What’s next for RH?

Now that the Supreme Court has ruled that the controversial Responsible Parenthood and Reproductive Health Law is “not unconstitutional,” save for eight provisions, what should pro-RH advocates do? There are legal, practical and political next steps to consider, but we think the immediate task is to spread a sense of affirmation: The great majority of Filipinos support the law. Everything else should proceed from that.

Should the advocates file a motion for reconsideration with the Supreme Court? As we argued yesterday, the striking down of those provisions in the law which imposed a limited responsibility on healthcare service providers who refuse to serve a patient for religious reasons to simply refer her to another health facility is deeply problematic. But is it enough to warrant a return to the Court?

Considering that the RH measure took a decade and a half to pass Congress, that it finally became law in

December 2012, and that the Court stopped the government from implementing it over a year ago, a motion for reconsideration would not be in the best interests of the mothers and infants that the law seeks to serve. According to the UN Population Fund, 11 Filipino women die of pregnancy-related causes every day. Even if we were to estimate the positive impact of the RH Law at the lower range, that it would save only one pregnant woman per day from complications leading to death, we can readily see that the legal struggle to declare the law unconstitutional has already cost some 400 lives. It’s time to put the law into effect.

How can this be done with utmost efficiency? As we have also argued previously, soon after the law was passed, the national budget will be the next battleground for the RH wars. Advocates must ensure that there is adequate funding for the law’s provisions; unfortunately, we can expect the controversy over the government purchase of condoms to continue. But in reality, the law is much more than that.

Consider, out of many possible examples, something as below-the-radar as Section 8: “All [local government units], 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 [Department of Health]. 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.”

This seems like a belaboring of the obvious, but not all LGUs and hospitals are conducting these annual reviews. And yet these are baseline figures; the more comprehensive and more accurate they are, the more reliable the national estimates will be. To borrow a favorite mantra of management consultants: You cannot manage what you cannot measure. But it will need a serious push from the DOH, and serious money from the Department of Budget and Management, to comply with the provision.

Who can reinforce the political consensus behind the passage and implementation of the RH Law? It is possible that those against the law will find enough like-minded legislators in the 17th Congress, to be convened in July 2016, to repeal it. The next president may also prove less than supportive. The challenge for RH advocates then is to prepare for the 2016 election as if the future of the RH Law depends on it.

This will become easier to do once the benefits from the new law become a daily reality: Once more and more LGUs “hire an adequate number of nurses, midwives and other skilled health professionals for maternal health care and skilled birth attendance”; once a critical mass of LGUs manages 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”; once a good number of accredited public health facilities can 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” (all the quotes are from the text of the law)—then it will become much harder for the law’s critics to wish it away.

But political preparation does not mean waiting for 2016. Among other things, it means filing bills in Congress right away, to fill the gap the Supreme Court created.