U.S. Foreign Assistance

Family Planning in the Philippines: A Global Wake-Up Call for Policymakers

“Birthrates Help Keep Filipinos in Poverty” – that’s the headline of an April 21, 2008 Washington Post article highlighting the plight of a growing number of poor women in the Philippines who lack access to one of the most basic forms of health care: family planning (FP) and reproductive health services. The article, which mentions that the U.S. is scaling down its FP program in the Philippines, should be a wake-up call for policymakers about the global impact of declining FP assistance on the lives of hundreds of millions of men and women in the Philippines and other developing nations.

U.S. investments in international family planning have been one of the most successful and cost-effective ways to improve maternal and child health, ease population pressures on the environment, and help countries fight poverty. But despite the achievements of recent decades — including an increase in use of contraceptives among married women in the developing world from 10 percent to 60 percent since 1960 and a decline in average fertility rates from about six children per woman to three children per woman — significant needs remain. For example, only one-third of married Filipino women use modern contraceptives.

The reality is that family planning remains out of reach for hundreds
of millions of women and men. In fact, more than 200 million women in
the developing world want to space or limit their childbearing but are
not using modern contraception. In some countries such as Haiti,
Pakistan and Uganda, one-third or more of married women have this
unmet need” for FP. 

Nonetheless, in recent years funding from the U.S. — a long-time
leading donor of FP/RH assistance — has declined significantly when
accounting for inflation and the growing demographic demand. And FP/RH
assistance from other donor nations has also declined.

Current U.S. funding for int’l FP (about $460 million) represents a cut
of $300 million or 40 percent (adjusted for inflation) from what the
U.S. provided for these programs back in 1995. Had the Bush
Administration gotten its way and Congress not intervened in the past
two years, U.S. funding for these programs would have been reduced by
an additional 25 percent. Making matters even worse, the Bush Admin has
withheld all U.S. funding (nearly $200 million) for the U.N. Population
Fund (UNFPA), which provides FP/RH assistance in more than double the
number of countries the U.S. does.

So what does this downward U.S. funding trend mean for a country like
the Philippines? As you’d probably suspect, it’s not good. In its
budget request to Congress last year, the Bush Administration proposed
spending only $5.2 million for FP/RH assistance in the Philippines –
less than 1/7 of what the U.S. spent in that country in 1995 ($37
million in inflation-adjusted dollars). That’s despite the fact that 25
percent of Filipinas ages 20-24 have an unmet need for family planning
– and these rates are even higher among uneducated women. So funding
is going down and contraceptive shipments are ending while the need and
demand remain high. And remember, the backdrop for all of this is a
country in which more than 40 percent of its people live below the
poverty line.

Ironically, this meager funding request for FP in the Philippines was
proposed in the same budget in which the Administration acknowledged to
Congress the connection between high birth rates and poverty in the
country. In its FY 2008 foreign assistance Congressional Budget
Justification, the Administration stated that “[the] Philippines
struggles to provide sufficient jobs, infrastructure, health services,
and education for its rapidly growing population.” (PDF, p. 348)

Just how fast is the population of the Philippines growing? It’s
doubled since the late 1970s and — if access to family planning does
not increase and current fertility rates remain static — it will double
again from 86 million today to 170 million in the next thirty years.
That’s a lot of additional mouths to feed, especially in a nation
that’s recently acknowledged it has a serious shortage of rice and
faces the threat of food riots.

Make no mistake, because of declining funding USAID has had to make
very difficult choices of where it allocates its limited FP dollars.
One of those choices is to scale back its family planning program in
the Philippines and to end shipments of contraceptives — contraceptives
that we know many Filipinos desire. Tragically, this story isn’t
limited to the Philippines. The U.S. has scaled back FP assistance to a
number of countries, some with even higher unmet need than the
Philippines. Kenya is one example, with troubling implications for
maternal and child health and its development prospects.

The great tragedy in all of this — “outrage” might be a more accurate
term — is that the cuts in FP funding are depriving women and men,
many of them impoverished, of something they fundamentally want: that
most basic ability to choose how many children to have and when to have
them. And by depriving them of this reproductive right, we’re
contributing to an increasingly unsustainable and impoverished world.

Update: Check out The Los Angeles Times article “Debate grows with Philippine population.”

2 Responses to “Family Planning in the Philippines: A Global Wake-Up Call for Policymakers”

  1. aditi

    Maternal and child Health is of utmost importance. Its startling to know that more than half a million women die in pregnancy and childbirth every year -
    that’s one death every minute.
    I also came across community on orkut
    which represents the UN campaign against poverty of which child and maternal hea

  2. Kathleen Mogelgaard

    Thanks, Tod, for this thoughtful yet troubling picture of the Philippines’ demographic future, and its resulting impacts on the health and well-being of Filipinos.
    Having recently returned from a National Audubon Society study tour to the Philippines, I saw first-hand how population growth is outpacing the country’s ability to provide sufficient food, shelter and livelihood for its people.
    I was in the Philippines with other members of the Audubon Society, as well as folks from the Sierra Club and the Izaak Walton League of America. We had the opportunity to travel the country and see some of the beautiful, remarkable, and globally unique species found there – species like Philippine eagle (with a 7-foot wingspan, one of the world’s largest eagles), and the tarsier (standing about 7 inches tall, one of the world’s smallest primates).
    Because of its remarkable wealth of biodiversity – hundreds of plant, animal and marine species found nowhere else in the world – the Philippines has been designated by Conservation International as one of the world’s top 25 “biodiversity hotspots.” This classification also signals a high level of threat to biodiveristy, and in the Philippines, rapid population growth is a very significant threat. The country has lost 80% of its forests over the last century, largely driven by human activities. Its thriving and unique marine environment, whose fisheries supply much of the population’s protein, is also feeling the strain of population pressure. The current population density in the Philippines is 296 people per square kilometer (compared to 31 people per square kilometer in the US). In a country on track to double its population in the next 30 years, these trends are alarming.
    Historically, the U.S. has been a world leader in providing voluntary family planning programs through the U.S. Agency for International Development, with a proven track record of reducing fertility and slowing global population growth. As you have pointed out, U.S. funding for these programs around the world has declined, and the U.S. trails most of the developed world in supporting family planning. For these reasons, Audubon has joined with our friends and colleagues in health, development, and faith-based groups to call on the US Congress to significantly increase funding for these valuable programs that improve human and environmental well-being, and help to put the Earth on a path to a more sustainable future.
    Kathleen Mogelgaard
    Assistant Director, Government Relations
    National Audubon Society

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