Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City, Metro Manila

FIFTEENTH CONGRESS
First Regular Session

51s
House Bill No. =

Introduced by AKBAYAN Party-List Representatives
Hon. Kaka Bag-ao and Hon. Walden Bello

Explanatory Note

This proposed legislation is a pro-life measure. If enacted, this would prevent the death of
eleven women everyday due to complications related to pregnancy and childbirth. It would help
prevent breast cancer, which kills 3,000 Filipino women annually, and cervical cancer, of which
more than 4,000 women die each year. It would protect men from prostate cancer.

‘The reproductive health bill is a public policy response to a status quo that must no longer be
ignored: thousands of lives are at risk every year because of ignorance and lack of access to
reproductive health services, including access to contraceptives. Thousands of women resort to
unsafe abortion practices because of unwanted pregnancy, a situation that can be prevented if
women and couples are given the opportunities for informed choice.

If promptly enacted, this bill would in fact curb abortion and halt a prevailing abortion crisis in
the Philippines.

This bill has several elements. First, it establishes a national policy framework on reproductive
health. In a system where the delivery of health services is devolved, access can be uneven, or
in the case of many, severely unavailable. What this bill ensures is that there is a uniform policy
on reproductive health across various agencies that have the mandate to provide healthcare so
that all Filipinos in the country, regardless of economic status, religious persuasions, and
sexuality, have equal access to reproductive health education, services and products.

The second element is that it establishes a national program on reproductive health. The status
quo has long been ignored by the national government even when it is already clear that it
requires national intervention. The program would not only institutionalize the delivery of RH
services, ensuring that the machinery of the State is mobilized to deliver an important
component of healthcare.


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The third element is choice. The bill does not impose the kind of services that individuals or
couples should receive. Instead, it provides a wide range of services, from artificial family
planning methods to natural family planning. Families are given access to services and products
of their choice. The bill is likewise premised on education, a crucial strategy to reverse
misconceptions about sex and sexuality, and ensure that Filipinos, especially the youth, are able
to discover and enjoy their sexuality with responsibility and with the correct information.

President Benigno Aquino III has repeatedly affirmed his support for responsible parenthood
and for the promotion of both natural and artifical family planning methods. This sets the
direction for Congress to promptly begin the deliberation of a long-overdue measure. While
differences of opinion are manifest in the previous debates on the RH bill, the public health
crisis spawned by the absence of a national RH policy and program requires all stakeholders to
step back from the climate of animosity that surrounded the reproductive health issue, and take
it for what it truly is: a public policy response to public health crisis that has claimed so many
lives, and must now be stopped.

‘The prompt approval of this bill is respectfully sought.

CM

Hon. WALDEN BELLO
Representative, Akbayan Party-list


Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City, Metro Manila

FIFTEENTH CONGRESS
First Regular Session

House Bill No. _9-L©

Introduced by AKBAYAN Party-List Representatives
Hon. Kaka Bag-ao and Hon. Walden Bello

AN ACT
PROVIDING FOR A NATIONAL POLICY ON REPRODUCTIVE HEALTH AND
POPULATION AND DEVELOPMENT, AND FOR OTHER PURPOSES

Be it enacted by the Senate and House of Representatives of the Philippines in Congress
assembled:

SECTION 1. Title. - This Act shall be known as the "The Reproductive Health and
Population and Development Act of 2010."

SECTION 2. - Declaration of Principles. The State recognizes and guarantees the
human rights of all persons including the right to equality and equity, the right to sustainable
human development, the right to health which includes reproductive health, the right to
education and information and the right to choose and make decisions for themselves in
accordance with their religious convictions, cultural beliefs, and the demands of responsible
parenthood,

Moreover, the State recognizes and guarantees the promotion of gender equality, equity and
women’s empowerment as a health and human rights concern. The advancement and
protection of women’s human rights shall be central to the efforts of the State to address
reproductive health care. As a distinct but inseparable measure to the guarantee of women’s
human rights, the State recognizes and guarantees the promotion of the welfare and rights of
children,

In furtherance of these principles, the State shall guarantee universal access to information and
education, and safe, affordable, and quality reproductive health care services.

The State likewise guarantees universal access to medically-safe, legal, affordable and quality
reproductive health care services, methods, devices, supplies and relevant information thereon
even as it prioritizes the needs of women and children, among other underprivileged sectors.

The State shall address and seek to eradicate discriminatory practices, laws and policies that
infringe on a person’s exercise of sexual and reproductive health and rights.

SECTION 3. Guiding Principles. This Act declares the following as guiding
principles:

a. The right to make free and informed decision, which is central to the exercise of any right
shall not be subjected to any form of coercion and must be fully guaranteed by the State
like the right itself.


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b, Respect for, protection and fulfillment of reproductive health and rights seek to promote not
‘only the rights and welfare of adult individuals and couples but those of adolescents and
children as well.

¢. Since human resource is the principal asset of the country, effective reproductive health
care services must be given primacy to ensure maternal health, birth of healthy children,
their full human development, and the promotion of responsible parenting.

d. The provision of accessible and affordable reproductive health care services is essential in
the promotion of people's right to health.

e. The State will promote, without bias, all modern methods of family planning.

f. The State shall promote a program that: (1) enables individuals and couples to have the
number of children they desire with due consideration to the health, particularly of women,
and resources available to them. (2) achieves equitable allocation and utilization of
resources; (3) ensures effective partnership among the national government, local
government units and the private sector in the design, implementation, coordination,
integration, monitoring and evaluation of people-centered programs towards quality of life
and environmental protection; and (4) conducts studies to analyze demographic trends
towards sustainable human development.

g. The provision of reproductive health care and information must be the joint responsibility of
the National Government and Local Government Units.

h. Active participation by non-government, women's, people's, civil society organizations; and
communities is crucial to ensure that reproductive health and population and development
policies, plans, and programs will address the priority needs of the poor, especially women,

While nothing in this Act changes the law on abortion, the government shall ensure that all
women needing care for post-abortion complications shall be treated and counseled in a
humane, non-judgmental and compassionate manner.

SECTION 4. Definition of Terms. - For the purpose of this Act, the following terms
shall be defined as follows:

1. Adolescence - refers to a life stage of people aged 10 to 19.

2. Adolescent sexuality - refers to, among others, the reproductive system, gender
identity, values or beliefs, emotions, relationships and sexual behavior of young people
as social beings.

3. AIDS (Acquired Immune Deficiency Syndrome) - refers to a condition
characterized by a combination of signs and symptoms, caused by HIV which attacks
and weakens the body’s immune system, making the afflicted individual susceptible to
other life-threatening infections.

4. Anti-Retroviral Medicines (ARVs) - Antiretroviral drugs are medications for the
treatment of infection by retroviruses, primarily HIV.

5. Basic Emergency Obstetric Care — refers to lifesaving services for maternal
complications being provided by a health facility or professional, which must include the
following six signal functions: administration of parenteral antibiotics; administration of
parenteral oxytocic drugs; administration of parenteral anticonvulsants for pre-eclampsia
and eclampsia; manual removal of placenta; removal of retained products; and assisted
vaginal delivery.

6. Comprehensive Emergency Obstetric Care — refers to basic emergency obstetric
care plus two other signal functions: performance of caesarian section and blood
transfusion.

7. Employer - includes any person acting in the interest of an employer, directly or


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indirectly. The term shall not include any labor organization or any of its officers or
agents except when acting as an employer.

. Family planning - refers to a program which enables couples and individuals to decide

freely and responsibly the number and spacing of their children and to have the
information and means to do so, and to have access to a full range of safe, effective,
and modern methods of preventing pregnancy.

). Gender equality — refers to the absence of discrimination on the basis of a person's

sex, Sexual orientation and gender identity in opportunities, in the allocation of
resources or benefits, or in access to services.

). Gender equity - fairness and justice in the distribution of benefits and responsibilities

between women and men, and often requires women-specific projects and programs to
end existing inequalities.

. Healthcare Service Providers - refers to (a) health care institution, which is duly

licensed and accredited and devoted primarily to the maintenance and operation of
facilities for health promotion, prevention, diagnosis, treatment, and care of individuals
suffering from illness, disease, injury, disability or deformity, or in need of obstetrical or
other medical and nursing care; ((b) a health care professional, who is any doctor of
medicine, nurse, or midwife; (c) public health worker engaged in the delivery of health
care services; and (d) barangay health worker who has undergone training programs
under any accredited government and non-government organization and who voluntarily
renders primarily health care services in the community after having been accredited to
function as such by the local health board in accordance with the guidelines
promulgated by the Department of Health (DOH).

. HIV (Human Immunodeficiency Virus) — refers to the virus which causes AIDS.

. Male responsibility - refers to the involvement, commitment, accountability, and

responsibility of males with women in all areas of sexual and reproductive health, as well
as the care of reproductive health concerns specific to men.

Maternal Death Review - refers to a qualitative and in-depth study of the causes of
maternal death with the primary purpose of preventing future deaths through changes
or additions to programs, plans and policies.

Modern Methods of Family Planning - refers to safe, effective and legal methods to
prevent pregnancy such as the pill, intra-uterine device (IUD), injectables, condom,
ligation, vasectomy, and modern natural family planning methods which include. mucus,
Billings, ovulation, lactational amenorrhea, basal body temperature, and Standard Days
methods.

. People Living with HIV (PLWH) — refers to individuals whose HIV tests indicate that

they are infected with HIV.

. Reproductive health — refers to the state of complete physical, mental and social

well-being and not merely the absence of disease or infirmity, in all matters relating to
the reproductive system and to its functions and processes. This implies that people are
able to have a satisfying and safe sex life, that they have the capability to reproduce
and the freedom to decide if, when and how often to do so, provided that these are not
against the law. This further implies that women and men attain equal relationships in
matters related to sexual relations and reproduction.

. Reproductive Health Care - the access to a full range of methods, techniques,

facilities and services that contribute to reproductive health and well being by preventing
and solving reproductive health-related problems. It also includes sexual health, the
purpose of which is the enhancement of life and personal relations. The elements of
reproductive health care include:

a. maternal, infant and child health and nutrition including breastfeeding

b. family planning information and services;


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¢. prevention of abortion and management of abortion complications;

d. adolescent and youth reproductive health;

e. prevention and management of reproductive tract infections (RTIs), HIV and
AIDS and other sexually transmittable infections (STIs);

f. elimination of violence against women;

g. education and counseling on sexuality and sexual health;

h. treatment of breast and reproductive tract cancers and other gynecological
conditions and disorders;

i, male responsibility and participation in reproductive health; and

j. prevention and treatment of infertility and sexual dysfunction

19. Reproductive Health Care program — refers to the systematic, integrated provision
of reproductive health care elements to all citizens especially the poor, marginalized and
those in vulnerable situations.

20. Reproductive tract infection (RTI) — refers to sexually transmitted infections, and
other types of infections affecting the reproductive system.

21. Reproductive Health and Sexuality Education — refers to lifelong learning process
of providing and acquiring complete, accurate and relevant information and education
on reproductive health and sexuality through life skills education and other approaches.

22. Reproductive rights - the rights of individuals and couples, to decide freely and
responsibly whether or not to have children; the number, spacing and timing of their
children; to make other decisions concerning reproduction free of discrimination,
coercion and violence; to have the information and means to do so; and to attain the
highest standard of sexual and reproductive health.

23.

Sexually Transmitted Infections (STIs) — refers to any infection that may be
acquired or passed on through sexual contact.

24. Skilled Attendant ~ an accredited health professional—such as a midwife, doctor or
nurse—who has been educated and trained to proficiency in the skills needed to manage
normal (uncomplicated) pregnancies, childbirth and the immediate postnatal period, and
in the identification, management and referral of complications in women and
newborns; traditional birth attendants or traditional midwives—trained or not—are
excluded from this category.

25.

Skilled Birth Attendance — childbirth managed by a skilled attendant plus the
enabling conditions of necessary equipment and support of a functioning health system,
including transport and referral facilities for emergency obstetric care,

26. Sustainable Human Development — refers to bringing people—particularly the poor
and vulnerable—at the center of development process, the central purpose of which is
the creation of an enabling environment in which all can enjoy long, healthy and
Creative lives, and done in a manner that promotes their rights and protects the life
opportunities of future generations and the natural ecosystem on which all life depends.

SECTION 5: Midwives for Skilled Attendance. The Local Government Units (LGUs)
with assistance of the Department of Health (DOH), shall employ an adequate number of
midwives to achieve a minimum ratio of one (1) fulltime skilled birth attendant for every one
hundred fifty (150) deliveries per year, to be based on the annual number of actual deliveries or
live births for the past two years. Provided, that people in geographically isolated and
depressed areas shall have the same level of access.

SECTION 6: Emergency Obstetric Care. - Each province and city shall ensure the
establishment or upgrading of hospitals with adequate and qualified personnel, equipment and
supplies to be able to provide emergency obstetric care. For every 500,000 population, there
shall be at least one (1) hospital for comprehensive emergency obstetric care and four (4)
hospitals for basic emergency obstetric care, provided, that people in geographically isolated
and depressed areas shall have the same level of access.


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SECTION 7. Access to Family Planning. All accredited health facilities shall provide
full range of modern family planning methods, except in specialty hospitals which may render
such services on optional basis. For poor patients, such services shall be fully covered by
Phillealth Insurance and/or government financial assistance.

After the use of any PhilHealth benefit involving childbirth and all other pregnancy-
related service wherein the beneficiary wishes to space or prevent her next pregnancy,
PhilHealth shall pay for the full cost of family planning for the next three (3) years. The benefit
payments shall be channeled to appropriate local or national government health facilities.

SECTION 8. Maternal Death Review. All Local Government Units (LGUs), national
and local government hospitals, and other public health units shall conduct annual maternal
death review in accordance with the guidelines set by the DOH.

SECTION 9. Family Planning Supplies as Essential Medicines - Hormonal
contraceptives, intrauterine devices, injectables and other safe and effective family planning
products and supplies shall be part of the National Drug Formulary and the same shall be
included in the regular purchase of essential medicines and supplies of all national and local
hospitals and other government health units

SECTION 10. Procurement and Distribution of Family Planning Supplies - The
DOH shall spearhead the efficient procurement, distribution of to LGUs and usage-monitoring
of family planning supplies for the whole country. The DOH shall coordinate with all appropriate
LGU bodies to plan and implement this procurement and distribution program. The supply and
budget allotments shall be based on, among others, the current levels and projections of the
following:

a number of women of reproductive age and couples who want to space or
limit their children;

b. contraceptive prevalence rate, by type of method used; and

c cost of family planning supplies.

SECTION 11. Benefits for Serious and Life - Threatening Reproductive Health
Conditions. All serious and life threatening reproductive health conditions such as HIV and
AIDS, breast and reproductive tract cancers, and obstetric complications shall be given the
maximum benefits as provided by PhilHealth programs.

SECTION 12. Mobile Health Care Service. Each Congressional District shall be
provided with the Mobile Health Care Service (MHCS) in the form of a van or other means of
transportation appropriate to coastal and mountainous areas. The MHCS shall deliver health
care goods and services to its constituents, more particularly to the poor and needy, as well as
disseminate knowledge and information on reproductive health. The purchase of such shall be
funded from the Priority Development Assistance Fund (PDAF) of each Congressional District.
The subsequent operation and maintenance of the MHCS shall be subject to an agreement
entered into between the district representative and the recipient province or cities. The MHCS
shall be operated by skilled health providers and adequately equipped with a wide range of
reproductive health care materials and information dissemination devices and equipment, the
latter including but not limited to a television set for audio-visual presentations, All MHCS shall
be operated by LGUs of provinces and highly urbanized cities.

SECTION. 13. Mandatory Age-Appropriate Reproductive Health and Sexuality
Education. Age-appropriate Reproductive Health and Sexuality Education shall be taught by
adequately trained teachers in formal and non-formal educational system starting from Grade 5
using life-skills and other approaches. Reproductive Health and Sexuality Education shall
commence at the start of the school year immediately following one year from the effectivity of
this Act. The Department of Education (DEPED), Commission on Higher Education (CHED),
TESDA, and Department of Social Welfare and Development (DSWD), and the Department of
Health (DOH) shall formulate the RH and Sexuality Education curriculum. Such curriculum shall
be common to both public and private schools, out of school children, youth and adults in the
Alternative Learning System (ALS) based on but not limited to the following contents: Psycho-
Social Wellbeing, Legal and Ethical aspects of RH, Demography and RH and Physical Wellbeing.

Age-appropriate reproductive health and sexuality education shall be integrated in all


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relevant subjects and shall include, but not limited to the following topics:

.. Values formation
Knowledge and skills in self protection against discrimination, sexual violence and abuse,
and teen pregnancy.
. Physical, Social and Emotional Changes in Adolescents
|. Children’s and women's rights
. Fertility awareness
STI, HIV and AIDS
. Population and development
. Responsible relationship
Family planning methods
Proscription and hazards of abortion
.. Gender and development
Responsible parenthood

a)

reverses pao

‘The DepEd, CHED, DSWD, TESDA, and DOH shall provide concerned parents with
adequate and relevant scientific materials on the age-appropriate topics and manner of
teaching reproductive health education to their children.

SECTION 14. Capability Building of Barangay Health Workers. Barangay Health
Workers and other community-based health workers shall undergo training on the promotion of
reproductive health and shall receive at least 10% increase in honoraria provided that those
receiving less than P1,000 shall receive at least 20% increase_upon successful completion of
training. This increase in honoraria shall be funded from the Gender and Development (GAD)
budget or other sources of funds of the Local Government Units.

SECTION 15. Employers’ Responsibilities. — The Department of Labor and
Employment (DOLE) shall ensure that employers respect the reproductive rights of workers.
Consistent with Article 134 of the Labor Code, employers with more than 200 employees shall
integrate the provision of reproductive health services to all employees in their respective health
facilities. Those with less than 200 workers shall enter into partnership with hospitals, health
facilities, and or health professionals in their areas for the delivery of reproductive health
services.

Employers shall also uphold the right of all workers to know work conditions which may
affect their health, particularly those related with their reproductive health. Employers shall
furnish in writing the following information to all employees and applicants:
a. The medical and health benefits which workers are entitled to, including maternity and
paternity leave benefits and the availability of family planning services;
b. The reproductive health hazards associated with work, including hazards that may affect,
their reproductive functions especially pregnant women;
c. The availability of health facilities for workers.

SECTION 16. Multi-Media Campaign. The DOH shall initiate and sustain a
heightened nationwide multi-media campaign to raise the level of public awareness on the
protection and promotion of reproductive health and rights including family planning and
population and development.

SECTION 17. Implementing mechanisms.

a, Pursuant to the herein declared policy, the DOH and the Local Health Units shall serve
as the lead agencies for the implementation of this Act and shall integrate in their regular
operations the following functions:

i. Fully and efficiently implement the Reproductive Health Care Program;

ii, Ensure people's access to medically safe, legal, quality and affordable reproductive
health goods and services;

ili, Ensure that reproductive health services are delivered with a full range of supplies,
facilities and equipment and that service providers are adequately trained for such
reproductive health care delivery;

iv. Take active steps to expand the coverage of the National Health Insurance Program
(NHIP), especially among poor and marginalized women, to include the full range of
reproductive health services and supplies as health insurance benefits;

6


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vi.

vii.

Strengthen the capacities of health regulatory agencies to ensure safe, high-quality,
accessible, and affordable reproductive health services and commodities with the
concurrent strengthening and enforcement of regulatory mandates and mechanisms;
Facilitate the involvement and participation of non-government organizations and the
private sector in reproductive health care service delivery and in the production,
distribution and delivery of quality reproductive health and family planning supplies
and commodities to make them accessible and affordable to ordinary citizens;
Furnish local government units with appropriate information and resources to keep
the latter updated on current studies and researches relating to family planning,
responsible parenthood, breastfeeding and infant nutrition; and

Perform such other functions necessary to attain the purposes of this Act.

b. The POPCOM, as an attached agency of DOH, shall serve as the coordinating body in

the implementation of this Act and shall have the following functions:

iii,

Integrate on a continuing basis the interrelated reproductive health and population
development agenda into a national policy, taking into account regional and local
concerns;

Provide the mechanism to ensure active and full participation of the private sector
and the citizenry through their organizations in the planning and implementation of
reproductive health care and population development programs and projects;

Conduct sustained and effective information drives on sustainable human

development and on all methods of family planning to prevent unintended, unplanned and
mistimed pregnancies.

SECTION 18. Prohibited Acts. -The following acts are prohibited:
a) Any healthcare service provider, whether public or private, who shall:

1. Knowingly withhold information or restrict the dissemination thereof, and/or
intentionally provide incorrect information regarding programs and services on
reproductive health including the right to informed choice and access to a full
range of legal, medically-safe and effective family planning methods;

2. Refuse to perform legal and medically-safe reproductive health procedures on
any person of legal age on the ground of lack of third party consent or
authorization. In case of married persons the mutual consent of the spouses
shall be preferred. However in case of disagreement, the decision of the one
undergoing the procedure shall prevail. In the case of abused minors where
parents and/or other family members are the perpetrators as certified to by the
Department of Social Welfare (DSWD) and Development, no prior parental
consent shall be necessary; and

3. Refuse to extend quality health care services and information on account of the
person’s marital status, gender, sexual orientation, age, religion, personal
circumstances, or nature of work, provided that, the conscientious objection of a
healthcare service provider based on his/her ethical or religious beliefs shall be
respected; however, the conscientious objector shall immediately refer the
person seeking such care and services to another healthcare service provider
within the same facility or one which is conveniently accessible; provided further
that the person is not in an emergency condition or serious case as defined in RA
8344 penalizing the refusal of hospitals and medical clinics to administer
appropriate initial medical treatment and support in emergency and serious
cases.

b) Any public official who, personally or through a subordinate, prohibits or restricts the

delivery of legal and medically-safe reproductive health care services, including family
planning; or forces, coerces or induces any person to use such services.

©) Any employer who shall require or cause any applicant for employment or an employee

to: submit himself/herself to sterilization; use any contraceptive method; or not use such
methods as a condition for employment or continued employment. Further, pregnancy
shall not be a ground for non-hiring or termination from employment.


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SECTION. 19. Penalties. - Any violation of this act shall be penalized by
imprisonment ranging from one (1) month to six (6) months or imposed a fine of Ten Thousand
(P 10,000.00) to Fifty Thousand Pesos (P 50,000.00) or both such fine and imprisonment at the
discretion of the court, provided that if the offender is a public official, s/he shall also be
administratively liable.

SECTION 20. Reporting Requirements. - Before the end of April each year, the
DOH shall submit an annual report to the President of the Philippines. The report shall provide a
definitive and comprehensive assessment of the implementation of its programs and those of
other Government agencies and instrumentalities, civil society and the private sector and
recommend appropriate priorities for executive and legislative actions. The report shall be
printed and distributed to all national agencies, the LGUs, civil society and the private sector
organizations involved in said programs.

The annual report shall evaluate the content, implementation, and impact of all policies
related to reproductive health, and family planning to ensure that such policies promote, protect
and fulfill women’s reproductive health and rights.

SECTION 21. Appropriations. - The amounts appropriated in the current annual
General Appropriations Act for reproductive health and natural and artificial family planning
under the DOH and POPCOM and other concerned agencies shall be allocated and utilized for
the implementation of this Act. Such additional sums necessary to provide for the upgrading of
facilities necessary to meet Basic Emergency Obstetric Care and Comprehensive Emergency
Obstetric Care standards; the training and deployment of skilled health providers, natural and
artificial family planning commodity requirements as outlined in Sec. 10, and for other
reproductive health services, shall be included in the subsequent years' general appropriations.

SECTION 22. Implementing Rules and Regulations. — Within thirty (30) days from
the effectivity of this Act, the Department of Health, National Economic and Development
Authority, Department of Education, and the Department of Social Welfare and Development,
together with non-government, women’s, people’s, and civil society organizations shall jointly
promulgate, the rules and regulations for the effective implementation of this Act. At least 30%
of the members of the drafting committee shall come from said organizations. Full
dissemination of the Implementing Rules and Regulations to the public shall be ensured.

SECTION 23. Separability Clause. - If any part, section or provision of this Act is
held invalid or unconstitutional, other provisions not affected thereby shall remain in force and
effect.

SECTION 24. Repealing Clause. All other laws, decrees, orders, issuances, rules and
regulations which are inconsistent with the provisions of this Act are hereby repealed, amended
or modified accordingly.

SECTION 25. Effectivity. - This Act shall take effect fifteen (15) days after its
publication in the Official Gazette or in at least two (2) newspapers of general circulation.

Approved,