One would think, given that the law on “responsible parenthood and reproductive health” (RPRH) has not only been passed but also passed muster (with some exceptions) with the Supreme Court, that all would now be hunky-dory when it comes to implementing it.
But as a review by the health and women’s NGO Likhaan points out, much needs to be done to ensure the full, effective and efficient implementation of the law. Indeed, Likhaan says in its introduction to its country report on sexual and reproductive health and rights in Asia, “all the current laws [on sexual and reproductive rights] should be considered as ‘works in progress’.”
The NGO (disclosure: I am a member of its board of trustees) points out that the RH Law “is an example of legislation that underwent dilutions in Congress and in the Supreme Court because of religious objections.” While other laws that sought to address gender-based violence “have blind spots that detract from substantive gender equality—such as the nonmandatory prosecution of violence against women (VAW) and the forgiveness clause in marital rape, which effectively extinguishes the crime of rape. Barriers to the effective implementation of laws also detract from their power, which can include financial, geographic and political barriers.”
Likhaan acknowledges that our laws on gender-based violence and the right to sexual and reproductive health services are “strong.” But laws that “uphold freedom and moral agency on sexuality and reproduction—notably sexual orientation and gender identity (Sogi), abortion, adolescent sexuality and reproductive health—are either weak, absent or discriminatory.”
LGBT rights have yet to find support in our legislature, despite bills that have been filed in this and previous Congresses, while the right of minors or young people below the age of 18 to access RH services without parental permission or knowledge was denied by the Supreme Court in its decision on the RH Law. These limitations the Likhaan report lays directly at the door of the Catholic hierarchy “and its doctrines against abortion, contraception, divorce,adolescent sexuality, and LGBT rights.
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STILL, we do have an RH Law in place, and it shouldn’t hurt to point out things that need to be done, by the Department of Health and related agencies, if the law is to be find meaning in everyday life for every Filipino.
Obviously, the DOH and its attached agencies have the responsibility to lead “the prompt and full implementation” of the RH Law, including its popularization so that everyone knows their rights under the law. Then, the DOH should work with local governments to see to it that the law is put into practice in towns and barangays, since health services have after all been devolved.
At the national level, the DOH “must delineate, in the national health budget,” specific allocations for “key RH elements” such as maternal and newborn care, family planning, STI and HIV/AIDS, postabortion care, adolescent RH, and violence against women and children. Likhaan argues that priority should likewise be given to hire long-term personnel where they are lacking, such as skilled birth attendants and providers of emergency obstetric care.
The DOH should also address the oft-complained-about lack (or absence) of equipment, supplies and emergency obstetric medicines. Likhaan also points to the need for public information campaigns that will “de-stigmatize taboo issues and create enlightened RH policies,” including adolescent sexuality and fertility, unsafe abortion, sexual orientation.
And speaking of adolescents, Likhaan points out the need for the DOH to “develop a strategic approach for adolescent RH services,” that would be compliant with the Supreme Court decision requiring parental consent for minors seeking RH services.
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For better planning and implementation, the DOH must also develop a map or directory of RH providers in a given area, “including their capabilities, availability, and cost of care,” that should be made available to the public. “This directory should also include the names of providers and facilities that are not providing [RH] services
because of ‘conscientious objection’.”
There is also a need, Likhaan points out, for the DOH to develop “functional partnerships” with civil society organizations—academics, practitioners, advocates, sectoral leaders—that can “provide technical inputs to the SRH program, while also fostering a multisectoral stakeholders’ movement that will ensure universal access to RH services.”
Playing an important role in the implementation of the RH Law is the public health insurance system, through PhilHealth, since it will enable patients or clients seeking RH services to access these services with little worry or trepidation.
PhilHealth, says Likhaan, “needs to ensure financial assistance to the poorest and most marginalized patients.” The agency should thus ensure the enrollment of the “poorest, poor and near poor” before the year ends, with the list of enrollees posted in their localities so they can meet the requirements and access their benefits. Part of popularizing the service is also communicating with the poor in ways they can easily understand and access.
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An “RH benefit package” should likewise be developed to cover routine services and supplies, as well as another package for life-threatening RH conditions like emergency obstetric conditions, reproductive tract cancers and HIV/AIDS. A “Women’s Health Care Benefit Package” would also go a long way to guarantee full health coverage for all Filipino women, even beyond reproductive age.
More on ways to make the RH Law fully implemented in tomorrow’s (Tuesday) column.