 |
International NGO Established in 1989 Supported by UNFPA and the Kobe City Government |
| | HOME | ABOUT US | PROGRAMS | PUBLICATIONS | DATABASE | WHAT'S NEW | ACCESS | LINKS | | |
|
Interview with Satish Mehra, UNFPA Representative, The Philippines In the past, AUICK (Asian Urban Information Center of Kobe) has invited prominent and experienced professionals in various fields as lecturers for its group training course. Mr. Satish Mehra, UNFPA Representative, Philippines, was one of lecturers invited to the "First Study Course on Specific Fields of Urban Policy" with a focus on the health, medical and welfare fields. He spoke with AUICK about missions of UNFPA, the ICPD Program of Action, urbanization and partnership with local governments in the Philippines.
Satish Mehra: UNFPA in the Philippines, now in its Fourth Country Programme cycle (1994 - 1998), aims to assist the Philippines in revitalizing the national population programme to help achieve a balance between population, resources, environment and economic growth for the attainment of sustainable development. Specifically, the programme seeks to improve and expand access to quality reproductive health and family planning services to women and men in order to decrease infant and maternal mortality resulting from poor reproductive health status and practice. It also aims to: increase awareness of and support for other population-related matters, like women, youth, gender issues, and the environment; to incorporate their concerns into development of population policies and programmes; and to integrate population perspectives into the country's development plans. An amount of US$35 million - US$25 million of which comes from UNFPA regular resources and US$10 million from multi-bi resources, is allocated to the programme. About two-thirds of the programme resources goes to the Reproductive Health and Family Planning Sub-Programme. This sector includes the multi-bilateral assistance from the Governments of Netherlands and Spain, and JICA. US$5.2 million Dutch multi-bi assistance out of US$5.6 million covers service delivery, training, equipment and supplies, research, monitoring and evaluation inputs. The US$1 million Spanish multi-bi funds is to be used to accelerate IEC activities for three provinces of the Cordillera Region where contraceptive prevalence rate is traditionally low. The Japanese multi-bi assistance of US$200,000 per year for four years is for medical equipment.
Satish Mehra: Following the ICPD, Philippines provided a strong push to the Government's commitment to ICPD. First, a pledge of commitment that spells out the role of ten government departments in integrating population concerns into their respective departmental programmes was signed by the concerned department secretaries during a Board of Commissioners' Meeting of the Commission on Population, the national agency tasked with overall coordination on population matters. Second, President Ramos signed an executive order requiring local government officials to promote the Philippine Family Planning Programme as a priority programme through: 1) advocacy activities, 2) vigorous and sustained participation in programme management, and 3) utilization of other local resources and expertise. Third, Dr. Carmencita Noriega-Reodica, the champion of Reproductive Health, who represented the Philippines both at the ICPD and the Beijing conferences was appointed Secretary of Health, the lead agency for RH/FP. Fourth, the Philippine Plan for Gender-Responsive Development which outlines the policies, strategies and programmes to be implemented by the government to respond to women's concerns, was signed by President Ramos. Finally, a revised bill that seeks to restructure the country's population programme, to make it more responsive to present day realities, is under review by the Senate. The bill sets a more holistic population policy and promotes equity and empowerment, particularly for women, youth, the elderly and the indigenous. In the field of reproductive health and family planning, the government's systematic efforts to promote the ICPD agenda started with consensus-building on reproductive health. A series of workshops and roundtable discussions among NGOs, programme managers of the DOH and key agencies of government involved in FP/RH resulted in the determination of areas for substantive and structural enhancements and coordination that would be responsive to a reproductive health approach to family planning. Towards the operationalization of RH services and information/advocacy, an expanded NGO base is being mobilized. To illustrate, two women NGOs, the Linangan ng Kababaihan (LIKHAAN) and Women's Health Care Foundation (WHCF) are operating UNFPA-assisted clinics that are serving as models for RH service delivery as they move towards providing the full range of RH services using gender-sensitive approaches. Another NGO, the Population Services Pilipinas, Inc. (PSPI) has established a male reproductive health center and is experimenting on various approaches to attract men and involve them in RH. Also contributing to the efforts to operationalize RH thrust are researches on women's perception of reproductive rights, users' perspectives of fertility regulation technologies, and an impact of violence against women on women's health, the approach of which provides an excellent opportunity for reaching women at the grassroots. In the area of Adolescent Health and Youth Development, a national survey among young married and unmarried male and female adults aged 15 - 24, was conducted to provide an empirical database on the sexuality and sexuality-related (including HIV/AIDS) knowledge, attitude and practices of Filipino youth. Government agencies, including the Department of Education, and NGOs are using the results of the survey for advocacy and awareness creation, as well as for the development and enhancement of programmes and projects for the youth. The media has assisted to disseminate the results of the survey to awaken the Filipino people to the adverse consequences of high risk behaviour among the Filipino youth.
Satish Mehra: During the 70's and the 80's, family planning was promoted in the Philippines parallel with other health interventions particularly focussing on married women of reproductive age. In the beginning of the 90's, a shift in orientation was taken to push family planning as a health intervention but still concentrating on the married women. Since the ICPD, however, the Philippine Family Planning Programme was broadened to adopt a reproductive health perspective. This approach recognizes the centrality of family planning in the provision of reproductive health services as well as the adoption of an incremental strategy for reproductive health care provision considering resource constraints. A key to this reformulation is a focus on women's health from a life cycle approach, strengthening a wider constellation of services within the reproductive health framework, and viewing women's reproductive needs and aspirations as part of the family's and community's strategy for its own survival and development. Both men and women of all ages are targets of information provision and service intervention. Through the years, however, the programme remains purely on a voluntary basis. The 1995 Family Planning survey reports that one out of every two Filipino couples now practices some form of family planning. A rise of ten percentage points from its level in 1993 and fourteen percentage points from its level in 1988.
Satish Mehra: In the Philippines, UNFPA supports a number of undertakings that contribute to the empowerment of women and elimination of gender bias. Within and outside the school system, the value of equality among the sexes and the significance of partnership in managing the homes and in child rearing and caring are being promoted. At the same time, male participation in family planning is being emphasized in the promotion of family planning. On top of this, UNFPA continues to fund projects which promote their economic improvement. In the past, marginalized women from fishing and urban poor communities were provided minimal financial assistance to start small livelihood activities. The projects contributed to the women's sense of empowerment as evidenced by their increase in income and enhanced self-esteem, as well as being better regarded by their spouses and the community as a whole. UNFPA also supports various women's groups in the areas of reproductive health and violence against women, in order to strengthen them as a "voice". These include, pilot modeling of a collaborative response among government and non-government institutions centered in a hospital-base crisis and healing center for victims/survivors of violence against women; providing support to policy institutions in the enactment of meaningful, responsive laws on women's health issues; mobilizing grassroots women as "participant researchers", empowering them to take stock of their own situation and not merely serve as respondents of research projects; broadening women's' participation in the policy-making process towards the creation of a women's lobby for women's health; and sensitizing media towards creating an environment of public opinion favorable to women's health, population, gender and development concerns.
Satish Mehra: The Philippine situation is a mirror image of what is happening in the whole world in terms of urbanization. Almost half of the total population of the Philippines is urban. Urban growth rate was 5.08% between 1980 and 1990, among the highest in the developing world. By the year 2000, the majority of Filipinos will be living in urban areas. Philippines has a total of 60 cities of which 16 are highly urbanized, each with an annual income of at least P50 million per annum and a minimum population of 200,000. The largest mega-city is Metro Manila with 10 million people and growing at 2.9 percent per year accounts for 14.2 percent of the national population. With a density of 12,467 persons per sq. km. (compared to 208 persons per sq. km. for the Philippines), Metro Manila is heavily congested. It dominates the whole urban Philippines, being about ten times larger than the next urban settlement, Cebu City. As the case in other countries, urbanization in the Philippines, brings with it advantages such as economic development, greater employment opportunities, better access to basic services and education facilities, etc. However, these same advantages also result in negative consequences because they provide a "pull" factor for migrants to the urban areas. Legislators and programme planners, technocrats and social development workers are aware of the challenges that go with the urbanization process. This was evident in the discussion that transpired during the launching of the 1996 State of the World Population Report. The distinguished panel of discussants and reactors from the government executive and legislative branches, the academe and non-government organizations, led by no less than the Vice President of the Philippines, shared their views on the multi-faceted subject and proposed strategies to address the various issues. Many of them believed that there is an urban bias for allocation of resources and redressing that bias to tip the balance in favour of the rural areas is necessary. Specifically, the Secretary of Health focussed on making the cities more livable and on safeguarding the health of the residents as a main challenge for sustainable development. In the Philippines, congested living conditions are areas where public infrastructures like water, roads and sewerage are inadequate; public health and sanitation leave much to be desired. This is compounded by the fact that rural migrants bring their health and resource management attitudes and behavior that are usually attuned to the environment and conditions of their places of origin. Due to fast increase in urban population and the general difficulty of meeting their basic needs for water, shelter and health, the urban demand for reproductive health services is on the rise. Without much improvement in the individual purchasing power and with low priority given by local governments to health vis a vis other projects such as infrastructure development, more strategic allocation of resources and more innovative and responsive strategies from both public and non-government sectors are required to address the social sector. The Secretary of Health recognizes that there is no model of intervention that can work in all parts of the country. The urban poor women's values, concerns and health-seeking behavior most likely are different from the urban affluent women and from the women in the uplands. Culturally sensitive health interventions are therefore necessary.
Satish Mehra: In the past, UNFPA in the Philippines collaborated mostly with national government agencies, and some traditional FP-oriented NGOs. However, with the devolution specifically of health services to the local government units, it became imperative for UNFPA to work with them. The ongoing country programme is implemented through the Department of Health, the Commission on Population, the Department of Education, Culture and Sports, the National Commission on the Role of Filipino Women, 18 Local Government Units and about 16 NGOs of varying orientation from the national and local levels. Due to the recent introduction of the devolution system, working with the local governments was not an easy task since the LGU's lack the infrastructure and human resources. We therefore had to start from the basics. Initially, we identified specific provinces that need UNFPA intervention, based on certain criteria. In order to avoid duplication of efforts, consultation with other major donors of the population programme were undertaken and a sharing of experiences and plans followed. We then visited the selected provinces and met the concerned governors and mayors to orient them about UNFPA, its mission and programme in the Philippines. Local government officials visited ongoing successful UNFPA-supported projects to further stir their interest and commitment. This was followed by technical consultations with local government staff for the development of a project document which addresses the specific needs of the particular province. This long process enables us to instill a sense of ownership among the LGUs thus enhancing the possibility of good implementation and sustainability of the project. - Interviewed on Dec. 6, 1996 |