Gov't urged to address RP's growing population
Manila Bulletin / 22 August
Sen. Pilar Juliana "Pia" S. Cayetano, chairwoman of the Senate Health and Demography Committee, said yesterday that the national government cannot just shut its eyes to the increasing population problem after the Department of Health (DoH) decided to place family planning at the bottom of its priorities.
Cayetano issued the statement after Health Secretary Francisco T. Duque III said that the DoH would be prioritizing maternal health care, while pushing for family planning merely as a "complementary strategy" for the segment of women who need it.
She pointed out that the Philippines faces a burgeoning population of 88.7 million, up from 76.8 million seven years ago when the last census was conducted.
Seven years from now, there would be 100 million Filipinos at an explosive growth rate of 2.36 percent annually, she said. (Mario B. Casayuran)
Birth control fund makes Lagman worry
Manila Standard Today / 20 August
ALBAY Rep. Edcel Lagman has asked the Department of Health to explain the delay in the use of the P180-million fund allocated for the government’s artificial birth control program.
In a letter to Health Secretary Francisco Duque, Lagman asked for the guidelines on the use of the fund. “It is already in the middle of the third quarter and many LGUs [local government units] would have liked to procure the much-needed health commodities and to conduct family planning seminars for their constituents.”
Lagman also asked for clarification on reports that before the LGUs could avail themselves of the fund, they were required to meet the minimum standards on local availability and access to the national family planning program.
He stressed that the access of LGUs to the said fund should not be dependent on any program relating to the NFP. “The congressional allocation was for artificial family planning, and therefore, its access by LGUs should not be made dependent on any program relating to the NFP.”
“In the same manner that access to NFP must not depend on the beneficiary’s existing programs on artificial family planning,” Lagman wrote in his letter.
Lagman together with then Rep. Rodante Marcoleta pushed for the inclusion of the artificial family planning fund in the health department’s budget for this year.
He pointed out that even President Gloria Macapagal Arroyo did not veto the fund. The President only required the issuance of guidelines and the execution of a memorandum of agreement between the local government unit concerned and the health department, Lagman said.
“I am deeply concerned that the long delay in the approval and issuance of the guidelines immobilizes precious funds for reproductive health,” said the Bicolano lawmaker. Macon Ramos Araneta
Opinion / Health News and View
Dr. A.G. Romualdez / Malaya / 21 August
No one (except possibly the Palace occupant) is happy about the situation
Last week, Dometilo Redulla, M.D., former Pro-vincial Health Officer of Leyte, passed away in his home province. Not very many people even in the field of health are aware of the vital role played by Doming (as he was fondly called by his friends) in shaping health system concepts not only in the Philippines but also globally.
Dr. Redulla was the chief of the Carigara Emergency Hospital (CEH) in the late 70s and early 80s when two major innovations in health service delivery were in the initial stages of development. One was the establishment of the "ladder-curriculum" for health care professionals (midwives, nurses, doctors) at the University of the Philippines Institute of Health Sciences (now known as the School of Health Sciences). Upon the advice of the World Health Organization’s Regional Adviser for Primary Health Care, the University linked development of the new curriculum to a community and health research program to be carried out in the towns constituting the catchment area of the hospital in Carigara. The idea was to base the training courses on evidence-based community needs.
The other development was the plan, spearheaded by then Health deputy minister Jesus Azurin, to integrate hospital and public health services at a level as close as possible to delivery points. At that time, public health programs were vertically implemented with lines of control all the way through regional offices and the national office under a deputy minister. Likewise the line of control for hospitals was a single vertical line directly managed by another deputy minister. As a result, delivery of services at the frontline level was seen as fragmented and inefficient. The Carigara catchment area was one of the trials of integration at the "district" level.
As chief of the catchment area hospital, Doming Redulla was instrumental in securing the cooperation of the municipal health officers in the towns of Carigara, Barugo, Jaro, Capoocan, and San Miguel. Together, these six doctors constituted the Carigara Research and Development Team.
With help from staff of the U.P. College of Medicine as well as WHO and other UN agencies, the team put together the information that led to what is still considered the most relevant curriculum in the country for the training of health workers for rural poor communities.
The successful integration of hospital and public health services at Carigara led to the development of the District Health Services concept. The concept was executed with the implementation of integration of health functions when Dr. Azurin became health minister in 1981. Some of the information from Carigara also found their way into the formulation of a manual for district hospitals published by the WHO Regional Office for the Western Pacific in 1990.
Unfortunately, integrated health services suffered a major set-back with the passage of the Local Government Code in 1991. Localization of services once again separated hospitals from public health as provincial governors took control of the former while the latter was given over to municipal mayors.
The effort to reintegrate health services was initiated with the Estrada administration’s health sector reform agenda. The idea of inter-local health zones revived the concept of towns within catchment areas of district hospitals working together as integrated health service units. This idea owes much to unsung heroes like Dr. Dometilo Redulla and the group of municipal health officers in the catchment area of the Carigara District Hospital.
***
During the last Congress, ALAGAD party list representative Rodante Marcoleta (the same politician who prominently participated in Malacañang’s successful maneuvers to foil the opposition’s impeachment attempts) managed to insert in the General Appropriations Act an allocation of 180 million pesos specifically for "artificial family planning". What followed is a classic example of the Palace’s transactional politics that ties itself up in Gordian knots so complicated that divine intervention is required to unravel them.
As a favor to the helpful congressman, Malacañang declined to invoke its line item veto power so eagerly anticipated by the much-feared conservative wing of the Catholic Church. Nevertheless, during the signing of R. A. 9401, verbal instructions were given to the Department of Health that the item was not to be used. In the subsequent transmittal letters to executing agencies, use of the line item for "artificial family planning" was severely restricted by a conditionality requiring the DOH to draft "strict budget execution guidelines for programs and activities under item III, Section C, No. 2.j of the DOH budget."
The DOH is now under severe pressure by the population management community to seek approval for a set of guidelines to enable the release of funds under Marcoleta’s line item. So far, the guidelines, already so complicated that the budget year will expire before they can be complied with, are still under study by the DOH. At this stage, it is doubtful if even Malacañang itself knows whether or when these will ever be approved.
As may be expected no one (except possibly the Palace occupant) is happy about the situation. Conservative religious groups are on edge because there is still a possibility that the funds would be released. Population and development supporters are distressed because the supply of contraceptives from USAID is really running out.
But of course the birds and the bees are delighted because they can continue to do their thing.
Opinion /Manila Bulletin
Life Expectancy and Population Growth
Francis N. Tolentino/August 22
LAST week we shared with our readers how uncontrolled population growth greatly affects the people’s lives. Everyone, especially young people, is deprived of many of the basic social services that the government ought to provide them because the latter’s resources are extremely lacking. A study quoted in our article last week claimed that population growth is bound to decrease through time, but the rate at which this happens is much too slow. Our resources deplete perhaps twice as fast as our population grows. A serious and clearly defined population management program (or a strengthening of existing ones) is thus an urgent business that the national government would need to attend to.
But while we continue to grapple with booming demographics, we are also being confronted with people living longer and continuing to take their share of our scarce resources. In 2003, life expectancy at birth for both sexes in the Philippines was recorded at 68 years old. Today, our life expectancy, according to the 2006 revision of the United Nations World Population Prospect Report for the period 2005-2010, is at 71.7 years old. As our young people’s need for education rises, so is our elderly’s need for health care and retirement benefits. With very limited resources, we wonder how society will be able to strike a balance on this.
World average life expectancy (at birth) is presently at 67.2 years. Japan ranks first in the world with the highest life expectancy at 82.6 years, followed by Hong Kong with 82.2 and Iceland with 81.8. The United States ranked 38th with a life expectancy of 78.2 years. The Philippines ranked 100th in this list. The shortest life span, according to the same report is at 39.2 years in Swaziland. (United Nations World Population Prospect, 2006 Revision)
Higher life expectancy and an unchecked population growth both hasten resource depletion. "Concerns over dramatic changes in the nature of global human population, estimated at over 6.7 billion in 2006, primarily take two different tracks: Environmental threats from rapidly encroaching human populations and economic demands born from an increasingly aging citizenship. While very different in principle, both trends are harmful… Environmental impacts include threats to sustainability and biodiversity, and economic impact studies show troubling projections.’’ (Earth’s Population Growth is Unsustainable, 2007).
Higher life expectancy is most commonly attributed to breakthroughs in the fields of health, nutrition and medicine. Improvements in these fields, coupled with increased welfare programs for the elderly enabled them to add a few more years to life. Moreover, ". . . more developed regions of the world generally have higher life expectancies than less developed regions. . .’’ obviously because of the disparity in available resources and the people’s living conditions.
Peter G. Peterson, former chairman of the Federal Reserve Bank of New York, had argued that "while extended lifespan and lower populations may initially seem positive, they carry with them potential economic hardships. For example, as the population ages, the elderly accumulate a significant financial cost from increased medical expenses and lower economic productivity. . . how will young and old live happily together if they see themselves as competitors of scarce resources?’’ Such is very true for the Philippines right now. The government would need to slice up part of the budget for education (intended for the younger members of the population) and divert it to added appropriations for health care and other social services for old people. Should this trend persist in the next few years, we might expect even worse than what the national government provides today.
Existing population management programs of the government need to be evaluated if we are at all to take our population problem seriously. These programs may need restructuring in order to fit into the changing needs of the population. Population Education, especially among our young people, would need to be strengthened in order to make them understand how the increase in the number of people affects the quality of their living conditions. For after all, a controlled population is in so many ways beneficial for both young and old people.
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