of benefits to be gained from implementing the proposed provisions legally. Both sides have, since the onset of the discussion, claimed they have the backing of majority of the population.

This research shall then seek to assist in addressing the informational gap between the two sides by collating data on the views and opinions of the Filipino women, who, stand to benefit or suffer the consequences of the implementation of the RH Law. By enabling the voice of the women to be heard, the research shall flesh out an important feature of the debate.

IV. Scope and Delimitation
This research shall study the attitudes of the female residents of Pureza, a barangay in the city of Manila, Philippines towards Republic Act 10354, or the Responsible Parenthood and Reproductive Health Act of 2012.
In carrying out the goals of this research, key terminologies need to be defined.

Senate Bill 2378 defines the term "reproductive health care" as follows:
Reproductive Health Care – refers to the state of complete physical, mental and social well-being and not merely the absence of disease or infirmity, in all matters relating to the reproductive system and to its functions and processes. This implies that people are able to have a satisfying and safe sex life, that they have the capability to reproduce and the freedom to decide if, when and how often to do so, provided that these are not against the law. This further implies that women and men attain equal relationships in matters related to sexual relations and reproduction.

Reproductive Rights is defined by Senate Bill 2378 as follows: the rights of individuals and couples, to decide freely and responsibly whether or not to have children; the number, spacing and timing of their children; to make other decisions concerning reproduction free of discrimination, coercion and violence; to have the information and means to do so; and to attain the highest standard of sexual and reproductive health.
The basic content of the Consolidated Reproductive Health Bill is divided into the following sections.

1. Title 2. Declaration of Policy 3. Guiding Principles 4. Definition of Terms 5. Midwives for Skilled Attendance 6. Emergency Obstetric Care 7. Access to Family Planning 8. Maternal and Newborn Health Care in Crisis Situations 9. Maternal Death Review 10. Family Planning Supplies as Essential Medicines 11. Procurement and Distribution of Family Planning Supplies 12. Integration of Family Planning and Responsible Parenthood Component in Anti-Poverty Programs 13. Roles of Local Government in Family Planning Programs 14. Benefits for Serious and Life-Threatening Reproductive Health Conditions 15. Mobile Health Care Service 16. Mandatory Age-Appropriate Reproductive Health and Sexuality Education 17. Additional Duty of the Local Population Officer 18. Certificate of Compliance 19. Capability Building of Barangay Health Workers 20. Ideal Family Size 21. Employers’ Responsibilities 22. Pro Bono Services for Indigent Women 23. Sexual And Reproductive Health Programs For Persons With Disabilities (PWDs) 24. Right to Reproductive Health Care Information 25. Implementing Mechanisms 26. Reporting Requirements 27. Congressional Oversight Committee 28. Prohibited Acts 29. Penalties 30. Appropriations 31. Implementing Rules and Regulations 32. Separability Clause 33. Repealing Clause 34. Effectivity
A complete copy of the law is attached in the annex section of this study.
The research shall limit the respondents to female residents of Pureza, Sta. Mesa, Manila. The respondents will be selected, subject to probability sampling (stratified sample).

V. Review of Related Literature

A substantial volume of work has been done on the issue of reproductive health in the Philippines. In 2009, the National Statistics Office, funded by The United States Agency for International Development or USAID, published “Philippines, National Demographic and Health Survey 2008: Key Findings” that contained “data for monitoring the population and health situation in the Philippines”, specific to “fertility, family planning, family health, nutrition, childhood mortality, awareness of tuberculosis, HIV-related knowledge, and access to HIV testing services”. It also “included a module to assess the frequency of violence against women. The research was conducted on 13,594 women in 12,469 households. Data culled from the research provides estimates for the Philippines as a whole, for urban and rural areas, and for the 17 administrative regions”. (National Statistics Office [Philippines])

The research had the following findings:
“Fertility varies with mother’s education. Women who have gone to college have an average of 2.3 children, while women with only elementary education have 4.5 children. Similarly, fertility varies with women’s economic status as measured by the wealth index. The poorest women have more than twice as many children as women who live in the wealthiest households (5.2 versus 1.9 children per woman).”

On knowledge of family planning methods, the survey uncovered the following results:

“More than half of married Filipino women are using family planning. One-third (34%) of married women currently use a modern method of family planning; an additional 17% are using a traditional method. The pill (16%), withdrawal (10%), and female sterilization (9%) are the most commonly used methods. Use of modern family planning is fairly consistent in urban and rural areas but varies by region. In ARMM, only 10% of married women use a modern method, while in Cagayan Valley, 46% of women are using a modern method. Modern contraceptive use increases with women’s education. Thirty-six percent of married women with high school or college education use modern methods compared with 9% of women with no education. Use of modern methods is fairly high, even among women from the poorest households (26%).”

This study seeks to partially replicate that national survey on a smaller scale, in that it shall identify the demographic constitution of the respondents (Age, economic status, civil status, educational attainment) in Pureza, Sta. Mesa and study the correlation between these demographic factors and the attitudes of the respondents towards the RH Law.

Similar surveys have also been executed on the national level by Pulse Asia(2004), soliciting information about the views of the general public on family planning methods. The survey found that 63 percent of Filipinos are in favor of the then reproductive health (RH) bill, eight percent were not in favor and 29 percent were ambivalent on the matter. The survey was conducted from Oct. 14 to 27, using face-to-face interviews of 1,200 adults 18 years old and above. (Flores)

In the analysis of the data, parallel researches done on the correlation of poverty incidence and access to reproductive health will also be drawn upon. The work done by the University of the Philippines School of Economics, Population and Poverty: The Real Score will be highlighted. In this work, the authors discussed the linkages between governance, population policy and poverty. The study contends that there is a close association between poverty incidence and family size, as indicated in this table below:

This research aims to provide information in support of these national surveys.

VI. Methodology

The researcher shall employ surveys and interviews in carrying out the objectives of this study. Stratified probability sampling will be used to identify the respondents of the survey in order to ensure that the entire target population of the female residents of Pureza, Manila will be proportionately represented. The interview questions have been included in the annex portion of the paper.

Works Cited
Christian V. Esguerra, Michael Lim Ubac and Philip C. Tubeza. "Philippine groups opposing reproductive health measure not giving up." Philippine Daily Inquirer 30 December 2012: 1.
Flores, Helen. www.newsflash.org. 20 January 2009. 7 January 2013.
National Statistics Office [Philippines] and ICF Macro. Philippines National Demographic and Health Survey. Calverton, Maryland: NSO and ICF Macro, 2009.
National Statistics Office [Philippines], Macro, and ICF. Philippines National Demographic and Health Survey 2008: Key Findings. Calverton, Maryland, USA: NSO, 2009.
Patria, Kim Arveen. Yahoo News. 28 December 2012. 2 January 2013.
R. Alonzo, A. Balisacan, D. Canlas, J. Capuno, R. Clarete, R. Danao, E. de Dios, B. Diokno, E. Esguerra, R. Fabella, Ma. S. Bautista, A. Kraft, F. Medalla, Ma. N. Mendoza, S. Monsod, C. Paderanga, Jr., E. Pernia, S. Quimbo, G. Sicat, O. Solon,E. Tan et al. Population and Poverty: The Real Score. Quezon City: University of the Philippines School of Economics, 2004.

Annex I
Republic Act 10354
The Responsible Parenthood and Reproductive Health Act of 2012
S. No. 2865 H. No. 4244
Republic of the Philippines
Congress of the Philippines
Metro Manila
Fifteenth Congress
Third Regular Session
Begun and held in Metro Manila, on Monday, the twenty-third day of July, two thousand twelve.
REPUBLIC ACT NO. 10354
An Act providing for a National Policy on Responsible Parenthood and Reproductive Health
Be it enacted by the Senate and House of Representatives of the Philippines in Congress assembled:
SECTION 1. Title. – This Act shall be known as “The Responsible Parenthood and Reproductive Health Act of 2012″.
SEC. 2. Declaration of Policy. – The State recognizes and guarantees the human rights of all persons including their right to equality and nondiscrimination of these rights, the right to sustainable human development, the right to health which includes reproductive health, the right to education and information, and the right to choose and make decisions for themselves in accordance with their religious convictions, ethics, cultural beliefs, and the demands of responsible parenthood.
Pursuant to the declaration of State policies under Section 12, Article II of the 1987 Philippine Constitution, it is the duty of the State to protect and strengthen the family as a basic autonomous social institution and equally protect the life of the mother and the life of the unborn from conception. The State shall protect and promote the right to health of women especially mothers in particular and of the people in general and instill health consciousness among them. The family is the natural and fundamental unit of society. The State shall likewise protect and advance the right of families in particular and the people in general to a balanced and healthful environment in accord with the rhythm and harmony of nature. The State also recognizes and guarantees the promotion and equal protection of the welfare and rights of children, the youth, and the unborn.
Moreover, the State recognizes and guarantees the promotion of gender equality, gender equity, women empowerment and dignity as a health and human rights concern and as a social responsibility. The advancement and protection of women’s human rights shall be central to the efforts of the State to address reproductive health care.
The State recognizes marriage as an inviolable social institution and the foundation of the family which in turn is the foundation of the nation. Pursuant thereto, the State shall defend:
(a) The right of spouses to found a family in accordance with their religious convictions and the demands of responsible parenthood;
(b) The right of children to assistance, including proper care and nutrition, and special protection from all forms of neglect, abuse, cruelty, exploitation, and other conditions prejudicial to their development;
(c) The right of the family to a family living wage and income; and
(d) The right of families or family associations to participate in the planning and implementation of policies and programs
The State likewise guarantees universal access to medically-safe, non-abortifacient, effective, legal, affordable, and quality reproductive health care services, methods, devices, supplies which do not prevent the implantation of a fertilized ovum as determined by the Food and Drug Administration (FDA) and relevant information and education thereon according to the priority needs of women, children and other underprivileged sectors, giving preferential access to those identified through the National Household Targeting System for Poverty Reduction (NHTS-PR) and other government measures of identifying marginalization, who shall be voluntary beneficiaries of reproductive health care, services and supplies for free.
The State shall eradicate discriminatory practices, laws and policies that infringe on a person’s exercise of reproductive health rights.
The State shall also promote openness to life; Provided, That parents bring forth to the world only those children whom they can raise in a truly humane way.
SEC. 3. Guiding Principles for Implementation. – This Act declares the following as guiding principles:
(a) The right to make free and informed decisions, which is central to the exercise of any right, shall not be subjected to any form of coercion and must be fully guaranteed by the State, like the right itself;
(b) Respect for protection and fulfillment of reproductive health and rights which seek to promote the rights and welfare of every person particularly couples, adult individuals, women and adolescents;
(c) Since human resource is among the principal assets of the country, effective and quality reproductive health care services must be given primacy to ensure maternal and child health, the health of the unborn, safe delivery and birth of healthy children, and sound replacement rate, in line with the State’s duty to promote the right to health, responsible parenthood, social justice and full human development;
(d) The provision of ethical and medically safe, legal, accessible, affordable, non-abortifacient, effective and quality reproductive health care services and supplies is essential in the promotion of people’s right to health, especially those of women, the poor, and the marginalized, and shall be incorporated as a component of basic health care;
(e) The State shall promote and provide information and access, without bias, to all methods of family planning, including effective natural and modern methods which have been proven medically safe, legal, non-abortifacient, and effective in accordance with scientific and evidence-based medical research standards such as those registered and approved by the FDA for the poor and marginalized as identified through the NHTS-PR and other government measures of identifying marginalization: Provided, That the State shall also provide funding support to promote modern natural methods of family planning, especially the Billings Ovulation Method, consistent with the needs of acceptors and their religious convictions;
(f) The State shall promote programs that: (1) enable individuals and couples to have the number of children they desire with due consideration to the health, particularly of women, and the resources available and affordable to them and in accordance with existing laws, public morals and their religious convictions: Provided, That no one shall be deprived, for economic reasons, of the rights to have children;
(2) achieve equitable allocation and utilization of resources; (3) ensure effective partnership among national government, local government units (LGUs) and the private sector in the design, implementation, coordination, integration, monitoring and evaluation of people-centered programs to enhance the quality of life and environmental protection; (4) conduct studies to analyze demographic trends including demographic dividends from sound population policies towards sustainable human development in keeping with the principles of gender equality, protection of mothers and children, born and unborn and the promotion and protection of women’s reproductive rights and health; and (5) conduct scientific studies to determine the safety and efficacy of alternative medicines and methods for reproductive health care development;
(g) The provision of reproductive health care, information and supplies giving priority to poor beneficiaries as identified through the NHTS-PR and other government measures of identifying marginalization must be the primary responsibility of the national government consistent with its obligation to respect, protect and promote the right to health and the right to life;
(h) The State shall respect individuals’ preferences and choice of family planning methods that are in accordance with their religious convictions and cultural beliefs, taking into consideration the State’s obligations under various human rights instruments;
(i) Active participation by nongovernment organizations (NGOs), women’s and people’s organizations, civil society, faith-based organizations, the religious sector and communities is crucial to ensure that reproductive health and population and development policies, plans, and programs will address the priority needs of women, the poor, and the marginalized;
(j) While this Act recognizes that abortion is illegal and punishable by law, the government shall ensure that all women needing care for post-abortive complications and all other complications arising from pregnancy, labor and delivery and related issues shall be treated and counseled in a humane, nonjudgmental and compassionate manner in accordance with law and medical ethics;
(k) Each family shall have the right to determine its ideal family size: Provided, however, That the State shall equip each parent with the necessary information on all aspects of family life, including reproductive health and responsible parenthood, in order to make that determination;
(l) There shall be no demographic or population targets and the mitigation, promotion and/or stabilization of the population growth rate is incidental to the advancement of reproductive health;
(m) Gender equality and women empowerment are central elements of reproductive health and population and development;
(n) The resources of the country must be made to serve the entire population, especially the poor, and allocations thereof must be adequate and effective: Provided, That the life of the unborn is protected;
(o) Development is a multi-faceted process that calls for the harmonization and integration of policies, plans, programs and projects that seek to uplift the quality of life of the people, more particularly the poor, the needy and the marginalized; and
(p) That a comprehensive reproductive health program addresses the needs of people throughout their life cycle.
SEC. 4. Definition of Terms. – For the purpose of this Act, the following terms shall be defined as follows:
(a) Abortifacient refers to any drug or device that induces abortion or the destruction of a fetus inside the mother’s womb or the prevention of the fertilized ovum to reach and be implanted in the mother’s womb upon determination of the FDA.
(b) Adolescent refers to young people between the ages of ten (10) to nineteen (19) years who are in transition from childhood to adulthood.
(c) Basic Emergency Obstetric and Newborn Care (BEMONC) refers to lifesaving services for emergency maternal and newborn conditions/complications being provided by a health facility or professional to include the following services: administration of parenteral oxytocic drugs, administration of dose of parenteral anticonvulsants, administration of parenteral antibiotics, administration of maternal steroids for preterm labor, performance of assisted vaginal deliveries, removal of retained placental products, and manual removal of retained placenta. It also includes neonatal interventions which include at the minimum: newborn resuscitation, provision of warmth, and referral, blood transfusion where possible.
(d) Comprehensive Emergency Obstetric and Newborn Care (CEMONC) refers to lifesaving services for emergency maternal and newborn conditions/complications as in Basic Emergency Obstetric and Newborn Care plus the provision of surgical delivery (caesarian section) and blood bank services, and other highly specialized obstetric interventions. It also includes emergency neonatal care which includes at the minimum: newborn resuscitation, treatment of neonatal sepsis infection, oxygen support, and antenatal administration of (maternal) steroids for threatened premature delivery.
(e) Family planning refers to a program which enables couples and individuals to decide freely and responsibly the number and spacing of their children and to have the information and means to do so, and to have access to a full range of safe, affordable, effective, non-abortifacient modem natural and artificial methods of planning pregnancy.
(f) Fetal and infant death review refers to a qualitative and in-depth study of the causes of fetal and infant death with the primary purpose of preventing future deaths through changes or additions to programs, plans and policies.
(g) Gender equality refers to the principle of equality between women and men and equal rights to enjoy conditions in realizing their full human potentials to contribute to, and benefit from, the results of development, with the State recognizing that all human beings are free and equal in dignity and rights. It entails equality in opportunities, in the allocation of resources or benefits, or in access to services in furtherance of the rights to health and sustainable human development among others, without discrimination.
(h) Gender equity refers to the policies, instruments, programs and actions that address the disadvantaged position of women in society by providing preferential treatment and affirmative action. It entails fairness and justice in the distribution of benefits and responsibilities between women and men, and often requires women-specific projects and programs to end existing inequalities. This concept recognizes that while reproductive health involves women and men, it is more critical for women’s health.
(i) Male responsibility refers to the involvement, commitment, accountability and responsibility of males in all areas of sexual health and reproductive health, as well as the care of reproductive health concerns specific to men.
(j) Maternal death review refers to a qualitative and in-depth study of the causes of maternal death with the primary purpose of preventing future deaths through changes or additions to programs, plans and policies.
(k) Maternal health refers to the health of a woman of reproductive age including, but not limited to, during pregnancy, childbirth and the postpartum period.
(l) Modern methods of family planning refers to safe, effective, non-abortifacient and legal methods, whether natural or artificial, that are registered with the FDA, to plan pregnancy.
(m) Natural family planning refers to a variety of methods used to plan or prevent pregnancy based on identifying the woman’s fertile days.
(n) Public health care service provider refers to: (1) public health care institution, which is duly licensed and accredited and devoted primarily to the maintenance and operation of facilities for health promotion, disease prevention, diagnosis, treatment and care of individuals suffering from illness, disease, injury, disability or deformity, or in need of obstetrical or other medical and nursing care; (2) public health care professional, who is a doctor of medicine, a nurse or a midwife; (3) public health worker engaged in the delivery of health care services; or (4) barangay health worker who has undergone training programs under any accredited government and NGO and who voluntarily renders primarily health care services in the community after having been accredited to function as such by the local health board in accordance with the guideline’s promulgated by the Department of Health (DOH).
(o) Poor refers to members of households identified as poor through the NHTS-PR by the Department of Social Welfare and Development (DSWD) or any subsequent system used by the national government in identifying the poor.
(p) Reproductive Health (RH) refers to the state of complete physical, mental and social well-being and not merely the absence of disease or infirmity, in all matters relating to the reproductive system and to its functions and processes. This implies that people are able to have a responsible, safe, consensual and satisfying sex life, that they have the capability to reproduce and the freedom to decide if, when, and how often to do so. This further implies that women and men attain equal relationships in matters related to sexual relations and reproduction.
(q) Reproductive health care refers to the access to a full range of methods, facilities, services and supplies that contribute to reproductive health and well-being by addressing reproductive health-related problems. It also includes sexual health, the purpose of which is the enhancement of life and personal relations. The elements of reproductive health care include the following:
(1) Family planning information and services which shall include as a first priority making women of reproductive age fully aware of their respective cycles to make them aware of when fertilization is highly probable, as well as highly improbable;
(2) Maternal, infant and child health and nutrition, including breastfeeding;
(3) Proscription of abortion and management of abortion complications;
(4) Adolescent and youth reproductive health guidance and counseling;
(5) Prevention, treatment and management of reproductive tract infections (RTIs), HIV and AIDS and other sexually transmittable infections (STIs);
(6) Elimination of violence against women and children and other forms of sexual and gender-based violence;
(7) Education and counseling on sexuality and reproductive health;
(8) Treatment of breast and reproductive tract cancers and other gynecological conditions and disorders;
(9) Male responsibility and involvement and men’s reproductive health;
(10) Prevention, treatment and management of infertility and sexual dysfunction;
(11) Reproductive health education for the adolescents; and
(12) Mental health aspect of reproductive health care.
(r) Reproductive health care program refers to the systematic and integrated provision of reproductive health care to all citizens prioritizing women, the poor, marginalized and those invulnerable or crisis situations.
(s) Reproductive health rights refers to the rights of individuals and couples, to decide freely and responsibly whether or not to have children; the number, spacing and timing of their children; to make other decisions concerning reproduction, free of discrimination, coercion and violence; to have the information and means to do so; and to attain the highest standard of sexual health and reproductive health: Provided, however, That reproductive health rights do not include abortion, and access to abortifacients.
(t) Reproductive health and sexuality education refers to a lifelong learning process of providing and acquiring complete, accurate and relevant age- and development-appropriate information and education on reproductive health and sexuality through life skills education and other approaches.
(u) Reproductive Tract Infection (RTI) refers to sexually transmitted infections (STIs), and other types of infections affecting the reproductive system.
(v) Responsible parenthood refers to the will and ability of a parent to respond to the needs and aspirations of the family and children. It is likewise a shared responsibility between parents to determine and achieve the desired number of children, spacing and timing of their children according to their own family life aspirations, taking into account psychological preparedness, health status, sociocultural and economic concerns consistent with their religious convictions.
(w) Sexual health refers to a state of physical, mental and social well-being in relation to sexuality. It requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free from coercion, discrimination and violence.
(x) Sexually Transmitted Infection (STI) refers to any infection that may be acquired or passed on through sexual contact, use of IV, intravenous drug needles, childbirth and breastfeeding.
(y) Skilled birth attendance refers to childbirth managed by a skilled health professional including the enabling conditions of necessary equipment and support of a functioning health system, including transport and referral faculties for emergency obstetric care.
(z) Skilled health professional refers to a midwife, doctor or nurse, who has been educated and trained in the skills needed to manage normal and complicated pregnancies, childbirth and the immediate postnatal period, and in the identification, management and referral of complications in women and newborns.
(aa) Sustainable human development refers to bringing people, particularly the poor and vulnerable, to the center of development process, the central purpose of which is the creation of an enabling environment in which all can enjoy long, healthy and productive lives, done in the manner that promotes their rights and protects the life opportunities of future generations and the natural ecosystem on which all life depends.
SEC. 5. Hiring of Skilled Health Professionals for Maternal Health Care and Skilled Birth Attendance.– The LGUs shall endeavor to hire an adequate number of nurses, midwives and other skilled health professionals for maternal health care and skilled birth attendance to achieve an ideal skilled health professional-to-patient ratio taking into consideration DOH targets: Provided, That people in geographically isolated or highly populated and depressed areas shall be provided the same level of access to health care: Provided, further, That the national government shall provide additional and necessary funding and other necessary assistance for the effective implementation of this provision.
For the purposes of this Act, midwives and nurses shall be allowed to administer lifesaving drugs such as, but not limited to, oxytocin and magnesium sulfate, in accordance with the guidelines set by the DOH, under emergency conditions and when there are no physicians available:Provided, That they are properly trained and certified to administer these lifesaving drugs.
SEC. 6. Health Care Facilities. – Each LGU, upon its determination of the necessity based on well-supported data provided by its local health office shall endeavor to establish or upgrade hospitals and facilities with adequate and qualified personnel, equipment and supplies to be able to provide emergency obstetric and newborn care: Provided, That people in geographically isolated or highly populated and depressed areas shall have the same level of access and shall not be neglected by providing other means such as home visits or mobile health care clinics as needed:Provided, further, That the national government shall provide additional and necessary funding and other necessary assistance for the effective implementation of this provision.
SEC. 7. Access to Family Planning. – All accredited public health facilities shall provide a full range of modern family planning methods, which shall also include medical consultations, supplies and necessary and reasonable procedures for poor and marginalized couples having infertility issues who desire to have children: Provided, That family planning services shall likewise be extended by private health facilities to paying patients with the option to grant free care and services to indigents, except in the case of non-maternity specialty hospitals and hospitals owned and operated by a religious group, but they have the option to provide such full range of modern family planning methods: Provided, further, That these hospitals shall immediately refer the person seeking such care and services to another health facility which is conveniently accessible:Provided, finally, That the person is not in an emergency condition or serious case as defined in Republic Act No. 8344.
No person shall be denied information and access to family planning services, whether natural or artificial: Provided, That minors will not be allowed access to modern methods of family planning without written consent from their parents or guardian/s except when the minor is already a parent or has had a miscarriage.
SEC. 8. Maternal Death Review and Fetal and Infant Death Review. – All LGUs, national and local government hospitals, and other public health units shall conduct an annual Maternal Death Review and Fetal and Infant Death Review in accordance with the guidelines set by the DOH. Such review should result in an evidence-based programming and budgeting process that would contribute to the development of more responsive reproductive health services to promote women’s health and safe motherhood.
SEC. 9. The Philippine National Drug Formulary System and Family Planning Supplies. – The National Drug Formulary shall include hormonal contraceptives, intrauterine devices, injectables and other safe, legal, non-abortifacient and effective family planning products and supplies. The Philippine National Drug Formulary System (PNDFS) shall be observed in selecting drugs including family planning supplies that will be included or removed from the Essential Drugs List (EDL) in accordance with existing practice and in consultation with reputable medical associations in the Philippines. For the purpose of this Act, any product or supply included or to be included in the EDL must have a certification from the FDA that said product and supply is made available on the condition that it is not to be used as an abortifacient.
These products and supplies shall also be included in the regular purchase of essential medicines and supplies of all national hospitals:Provided, further, That the foregoing offices shall not purchase or acquire by any means emergency contraceptive pills, postcoital pills, abortifacients that will be used for such purpose and their other forms or equivalent.
SEC. 10. Procurement and Distribution of Family Planning Supplies. – The DOH shall procure, distribute to LGUs and monitor the usage of family planning supplies for the whole country. The DOH shall coordinate with all appropriate local government bodies to plan and implement this procurement and distribution program. The supply and budget allotments shall be based on, among others, the current levels and projections of the following:
(a) Number of women of reproductive age and couples who want to space or limit their children;
(b) Contraceptive prevalence rate, by type of method used; and
(c) Cost of family planning supplies.
Provided, That LGUs may implement its own procurement, distribution and monitoring program consistent with the overall provisions of this Act and the guidelines of the DOH.
SEC. 11. Integration of Responsible Parenthood and Family Planning Component in Anti-Poverty Programs. – A multidimensional approach shall be adopted in the implementation of policies and programs to fight poverty. Towards this end, the DOH shall implement programs prioritizing full access of poor and marginalized women as identified through the NHTS-PR and other government measures of identifying marginalization to reproductive health care, services, products and programs. The DOH shall provide such programs, technical support, including capacity building and monitoring.
SEC. 12. PhilHealth Benefits for Serious .and Life-Threatening Reproductive Health Conditions. – All serious and life-threatening reproductive health conditions such as HIV and AIDS, breast and reproductive tract cancers, and obstetric complications, and menopausal and post-menopausal-related conditions shall be given the maximum benefits, including the provision of Anti-Retroviral Medicines (ARVs), as provided in the guidelines set by the Philippine Health Insurance Corporation (PHIC).
SEC. 13. Mobile Health Care Service. – The national or the local government may provide each provincial, city, municipal and district hospital with a Mobile Health Care Service (MHCS) in the form of a van or other means of transportation appropriate to its terrain, taking into consideration the health care needs of each LGU. The MHCS shall deliver health care goods and services to its constituents, more particularly to the poor and needy, as well as disseminate knowledge and information on reproductive health. The MHCS shall be operated by skilled health providers and adequately equipped with a wide range of health care materials and information dissemination devices and equipment, the latter including, but not limited to, a television set for audio-visual presentations. All MHCS shall be operated by LGUs of provinces and highly urbanized cities.
SEC. 14. Age- and Development-Appropriate Reproductive Health Education. – The State shall provide age- and development-appropriate reproductive health education to adolescents which shall be taught by adequately trained teachers informal and nonformal educational system and integrated in relevant subjects such as, but not limited to, values formation; knowledge and skills in self-protection against discrimination; sexual abuse and violence against women and children and other forms of gender based violence and teen pregnancy; physical, social and emotional changes in adolescents; women’s rights and children’s rights; responsible teenage behavior; gender and development; and responsible parenthood: Provided, That flexibility in the formulation and adoption of appropriate course content, scope and methodology in each educational level or group shall be allowed only after consultations with parents-teachers-community associations, school officials and other interest groups. The Department of Education (DepED) shall formulate a curriculum which shall be used by public schools and may be adopted by private schools.
SEC. 15. Certificate of Compliance. – No marriage license shall be issued by the Local Civil Registrar unless the applicants present a Certificate of Compliance issued for free by the local Family Planning Office certifying that they had duly received adequate instructions and information on responsible parenthood, family planning, breastfeeding and infant nutrition.
SEC. 16. Capacity Building of Barangay Health Workers (BHWs). – The DOH shall be responsible for disseminating information and providing training programs to the LGUs. The LGUs, with the technical assistance of the DOH, shall be responsible for the training of BHWs and other barangay volunteers on the promotion of reproductive health. The DOH shall provide the LGUs with medical supplies and equipment needed by BHWs to carry out their functions effectively: Provided, further, That the national government shall provide additional and necessary funding and other necessary assistance for the effective implementation of this provision including the possible provision of additional honoraria for BHWs.
SEC. 17. Pro Bono Services for Indigent Women. – Private and nongovernment reproductive healthcare service providers including, but not limited to, gynecologists and obstetricians, are encouraged to provide at least forty-eight (48) hours annually of reproductive health services, ranging from providing information and education to rendering medical services, free of charge to indigent and low-income patients as identified through the NHTS-PR and other government measures of identifying marginalization, especially to pregnant adolescents. The forty-eight (48) hours annual pro bono services shall be included as a prerequisite in the accreditation under the PhilHealth.
SEC. 18. Sexual and Reproductive Health Programs for Persons with Disabilities (PWDs). – The cities and municipalities shall endeavor that barriers to reproductive health services for PWDs are obliterated by the following:
(a) Providing physical access, and resolving transportation and proximity issues to clinics, hospitals and places where public health education is provided, contraceptives are sold or distributed or other places where reproductive health services are provided;
(b) Adapting examination tables and other laboratory procedures to the needs and conditions of PWDs;
(c) Increasing access to information and communication materials on sexual and reproductive health in braille, large print, simple language, sign language and pictures;
(d) Providing continuing education and inclusion of rights of PWDs among health care providers; and
(e) Undertaking activities to raise awareness and address misconceptions among the general public on the stigma and their lack of knowledge on the sexual and reproductive health needs and rights of PWDs.
SEC. 19. Duties and Responsibilities. – (a) Pursuant to the herein declared policy, the DOH shall serve as the lead agency for the implementation of this Act and shall integrate in their regular operations the following functions:
(1) Fully and efficiently implement the reproductive health care program;
(2) Ensure people’s access to medically safe, non-abortifacient, legal, quality and affordable reproductive health goods and services; and
(3) Perform such other functions necessary to attain the purposes of this Act.
(b) The DOH, in coordination with the PHIC, as may be applicable, shall:
(1) Strengthen the capacities of health regulatory agencies to ensure safe, high quality, accessible and affordable reproductive health services and commodities with the concurrent strengthening and enforcement of regulatory mandates and mechanisms;
(2) Facilitate the involvement and participation of NGOs and the private sector in reproductive health care service delivery and in the production, distribution and delivery of quality reproductive health and family planning supplies and commodities to make them accessible and affordable to ordinary citizens;
(3) Engage the services, skills and proficiencies of experts in natural family planning who shall provide the necessary training for all BHWs;
(4) Supervise and provide assistance to LGUs in the delivery of reproductive health care services and in the purchase of family planning goods and supplies; and
(5) Furnish LGUs, through their respective local health offices, appropriate information and resources to keep the latter updated on current studies and researches relating to family planning, responsible parenthood, breastfeeding and infant nutrition.
(c) The FDA shall issue strict guidelines with respect to the use of contraceptives, taking into consideration the side effects or other harmful effects of their use.
(d) Corporate citizens shall exercise prudence in advertising its products or services through all forms of media, especially on matters relating to sexuality, further taking into consideration its influence on children and the youth.
SEC. 20. Public Awareness. – The DOH and the LGUs shall initiate and sustain a heightened nationwide multimedia-campaign to raise the level of public awareness on the protection and promotion of reproductive health and rights including, but not limited to, maternal health and nutrition, family planning and responsible parenthood information and services, adolescent and youth reproductive health, guidance and counseling and other elements of reproductive health care under Section 4(q).
Education and information materials to be developed and disseminated for this purpose shall be reviewed regularly to ensure their effectiveness and relevance.
SEC. 21. Reporting Requirements. – Before the end of April each year, the DOH shall submit to the President of the Philippines and Congress an annual consolidated report, which shall provide a definitive and comprehensive assessment of the implementation of its programs and those of other government agencies and instrumentalities and recommend priorities for executive and legislative actions. The report shall be printed and distributed to all national agencies, the LGUs, NGOs and private sector organizations involved in said programs.
The annual report shall evaluate the content, implementation, and impact of all policies related to reproductive health and family planning to ensure that such policies promote, protect and fulfill women’s reproductive health and rights.
SEC. 22. Congressional Oversight Committee on Reproductive Health Act. – There is hereby created a Congressional Oversight Committee (COC) composed of five (5) members each from the Senate and the House of Representatives. The members from the Senate and the House of Representatives shall be appointed by the Senate President and the Speaker, respectively, with at least one (1) member representing the Minority.
The COC shall be headed by the respective Chairs of the Committee on Health and Demography of the Senate and the Committee on Population and Family Relations of the House of Representatives. The Secretariat of the COC shall come from the existing Secretariat personnel of the Senate and the House of Representatives committees concerned.
The COC shall monitor and ensure the effective implementation of this Act, recommend the necessary remedial legislation or administrative measures, and shall conduct a review of this Act every five (5) years from its effectivity. The COC shall perform such other duties and functions as may be necessary to attain the objectives of tins Act.
SEC. 23. Prohibited Acts. – The following acts are prohibited:
(a) Any health care service provider, whether public or private, who shall:
(1) Knowingly withhold information or restrict the dissemination thereof, and/or intentionally provide incorrect information regarding programs and services on reproductive health including the right to informed choice and access to a full range of legal, medically-safe, non-abortifacient and effective family planning methods;
(2) Refuse to perform legal and medically-safe reproductive health procedures on any person of legal age on the ground of lack of consent or authorization of the following persons in the following instances:
(i) Spousal consent in case of married persons: Provided, That in case of disagreement, the decision of the one undergoing the procedure shall prevail; and
(ii) Parental consent or that of the person exercising parental authority in the case of abused minors, where the parent or the person exercising parental authority is the respondent, accused or convicted perpetrator as certified by the proper prosecutorial office of the court. In the case of minors, the written consent of parents or legal guardian or, in their absence, persons exercising parental authority or next-of-kin shall be required only in elective surgical procedures and in no case shall consent be required in emergency or serious cases as defined in Republic Act No. 8344; and
(3) Refuse to extend quality health care services and information on account of the person’s marital status, gender, age, religious convictions, personal circumstances, or nature of work: Provided, That the conscientious objection of a health care service provider based on his/her ethical or religious beliefs shall be respected; however, the conscientious objector shall immediately refer the person seeking such care and services to another health care service provider within the same facility or one which is conveniently accessible: Provided, further, That the person is not in an emergency condition or serious case as defined in Republic Act No. 8344, which penalizes the refusal of hospitals and medical clinics to administer appropriate initial medical treatment and support in emergency and serious cases;
(b) Any public officer, elected or appointed, specifically charged with the duty to implement the provisions hereof, who, personally or through a subordinate, prohibits or restricts the delivery of legal and medically-safe reproductive health care services, including family planning; or forces, coerces or induces any person to use such services; or refuses to allocate, approve or release any budget for reproductive health care services, or to support reproductive health programs; or shall do any act that hinders the full implementation of a reproductive health program as mandated by this Act;
(c) Any employer who shall suggest, require, unduly influence or cause any applicant for employment or an employee to submit himself/herself to sterilization, use any modern methods of family planning, or not use such methods as a condition for employment, continued employment, promotion or the provision of employment benefits. Further, pregnancy or the number of children shall not be a ground for non-hiring or termination from employment;
(d) Any person who shall falsify a Certificate of Compliance as required in Section 15 of this Act; and
(e) Any pharmaceutical company, whether domestic or multinational, or its agents or distributors, which directly or indirectly colludes with government officials, whether appointed or elected, in the distribution, procurement and/or sale by the national government and LGUs of modern family planning supplies, products and devices.
SEC. 24. Penalties. – Any violation of this Act or commission of the foregoing prohibited acts shall be penalized by imprisonment ranging from one (1) month to six (6) months or a fine of Ten thousand pesos (P10,000.00) to One hundred thousand pesos (P100,000.00), or both such fine and imprisonment at the discretion of the competent court: Provided, That, if the offender is a public officer, elected or appointed, he/she shall also suffer the penalty of suspension not exceeding one (1) year or removal and forfeiture of retirement benefits depending on the gravity of the offense after due notice and hearing by the appropriate body or agency.
If the offender is a juridical person, the penalty shall be imposed upon the president or any responsible officer. An offender who is an alien shall, after service of sentence, be deported immediately without further proceedings by the Bureau of Immigration. If the offender is a pharmaceutical company, its agent and/or distributor, their license or permit to operate or conduct business in the Philippines shall be perpetually revoked, and a fine triple the amount involved in the violation shall be imposed.
SEC. 25. Appropriations. – The amounts appropriated in the current annual General Appropriations Act (GAA) for reproductive health and natural and artificial family planning and responsible parenthood under the DOH and other concerned agencies shall be allocated and utilized for the implementation of this Act. Such additional sums necessary to provide for the upgrading of faculties necessary to meet BEMONC and CEMONC standards; the training and deployment of skilled health providers; natural and artificial family planning commodity requirements as outlined in Section 10, and for other reproductive health and responsible parenthood services, shall be included in the subsequent years’ general appropriations. The Gender and Development (GAD) funds of LGUs and national agencies may be a source of funding for the implementation of this Act.
SEC. 26. Implementing Rules and Regulations (IRR). – Within sixty (60) days from the effectivity of this Act, the DOH Secretary or his/her designated representative as Chairperson, the authorized representative/s of DepED, DSWD, Philippine Commission on Women, PHIC, Department of the Interior and Local Government, National Economic and Development Authority, League of Provinces, League of Cities, and League of Municipalities, together with NGOs, faith-based organizations, people’s, women’s and young people’s organizations, shall jointly promulgate the rules and regulations for the effective implementation of this Act. At least four (4) members of the IRR drafting committee, to be selected by the DOH Secretary, shall come from NGOs.
SEC. 27. Interpretation Clause. – This Act shall be liberally construed to ensure the provision, delivery and access to reproductive health care services, and to promote, protect and fulfill women’s reproductive health and rights.
SEC. 28. Separability Clause. – If any part or provision of this Act is held invalid or unconstitutional, the other provisions not affected thereby shall remain in force and effect.
SEC. 29. Repealing Clause. – Except for prevailing laws against abortion, any law, presidential decree or issuance, executive order, letter of instruction, administrative order, rule or regulation contrary to or is inconsistent with the provisions of this Act including Republic Act No. 7392, otherwise known as the Midwifery Act, is hereby repealed, modified or amended accordingly.
SEC 30. Effectivity. – This Act shall take effect fifteen (15) days after its publication in at least two (2) newspapers of general circulation.
Approved,
(Sgd.) FELICIANO BELMONTE JR.
Speaker of the House of Representatives | (Sgd.) JUAN PONCE ENRILE
President of the Senate |

(Sgd.) MARILYN B. BARUA-YAP
Secretary General
House of Representatives | (Sgd.) EMMA LIRIO-REYES
Secretary of the Senate |
Approved: DEC 21, 2012 (Sgd.) BENIGNO S. AQUINO III
President of the Philippines |

ANNEX II

Questionnaire I. Gather background information on age, educational attainment, employment, civil status and religion of respondents. II. Interview Questions 1. Do you have any knowledge of the RH Law? Yes/No. 2. If yes, how did you come to know about it? a. Newspapers b. TV c. Radio d. Family/Friends e. Posters/billboards f. Books g. Other sources 3. How would you rate your knowledge of the RH Law?
-Scale from strong knowledge, fair knowledge, ambivalence, poor knowledge, no knowledge 4. Are you in favor of using any form of family planning method? Yes/No. 5. Are you currently using any form of family planning method? a. Artificial – birth control pills, condoms, IUD, injectables b. Natural – calendar method, withdrawal, etc c. Permament – female/male sterilization d. None 6. Are you in favor of the passage of the RH Law? Yes/No. 7. What reasons account for your stance on the RH Law? a. Personal beliefs b. Education/Information received c. Religion d. Opinion of Influencers such as parents, priests, teachers, etc e. Previous experiences f. Others(Cite reason)…...

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