COVID-19 has overwhelmed national health systems around the world derailing health agendas that were just as important. In the Philippines, adolescent pregnancy is threatening the well-being and health of girls, yet the growing danger was sidestepped in a time of pandemic.
In 2019, the decreasing average ages of young mothers and increasing number of adolescent-headed families prompted the country’s Commission on Population and Development (POPCOM) to declare adolescent pregnancy as a “national social emergency”.
A year after the 2019 emergency declaration, reproductive health interventions funds were redirected to COVID-19 relief responses. Philippine Senator Risa Hontiveros dubbed this as the “covidisation” of reproductive health where the budget for reproductive health initiatives was re-appropriated despite the amplified need and heightened challenges.
The 2021 Social Weather Stations survey shows that Filipinos see adolescent pregnancy as the “most important problem of women today”. This public perception aligns with the pre-pandemic data, among which is the 2017 Philippine National Demographic Health Survey showing that 9 per cent of girls aged 15 to 19 have either given birth or are pregnant. Worse, POPCOM’s 2021 study details that 2, 411 girls aged 10 to 14 gave birth in 2019, which is thrice the record in 2000.
The decreasing ages of pregnant girls prove that the narrative of “moral decadence” as the cause of adolescent pregnancy is erroneous. Instead, these pregnancies are results of gender violence, further aggravated during the COVID-19 pandemic.
Factors constraining policy responses
Longstanding factors hamper adequate policy response to adolescent pregnancy in the Philippines. The stigma surrounding sex and sexuality makes family planning services inaccessible, especially among adolescents in rural communities. In the 4th Annual Responsible and Reproductive Health Report done by the Department of Health, only 35.8 per cent of those aged 15-19 have access to family planning information while only 29.7 per cent have access to modern contraception methods.
The stigma is traceable to the influential religious groups against reproductive health services in the country. It took 13 years for the Responsible Parenthood and Reproductive Health Act of 2012 (RH Law) to be approved after it was filed in Congress in 1999 due to massive opposition from the religious sector. The RH Law aims to provide universal access to contraceptives, family planning methods, maternal care, and sex education in the whole country.
Until today, the implementation of the RH Law remains rocky. The United Nations Population Fund (UNFPA) reports that sex education in the Philippines is still lacking, which is problematic for two reasons. First, sex education is confined in schools, excluding girls who dropped out of school due to the exact issue at hand. The Philippine Statistics Authority's Annual Poverty Indicators Survey, for instance, shows that 61.9 per cent of school dropouts among girls are due to “marriage or family matters”—a euphemism for dropouts due to adolescent pregnancy. Second, sex education implementation became more inaccessible in the COVID-19 pandemic given the lack of online resources and hybrid modules.
Coupled with the lack of sex education resources in the pandemic, mobility restrictions and lockdown measures constrain the delivery of reproductive health services, resulting in an estimated 120,000 unintended pregnancies in 2020 alone. This becomes alarming in a health and economic crisis, as the issue is also deeply a gender and development one. As illustration, a 2020 UNFPA policy brief says that 33 billion PHP (around S$904 billion) are lost annually due to teenage pregnancy in the Philippines.
Addressing cracks within and among existing policies
For one, the challenges seem to come from implementation gaps and inconsistencies among existing policies. Moving forward on adolescent pregnancy prevention will call for streamlining implementation and revamping public policies. There could, however, be four policy recommendations toward an actionable plan.
First, evidence-based policies on sex and sexuality must be consolidated for consistency and effectiveness. This includes using data to determine age demand and readiness to process modular information regarding reproductive health. The Revised Penal Code of the Philippines, for example, had among the world's youngest age of sexual consent at only 12. Although the age of sexual consent was raised to 16 on 7 March 2022, those below 18 years old still need permission from parents or a guardian to acquire reproductive health information. The gap in age of sexual consent and age of free access to reproductive services show a a disconnect in the internal logic of existing policies.
Second, policy implementation strategies must pay attention to the Philippines’ archipelagic and religious nature. Given the Philippines' decentralised health services, national policies get poorly implemented when not formally supported by the local government through ordinances. In 2016, for example, the Mayor of Sorsogon City in Southern Philippines declared the city as "pro-life" and consequently withdrew all contraceptives and stopped all family planning services in the city. Appropriate penalties for such governance deficiency and neglect of national laws must be integrated in the existing RH Law and policies.
Third, government policies on adolescent pregnancy must treat the seemingly private nature of sexual affairs and religious life as actually public issues. Arguing in terms of the State’s non-interference in so-called private family affairs, the Philippine Supreme Court’s exercise of judicial review over the RH Law prohibits minors from accessing contraceptives. The Supreme Court ruling also gives health workers the choice to refrain from providing pieces of advice on sexual and reproductive health to minors if health workers object on religious grounds— a ruling that extends even during health crises like the COVID-19 pandemic.
Fourth, reproductive health programmes must be allocated non-discretionary and fixed fiscal funding. This is necessary to prevent the axing of reproductive health budget following a change in administrative priorities, which happened in the pandemic Philippines as the 2020 budget for reproductive health went down by 29 per cent compared to 2019. Assurance of funding becomes more relevant given that the health issue of adolescent pregnancy drags economic growth, presenting itself as a should-be priority in COVID-19 economic recovery.
Whilst the road ahead remains an arduous and long-drawn one with COVID still an issue that plagues the country and around the world, perhaps the first step is to shorten this long umbilical cord of socio-cultural barriers and policy gaps that challenges the adolescent pregnancy measures needed in the Philippines.
Making a concerted move is no more crucial than in a time of health crisis since experts have revealed how this pandemic continues to exacerbate social, health and mental well-being issues globally. In the Philippines, the rise in gender violence corelates with the persistent adolescent pregnancy increase; becoming a big threat to the nation’s young lives, more than COVID.
This entry received 1st prize in an op-ed competition by Bridging GAP (Gender and Policy), a student group at the Lee Kuan Yew School of Public Policy which aims to enhance awareness of the importance of gender among public policy students.