Imagine a world where “every pregnancy is wanted, every childbirth is safe, and every young person’s potential is fulfilled.” This is the mandate by which the United Nationals Population Fund, formerly the United Nations Fund for Population Activities (UNFPA), has been operating since 1969. Seeking to promote equal rights and protection on sexual and reproductive health, especially for young women and children, the UN agency provides technical expertise, guidance, and support to over 155 countries and territories around the world.
Last October 17, the UNFPA formally launched the 2018 State of the World Population (SWOP) Report at the EDSA Shangri-La Hotel. The event was organized by the Municipality of Tanay, Rizal, together with the Philippine Commission on Population (POPCOM), a government agency under the Department of Health (DOH). With the theme of “The Power of Choice: Reproductive Rights and Demographic Transition,” the event sought to promote the 2018 SWOP report and ensure equal access to information among all sectors of society.
Iori Kato, the Country Representative of the UNFPA, presented the 2018 SWOP Report, an annual report prepared by the UNFPA. It has found that the power to choose family size stemming from reproductive rights affects many other rights, including the right to employment, health, and education. These findings and recommendations, however, have yet to be wholly implemented in the local setting for the full realization of reproductive health rights for women and children in the Philippines.
IDENTIFYING THE FUNDAMENTALS
“Reproductive rights is not a new concept,” says Kato. According to the 2018 SWOP Report, no country today has yet made reproductive rights available to all. There are still limitations when it comes to the pursuit of reproductive health rights for all, especially women. Couples are unable to have their preferred family size due to lack of economic and social support, or inadequate means to control their fertility.
Kato highlights four main issues in the SWOP Report. The first is the power of choice, referring to the fundamental right of individuals to freely and responsibly choose the size of their family. This includes the number, spacing, and timing of their children. Second, when choices are made based on information and proper means concerning reproductive health and rights, there is a direct impact on the fertility rate. Today, there is a global transition from high to low fertility as more people are able to freely choose without discrimination, coercion or violence. The SWOP Report recorded a downward trend in the global fertility rate over the last 150 years. Third, these choices make good economic sense based on global evidence. Fertility can either accelerate or impede the progress and development of societies. As the power of choice allows fundamental rights to be fully realized, people tend to reach their full potential. When couples have the power and means to prevent or delay a pregnancy, they can choose to enter or stay in the labor force to sustain or increase their income. Fourth, the SWOP Report and recommendations are limited particularly in relation to women empowerment, labor practices, and teen pregnancies in the Philippines.
GATHERING THE INFORMATION
The 2017 National Demographic and Health Survey (NDHS) reported that the Total Fertility Rate (TFR) in the Philippines has declined from 4.1 children per Filipino woman in 1993 to 2.7 in 2017. Dr. Juan Antonio A. Perez III, the Executive Director of POPCOM, said this was due to the increase in the use of modern family planning methods among married women. The implementation of the Responsible Parenthood and Reproductive Health Act of 2012 or the RH Law has also contributed to the faster decline of the TFR. Despite this steady decline, the Philippines’ TFR is still the highest among the 10 ASEAN members—the second largest population in Southeast Asia. Thus, the target is to make the TFR reach 2.1.
The National Demographic and Health Survey showed 17% percent of married women want to practice family planning but do not have the access and information to such methods, while the survey shows 49% of sexually active, unmarried women have unmet needs in family planning.
The NDHS also declares that 75% of women ages 15 to 49 years old have expressed to wanting only two children, while 60% wanted to stop having more children and 15% said they wanted to postpone their pregnancy. Executive Director Perez expressed concern for the high unmet need in family planning. The NDHS showed 17% percent of married women want to practice family planning but do not have the access and information to such methods, while the survey shows 49% of sexually active, unmarried women have unmet needs in family planning. This reflects a decline from the 30% unmet need in 1993. However, the goal of POPCOM is to have zero unmet need. “Millions of Filipinos would benefit from having the power to choose whether and when to have children, and how many children to have,” Kato says. “If you can plan your family , you can plan your life,” the UNFPA Country representative adds.
ANALYZING THE EVIDENCE
In some nations where there is a rapid decline, particularly in Europe, there is a demographic transition that contributes to economic growth. In Asia, there is a strong decline in the fertility rate of countries which had national family planning programs. As more women gained access to modern contraception methods owing to government-sponsored and NGO programs, the fertility levels slowly decreased. In turn, family planning programs were engineered because there was a finding of better economic growth opportunities if couples chose fewer children. “Demographic transition more than suggests that all countries which are undergoing economic development shift from a situation where there is low population growth due to high birth rates and high death rates to a situation where the population growth plateaus due to low birth rates and low death rates,” says Kato.
This population trend matters to the Philippines because the fertility rate directly impacts the country’s potential for economic growth based on whether it can transform the window of opportunity into a demographic dividend. This realization of the demographic dividend is found in Chapter 13 of the Philippine Development Plan (PDP) 2017-2022 by the National Economic and Development Authority (NEDA), anchored on the Zero to 10-Point Socioeconomic Agenda. This demographic dividend entails a situation where there is an increase in the working age population than the young and old dependents group. Thus, the number of people who are able to economically support is higher than those who need support. “This one-time window of opportunity will be closing rapidly as the dependency ratio rises again with the growth of the family population,” Kato says. “The Philippines has yet to enjoy this demographic dividend and if the country does not do something by way of programmatic and policy intervention now, it might miss this golden opportunity,” he adds.
The enjoyment of the demographic dividend is also highly policy-dependent. It is necessary to develop and draft more policies towards health, education, and employment, particularly on skills development and employment generation for young adults, and also on gender equality and women empowerment in the workplace.
For this country to reap a demographic dividend for economic prosperity, there is an imminent need to invest more in health, education, and employability of young people and on gender equality. – Kato
According to Kato, this is what the so-called ‘East Asian tigers’ did in the late ‘70s to ’80s like Hong Kong, Singapore, Republic of Korea, and Taiwan. To fully realize and maximize demographic dividends, three conditions must be met. First there must be improvement of the health of women and children as this contributes to the continued survival and an increase in the working-age population group. Second, an increase in the working-age group due to investments in health and education results in saving of fiscal space by having fewer children. Third, better education and health opportunities lead to well-paid jobs and decent work. In the Philippines, the first condition has already been met. However, there is still a challenge with regard to the high unemployment and underemployment in the Philippines, especially of the youth.
SELECTING THE BEST ALTERNATIVE
The 2018 SWOP Report makes recommendation for all countries based on their level of fertility and stage of demographic transition. To fully realize reproductive rights and maximize the demographic transition, as well as achieve the 2030 Agenda for Sustainable Development, the UNFPA made five policy recommendations for the country.
First, the Philippines must fulfill the commitment to reproductive rights recognized during the 1994 ICPD. Second, the country must get to zero unmet need with nationally-owned and funded family planning programs. More than four in five worldwide involve women with unmet need and national family planning programs that aim to reach most marginalized are needed. Third, there is a need to prioritize and close the disparities in reproductive health services, which should be comprehensive, high-quality, and accessible to all both national and local. Likewise, labor and health services should be integral to primary health care. Fourth, the country must provide universal comprehensive sexuality education, and do more to reach youth and adolescents. “People need to know how to exercise their reproductive rights and to make choices regarding their family size and this knowledge should be imparted to young people before they become sexually active,” Kato says, highlighting the importance of age and development-appropriate comprehensive sexual education (CSE). “The CSE, because of the word ‘sexuality,’ has a misconception because it is not always about sex,” Kato explains. “It is also about relationships, negotiation, and communication. It is also about self-esteem and respect for yourself and for others,” he further adds. Finally, the UNFPA recommends achieving gender equality on all fronts through eradication of gender-based violence including child marriage and sexual harassment in the workplace. “Shortfalls in women’s rights are closely linked with the shortfalls in reproductive rights. Neither can be achieved without the other,” declares Kato. Economic disparity in terms of low wages and child care should also be addressed to make for a healthier and productive workplace.
These recommendations serve to help the Philippines achieve the reality of choice for all—choice in terms of Filipinos having their desired number or size of the family as they wish or choice in terms of reaching their full economic potential. — MAIELLE MONTAYRE