PRELIMINARY CRITIQUE OF

DOH ADMIN. ORDER 2012-009 National Strategy Towards Reducing Unmet Need for Modern Family Planning as a means to Achieving MDGs on Maternal Health.
(Released June 27, 2012)

by The CBCP Legal Office

UNMET NEED In a 1996 Study entitled, No Need for Unmet Need, presented at the John Hopkins School of Hygiene and Public Health by Lant Pritchett 1, unmet need is flawed; analytically, empirically as a guide to public policy, as a predictor of demographic impact, and even as a guide to family planning policy. Citing Pritchetts Paper, another White Paper from World Youth Alliance 2 reports that: The number of unintended pregnancies in the world is high, but the idea of a global unmet need for contraception is misguided. Although there may be 215 million women who want to delay or avoid pregnancy and are not using contraception, that does not mean that all of these women want to use contraception. Social scientists and public policy experts identify women as having an unmet need for contraception even when those women have not expressed a desire to use contraception. The idea of unmet need for contraception ignores the reasons for unmet need that women express, such as concern about health and other side effects of artificial contraception,

Professor, John F. Kennedy School of Government, Harvard University; Co-editor of the Journal of Development Economics. (http://ksgfaculty.harvard.edu/faculty/cv/LantPritchett.pdf) 2 http://www.wya.net/advocacy/research/WYA%20family%20planning%20white%20paper.pdf, Accessed July 18, 2012

incompatibility with religious and ethical beliefs, and the financial cost of contraception. In the Philippines, non-use of a modern family planning method among women does not mean they have an unmet need. There are myriads of reasons why women do not use artificial contraceptives. Primarily, a woman feels she does not need any method at all. Some women refuse to use a method for reasons of religious conviction. Others refrain because of aversion to the side effects, others for fear of mortal consequences to health from the carcinogenic substances. In these cases, there is refusal; hence, there is no need to speak of. And yet, all cases of non-use are routinely interpreted as a gaping need to justify a massive family planning program such as this. Notably, if as premised by the directive, there are around six million Filipino women estimated to have unmet need for modern family planning, why does it direct POPCOM to ensure increasing demand? Intrusive and Insulting to Families There is a subtle coercion and undue influence in the way the Directive spells out the manner of disseminating its population control agenda. DOH and its allied agencies become instruments to indirectly obstruct, defeat or impair freedom of religious belief and exercise of women and men who refuse or choose not to contracept or be sterilized. The Directive makes reference to the right of spouses to determine the number of children they want to havea fundamental right acknowledged in the Constitution (Article XV, Section 3 (1)). However, in the same breath, the directive creates Community Health Teams who will knock at homes and doorsteps in all barangays nationwide, there to preach and exhort couples and individuals in the ethos of contraception in a manner that is person-to-person, client-centered, life-cycle approach on delivering family planning services at any point of contact. This is a highly unethical and unlawful act of meddling with the private life or family relations of spouses and individuals? (Article 26 (2), Civil Code of the Philippines) Behavior Change The communication program described in the Administrative Order is clearly patterned after the World Health Organization (WHO) strategy of neutralizing and overturning the citizens traditional religious, cultural and family values. These are considered by WHO as barriers or obstacles to the population control agenda.

Unlawful Dispensing of Contraceptives by non-Pharmacists and nonPhysicians

In sending out Barangay Health Workers, midwives, nurses, other health providers direct to homes and families, armed with supplies of pills, injectibles, condoms (devices), DOH and its agents defy and court the penal sanctions in R.A. 5921, An Act Regulating the Practice of Pharmacy and Setting Standards of Pharmaceutical Education in the Philippines. This law prohibits dispensing medicine, pharmaceuticals, drugs and devices except through a prescription drugstore or hospital pharmacy. The law has not been repealed nor amended. In implanting IUDs and performing sterilization procedures, they also risk liability for physical injuries and mutilation.

Betrayal of Public Mandate In promoting and distributing drugs and devices confirmed by medical studies to be carcinogenic, injurious, dangerous and unsafe to its users, particularly women, DOH betrays its mandate to safeguard public health. DOH mocks its public trust of protecting consumers against hazardous substances (Article XVI, Section 9, and Constitution). Furthermore, the question arises: if the pernicious side effects of contraception eventually descend on the women who imbibed pills, implanted with IUDs, injected with Depo-Provera by authority of this Directive, does government have provisions for their expensive medication? Will DOH also make available the medicines against cancer? In several far flung areas, like in Mindanao, Barangay Health Centres even refuse to remove IUDs they implanted on mothers who have asked for the removal because of severe pelvic infections. Betraying the Poor The incessant targeting by DOH of poor families for contraception and sterilization abuses and exploits the moral dependence, indigence, and other weakness of the poor. This is an open violation of human rights of the poor. If the poor and indigent families have an unmet need, these are for food on their table, medicine for common ailments, nutrition for mothers, infants and children, clean drinking water, electricity, sanitation, education, and means of livelihood.

Sidetracking the Legislature The Directive contains prescriptions and details that sound like implementing rules for an RH law where there is none at all. Its issuance at a time when Congress and the Senate are deliberating on RH bills makes mocks and disrespects the authority of a co-equal branch of government.

Of the MDGs and ICPD While the Philippines is signatory to the MDG Declaration, it is only a declaration, period. A plan. The question will be, is the Philippines, a sovereign state, obliged to work out its mechanisms if in doing so, national interest--women's health, family strength, integrity of the marital bond, personal privacy, human capital, right to life, religious liberty, common good will be compromised and trampled upon? Clearly not. Most of these are fundamental rights enshrined in the Constitution. Moreover, as to the MDG's and even ICPD on "behavior change", RH care, etc. our laws tell us that: Prohibitive laws concerning persons, their acts or property, and those which have for their object public order, public policy and good customs shall not be rendered ineffective by laws or judgments promulgated, or by determinations or conventions agreed upon in a foreign country." (Article 17, 2nd parag., Civil Code of the Philippines). Manila, July 16, 2012, Feast of Our Lady of Mt. Carmel. .

Atty. Jo Imbong July 13, 2012