In October 2020, staff at the Johns Hopkins Center for Communication Programs (CCP) noticed a change in the search patterns bringing people to the Knowledge SUCCESS website. “What is the advocacy message of family planning” had moved up the charts, with a nearly 900% increase over the previous month.
Ninety-nine percent of those queries originated in the Philippines. The increase in those queries began following a September 29 hearing before the Philippines Senate Committee on Women, Children, Family Relations and Gender Equality. In a presentation on the impact of COVID-19 on unplanned pregnancies, UNFPA Philippines warned that the country risked a spike in the number of unintended pregnancies if coronavirus-related quarantine measures remained in place until the end of 2020.
The Southeast Asian island nation has a population of 110 million people and a fertility rate of 2.6. Citing a study by the University of the Philippines Population Institute (UPPI), UNFPA pointed out that the restrictions on mobility designed to slow down and prevent the transmission of COVID-19 resulted in unintended consequences. As the national and local health systems were overwhelmed by the response to the COVID-19 pandemic, attention and resources for women’s health were diverted. Pregnant women’s utilization of facilities for antenatal check-up and delivery declined because of service disruption, evidenced by limited skilled attendants as more health workers were pulled to COVID-19 response activities. Difficulty in commuting to health facilities, plus the fear of contracting COVID-19, compounded the problem.
Yet even before the pandemic, the Philippines had immense maternal and reproductive health challenges. The country registered about 2,600 maternal death cases annually. UNFPA warned that due to the pandemic, maternal mortality cases in 2020 could increase by 26% from 2019. Access to modern contraception was disrupted too.
According to UNFPA:
“This is an epidemic within an epidemic,” UNFPA warned.
Dr. Juan Antonio Perez III, the Executive Director of the Philippines Commission on Population and Development (POPCOM), says that the COVID-19 pandemic exacerbated existing challenges regarding both access to family planning services and opposition to providing services. In 2012, for example, the country’s Senate passed the Responsible Parenthood and Reproductive Health Law, which would streamline family planning and sexual and reproductive health, address maternal and child health, and tackle HIV and gender-based violence. Government and activists hoped that the law would improve family planning practices and outcomes by adhering to the principles and stated objectives of the program of action of the 1994 Cairo International Conference on Population and Development.
In 2013, however, the Supreme Court issued an order halting the enforcement of the Responsible Parenthood and Reproductive Health Law. In April 2014, the Supreme Court approved its implementation, but with stringent conditions. For example, adolescents were denied access to family planning services except with parental consent, which was as good as having no access. By 2019, the Philippines had one of the highest rates of adolescent fertility in Asia, according to POPCOM. Yet 2020 could see 18,000 more teenage girls getting pregnant because of the indirect effects of COVID-19 in the Philippines.
“The lockdown caused most health facilities to operate with limited manpower and number of hours, so online platforms became the most dominant force through which Filipinos sought and acquired information,” says Dr. Marvin C. Masalunga, a Medical Officer at the Philippine General Hospital. “Ordinarily, most of these people would be the regular clientele of the various health centers or government health agencies.”
Dr. Masalunga says that while family planning and reproductive health services were disrupted, the government undertook several steps to address the problem. The Philippine General Hospital set up hotlines for remote medical consultations in addition to using social media platforms such as WhatsApp and Facebook to relay messages to the public.
From the data compiled by POPCOM, between May and December 2020 – months of COVID-19 lockdown – 73.29% of people who sought remote family planning services were female, while 12.44% were male. (14.27% did not disclose their gender identity.) People aged 25-49 comprised 40%, while those aged 15-24 were 12%. A bigger percentage, 48%, never disclosed their age. The majority who sought family planning services were married, at 60%.
Dr. Masalunga stated that Local Government Units complemented remote service efforts by doing house-to-house visits, providing contraceptives lasting as long as three months.
Dr. Perez, who is also the undersecretary of the Philippines National Economic and Development Authority, states that the focus of the family planning community in the Philippines is on building partnerships and sustaining advocacy for increased investment in the health and population sectors. “We continue to advocate for comprehensive sexuality education including access to family planning services for adolescents below the age of 18, who are sexually active as evidenced by pregnancy and other social behaviors,” he says. “We want to make service delivery more effective and that includes building partnerships between local governments and national agencies such as POPCOM, and the private sector.”
It is such measures that the Philippines hope will ensure that the country rises above the pandemic, which has caused such huge disruptions to its health systems and service delivery.