Rural Women Status Report on CEDAW 2011

PKKK Thematic Papers_6 Health & VAWC

Rural Women and Right to HEALTH

and Protection from GENDER-BASED VIOLENCE
The ratification of CEDAW (Convention on the Elimination of All Forms of Discrimination Against
Women), which is described as international bill of rights of women, by the Philippine government
implies its commitment to uphold gender equality and womens empowerment and to eradicate
whatever forms of discrimination exist in the Philippine setting, in all sectors and conditions including
gender-based violence and health. And yet eradication of discrimination and biases against rural
women remains elusive due to the following: (1) absence of national and local government support to
provide the health needs of the people particularly the poor; and (2) inequality issues such as and
cultural barriers, Catholic Church influence on the enactment of reproductive health bill; (3) and lack
of gender-sensitivity and gender-responsiveness of local government units.
Many Filipinos, especially rural women are unable to access and use of health care. Compared with
other Asian countries, health expenditure in the Philippines registered 3.8 percent which is way below
the five percent standard set by the World Health Organization for developing countries. Our health
sector is grossly underfunded by at least 40%, representing the cost of unmet needs of many of our
people (ABI 2011).
Immediate enactment of a national reproductive health bill is further delayed with strong opposition
and influence of the Catholic Church. For 12 years, RH bill is being debated in the Philippine
Congress.
Gender-based violence affects women and children and the whole family tremendously. Of the
number of VAWC cases received/monitored by PKKK, less than 10% were able to pursue justice due
to limited means and little access to support/services. Undocumented cases of VAWC and trafficking
prevail, despite being public knowledge within the community and VAWC have become accepted in
the communitys culture/way of living.
Health and Reproductive Health
Womens health is directly linked with reproductive health and directly associated with maternal
mortality rate (MMR), morbidity rate (MR) and child health (IMR) for infants. Compared to other Asian
countries, the Philippines has the worst health performance, both for maternal mortality and infant
mortality. According to Save the Children Report 2009, substantial number of mothers are dying
numbering to 4,000 a year (11 mothers dying per day) of preventable and treatable complications of
pregnancy and childbirth. The government is targeting to reduce deaths at a faster pace, from the
present record of 162 deaths for every 100,000 to 52 per 100,000 by year 2015.
About one in every 30 children dies before his or her fifth birthday. Childhood mortality continues to
decline. Infant mortality rate for the period 2004-2008 is 25 deaths per 1,000 live births and the
under-five mortality rate is 34 deaths per 1,000 live births. This is lower than the rates of 29 and 40
reported in 2003 (NDHS Survey 2008).
Post-natal care has registered remarkable improvements when the government intensified its
immunization program in the 1990s. During this time, the rate 90 % of fully immunized children was
reached. However, there was an observed decline since 1998. Hence, the national immunization
program was again launched in 2004, 2007 and 2010 and expanded its coverage.

Rural Women Status Report on CEDAW 2011

PKKK Thematic Papers_6 Health & VAWC

Breastfeeding within the first hour after birth can prevent 22% of neo-natal deaths, while
breastfeeding within the first day after birth can prevent 16% of neo-natal deaths. The countrys
breastfeeding prevalence is at 88 percent over the last two decades. While prevalence of exclusively
breastfeeding percent among infants under six months has remained at 34 percent over the period
of 2003-2008. With Proclamation No. 1113 issued in 2005 declaring August 1-7 of every year as
World Breastfeeding Week and the enactment of Republic Act 10028 also known as Expanding the
Promotion of Breastfeeding in 2009, more mother would breastfed their infants as the law
encourages government offices and private establishments provide lactation stations for working
mothers.
Maternal deaths can be address if the government will ensure that all women and newborns have
skilled care during pregnancy, childbirth and the immediate post natal care period. Such care is to be
provided by skilled birth attendant: midwives, nurses and doctors. This means all births should take
place in well-provided birthing facilities, discouraging home deliveries, especially without trained
birth attendants. The Philippine Department of Health has adopted this as a national Maternal
Newborn Child Health and Nutrition (MNCHN) strategy.
The absence of RH bill and non-support of some local government units on RH and FP doesnt
encourage families to seriously manage the number of children. We have yet to see more local
governments provide for local policies on population and development and allocate funds for the
expansion of contraceptive self-reliance, which is a DOH Administrative Order, requiring LGUs to take
on the responsibility of providing for contraceptive commodities in their local territorial jurisdictions.
The Catholic Church sees the passage of the RH Bill to be promoting promiscuity among the youth.
The Churchs position on RH can be traced back from its patriarchal viewpoint of being the caretaker
and moral-keeper among the people it rules over. The moral ascendancy it portrays implies unequal
treatment to people, with beliefs different from it, particularly the women, whose decisions on childbearing are not consulted.
Apart from the lack of national policy on RH, other issues that also hampered CSOs advocacies and
interventions programs on RH and FP implementation are phasing out of foreign assistance on free
contraceptives; inadequate funds or no specific budget line item for FP commodities in some of the
LGUs budgets; lack of available and accessible local health facilities, information, education
campaign and services; and low male involvement in FP and low acceptance of no-scalpel vasectomy
(a male-directed FP method).
Aquino Health Agenda (AHA): Universal Health Care for all Filipinos
The Department of Health (DOH) Administrative Order No. 2010-0036 titled, "The Aquino Health
Agenda: Achieving Universal Health Care for All Filipinos" aims to provide every Filipino of the highest
possible quality of health care that is accessible, efficient, equitably distributed, adequately funded,
fairly financed, and appropriately used by an informed and empowered public by (1) strengthening
the National Health Insurance Program (NHIP) as the prime mover in improving financial risk
protection; (2) generating resources to modernize and sustain health facilities; and (3) improving the
provision of public health services to achieve the Millennium Development Goals (MDGs).

Rural Women Status Report on CEDAW 2011

PKKK Thematic Papers_6 Health & VAWC

For 2011, the government has set aside P3.5 billion for the National Health Insurance Program to
cover about 4.7 million poor families and 1.4 million squatter households. This will be released after a
new guideline is finalized and issued by the DBM, PhilHealth and the DOH. This amount will be
increased to P12 billion in 2012 and benefit some 5.7 million poor families with wider health-care
coverage. (http://www.businessmirror.com.ph/home/top-news/18188-dbm-allots-p15b-for-philhealth-).
Data shows that less than 50 percent among rural women have access to health insurance; of which
less than 10 percent are landless workers.
While total health expenditure has been increasing for the past two years, majority of this has been
due to out-of-pocket expenditure by family and individuals. This means this has not really addressed
the needs of the poorer sector, only those with money that can afford out of pocket payments
benefitted.
The AHA espoused the Fourmula One strategy which heavily depends on the local governments
performance and awareness about good governance, provisions can become available. Quality of
service also varies across areas.
Gender-Based Violence: On Violence Against Women and Children
The problem of violence against women and children is present across classes, races, and culture
(even among the lumads).
Examples of incidence of violence are: physical assault/abuse,
womanizing of husbands, mental/psychological and financial abuse. Victims of violence find it difficult
to break away from the cycle of violence they are in because women usually lack the resources to
support their children, they have become dependent on their husbands/ partners, fear of the
negative impression/ judgment from the community people/society, they get the blame as to being
the cause of the violent behaviors of their husbands, and unresponsive local government to support
their cause.
The unresponsiveness of the LGU can be attributed to low level of awareness about womens rights,
family responsibility and related laws and the dominance still of the patriarchal mindset of our
society. Hence, people (whether the women victims and the LGU officials) would rather remain quiet
about the problem and keep it to themselves.
Slow and loose implementation of the Anti-VAWC law and other related laws at the local level can be
attributed to many LGU authorities lack of information and understanding of these laws. Extensive
education and orientation sessions should be done among the LGU employees, the different agencies
including division school officials of the Department of Education.
Also, one hindering factor in pursuing the case is the multiplicity of needs and requirements that
victims-survivors have to attend to. Families and relatives of victims often give up or accede to
settlement rather than filing a case because of financial constraint and the cumbersome judicial
process they have to undergo which they themselves are not knowledgeable about.
The Philippine Womens Commission (formerly National Commission on the Role of Filipino Women)
reports that the Philippines has made gains, in the last ten years, in institutionalizing policies
addressing violence against women. Considered landmark laws are RA 7877 addressing sexual
harassment; RA 8353 on rape and marital rape; RA 9208 on trafficking in persons, especially women
and children; RA 9262 on violence against women and children and RA 8504 on the Philippine HIV-

Rural Women Status Report on CEDAW 2011

PKKK Thematic Papers_6 Health & VAWC

AIDS law. In terms of implementation, the Philippine government set up mechanisms to address
facility in implementation and monitoring. First, is the creation of the Inter-Agency Council Against
Trafficking (IACAT). Second, is the Inter-agency Council on Violence Against Women and Children
(IACVAWC).

Rural Women Status Report on CEDAW 2011

Anti-VAWC

Laws/Policies/ Programs
that Promote Gender
Equality

On Violence
Against Women
and Children

Section 12 of CEDAW
Inter-agency Council on
Violence Against Women and
Children (IACVAWC)
RA 7877 addressing sexual
harassment;
RA 8353 on rape and marital
rape; RA 9208 on trafficking
in persons, especially women
and children;
RA 9262 on violence against
women and children and
RA 8504 on the Philippine
HIV-AIDS law;
Inter-Agency Council Against
Trafficking (IACAT)

Increased
support to the
reported VAWC
cases; i.e.
provided with
legal remedies,
survivors were
able to claim
assistance
(legal, health,
psycho-social,
financial
services)

PKKK Thematic Papers_6 Health & VAWC

Laws / Policies/
Programs that
Hinder Gender
Equality

Recommendation from
PKKK based on GRRWDP

Establish crisis centers that are

accessible to rural areas
(upland and fishing
communities) and with free
medical support, food,
counseling, safe environment,
and other services;
Guidelines for anti-VAWC desks
should include the allocation of
budget necessary for
immediate financial support
needed by the women victims;
Establish referral system* for
rural women organizations that
conduct monitoring of VAWC
cases and provide assistance to
victims/survivors (IACRW)
*referral system includes
networks for capacity building,
service providers for the VAWC
survivors needs, livelihood
support for the survivors family

Communitybased support
systems
promote
preventive
information
campaigns on
VAWC and
conduct active
documentation
of VAWC cases
in the rural
areas

Create community-based multisectoral committees in

monitoring VAWC cases and in
providing immediate assistance
especially in the process of
obtaining BPOs;
Conduct information campaign
on the RA9262, MCW and other
womens rights in all barangays
Convene community-based
support groups that plan
information campaigns, design
quick interventions and provide
support to victims of VAWC
Support information campaign

Anti-VAWC

Rural Women Status Report on CEDAW 2011

PKKK Thematic Papers_6 Health & VAWC

campaign is
linked with overall womens
health concerns

Right to Health
Reduced
maternal
mortality rates,
especially in the
rural areas

Improved access
to Philhealth
benefits,
especially
maternal and
neonatal
services

on universalizing health care

and anti-VAWC Launch program
campaigns that integrate antiVAWC with womens health
programs in the barangays
(DILG/DOH)
Department of Health (DOH)
Administrative Order No.
2010-0036

Non-passage of
RH Bill

DOH AO on Contraceptive
Self Reliance (CSR)

Department of Health (DOH)

Administrative Order No.
2010-0036
Department of Health (DOH)
Administrative Order No.
2010-0036

Mapping of available health

services in the far-flung barrios
(nature and quality); identify
health needs of the rural
women;
Conduct free reproductive
check up for women, especially
pap smear;
Education campaign on
womens rights to health,
reproductive health, nutrition
and sanitation;
Provincial Health Plan on
women should consider
situations in the remote areas
and adopt pro-active strategies
like regular community visits
(not one-time medical
missions);
Advocate for the
implementation of the DOH AO
on Contraceptive Self Reliance
(CSR), where the LGUs are
mandated to provide for
contraceptive commodities in
local health units (thru the
RHUs and City Health Offices)
Allocate funds for rural
womens reproductive health
care
Expand coverage to include
hospitalization but other
reproductive health care needs;
Conduct consultations and
policy reviews of Philhealth
coverage among rural women;
Dialogue with the Regional
DOLE on social protection and
occupation safety hazards for
farm workers; Engage LGUs and

Rural Women Status Report on CEDAW 2011

PKKK Thematic Papers_6 Health & VAWC

Regional DOH in budget

formulation, planning and
monitoring
Improved access
to primary
health care
services

Department of Health (DOH)

Administrative Order No.
2010-0036

Provincial Health Plan and

upgrading of provincial hospital
facilities;
Inclusion of health programs in
the Development Plans
Targeted information
campaigns for marginalized
and impoverished women
Universal Health Orientation
and education campaign in
every Barangay
Launch community-based
health programs;
Engage LGUs and Regional
DOH in budget formulation,
planning and monitoring