Diane was one of the 119 girls Roots of Health selected to participate in a research project to assess contextual factors associated with teen pregnancy in Palawan, Philippines. She was later on selected again to be part of a smaller group of 23 girls. Like the other girls in the group, she participated in an in-depth interview where the research team asked her to share her relationships and experiences with her family, friends, and others that may have influenced her pregnancy.

Diane’s story (and the many other stories) underscores the urgent need for accurate and consistent access to sex education, increased access to reproductive health services, and more social support from families. The research also found that the lack of consent is a big issue amongst girls having sex for the first time. 

These very same stories are front and center in the three reports developed by Roots of Health, with funding from EMPower and analytical support from Columbia University Mailman School of Public Health, that address the issue of teen pregnancy in the Philippines.

Unprepared: A Summary of Survey Findings on Teenage Pregnancy in Palawan, Philippines

In 2020, with support from EMpower’s Girls Fund program, ROH carried out a two-part quantitative and qualitative research project in order to better understand the risk factors that affect adolescent pregnancy. ROH issued an anonymous, self-administered survey to 119 adolescent women and girls who have had teen pregnancies in order to understand their unique situations before becoming pregnant and identify any common factors that generate a disproportionate risk of teen pregnancy for some. 

The survey assessed risk factors experienced prior to pregnancy including participants’ family and household functioning, self-esteem, experiences with romantic and sexual relationships, and any risky behaviors that participants engaged in. Questions also covered girls’ experiences during their pregnancy including social and financial support, and their experiences accessing reproductive health services throughout their adolescence. 

The results from this research are in this Quantitative Report.

I wish I didn’t get pregnant early: A Summary of Survey Findings From In-Depth Interviews on Teenage Pregnancy in Palawan, Philippines

“I had thought about using contraceptives, but my boyfriend kept telling me that he guarantees that I won’t get pregnant, and I believed it,” Diane shared.

After giving birth, her boyfriend was initially supportive of the child but eventually stopped providing support. “He now lives with a different family of his own, and I did not take his surname for my child.”

A deeper dive into the young women and girls’ lived experiences is detailed in the qualitative data analysis report, which provides a better understanding of adolescent women and girls’ unique situations before becoming pregnant, including factors such as their family and household functioning, self-esteem, experiences with romantic and sexual relationships, and their ability to access health services. 

Based on in-depth interviews with 23 women and girls who had teen pregnancies, including a thematic analysis from the Columbia University Mailman School of Public Health, this report details girls’ experiences with their families, friends, partners, and health systems before, during, and after their pregnancies. 

Read the results from the interviews and the analysis in this Qualitative Report.

What We Could Have Done Differently: In-depth Interviews with Teen Moms and Key Recommendations to Reduce Teen Pregnancy

Diane’s experience, among many, highlights the youth’s lack of information on sexual and reproductive health, exacerbated by unequal power dynamics in relationships and lack of access to youth-friendly contraceptive services.

Based on the data generated from the two studies, ROH identified key recommendations for the major stakeholders in the fight to reduce teen pregnancy. These recommendations are divided up by relevance to each of the stakeholder groups. 

“We crafted a comprehensive Advocacy Toolkit in order to effectively use what we learned from our research to better support adolescent women and girls,” said Amina Evangelista Swanepoel, ROH Founding Executive Director. 

“This third report highlights several different issue areas that affect women and girls. It identifies possible steps that stakeholders such as parents, the Department of Education, and the Department of Health, can take to help strengthen teen pregnancy prevention programs.”

Access recommendations and additional resources in the Advocacy Toolkits.

With a deeper understanding of teen pregnancy and what policy stakeholders and gatekeepers can do to address it, Roots of Health hopes that young girls like Diane will no longer have to deal with the physical and mental health risks, social stigma, and socioeconomic disenfranchisement that an early unplanned pregnancy may entail.

MESSAGES FROM PARTNERS

Kundhavi Balachandran, EMpower Program Officer East and Southeast Asia
“Carrying out an analysis of this magnitude at any time would have been impressive, but doing this amidst the global pandemic, whilst juggling many other existential priorities and the limitations of face-to-face interactions is truly commendable.”

“EMpower is delighted that our partner Roots of Health is reaching yet another milestone in their work in Sexual and Reproductive Health and Rights with the launch of the ‘Teen Pregnancy Report’. We look forward to reading the full report and have a better understanding of the issue from the perspective of the girls and young women, and what could be done to increase their safety, autonomy, and opportunities to reach their full potential, ”

Raisa Santos, Preethika Sundararaj, and Amy Willerford, Columbia University Mailman School of Public Health
“Empowering adolescent women requires we listen to their stories to gain perspective of what they need to lead their healthiest and most successful lives. It also requires comprehensive sexual education that engages not only adolescent women, but men as well, emphasizing the importance of consent and autonomy for women in making informed decisions regarding their sexual health. We are delighted to have been a part of this essential work to enhance our collective approach to meeting the social and health needs of adolescents in the Philippines throughout their lifetime.”

*not her real name

ABOUT UGAT NG KALUSUGAN / ROOTS OF HEALTH

Ugat ng Kalusugan (Roots of Health), founded in 2009, works to empower women, young people and families in Palawan, Philippines to lead healthy reproductive lives by providing rights- and results-based educational and clinical services. The organization improves women’s and young people’s reproductive health and decreases the number of unplanned pregnancies and HIV incidence by providing sexuality health education and access to modern contraceptives through a clinical services program.

Since its inception in 2009 and through the onslaught of the COVID-19 pandemic, Roots of Health has positively impacted the lives of more than 171,000 women and young people by improving their reproductive health and decreasing the number of unplanned pregnancies and HIV incidence through comprehensive sexuality education and access to modern contraceptives through a clinical services program.

ABOUT EMPOWER

EMpower sits at the nexus of two worlds — finance and youth leadership — where they put smart money behind smart solutions.

EMpower has been weaving these contributions together for 20 years — and they’re just getting started. Their work today builds upon the best of their legacy: high-touch connections, locally-driven grant making and a curation of global best practices. As they move into the next decade, they are deepening their impact through more and bigger grants, made better through youth-centered decision making and an expanded footprint on the ground. At a time when our world needs shared efforts more than ever, EMpower is proud to connect many forces for change to create a better world.

ABOUT THE MAILMAN SCHOOL OF PUBLIC HEALTH

For nearly 100 years, the Columbia University Mailman School of Public Health has been a global leader in advancing education, research and practice to prevent disease and disability and improve the health of entire populations. Since 1922, the Mailman School has been at the forefront of public health research, education, and community collaboration. Addressing everything from chronic disease to HIV/AIDS to healthcare policy, the School tackles today’s pressing public health issues, translating research into action.

Every year, Roots of Health hosts graduate students from the Mailman School for their practicum field placement. This is an opportunity for students to apply the concepts and methods of social science and public health learned in the classroom to actual public health problems. 

The post Understanding Teen Pregnancy in the Philippines and What We Can Do About It appeared first on Roots Of Health.

That’s why we recently launched our new Ugat ng Kalusugan YouTube channel. In this channel, young people can watch short videos in Tagalog about sexual and reproductive health. By providing them with information they need in a language that is easier to understand, we can empower young people  them avoid unplanned early pregnancies and sexually transmitted infections. We converted our age-appropriate, comprehensive sexuality education curriculum into videos that we will be releasing in the weeks and months to come, starting with and “Introduction to Contraceptives and Condoms” and “All About IUDs.”

The production of these videos were made possible by the support of the Embassy of Canada in the Philippines through the Canada Fund for Local Initiatives (CFLI).

As it’s much easier to keep young people engaged through multimedia content that is not only informative, but also entertaining, we also produced animated videos on sexual health topics such as “Why the Withdrawal Method Doesn’t Work” and “Being LGBT is not an Illness.”

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Puerto Princesa City, Palawan, PHILIPPINES―In an effort to help address the reproductive health disparities and vulnerabilities that women and young people face during the COVID-19 pandemic, Roots of Health (ROH), in partnership with WomenStrong International, is launching its Learning Product, “Communities, Contraceptives and COVID-19: Ensuring Continued Access to Reproductive Health Services in the New Normal” on Friday, July 9, 2021.

The Learning Product was ROH’s brainchild after providing over 18,000 women and girls with access to contraception in 2020, almost 9% more than the previous year, a significant and stunning feat despite the pandemic restrictions.

In the country, over 196,000 Filipino girls between the ages of 15 and 19 give birth every year. The pandemic has made the situation even worse with fewer services, resulting in the continued increase in teen pregnancy, maternal deaths, and HIV cases. These had been at the center of ROH’s initiatives to encourage more health-seeking behavior among women and young people.

Recognizing the challenges in providing services even before the COVID-19 pandemic, the Learning Product can offer reproductive health care providers and stakeholders insights on continued access to reproductive health care during a pandemic and other similar public health system disruptions. The guide features an anthology of best practices derived from experiences on the ground working with women and young people. 

With its ultimate goal to improve access to RH services for women and youth outside Palawan, health care providers and civil service organizations are enjoined to adopt ROH’s best practices in providing community-based RH services during COVID-19; and making health facilities more youth-friendly, through ROH’s Youth-Friendly Clinics Assessment Tool.

As women and young people struggle with access to reproductive health education and services, a situation amplified by the pandemic, ROH hopes to curb teen pregnancy, maternal mortality, and HIV, by increasing awareness on unmet need for reproductive health services amid COVID-19 and its consequent sexual health vulnerabilities.

“Communities, Contraceptives and COVID-19: Ensuring Continued Access to Reproductive Health Services in the New Normal” is written by Amina Evangelista Swanepoel (ROH Executive Director) and Amie Perez (ROH Media Director), with illustrations by Aaron Bonete and layout by Gloria Lim.

Download the PDF version here.

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Academia

192 Faculty members of Ateneo de Manila and University of the Philippines
Alyansang Tapat sa Lasallista (TAPAT)
Bigkis ng mga Iskolar Para sa Bayan Tungo sa Makabuluhang Pagbabago – UP Manila (BIGKIS UPM)
Buklod CSSP
George Akerlof, Economist & 2001 Nobel Prize-winner
Fr. Joaquin Bernas, Dean Emeritus of Ateneo Law School
Katilingban ng mga Aktibong Kabataan para sa Bayan (KAAKBAY)
Letran Student Council
Movement of Students for Progressive Leadership in UP (MOVE UP)
Partido sang Mainuswagon nga Bumulutho sa UP Visayas (PMB UPV)
Students of Eulogio “Amang” Rodriguez Institute of Science and Technology (EARIST) Manila
University of the East Student Council
UP Alliance for Responsible Involvement and Student Empowerment (UP ARISE)
UP Alyansa ng mga Mag-aaral para sa Panlipunang Katwiran at Kaunlaran (UP ALYANSA)
UP Association of Political Science Majors (UP APSM)
UP Babaylan
UP Bukluran sa Sikolohiyang Pilipino (UP Buklod Isip)
UP Business Administration Student Council (BAC)
UP Center for Women’s Studies
UP College of Mass Communication Interdependent Student-Centered Activism (ISA)
UP College of Social Sciences and Philosophy Student Council (CSSPSC)
UP College of Social Work and Community Development Student Council (CSWCDSC)
UP College of Science Student Council (CSSC)
UP Economics Towards Consciousness (UP ETC)
UP Diliman University Student Council
UP Law Student Government (LSG)
UP Manila University Student Council
UP Organization of Human Rights Advocates (UP OHRA)
UP Psychological Association (UP PsycA)
UP Samahan sa Agham Pampulitika (UP SAPUL)
UP School of Economics Student Council (SESC)
UP Sirkulo ng mga Kabataang Artista (UP SIKAT)
Youth Consortium for the RH Bill

Business

The Employers Confederation of the Philippines
Financial Executives Institute of the Philippines
Makati Business Club (MBC)
Management Association of the Philippines
Philippine Chamber of Commerce and Industry

Civil Society

Akbayan
Waray-Waray Youth Advocates (WARAYA)
Democratic Socialist Women of the Philippines
Filipino Freethinkers
Gabriela National Alliance of Women’s Organizations in the Philippines
Philippine Atheists and Agnostics Society

Government

Commission on Human Rights
Department of Social Welfare and Development
Human Development and Poverty Reduction Cabinet Cluster
National Anti-Poverty Commission
National Economic and Development Authority (NEDA)
Office of the President
Philippine Department of Health (DOH)

International

Avaaz
Plan International
Save the Children
United Nations Children Fund (UNCF)
United Nations Population Fund (UNFPA)
World Health Organization (WHO)

Medical

Alliance of Young Nurse Leaders and Advocates (AYNLA)
Alliance of Young Health Advocates
Philippine Academy of Family Physicians (PAFP)
Philippine Medical Association
Philippine Obstetrical And Gynecological Society
Reproductive Health Nurses Association of the Philippines
Society for Advancement of Reproductive Health-Philippines

NGOs

Council on Population, Health and Welfare Inc.
Family Planning Organization of the Philippines
The Forum for Family Planning and Development
The Human Development and Poverty Reduction Center
Lifeline Foundation Support Team Inc.
Likhaan
Maja_Japan Online Charity Corp
The Philippine Legislators’ Committee on Population and Development
Reproductive Health Advocacy Network
Roots of Health

Religious

Apostolic Catholic Church
Baptist Conference of the Philippines
Catholics for Reproductive Health
Christian and Missionary Alliance Churches of the Philippines
Christian Brotherhood International (CBI)
Convention of Philippine Baptist Churches
Council of Christian Bishops of the Philippines (CCBP)
Episcopal Church of the Philippines
Iglesia Filipina Independiente
Iglesia ni Cristo
National Council of Churches in the Philippines
The Philippine Center for Islam and Democracy (PCID)
Philippine Council of Evangelical Churches
Philippine for Jesus Movement
Seventh Day Adventist
Salvation Army
Southern Philippines Muslims Unity and Development Association (SPMUDA)
United Church of Christ of the Philippines
United Methodist Church

This is by no means exhaustive. If you know any more include them in the comments at the bottom of the list or email me at marcus@rootsofhealth.org.

The post Groups Supporting the RH Bill appeared first on Roots Of Health.

By Alberto Romualdez, M.D.

Below is part of the report from an expert group convened recently by the Universal Health Care Study Group of the University of the Philippines Manila:

On Monday, 8 August 2011, 21 experts from diverse scientific fields including biochemistry, physiology, pharmacology, obstetrics and gynecology, reproductive endocrinology and infertility, internal medicine, demography, and public health gathered to examine raging questions on pregnancy and contraception applying scientific and evidence-based analysis.

These are our conclusions:

1. Conception is not an exact scientific term. For some it means implantation; for others it is an event that occurs at some time after fertilization. No one at the meeting equates conception with fertilization.

2. Fertilization encompasses the process of penetration of the egg cell by the sperm cell and the combination of their genetic material to form the fertilized egg or the zygote. The process is estimated to take about 24 hours. At present, there is no accepted laboratory or clinical method of determining if and exactly when natural fertilization has taken place, but we accept that it has occurred after a pregnancy has been detected.

Natural losses occur all the time; 33%-50% of all fertilized eggs never implant without the woman doing or taking anything.

3. All contraceptives, including hormonal contraceptives and IUDs, have been demonstrated by laboratory and clinical studies, to act primarily prior to fertilization. Hormonal contraceptives prevent ovulation and make cervical mucus impenetrable to sperm. Medicated IUDs act like hormonal contraceptives. Copper T IUDs incapacitate sperm and prevent fertilization.

4. The thickening or thinning of the endometrium (inner lining of the uterus) associated with the use of hormonal contraceptives has not been demonstrated to exert contraceptive action, i.e. if ovulation happens and there is fertilization, the developing fertilized egg (blastocyst) will implant and result in a pregnancy (contraceptive failure). In fact, blastocysts have been shown to implant in inhospitable sites without an endometrium, such as in Fallopian tubes.

5. Pregnancy can be detected and established using currently available laboratory and clinical tests – e.g. blood and urine levels of HCG (Human Chorionic Gonadotrophin) and ultrasound – only after implantation of the blastocyst. While there are efforts to study chemical factors associated with fertilization, currently there is no test establishing if and when it occurs.

6. Abortion is the termination of an established pregnancy before fetal viability (the fetus’ ability to exist independently of the mother). Aside from the 50% of zygotes that are naturally unable to implant, an additional wastage of about 20% of all fertilized eggs occurs due to spontaneous abortions (miscarriages).

7. Abortifacient drugs have different chemical properties and actions from contraceptives. Abortifacients terminate an established pregnancy, while contraceptives prevent pregnancy by preventing fertilization.

8. Like all medical products and interventions, contraceptives must first be approved for safety and effectiveness by drug regulatory agencies. Like all approved drugs, contraceptives have “side effects” and adverse reactions, which warrant their use based on risk-benefit balance and the principles of Rational Drug Use. Risk-benefit balance also applies when doing nothing or not providing medicines, which can result in greater morbidities and death.

In the case of contraceptives, which are 50-year-old medicines, the Medical Eligibility Criteria (MEC) developed by the WHO is the comprehensive clinicians’ reference guiding the advisability of contraceptives for particular medical conditions.

9. The benefits of the rational use of contraceptives far outweigh the risks. The risk of dying from pregnancy and childbirth complications is high (1 to 2 per 1000 live births, repeated with every pregnancy). Compared to women nonsmokers aged below 35 who use contraceptives, the risk of dying from pregnancy and delivery complications is about 2,700 times higher.

10. The risk of cardiovascular complications from the appropriate use of hormonal contraceptives is low. While the risk for venous thrombo-embolism (blood clotting in the veins) among oral contraceptive users is increased, the risk of dying is low, 900 times lower than the risk of dying from pregnancy and childbirth complications. Heart attack and stroke are also rare in women of reproductive age and occur in women using hormonal contraceptives only in the presence of risk factors –like smoking, hypertension, and diabetes. The MEC will guide providers in handling patients with cardiovascular conditions.

11. The risk of breast cancer from the use of combined hormonal pills (exogenous estrogen or estrogen from external sources) is lower than the risk from prolonged exposure to endogenous estrogens (hormones naturally present in the body). Current users of oral contraceptives have a risk of 1.2 compared to 1.9 among women who had early menarche (first menstruation) and late menopause, and 3.0 among women who had their first child after age 35. The risk of breast cancer from oral contraceptive use also completely disappears after 10 years of discontinuing use.

12. Combined hormonal pills are known to have protective effects against ovarian, endometrial and colorectal cancer.

13. The safety and efficacy of contraceptives which passed the scientific scrutiny of the most stringent drug regulatory agencies, including the US FDA, warranted their inclusion in the WHO’s “core list” of Essential Medicines since 1977. The core list enumerates “minimum medicine needs for a basic health care system listing the most efficacious, safe and cost-effective medicines for priority conditions.”

14. Contraceptives are included in the Universal Health package of the Department of Health.

15. The use of contraceptives in family planning programs is known to reduce maternal mortality by 35% through the elimination of unintended pregnancy and unsafe induced abortions.

Article first appeared in Malaya

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