Mixed reviews on the health front

The daughter of a friend recently made an “ocular inspection” of a government health center in their barangay (in Quezon City), and was pleasantly surprised. She had been “stressed out,” she said, after a visit to a private pediatrician, especially when she found out that she was required to pay a small fortune for her child’s vaccines.

So, she dropped by the health center, where vaccines are provided for free, save for a token but discretionary “donation” — and found a clean and orderly locale with friendly personnel. At the time of her visit, there was none of the usual crowd, so she was even able to chat with the doctor. And the doctor, she reported, laughed out loud when she mentioned how much she had to pay her pediatrician. “We use the same vaccines,” he assured her.

Worried that she might be depriving other families if she availed herself of the much cheaper medicine at a public facility, the staff assured her that there were more than enough supplies. “This is our taxes at work!” she wrote in her FB post. Indeed, public health exists to serve, not just the poorest citizens, but even those better off. “Universal health coverage,” after all, is a cornerstone of democracy.

Well, the good news is that the benefits of public health extend beyond childhood vaccination. I just reviewed a recent report (the latest draft) on the implementation of the Responsible Parenthood and Reproductive Health (RPRH) Law that covered five elements of RH: maternal, neonatal, child health and nutrition; family planning; adolescent sexuality and reproductive health; sexually transmitted infections and HIV/AIDS; and gender-based violence. Overall, the program seems on track, with the numbers indicating more women, men and adolescents as well as babies being reached.

On family planning, contraceptive use among married women increased from 24.9 percent in 1993 to 40.4 percent in 2017. But even with this increased coverage, “the country lagged behind selected Asian countries in terms of annual average increase in contraceptive prevalence rate especially beginning 2013.” Still, despite progress, “there were 2.6 million currently married women and 5.1 million unmarried women who wanted to use family planning but were not able to do so in 2017.”

In response, the government embarked on an “aggressive implementation of the FP program and led to actual service provision; procurement and distribution of FP commodities to [Department of Health] regional offices and local government health facilities including hospitals; tracking of FP commodity stock status at service delivery points through the FP Hotline; conduct of demand-generation activities by the DOH, [Population Commission], and civil society organizations; training of health providers; and setting up of a Focal Point system as part of FP 2020, which is a ‘global partnership that upholds the rights of women and girls to decide freely and for themselves on the number of children they want.’”

But certain areas are proving problematic. While the report says that “there were fewer young Filipino women aged 15-19 years who have begun childbearing in 2017 (8.6 percent) compared in 2013 (10 percent)” there are still almost half a million (420,000) teens who have already begun childbearing.

“Unmet need for FP is highest among this group,” says the report, adding that this “possibly explains the increasing percentage of repeat pregnancies among this group.” It is estimated that over 1.4 million young women who want to limit or space childbirth are unable to use any FP method.

HIV/AIDS remains an area of concern. While the Philippines remains a low-HIV prevalence country, “alarmingly, its number of HIV cases has been one of the fastest growing in Asia and the Pacific,” with the number of reported cases per day almost doubling since 2014. Also alarming: HIV among 15-24 year olds “continues to rise, with 31 percent of documented cases coming from this age group.”

The elephant in the room? For adolescent pregnancies and HIV, the “hostile” atmosphere of health centers to young people in need, plus the need for them to present written consent from their parents before receiving services.