Transcript of Senator Risa Hontiveros' Q&A with DOH

PHILIPPINES, January 28 - Press Release
January 28, 2025

Transcript of Senator Risa Hontiveros' Q&A with DOH
Joint Committee hearing on Rising Number of Adolescent Pregnancy and HIV among the Youth
28 January 2025

Asec. Albert Domingo (DOH): Thank you, Mr. Chair marami salamat po sa lahat ng ating mga senador at mga kapwa resource persons ang datos po natin nakikita pa rin natin na yung adolescent birth rate kung ilan ang bata na ipinanganganak sa nanay na 15 to 19 years old, noong 2020 ito po ay nasa 24 per 100,000 or in real numbers actual numbers 121,896 noong 2021 nasa 22 per 100,000 or 112,990. Noong 2022 nasa 24 per hundred thousand or 123,362 tapos nung 2023 po nasa 25 tumaas 25 per 100,000 live births or 132,157. Bakit po ito nakakabahala Mr. Chair? Kapag ang ating nanay po ay nasa adolescent age una po ang kanyang pangangatawan ay hindi pa handa physically medically para magdala ng bata. Hindi po yan ang angkop na edad para sa matris at para na rin sa kanyang hormonal make-up para magkaroon ng anak.

Ikalawa po is yung tinatawag na health-seeking behavior. Sa health-seeking behavior, gusto po natin na meron tayong antenatal check-ups, ideally apat bago siya manganak dahil sa check-up na ito nalalaman kung kamusta hindi lamang si baby ngunit pati si mommy.

Kasi ang mangyayari po kapag hindi maganda ang kanyang kalusugan at ang kalusugan niyang kanyang sanggol ay pag siya po ay nanganak, nagiging maternal mortality. Which brings me, Mr. Chair, to the point on maternal mortality ratio.

Ang atin pong maternal mortality ay pinakamababa noong 2019 in recent years nasa 87 per 100,000. Pero sumirit po siya papunta sa 182 per 100,000 noong 2021. Bahagyang bumaba noong 2022 naging 138 per 100,000. Pero malayong malayo po yan. Sa ngayon po, nasa panahon na tayo ng Sustainable Development Goals. Yung previous set of goals, po, Millennium Development Goals, kung di po nagkakamali from memory, the target was nasa 50 per 100,000 or thereabouts malayo po yung 138. At dahil po dyan Mr. Chair, ikoconnect ko na rin po it was also part of the agenda forwarded to us yung HIV epidemic. Ito rin po ay pertinent dahil ang isa pong, hindi lang pala isa ang pinaka mataas na mode of transmission ng ating hiv ay ang sexual transmission, sa pakikipagtalik. Sa ating datos po sa HIV-AIDS, up to 47% of new infections are from the young key populations na nasa edad 15 hanggang 24. Ang kwento po nito Mr Chair, ang atin pong mga kabataan na maagang makipagtalik ay mas mataas ang risky behavior at mas nahihirapan na kumuha ng mga HIV-related services.

Makikita po sa datos natin na on average, yung ating pong mga young key populations for HIV, sila po ay nakipagtalik nung sila ay 16 years old. At una po silang gumamit ng condom on average nung sila po ay nasa 17 years old. Kung bakit po, yun po yung mga kailangan natin tingnan. At sa aming pakiwari ay baka yung impormasyon or yung commodity, yung condom mismo, ay hindi nakarating sa kanila nung panahon na sila mismo ay nagsimula na sa pakikipagtalik based on our data.

Having said that, Mr. Chair, nakikita natin na malaking bagay yung usapin na dito. The bill, which we are also aware is being considered, yung ating pong substitute to SB1979, the framing of the latest version is a national policy in preventing adolescent pregnancies. Even though it focuses, Mr. Chair, on adolescent pregnancies, it also touches on other disease and health conditions, like we mentioned HIV, because the very same act which we hold so dear and so sacred in our culture has to also be guided by scientific information and means to carry it out in a healthy way possible. And in that case, marami po tayong masosolusyunan, hindi lang ho yun, ang sabi nga ng Secretary Herbosa, dapat hindi yan tinatawag na teenage pregnancy, childhood pregnancy yan eh. Kasi nagiging hung up tayo doon sa 13 hanggang 19. Para bang nagiging legitimate siya. We're not saying it's legitimate, pero nanonormalize na pag teenage nabubuntis, dapat gulatin natin ang ating bansa. Hindi dapat na bubuntis ang bata. Ang bata ay dapat nag-aaral, ang bata ay dapat lumalaki, at pinupursue niya yung kanyang mga pangarap as sa buhay. Hindi siya dapat nagdadala ng isa pang bata. Which, by the way, to our understanding, we're not lawyers, but if it's 16 or below 16, it is statutory rape. So mayroon talagang maling nangyayari na parang whether it is a lack of information or a lack of access to the commodities or with respect to our counterpart agencies, a lack of enforcement, the fact remains that childhood pregnancies are high, maternal mortalities are high, and many new cases of HIV are because of the young key populations. Thank you, Mr. Chair.

Senator Risa Hontiveros (SRH): Just a few initially kay Usec Domingo. A CSO in Puerto Princesa, Palawan roots of health has taight over 100,000 students and trained about6m,500 teachers in CSE in the past 15 years. puerto princesa is the lone city in the mimaropa region that bucked the trend of rising adolescent pregnancy so masasabi po ba natin na yung cse ay gumanap ng malaking papel sa pagpapababa ng teenage pregnancy sa siyudad mr chair?

Asec. Domingo: Thank you una po for the record, it's Assistant Secretary, not Usec. baka mapagalitan po ako ng ibang other Execom. Having said that, Mr. Chair, Senator, actually, nakikinig po ako. Nakikinig po kami kanina sa usapin ng curriculum. At baka luma lang po ang nakuha ko, but it might be pertinent kasi historic po ang the data sa Puerto Princesa. Yung nakuha po namin is yung August 2016 K-12 curriculum guide. And I think in support of our colleagues from DepEd, malinaw nung napilitan na rin po kaming magpanggap na teacher. Hindi, kasi gusto natin yung pababayin yung teenage and childhood pregnancies. So tinignan namin with age equivalence, dun sa Grade 5, Mr. Chair, if DepEd, correct me if I'm saying it wrong, but to my understanding as a non-deped, non-teacher, the mention of puberty begins at least in the 2016 curriculum version at the age of 11 which is Grade 6. In the second quarter, you will have a subject on puberty at ang pinag-uusapan nila and also for the record, I'm flipping through the very thick nagpaspasan ho kaming basa. Pero dun sa grade 6, malinaw, sorry I correct myself, Grade 5 which is 10 years old. On page 48 of the 95-page document, it says, changes during puberty, physical changes, sexual characteristics, hair growth, voice change, breast development. And then, pagdating ng Grade 8 sa first quarter, Family Health 1, yung subject doon pa lang ho papasok yung mas detailed. And what is the age of grade 8? It's 13 years old. 13 years. po yan, 13 anos. Pinag-uusapan na yung gender and human sexuality in the document of DepEd itself, in which we support, correlate with values education, coordinate with guidance counselor. Nakasulat yung learning competencies, identify basic terms in sexuality, discuss sexuality as an important component. But more importantly, Mr. Chair, flipping through the same document, pag umabante tayo sa bandang second quarter ng Grade 8 pag-uusapan na yung responsible parenthood. Kasama sa learning competency would be the importance of responsible parenthood and enumeration of the modern family planning methods natural and artificial so yan po yung nakita namin and we tried going also back I was listening intently Mr. Chair and we fully support na parang ang sinabi ng RA10354 is adolescent.

So, nagkalkal po ako personally dito sa curriculum. Wala naman pong nakitang mention on the sexualuty below the age of 10 insofar as this version of the curriculum is concerned. The earliest mention was noong grade 2, which is 7 years old. yung family health sa third quarter, meron siyang curriculum learning competencies on expression of feelings. But even the wording does not refer to any sexuality. It just mentions na para bang ina-acknowledge niya na para sa isang tao normal na magkaroon ng feelings towards each other.

So yun po yung nakita po namin sa 2016 version, which we think connected to the question of the Honorable Hontiveros is germane kung bakit doon sa Puerto Princesa if they were were actually using this version as we appreciate it then it is reasonable to argue now it is compliant with the law 1054 section 14 and also napababa nga nila ang childhood pregnancies.

SRH: Salamat po Mr. Chair at Dr. Domingo and harinawa nga na yung reduction of teenage pregnancy sa Puerto Princesa ay matetrace din in a significant way to the compliance of the CSE, ng Roots of Health, ayon dito sa curriculum of the DepEd. Dahil talagang kinikilala hindi lang dito sa ating bansa, sa ating rehiyon, in many countries all over the world, Singapore, Estonia, UK, etc., etc., na yung CSE ay documented over at least the past three decades na epektibo sa pagprevent at pagpapababa sa rates of teenage pregnancy. Now, just a couple of more questions for Deped at this point. The DOH, if I may, Mr. Chair. The RPRH law requires also the DOH to submit annual reports on the status of its implementation. Ano po ang findings sa latest report ninyo? Kumusta po ang implementasyon hindi lang po in terms of outputs but also in terms of outcomes, Mr. Chair?

Asec. Domingo: Thank you, Mr. Chair. We will submit a copy of the implementation report, but from memory, yung general themes po niya and based also on the data hindi pa natin nararating yung ating mga gusto in particular for example the unmet need for modern family planning is still quite high, paliwanag po natin Mr Chair Honorable Senator Risa, sa ating mga kababayan., pag sinabi pong unmet need for modern family planning, hindi po yan modern artificial lang, mayroon din pong modern natural which is uh culturally and religiously compliant depending on who the provider is discussing. So it involves all scientific, natural, and artificial methods.

And yun pong Modern Family Planning Rates. Hindi pa siya doon sa gusto natin. Right now, the Unmet Need for Modern Family Planning 2023, this is only unmet need and this is only a medyo data po, kasi pag sinabi naming field health service information system, nakacapture lang namin yung sa RHU sa public system, hindi namin nakacapture yung sa private na gysutong magkaroon ng ating calendar method, or rhythm method, or condom or long acting method, hindi nakacapture, kaya pag sinabi ko yung number, huwag po nating i-quote sa media na mababa kasi sasavihin ko 2.98 % in the public sector, repeat, in the public sector. Hindi po namin nakacapture yung mga pumupunta sa botika, sa mga planetary botika, hindi ko sasabihin yung brand, na doon sila bibili kasi hindi po pumapasok yung data dito.

SRH: Understood po, Mr. Chair and lastly for DOH, at this point in time and then if later on you can submit further to the committee through the chair, yung outcomes po. Hindi lang outputs pero yung outcomes na lumabas sa latest report nyo sa RPRH implementation. Ano po yung top indicators na ambag sa adolescent pregnancy? At anong intervention ang naintroduce na ng DOH o planong iintroduce ng department para tugunan or at least address itong factors na ito?

Speaker D: Yes Mr. Chair yung mga factors po dito is young health seeking behavior and pinaka malaki pwede kasing pre pregnancy during pregnancy and post pregnancy but sinabi po nating pre pregnancy yung kaalaman ng ating kabataan. Ano ba ang mekanismo ng reproduction. Importante yan dahil kung alam nila, then mas maaalagaan nila, mas makakalapit sila sa kanilang pastor or sa kanilang guro or sa kanilang kamag-anak na pinakakatiwalaan para makakuha ng tamang impormasyon. At hindi pupunta sa TikTok or kung saan saan social media at kung ano yung makita doon, ah, ganito pala nangyayari. Tapos magugulat nilang sila after that pre-pregnancy act na pupunta sila sa pregnancy. So pagpunta naman sa pregnancy, ano yung health-seeking behaviors ang gusto nating malaman? Gusto nating maintindihan nila. Gusto nating maintindihan ng ating kabataan na ang pagdadalang-tao ay isang sagradong function, no? Whether you look at it both from the religious or also the medical, we hold it as sacred because no one giving birth should actually die. Yan yung hindi ko lang nasabi exact quote eh. But it's an old often repeated still valid quote, sa Tagalog, pag nagpapaanak ka, nagbibigay-buhay ka, hindi ka dapat mamamatay. I'm referring to maternal mortality which is why during pregnancy, the health-seeking behavior nagpapacheck up sila, malalaman, gagamit ng Leopold's maneuver, malalaman ano ba yung fetal position, naka breech ka ba, nakatama ka ba, tama ba yung birth weight estuimated staging etc etc. ikaw ba ay tawag dito yung placent yung placenta mo ba ay nasa tamang lugar baka may placenta previa or others, bigla akong napareview ng OB. Anyway, having after pregnancy, post pregnancy pag nanganak na po, ibang bagay baka nagkaroon siya ng gestational diabetes mellitus or gestational hypertension or baka nagkaroon siya ng postpartum depression which is a mental health condition biologically linked to the child carrying condition of pregnancy na maaaring hindi kaya ng ating batang magulang. So yun po yung mga health seeking behaviors, overview po MR HCAIR HONorable Hontiveros na gusto sana nating maiparating ng tama sa ating mga kabataan,. GTo begin with kasi we still maintain the position hindi sila dapat nabubuntis dahil physically uh para bang capability hindi nila kakayahan ng katawan nila na mabuntis ang maganda ho talaga sa kanila at ikaw connect ko sa national development is mag-aral muna hindi lang to dahil bilang i'm starting to sound like my mom mag-aral ka muna pero there is actually an economic reason and also a health reason dahil kapag nag-aral po sila mas nadedevelop ang kanilang katawan, mas nagiging productive membvers sila, later on ang singil nila sa PhilHealth ay bababa bakit? Kasi alam nila ang tamang health seeking behaviors, alam nila kung paano maging malusog na pamilya so it's all interconnected mr. chair SRH: Thank you, thank you also usec, asec at salamat po, Mr. Chair. Napakahalaga po ng mga ibinahagi so far at bukod sa health seeking behaviors, including saan ba sila humihingi at nakakatanggap ng kaalaman tungkol sa pag-iwas sa teengae pregnancy tungkol sa pag-alaga sa pangkalahatang kalusugan. Salamat sa pagbanggit sa social media dahil bukod sa larangan din yan na dapat sana daluyan ng tamang impormasyon para umiwas sa teenage pregnancy or kahit sa CSE, higit na mas mabuti kung tayong mga magulang at guardians, kung ang mga partner nating mga guro ang gumagabay sa ating mga kabataan. Hindi yung dun lamang sa social media na hindi sigurado na mayroong caring adult supervision or guidance or support. At hindi din lamang sa kanilang mga kababata who may be acting in good faith, pero maaring kulang din or walang or baka maling impormasyon. So mas maigi na through CSE, DepEd and DOH in partnership with the families. And last, but not the least, at this point Mr. Chair, salamat din po sa pagbanggit ng economic dimension ng teenage pregnancy dahil talagang kapag hindi natin natulungan yung mga anak natin ang yung estudyante natin, yung community youth natin na umiwas sa teenage pregnancy, o pag hindi natin natulungan yung mga nabuntis na at nanganak na, na tumindig ulit at itindig ulit ang sarili nila at kanilang mga babies ay talagang nagpapatuloy yung intergenerational na kahirapan yung kawalan ng kakayahan na magtapos sa pag-aaral, kawalan ng kakayanan na makapaghanap ng disenteng trabaho at hanapbuhay. And therefore, kawalan ng kakayahang itaguyod ang sariling pamilya sa tamang panahon. So, marami salamat po para dun sa pagbibigay diin din dun sa economic, dagdag sa health aspects ng teenage pregnancy. Salamat po, Mr. Chair.