MANILA — In May 1968, representatives of 84 states declared access to family planning to be a basic human right at the International Conference on Human Rights in Tehran, Iran.
That recognition helped shift the discussion of family planning from merely looking at controlling population size to one that highlights the right of individuals, particularly women and girls, to access information and services about their health and make informed choices. Half a century later, the declaration continues to guide discussions and actions by different entities involved in bringing the concept of reproductive health and family planning to communities worldwide.
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► Highlights from the London Family Planning Summit
Despite the lofty goal, myriad challenges remain. In the Philippines, for instance, there is a steep gap between the number of children women would like to have and the actual figure.
“If you look at how many children women have, the poorest 20 percent [in the Philippines] have on average more than five children. But if you ask them what [is] their ideal number of children, it would be around three,” said Klaus Beck, Philippines country representative of the U.N. Population Fund.
Factors influencing these numbers vary, from lack of education and limited access to information and services, to religious influence and political priorities. But organizations such as UNFPA are increasingly looking at ways to expand their reach.
Devex asked Beck about a pilot family planning project focused on the workplace, and how to address contextual barriers to expanding family planning information and services in the Philippines.
The conversation has been edited for length and clarity.
One of your initiatives to expand family planning access here is through the workplace. Can you talk briefly about that?
We’re looking at ways we can help reach those women who have unmet need for family planning, and at ways of partnering to reach out. And one place you can reach women is through their workplaces.
That’s why we’ve been partnering with 11 private sector companies and organizations to help them develop policies for family planning in their workplace and help them train peers to provide education to their co-employees, and/or training of health staff in their company, and, at times, help provide family planning services to some of the employees.
That’s a way to reach out, and we’ve been able to reach 1.4 million women with information through that way of operating.
We’re excited about this. There are a number of companies who want to provide this type of services for their employees, to help them in their lives, to be more healthy. It can also be useful for the companies themselves to know that they are planning their families and pregnancies.
Mostly, we reach out through partners. We work with the Employers Confederation of the Philippines. We also reach out through other vehicles: We have two microfinance institutions that are among the private sector partners that we’re working with, and they have a lot of members — mostly women of reproductive age.
It’s a pilot project of sorts. We’re trying to get a mix of industries. We have canning companies, garment factories, microfinance institutions. We’re trying to see if we can get models in different sectors, so that other companies in those sectors can learn from that model and take it on themselves.
How has the response been, especially from the employees?
It’s been quite good. They appreciated the information sessions and the impact it can have on their lives if they choose to use contraceptives which they haven’t used before. You find that when you meet women, particularly when they’re able to select longer term contraceptive methods preventing them from getting pregnant anytime soon, it gives them a peace of mind.
It’s an emotional interaction because you can really sense the relief they have that they don’t have to worry about becoming pregnant any time soon, meaning they can take care of other children they may have in the family, and continue going to work. If and when they want to get pregnant again, they can still do that, but it’s a positive choice, not something that happens by chance.
From workplace pilots, how do you see UNFPA in the Philippines evolving in five to 10 years?
We are increasingly trying to become a partnership broker. In the past, we would be more directly engaged in training health care providers and providing contraceptive medicine equipment to facilities — so very hands on, which is very rewarding because you can change and have an impact in some women’s lives directly.
“More and more, whatever little resources we have, we need to find a way to have a larger impact.”— Klaus Beck, Philippines country representative to UNFPA
But more and more, whatever little resources we have, we need to find a way to have a larger impact. If doing pilots in work places ensures that this can work and have an impact for the companies and the women themselves, then we can expand our partnerships to other companies that are trying to do that on their own, with relatively little support from us.
We also work with the Philippine Department of Health, and the Commission on Population to help them in their leadership with the full implementation of the reproductive health law. So, again, trying to find a way to help government get even better value for the money they are spending on this, and having a greater impact, either through our direct assistance or through partners that can help provide that.
We’re working in two different ways, but our main goal is still the same: Reduce unmet need for family planning, prevent any maternal deaths that we can, and end gender-based violence and harmful practices such as child marriage. Those are the three goals we have as an organization, and our vision for 2030 is that we have ended all of these, globally and here.
In the Philippines, religion plays a huge influence in people’s lives. And within the family, which is the basic unit of society, sex education is still very much a taboo subject. How do you navigate these issues in your work here?
The reproductive health law here passed in 2012, after a lot of debate and discussion. Numbers show that about 75 percent of the population supports that law, so that’s one thing that’s important to remember.
“Everybody has the right to determine this [use of family planning], so you should have the option and the information to choose.”—
Now that law is meant to provide access to information and services, particularly for the poor. It doesn’t say that anyone who doesn’t want to use or doesn’t believe in using modern family planning should use modern family planning. No. It goes back to our conversation about rights. Everybody has the right to determine this, so you should have the option and the information to choose. If your religious belief is one that doesn’t make you feel comfortable using modern family planning, then of course you shouldn’t use modern family planning. But you should at least be informed about the options that are there, and how they work, and then you make those decisions on your own, or with your spouse. So that’s I think one thing.
And then we look at the numbers showing an unmet need for family planning, so our work then is based on individuals expressing these needs.
Regarding sexual education for young people, it’s an uncomfortable topic at times, not only in the Philippines. If you talk to parents, many parents do not feel comfortable talking to their children about this, which is why it is important that there are ways for young people to get information. If not the parents, then maybe the schools can provide factual information. What happens if you don’t get if from your family or school is that you rely on your peers or the internet, which may not provide accurate information.
So young people will get information. But you can either leave it to young people to figure this out and get whatever information they can find, or you can decide on providing information that is accurate.
I know it’s sensitive. I’m also a parent, I have a teenage daughter, and it’s not the easiest topic to talk about. But if you think about all those young people, young girls, who get pregnant without it being planned, it’s still a high number in the Philippines, and that’s something you would not want to see in any country. We know it has consequences for them in terms of their chances of finishing school, getting good employment and higher income, but also in terms of health, such as complications in childbirth at a young age.
That’s critical for individual girls and society as a whole. Teenage pregnancy costs the Philippines about 33 billion Philippine pesos ($629 million) a year in foregone income. That’s a lot of money, about 1.1 percent of gross domestic product. So it has an economic cost and it has human costs. And we’re concerned about both.