Progress Towards Contraceptive Access in the Philippines

The recent U.S. Supreme Court ruling that employers with religious objections can deny women contraceptive health coverage is a setback for the rights and freedoms of American women.

But in other parts of the world, there remain some bright spots for women’s reproductive rights and contraceptive access, even with the COVID-19 pandemic.

Progress Towards Contraceptive Access in the Philippines
Roots of Health is a nonprofit organization focused on improving the health of women and girls, and their communities, in Puerto Princesa, Palawan, in the Philippines. 

In the Philippines, since 2012, when reproductive rights and education were finally enshrined in law in this fiercely Catholic country, the government has committed to providing free family planning services to those living in poverty.

Although the rollout across this sprawling archipelago nation has been spotty, with the need continually outpacing supply, women’s contraceptive use has been on the rise. This success can be attributed in part to grassroots women-led organizations such as Roots of Health, a WomenStrong member and the lone reproductive healthcare provider in the beautiful but impoverished province of Palawan.


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Founded a decade ago by a brave mother-daughter duo of health practitioners, Dr. Susan Evangelista and her public health specialist daughter Amina Evangelista Swanepoel, Roots of Health has developed a multi-pronged strategy of providing comprehensive sexuality education and access to a broad spectrum of free clinical reproductive health services, while broadening community support.

Amina and her mother adopted early on a goals-based, life-planning approach to reproductive health. Girls and women begin by clarifying for themselves their dreams and aspirations, and then consider how an unwanted pregnancy or serious illness could interfere with those dreams. They leave empowered with the information they need to make informed decisions and confidence in their freedom to determine the course of their own lives.

Roots of Health also coordinates closely with local, regional and national health and education agencies to train and deploy health workers, teachers, parents, and young people who can support reproductive health services and ensure a ready supply of contraceptives.

To ensure that all gatekeepers for young people’s health are engaged, Roots of Health has carried out its sexual and reproductive health training in high schools, for students and teachers alike; with parents, in government-family convenings; for health workers, through sessions in partnership with the Department of Health; and to the broader community—all on the inarguable basis of young people’s freedom of choice as embodied in their human rights.

Enter COVID-19.

The ensuing lockdown, once it came, was draconian. Worried about the impact of the abrupt closure of clinics and schools on the girls and women they serve, during those frantic first two weeks of the quarantine, Roots of Health staff quickly pivoted to social media and remote programming, where they checked in with their clients via Facebook messenger, counseled them through online chats and created new instructional videos for using various forms of contraception that they then streamed on Facebook Live.

After those first two weeks, Amina said the neighborhood health centers began reaching out to her team, to help resupply the government stock of birth control pills and to administer injectable contraceptives to those who preferred to continue with their quarterly injections.

With the incidence of COVID-19 cases then beginning to taper, one bold Roots of Health midwife was willing to venture out to a community-based health center to administer injections, after which others began to feel confident enough to join her. After another 3-4 weeks, Roots of Health reopened its two clinics in Puerto Princesa, the provincial capital.

Combined, staff now see about one-third of their usual number of clients, with totals of 25-30 clients per day, rather than the 70-100 they would habitually see daily before the pandemic. A recent local outbreak and nationwide surge of COVID cases have delayed the resumption of the full panoply of services offered, with those requiring longer in-person consultations on hold until everyone’s health can be assured.

Progress Towards Contraceptive Access in the Philippines
One bold Roots of Health midwife was willing to venture out to a community-based health center to administer injections—after which others began to feel confident enough to join her.

As in an increasing number of venues worldwide, some health workers in Palawan have experienced social ostracism and suspicion, with local public transport drivers, for instance, refusing to pick them up.

Yet these bold practitioners continue to brave the taunts and put themselves and their families at potential health risk, to support these women and girls.

Given the fluid situation and her staff members’ current exposure, Amina, who has two Columbia University masters’ degrees, said she wishes she’d had more training.

“I have found myself wishing I was a nurse,” she said. “It’s hard as a manager—I’m not on the front lines, I’m not putting myself at risk … I’m trying to be as supportive to those on the front lines as I can.” As part of that support, Roots of Health staff, like the staff of many women-led organizations, practice collective self-care during their regular online check-ins and encourage each other to share their experiences and anxieties.

“It’s good to talk through our feelings,” Amina acknowledged. She added that she’s been reading about “toxic productivity” and has tried to reassure her team that, as they juggle working from home with the competing needs of family members, they shouldn’t feel pressured to accomplish what they would have expected of themselves pre-pandemic.

Yet the well-being and welfare of the vulnerable girls and women they serve are never far from the minds and hearts of these mission-driven nurses and midwives, who, to this day, are willing to go to heroic lengths to ensure their sister Palawenas’ reproductive health and rights. 

How heartening, at this discouraging moment in the United States, to remember that all over the world, such warriors continue to serve and protect women and girls.


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About

Dr. Susan M. Blaustein is the Founder and Executive Director of WomenStrong International, which finds, funds, nurtures, and shares women-driven solutions to transform lives in urban communities.