WUNRN
PHILIPPINES - CONDITIONAL CASH
TRANSFERS FOR BETTER MATERNAL & CHILD HEALTH
Photo: Jason Gutierrez/IRIN
Known locally as “Pantawid Pamilyang Pilipino Program” (4Ps), five-year
conditional cash transfers (CCTs) were first rolled out in 2007 as a pilot
programme to cut poverty. Now, with a budget of US$227 million, the Department
of Social Welfare and Development (DSWD) aims make CCTs available to 5.2 million
eligible households by 2015.
The 4Ps identified 5.2 million of the poorest households with pregnant women
and children aged 0-14, three million of which have been receiving cash grants
since April 2012.
In exchange, beneficiaries must meet certain health and education goals.
Participants receive a monthly grant of $12 for getting pre- and post-natal
check-ups and delivering their babies in a health centre under the supervision
of a skilled birth attendant, rather than with a traditional birth attendant as
most women currently do, and must attend monthly parenting seminars offered by
the DSWD.
National
surveys indicate that prenatal check-ups average 4.4 visits per
woman - the international recommendation is four - but only 44.2 percent of
births occur in a health facility.
Beneficiaries also receive a monthly grant of $7 per child, for a maximum of
three children, in exchange for proof of regular paediatric check-ups and
school-aged children attending at least 85 percent of their classes.
Cash not enough
Perla Maribel Diotor, 36, a CCT beneficiary who lives in Baseco, one of the
biggest slum communities in Manila, the capital, gave up paid employment when
she became pregnant with her first child, now five children ago. She said the
programme had helped her in the two years since she joined.
Her husband works “occasionally”, doing construction work, fishing or “whatever
job is available”. On some days, he brings home the equivalent of $2. “I only
wanted three kids, but I kept getting pregnant,” Diotor said.
The World Bank
estimates that 22 percent of women of reproductive age in the
According to the 2008
National Demographic Health Survey (NDHS), women surveyed reported
wanting 2.4 children, but had on average 3.3 each.
Until late 2011, the distribution of modern contraceptives was banned at public
health clinics in
Diotor and others like her have had to find contraception on their own, usually
going to NGOs, where the supply is often erratic and insufficient.
“Interventions made when a woman is already pregnant are already too late. We
can save lives by preventing unwanted pregnancies,” said Junice Melgar,
executive director of Likhaan Centre for Women’s Health,
a local NGO working in some of
A study
published in 2010 by the Guttmacher Institute, a German reproductive
health think-tank, estimated that up to 2,100 maternal deaths could be
prevented each year by providing modern contraceptives to all women at risk of
unintended pregnancy.
Government awareness
The maternal mortality ratio (MMR) in the
“We need a more serious approach to family planning. The family development
sessions that beneficiaries are required to take are more of lectures that
focus on natural family planning methods. Even then, were the women given beads
or calendars to track their cycles? [No.] It’s more of a lip service to family
planning,” said Melgar.
During the administration of previous President Gloria Macapagal Arroyo, from
2001 to 2010, the government supported only natural family planning methods,
leaving NGOs and women’s groups to provide for the contraceptive needs of poor
women. “We are really feeling the results of nine years under the Arroyo
government,” Melgar noted.
The current government recently approved the purchase
of $12 million in family planning commodities in an attempt to counter rising maternal
deaths. “This administration [of President Benigno Aquino] has been very clear
about its support for responsible parenthood, but admittedly, there is really a
problem on the supply side,” said DSWD Secretary Corazon Soliman.
“We lack midwives to attend our pregnant mothers. We lack adequate healthcare
facilities. We are doing what we can, given our limited resources. We have
started nursing programmes to fill the manpower gap, but building healthcare
infrastructures and equipping them takes time,” she said.
Enrique Ona, the Department of Health Secretary, told IRIN, “The latest family
planning survey covers the period 2006 to 2010. We don’t have a survey that
will reflect the effect of a fully implemented CCT programme yet.”