The expiration of permits issued for modern contraceptives could lead to at least a thousand mothers dying every year by 2022, according to the Commission on Population (Popcom).
To date, the Supreme Court has not lifted its temporary restraining order (TRO) on the full implementation of the Responsible Parenthood and Reproductive Health (RPRH) Act of 2012, which effectively fails to renew certificates of product registration (CPRs) for contraceptives.
Popcom Executive Director Juan A. Perez III said that, with the lapse in the CPR of Implanon, a popular implant that is being distributed for free by the government, there would have been 500,000 unintended births and 1,100 maternal deaths between June 2016 and March 2017.
“That is the equivalent of three jumbo jets full of pregnant women who die every year,” Perez said. “If the Supreme Court does not lift the TRO, that will increase to 8,000 maternal deaths by 2022, which is the reason we in Popcom are saying it would be equivalent to a public-health emergency if the Supreme Court does not lift the TRO.”
Perez told the BusinessMirror that on average, with the absence of more modern contraceptives, they expect that there could be an average of 800 to 1,000 maternal deaths every year. He explained that this is a rough estimate given the Popcom’s own model and the data provided by the Philippine Statistics Authority (PSA).
PSA data showed that for every 100,000 live births in the Philippines, 162 women die during pregnancy and childbirth or shortly after childbirth.
Perez said that, usually, PSA data are more conservative, which may be partly due to the methodology it uses. But, he said, Popcom’s field work indicates that there could be more maternal deaths because of some religious and indigenous practices in many remote barangays in the country.
Perez also added Popcom even received reports that there was a 23-percent nonreporting of deaths, depending on how remote these areas are. He said, for one, Muslims bury their dead immediately and indigenous peoples (IPs) just bury their dead according to their customs without knowing how or why they died. Some of these deaths could be related to childbirth.
These are people among those that the government would like to provide contraceptives to, because they may not have access to them. Many of them live in poor, remote villages nationwide.
“You have problems like those in the Muslim area. They bury their dead within 24 hours, they do not record [the causes]. The indigenous populations, they bury their dead in their backyard, they do not bother to report it to the midwife at the RHU [Rural Health Unit], so you have those inherent problems. We know these areas with IPs, etc., that’s 10 percent of the barangays, that’s about 4,000 barangays,” Perez told the BusinessMirror. Given
that these communities cannot be prevented from practicing their beliefs and customs, especially when it comes to burying one of their own, including women who die in child-birth, Perez said it is important for them to be given access to free contraceptives.
The Supreme Court’s TRO prevents the government from doing that and pushing the P261.44 million worth of Implanon purchased by the government nearer to their 2018 expiration date.
Health Undersecretary Gerardo V. Bayuga said there are 459.28 million Implanon units purchased by the government. These are set to expire next year.
Bayuga said poverty, poor nutrition and health conditions may complicate pregnancies and cause women to die in childbirth.
He there are 7 million women who need contraceptive services and their needs must be met by the government since they belong to the poorest sector.
“We at the Department of Health are tasked to ensure the health of Filipinos, especially women so that if you are healthy, you will not die. But because of this [the TRO], we are helpless in some way in fulfilling our task,” Bayuga said.
Enacted in December 2012, the Philippine Legislators’ Committee on Population and Development Foundation Inc. said Republic Act 10354, or the RPRH law, institutionalized the reproductive- health program in the country by providing for maternal health care, almost access to family planning, information and education to reproductive health, and funding.
Since then, the law has faced several challenges before the Supreme Court, as its oppositionists contested its constitutionality and, after the SC ruled that the law is constitutional, questioned the procedure by which the FDA certified select family-planning products.
This then prompted the SC to issue the TRO on public promotion, procurement and distribution of two brands of contraceptive implants.
In August 2016, after a motion for reconsideration had been filed by the government, the SC denied the government’s motion and expanded the TRO to cover other contraceptive products available in the Philippine market. Reducing the number of maternal deaths is one of the targets under the Sustainable Development Goal (SDG) 3 on Ensuring the Healthy Lives and Promote Well-Being for All at All Ages.
This goal aims to reduce global maternal mortality and end preventable deaths of newborns and under-5 children, as well as the epidemics of AIDS and other communicable diseases.
The SDGs or Global Goals is a set of 17 socioeconomic goals that 193 United Nations member-countries, like the Philippines, committed to meet by 2030. The goals are composed of around 169 targets and over 300 global indicators. The SDGs were adopted in September 2015.
The Global Goals aim to end poverty and hunger; promote universal health; education for all and lifelong learning; achieve gender equality; sustainable water management; ensure sustainable energy for all; decent work for all; resilient infrastructure; and reduce income inequality between and among countries.
The goals also include create sustainable cities; ensure sustainable consumption and production; take action against climate change; conserve and sustainably use oceans and marine resources; reduce biodiversity loss; achieve peaceful and inclusive societies, and revitalize global partnership for development.