POPULATION and

REPRODUCTIVE HEALTH
What Every Legislator Should Know
January 2008
The opinions expressed in this primer are those of PLCPD and do not necessarily
refect the views of the David & Lucile Packard Foundation.
Executive Director: Ramon San Pascual
Text: Elenor de Leon, Ma. Cecilia de los Reyes, Rene A. Llorin
Research Assistance: Vincent Hermogeno
Editing: Ma. Cecilia de los Reyes, Romeo Dongeto
Photos: Alex Baluyut, Dodie Lucas
Illustrations: Ralph Ramil Mendoza
Layout: Dodie Lucas
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cor. K-J street, East Kamias, Quezon City 1102
Tel. nos. (+632)925-1800 (+632)436-2373
E-mail: plcpdfound@plcpd.org.ph Website: http://www.plcpd.org.ph
Congressional Offces:
Rm 611 Northwing Building Batasan Complex
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Tel. nos.: 931-5354, 931-5001 loc 7430
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Tel. 5526601 loc. 1208
A publication of With support from
PLCPD
Philippine Legislators Committee
on Population and Development
Foundation, Inc.
Since 1989
the David
Lucile
&
Packard
FOUNDATION
3
What Every Legislator Should Know
1. How bad is the Philippine
population problem?
T
he number of Filipinos is continuously growing by 2.36
percent annually. The latest population projection (mid-
2006) reveals that we already number at an estimated 87
million. As the number of people increases, so do the demands.
Every school year, we hear the same problems: textbook shortage,
now pegged at 25 million; teacher shortage, with an estimated
50,000 more needed in public schools. Despite the governments
proclaimed economic gains, more than half of Filipinos (53%) rate
themselves as poor (SWS rst quarter 2007 survey).
Although some may argue that the population growth rate is below
the national average at the provincial and municipal levels, especially
in rural local governments, the capacity to provide basic services is
severely constrained overall. Consider the following numbers:
Forty-four percent (44%) of Filipinos still earn less than two
dollars per day, and about two-thirds of them are engaged
in activities that rely heavily on environmental and natural
resources. (State of the Philippine Environment: A Progress
Report, Feb. 2006)
The number of unemployed rose from 2.91 million in 2005
to 2.93 in 2006, while labor force participation rate remained
at 64.9 percent.
Classroom shortage of 6,832 was addressed by creating two
shifts of classes, resulting to a classroom-to-student ratio of
1:100.

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4
POPULATION and REPRODUCTIVE HEALTH
Our 2005 health budget amounting to P10.273 billion translates
to a mere 35 centavos per Filipino daily, way below the per capita
allocation for health in other Asian countries.
There is only 1 doctor for every 27,842 Filipinos (2,969
doctors / 82,663,561 pop) as opposed to the ideal ratio of
1doctor for every 20,000 people (2004 Philippine Health
Statistics Report).
There is only 1 nurse for every 18,638 Filipinos (4,435 nurses
/ 82,663,561 pop), which falls extremely short of the ideal ratio
of 1 nurse for every 5,000 people (2004 Philippine Health
Statistics Report).
Because of the mass exodus of doctors, nurses and caregivers,
two hundred hospitals have already closed down since 2003
and eight hundred have partially closed due to the shortage of
health workers. (Galvez-Tan, J. Z. Philippines: The Challenge
of Managing Migration, Retention and Return of Health
Professionals).
2. How does our large and
continuously growing population
contribute to the countrys
worsening poverty?
A
study conducted by Aniceto Orbeta, Jr. (Poverty, Vulnerability
and Family Size: Evidence from the Philippines, ADB Institute
Discussion Paper No. 29, June 2005) shows the strong and
enduring link between poverty incidence and vulnerability to poverty,
and family size.
According to said study, only 23.8 percent of families with four
members are poor, compared to 48.7 percent of families with seven
members. Poverty gap and severity also worsens as one moves from a
smaller to a bigger family size.
Evidence also shows that families are not able to maintain per capita
income, per capita expenditures and per capita savings as their size
increases. Incidence of child labor also rises as family size increases.

A
5
What Every Legislator Should Know
Similarly, data show that there are 11 dependents for every 6
working Filipinos, or almost two dependents per working Filipino.
3. Why is it important to focus on
reproductive health?
T
he results of the 2003 National Demographic and Health
Survey (NDHS) show that Filipino women, especially
among the ranks of the poor, still bear more children than
they desire.
Only half of married women practice family planning because
of lack of information and proper knowledge of various family
planning methods and services. The greater proportion of these
women live in rural areas where there are few service providers
and where services are scarce and inaccessible.
Poor women have three times more children than the rich
(5.9 children for the poor and 2.0 for the rich), give birth to
their rst child at a younger age, and have more problems
spacing their children than wealthier women.
Likewise, men who belong to the poorest segments of society
have more children (5) compared to those who belong to the
richest sectors (3).
One in four pregnancies is mistimed and one in ve is not
wanted at all.
Meanwhile, despite the advances made in medicine, maternal health
remains problematic in the country:

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6
POPULATION and REPRODUCTIVE HEALTH
Maternal mortality is pegged at a disturbing 162 for every
100,000 live births (2006 Family Planning Survey). The only
exception are a handful of areas where there is an efcient program
on maternal and child health, such as the municipality of Carmen,
Bohol. The vast majority of local governments have yet to establish
a system that would drastically reduce maternal mortality.
Only 38 percent of deliveries have been found to be attended
by skilled health professionals (2003 NDHS). Majority still seek
the services of traditional hilots because they could not afford
birthing in hospitals or because of lack of proper information.
Unless these peoples needs are addressed, Filipinos will keep on
having more children than they want and can afford to have, and
thousands of mothers will continue to die from causes that could
have been prevented, were they only provided with complete
information and services on reproductive health.
4. Has the countrys population
growth rate (PGR) really slowed
down to 1.9 percent?
T
here is no truth to the claim that the countrys population
growth rate (PGR) has slowed down to 1.9 percent annually.
What the NSO data showed are mere projections derived from
estimates of fertility and mortality, rather than on actual censuses. By
contrast, the 2.36 percent PGR was derived from data of the 1995
and 2000 censuses the most accurate method for computing PGR.

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7
What Every Legislator Should Know
Moreover, so many assumptions are made when making
population projections, making the gures less accurate. For
example, projections may assume an increase in the use of
contraceptives and a decline in fertility rate. But the past ve
years have shown a very slow increase in contraceptive use. The
decline in fertility rate for the past 10 years has also been very slow.
This is the reason why National Statistics Ofce (NSO) Director
Carmencita Ericta recommends caution when interpreting data
from population projections.
5. Will the country experience
a demographic winter when
a population and reproductive
health policy is legislated?
E
conomists from the UP School of Economics believe that the
threat of the so-called demographic winter (birth dearth,
aging, etc.) for the Philippines is greatly exaggerated, and
using it as an argument against a sensible population policy is a plain
and simple scare tactic. They also say population aging is as distant
as about 100 years from today for the Philippines.
Projections indicate that if total fertility rate (TFR) continues to
decline by 0.2 children every ve years, replacement fertility
of 2.1 children per woman would be reached only by 2040.
However, the effects of population momentum would persist for
another 60 years before population ceases to grow, by which time the
Philippines total population would be 240 million.
Legislators from European Union countries, which are often
cited as examples of countries facing demographic winter, have
debunked the assumption that contraceptives are to blame for
their situation. Hon. Anne Van Lancker, EU Parliamentarian from
Belgium, cited the case of Scandinavian countries, particularly
Norway, where contraceptives are widely accessible to the people,
but are not experiencing the problem of an ageing population.
E
8
POPULATION and REPRODUCTIVE HEALTH
According to Hon. Kari Kjonaas Kjos of Norway, they were able
to elude the problem of population ageing because they have
learned to invest in their people. Specically, Norway has ensured
the establishment of mother-child facilities, economic incentives
for fathers to take parental leave, and a pension system that covers
everybody by the age of 67, employed or unemployed. This
enabled mothers and couples to contribute signicantly to the
countrys economy and preserve their family life at the same time.
6. Why is age-appropriate and
mandatory sexuality education
important?
A
dolescent fertility has become a growing cause of concern as
the results of the 2003 NDHS and the Young Adult Fertility
and Sexuality Study (YAFSS) show.
The 2003 NDHS shows the following:
Twenty-six percent (26%) of women aged 15-24 years have
already begun childbearing.
About one in 16 girls aged 15-19 are already young mothers.

Meanwhile, the latest Young Adult Fertility and Sexuality Study
conducted by the UP Population Institute (UPPI) in 2002 reveals
the following:
An estimated 4.9 million young adults (15-27 years old) have
already engaged in premarital sex.
Of the sexually active young Filipinos, an estimated 34 percent
are having multiple partners.
Majority of this group say that sex was something they did not
plan but went with anyway.
Only 19 percent used any contraception to protect themselves
against pregnancy or sexually transmitted diseases the rst time
they had sex.
Thirty-six percent (36%) of hospital cases of abortion belong
to young women aged 15-24.

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9
What Every Legislator Should Know
More and more of our youth are engaging in various forms of sexual
activities. Without the proper education on their reproductive health
and rights, these activities could lead to unwanted pregnancies
or worse, abortion and abortion-related complications. An age-
appropriate and mandatory sexuality education will equip our youth
with the appropriate and relevant information and services on their
reproductive health and rights, which they badly need.
The fear that sexuality education would lead to promiscuity among
the youth is also unfounded. A study conducted by the Joint United
Nations Programme on HIV/AIDS (UNAIDS) in October 1997
reveals that young people who were taught about their sexuality
become more cautious in matters concerning sex. Similarly, a study by
Grunseit and Kippax (1993) also found that sex education, in fact,
delays the start of sexual activity and leads to protective behavior
once sexual activity begins. In ve Latin American cities, researchers
found that young women who took a sex education course are more
likely to delay having sex (Blaney, 1993).
7. Why is there a need for a
comprehensive legislation on
population and reproductive
health?
T
he Philippines policy on population and reproductive health
(including family planning) has always been dependent
on the incumbent. The late President Ferdinand Marcos
instituted various commendable policies on said issues. However,
President Corazon Aquinos ambiguous stand on the role of family
T
10
POPULATION and REPRODUCTIVE HEALTH
planning adversely affected the implementation of the national
family planning program by the Commission on Population
(POPCOM) and its partners.
Former President Fidel V. Ramos administration, in contrast,
saw a strong support for family planning initiatives as it was
sought in the context of sustainable development. When
Joseph Estrada became President, enlightened officials in his
Cabinet aggressively pursued and implemented family planning
programs albeit the lack of any official pronouncement on
population and family planning.
Estrada was replaced by President Gloria Macapagal-Arroyo, whose
stand on the matter of population has been ip-opping. She once
acknowledged the need to reduce the countrys population growth
rate to 1.9 percent, only to say in another statement that she is
leaving the matter to local government units.
Relegating the responsibility of crafting and implementing policy
interventions on population, reproductive health at the local level
is not a viable option. This would lead to unsustainable and uneven
programs across LGUs because of the relatively short term of LGU
ofcials (3 years), disparities in internal revenue allotment (IRA),
and the local ofcials priorities, among others.
A number of progressive local government units like Aurora,
Mountain Province, Ifugao, Marikina, and Davao City have
already put in place family planning and reproductive health
policies and programs in their respective areas. But what to do with
a city as big as Manila, where any form of information and services
related to family planning has been banned?
Unless a comprehensive national legislation on population
and reproductive health is put in place, our peoples right
to complete, accurate and comprehensible information, and
comprehensive services on population and reproductive health
will always remain dependent on the whim of whoever is in
power.
11
What Every Legislator Should Know
8. What is wrong with the
governments natural family
planning-only (NFP-only) policy?
U
niversal access to a constellation of methods in family
planning utilizing a principle of voluntary choice is founded
on the 1987 Philippine Constitution, which guarantees for
every human person full respect for human rights (Sec. 11, Art. 2,).
Moreover, the fundamental law of the land gives due cognizance to
the particular needs of women for gender equality (Sec. 14, Art. 2);
of the youth to enjoy protection of their physical, moral, spiritual,
intellectual, and social well-being (Sec. 13, Art. 2); and of spouses to
found a family in accordance with their religious convictions and the
demands of responsible parenthood (Sec. 3:1, Art. 15).
A policy focusing on natural family planning alone actually goes
against these Constitutional principles. The governments Natural
Family Planning-only (NFP-only) policy will isolate the majority of
women who prefer modern and articial methods. Focusing only
on natural methods is disempowering and discriminatory to women
as it deprives them of universal access to the whole range of family
planning methods so that they can choose what is most appropriate
for their bodies, in accordance with their beliefs.
International and local studies have established that natural
methods are not for everyone. For example, the standard days
method is effective only for women whose menstrual cycles fall
between 26-32 days and requires the unfailing cooperation by the
husband as the couple must abstain from sex for 12 consecutive days
during the womans fertile period.
Various national surveys of the National Statistics Ofce have also
revealed that Filipinos prefer modern family planning methods, with
pills as the consistent no. 1 method of choice.
The governments NFP-only policy will also reverse the gains in
lowering fertility and slowing down population growth to propel
U
12
POPULATION and REPRODUCTIVE HEALTH
national development. It is
impossible to achieve the
governments 1.9 percent
population growth rate target
if other legally permissible and
medically-safe family planning methods are disregarded.
If government is really concerned about womens fear of side
effects and complications, and the general acceptability of modern
methods, then, it should put its resources to programs for educating
people on the pros and cons of all methods, rather than a policy
imposing only one method.
9. What hampers the establishment
of a comprehensive legislated
policy on population and reproduc-
tive health?
S
ome leaders of the Catholic hierarchy and lay organizations
have vigorously opposed reproductive health, family planning
and population initiatives. While these groups have the right to
stand for their religious beliefs, as guaranteed by the Constitution, the
situation becomes problematic when they threaten and coerce those
who believe otherwise, as what has been happening come election
time. During the 2004 elections and in the 2007 elections, members
of the Catholic hierarchy and lay organizations have been known to
campaign against candidates supportive of policies and programs on
population, reproductive health, and family planning. This is highly
inappropriate as these candidates, when elected into ofce, will have
the responsibility of crafting policies and implementing programs that
will benet all Filipinos, whether Catholic or otherwise. Moreover,
data from the 2003 NDHS show that only 2.4 percent of married
women cite religion as their reason for not using contraception.
Sadly, there are also leaders in government who choose not to
recognize that the countrys population and reproductive health
S
13
What Every Legislator Should Know
situation really needs to be addressed as it has serious negative impacts
on our development as a nation. By turning a blind eye on the
situation, they are failing to concretely address the peoples needs.
At the local government level, aside from the opposition mounted by
the Catholic hierarchy, population and reproductive health policies are
often not prioritized as these compete with other pressing issues. And
when such policies do get enacted, they are often not implemented
as most local governments, especially the 4
th
to 6
th
class LGUS, have
barely enough funds, severely limiting their capacity in implementing
mandated programs. These are structural and institutional constraints
faced by local government units that need to be addressed as well.
10. Do the people want
reproductive health and
population policies and programs?
T
he results of the Pulse Asia Ulat ng Bayan surveys on Family
Planning done in 2000, 2004 and 2007 indicate the peoples
consistent clamor for a comprehensive national policy on
reproductive health and family planning.
In particular, the March 2007 Ulat ng Bayan ndings reveal the
following:
Nine out of 10 Filipinos (92%) consider family planning
important.

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14
POPULATION and REPRODUCTIVE HEALTH
Nearly 8 out of 10 Filipinos (76%) believe in the importance of
including family planning in a candidates program of action.
Three-quarters of the adult Filipino population (75%) will
support candidates who are in favor of a government budget
for family planning.
About 9 in 10 Filipinos (89%) think it is important that
government provide budgetary support for modern methods
of family planning including the pill, intra-uterine devices
(IUD), condoms, ligation and vasectomy.
One in two Filipinos (50%) is of the opinion that rapid
population growth hinders the countrys development
A larger proportion of Filipinos believe that the church (or
religion) should not participate in the issue of what family
planning methods couples should use (44% vs 33%).
11. As a LEGISLATOR, what could you
do to address this problem?
You can denitely do something to address the problem.
If you really want to serve the people by addressing their needs, you
must know that sound population and reproductive health programs
and services are among their basic rights and foremost needs. You
must understand that these concerns have a direct impact on areas
that are crucial to the peoples well-being such as income, education,
health, and environment.
It would be better to institutionalize a sound population
management policy and implement the necessary programs today
than to simply cope with the problems of raising the resources for
providing adequate social services and infrastructure to support a
constantly growing and unmanaged population.
As a member of Congress can break the silence and apathy on
these issues by including said concerns in your legislative agenda,
by supporting the bills on reproductive health and population
management currently led in the 14
th
Congress (House Bills 17 and

15
What Every Legislator Should Know
182, and Senate Bills 40 and 43), by including said concerns in your
discussions with your constituents and the media, and by initiating
reproductive health and population management programs and
services in your districts. You should also be willing to allocate and
obtain resources for the institutionalization, implementation and
sustainability of these programs.
As a local government ofcial, you can initiate the crafting of local
reproductive health and population policies and build a common
agenda in your LGU. It is best to consult with the people to validate
their needs and wants. This will also ensure their participation in the
policymaking process.
While local policies do provide a solution to the various problems
of population and reproductive health, local governance will work
better in collaboration with national programs. However, in the
absence of a comprehensive and sustainable national policy, LGUs
may initiate support actions through resolutions and activities dem-
onstrating their support for the passage of bills currently led in the
14
th
Congress.
Reproductive health and population management are winning
issues. By supporting said concerns, you will
denitely win the hearts of
your constituents and be
remembered for years
to come.
T
his primer is produced by the Philippine Legislators
Committee on Population and Development
Foundation, Inc., with support from the David and
Lucile Packard Foundation.
The Philippine Legislators Committee on Population and
Development Foundation, Inc. (PLCPD) evolved out of
the Philippine Parliamentarians Conference on Human
Survival: Population and Development Plan of Action
(PARLCON) convened in 1988.
PLCPD was formally established in December 1989 as a
non-stock, non-proft foundation dedicated to developing
policy champions and generating responsive public
policies on population and human development, which
include, among others: gender and development;
reproductive health and rights; housing and urban
development; sustainable development; food security;
human rights; economic, political, and social participation;
education; health and nutrition; and globalization.
Vision
Improved quality of life for all through population and
human development legislation.
Mission
In order to achieve this vision, PLCPD commits to work with
and among legislative bodies at all levels, from the national
to the local, as a defnite arena for the introduction of
substantive change in the feld of population and human
development.
PLCPD will harness the participation of the citizenry in
strengthening the voice of its members to make their work
more effective in pushing for appropriate legislation. It will
network with NGOs, peoples organizations, cooperatives,
government agencies, the academe, media, the church,
business, and other citizens groups and act as their
channel for advocacy.