Dissecting the Comprehensive Reproductive Health Act

By ANNE MARXZE D. UMIL
Bulatlat.com

MANILA – There are six versions of the Reproductive Health Bill filed in the House of Representatives and one of these is House Bill 3387 or the Comprehensive Reproductive Health Act by the Gabriela Women’s Party (GWP). In its explanatory note, GWP said the bill does not only focus on population control, but also looks at the welfare and health of Filipino women.

The rationale of the bill reads, “A Comprehensive Reproductive Health Law is seen to offer health care services that will basically benefit women, especially the marginalized. Advancing reproductive health rights in a comprehensive, available, accessible, acceptable, and democratic manner is a long-overdue mandate of the Philippine government to its female population.”

The United Nations Populations Fund (UNFPA) State of the World Population Report of 2009 reveals that 230 Filipinas die for every 100,000 live births, compared with 110 in Thailand, 62 in Malaysia and 14 in Singapore. Globally, the UNFPA State of the World Population Report of 2009 points out that the top four (4) causes of maternal deaths are: 1) severe bleeding (mostly bleeding postpartum), infections (also mostly soon after delivery), hypertensive disorders in pregnancy (eclampsia) and obstructed labour. Women also die because of poor health at conception and a lack of adequate care needed for the healthy outcome of the pregnancy for themselves and their babies. In citing these reports, GWP asserts that there is a need for a reproductive health bill that does not merely zero-in on the debate regarding population control.

Reproductive Health Education

Provisions of the bill include mandatory age-appropriate reproductive health education for girls 12 years old and below and adolescent women 13 to 19 years old.

Chapter 2 section 7 of the bill provides for reproductive health education to girls, starting from pre-school up to grade 6, by adequately trained teachers. It mandates the Department of Education (Dep Ed), with support from the Commission on Population (Popcom) and the Department of Health (DOH), to formulate a Reproductive Health Education curriculum for use by both public and private schools. The curriculum should include related population and development concepts in addition to the following subjects and standards:

a. VAC-prevention education, including teaching children to discern between a “safe touch” and an “unsafe or unwanted touch;”safety lessons,
b. Reproductive health and sexual rights,
c. Reproductive health care and services,
d. Attitudes, beliefs and values on sexual development, sexual behavior and sexual health

In Chapter 3 section 8, the Dep Ed and Commission on Higher Education (Ched) was tasked to formulate a Reproductive Health Education curriculum for students of public and private colleges and universities. It should include related population and development concepts in addition to the following subjects and standards:

a. Reproductive health and sexual rights,
b. Reproductive health care and services,
c. Attitudes, beliefs and values on sexual development, sexual behavior and sexual health,
d. Proscription and hazards of abortion and management of post-abortion complications,
e. Responsible parenthood,
f. Use and application of natural and modern fertility management methods to promote reproductive health, achieve desired family size and prevent unwanted, unplanned and mistimed pregnancies,
g. Prevention and treatment of HIV/AIDS and other STIs/STDs, prostate cancer, breast cancer, cervical cancer and other gynecological disorders,
h. Responsible sexuality, and
i. Maternal, peri-natal and post-natal education, care and services

The bill also mandates the Popcom to provide concerned parents with adequate and relevant scientific materials on age-appropriate topics and manner of teaching reproductive health education to their children.

The bill also includes regular educational seminars and activities on sexuality and reproductive health to be implemented by public health centers and lying-in clinics.

Proper Care for The Reproductive Health of Women

To ensure the health of pregnant women, the bill includes the development and implementation of a continuing program for training of birth attendants and the provision of commensurate wages, as stipulated in the Magna Carta for Health Workers, for skilled birth attendants.

The bill sets minimum reproductive health standards for public lying-in clinics and hospitals. The proposed reproductive health standards provide for the monitoring of high risk pregnant mothers, and a minimum package of reproductive health programs that should be available and affordable at the different levels of the public health system, from the lying-in clinic level to secondary and tertiary hospitals. It also includes nationally agreed standards and local protocols for integrated antenatal care services and timely referral and management of complications. Reproductive health care programs and services at the primary health care level would be reinforced through promulgation of appropriate policies, capacity building programs and resource investments

Provisions of the bill also includes; the maternal death review in all local government units, national and local government hospitals and other public health units; hospital-based fertility management requiring national and local government hospitals to make available services for tubal ligation, vasectomy, intrauterine device insertion and other fertility management methods; categorizing contraceptives as essential medicines and including hormonal contraceptives, intrauterine devices, injectables and other allied reproductive health products and supplies in the regular purchase of essential medicines and supplies of all national and local hospitals and other government health units.

Included in the bill are provisions for mental health services. Chapter 4 Section 21 reads that mental health is related to many aspects of sexual and reproductive health. Mental health issues among women, which the bill seeks to address, include, among others, perinatal depression and suicide, mental health and psychological consequences of gender-based violence, or HIV/AIDS, feelings of loss and guilt after miscarriage, stillbirth, or unsafe abortion. The bill stipulates that measures to promote the mental and psychological well-being of pregnant mothers should be incorporated into the health programs of lying-in clinics and public hospitals. Section 22 of the bill provides for the enhancement of the capabilities of lying-in clinics and public hospitals in counseling women and couples with infertility problems.

The bill also encompasses the right of menopausal and post-menopausal women. It seeks to make affordable and accessible to poor women reproductive health procedures such as hysterectomy or hormonal replacement therapy for menopausal or post-menopausal women, pap smears, and related reproductive health procedures required by women of menopausal or post-menopausal age. Programs for women with cancer of the reproductive system are also included in the bill.

As special provisions the bill mandates the DOH, through its Maternal and Health program, to promulgate researches on fibromyalgia and other relevant health issues affecting women’s reproductive health.

Private and non-government reproductive health care service providers, including but not limited to gynecologists and obstetricians, are mandated to provide, at least 200 hours annually, reproductive health services ranging from providing information and education, to rendering medical services free of charge to indigent and low income patients, especially to pregnant adolescents. These 200 hours annual pro bono services would be included as prerequisite in the accreditation and the renewal of relevant professional licenses.

These, according to Gabriela Women’s Party, distinguishes House Bill 3387 or the Comprehensive Reproductive Health Act from other reproductive health bills filed in Congress. And this, said GWP, is what they mean by providing comprehensive reproductive health services to women and not merely focusing on population control. (Bulatlat.com)