Philippines: Lack of services fuels teen pregnancy

Lack of services and information about adolescent reproductive health are fuelling the rise of teen pregnancies and hurting child survival rates, according to health experts.

"Teenage pregnancy is becoming a great problem in the country. These young mothers are unable to give quality care to their babies, hence these babies usually are sickly and malnourished," Jacqueline Kitong, reproductive health adviser in the Philippines for the UN Population Fund (UNFPA), told IRIN.

Children born of a teenage mother have a 50 percent higher risk of dying than those whose mothers are older, according to the World Health Organization.

About one-third of all pregnancies in the Philippines occur between the ages of 15 and 24, said Kitong. By age 20, about 25 percent of all women of childbearing age have children or are pregnant, according to the most recent government Young Adult Fertility and Sexuality studyfrom 2002.

Childbearing in this age group boosts the risk of infant and child mortality as well as maternal mortality and sickness, according to the government's most recent nationwide health survey in 2008.
 
As a woman's level of formal education and income rises, so do her child's chances of survival; the under-five mortality rate for children of mothers with no education was 136 deaths per 1,000 live births, versus 18 deaths per 1,000 live births for children whose mothers were university educated.

One-third of the women who have had a child before age 18 belong to the poorest quintile, compared with only 6 percent of richer women, noted the World Bank in a 2011 reproductive health survey.

The mother's age also played a role, with under-five mortality rates higher among those aged 20 or younger as well as those aged 40-49.

Myths

Kitong said the problem lay in not addressing adolescents' basic health questions.

"There is poor, inadequate and suppressed awareness on fertility, adolescent sexuality and development. Some of them don't even know why they got pregnant because they don't know how their body works," said Kitong.

"A lot of the girls who come in to see us say they want to try family planning methods, but only after having their first child," said Ami Evangelista-Swanepol, executive director of a public health clinic serving women and children in the country's southern island of Palwan. "Like birth control is an afterthought."

Now 19 years old, Jenny* gave birth to her first child at 16. When asked about family planning or birth control, she looked up blankly and asked: "Isn't that just for married people?" She lives with but is not married to the children's father.

According to 2006 data from the US-based reproductive health think-tank, Guttmacher Institute, there are an estimated 3.1 million pregnancies every year in the Philippines.

About 15 percent, or about 473,000, end in illegal abortions.

In 2006, a sex education programme starting at the primary school level introduced by the Education Department and UNFPA was met with outrage by the Catholic church.

"We started the programme at the grade four level because it is at that age that some girls start to menstruate. The curriculum was more focused on development strategies to cope with the changes their body is undergoing," explained Kitong.

While the programme was implemented in a number of test sites, a planned nationwide roll-out to all primary schools was halted.

*Not her real name