MANILA, Philippines — Dare to Care Alliance, Forum for Population and Development Inc., Medical Action Group, Action for Economic Reforms, Akbayan Citizens' Action Party, and the Commission on Population and Development call on Congress to fund PhilHealth benefits financing contraceptive pills and injectables to address rapid repeat pregnancies. 

The Philippine Statistics Authority reports that the country's total fertility rate stood at 1.7 in 2025, below the replacement level of 2.1 births per woman needed to sustain the population over time. On its own, this suggests the Philippines is undergoing a demographic shift typically associated with more developed economies. But this national average conceals a deeper inequity in the reproductive health of Filipino women and girls, one that a falling fertility rate alone cannot explain.

"A fertility rate of 1.7 might read as the government meeting its family planning goals, but it hides the reality that unmet need for family planning remains stubbornly high among different demographics of women," said Dr. Corazon Raymundo, President of the Forum for Population and Development Inc. "If we are serious about reproductive health, we cannot stop counting once the national average looks favorable."

A closer look reveals who is being left behind

An analysis of the 2022 National Demographic and Health Survey shows that rapid repeat pregnancy (RRP), defined by the World Health Organization as a pregnancy occurring within 24 months of a previous birth, affects nearly 1 out of 4 Filipino women of reproductive age (23%). RRP occurs more often among younger women aged 20 to 24 and among those of lower socioeconomic status.

Unmet need for family planning is a driver of RRP. While unmet need nationally has fallen from 30% in 1993 to 13% in 2025, this progress masks a population left behind: women who already have children report higher unmet need than their childless peers. Specifically, 13% of women of reproductive age with children experience unmet need compared to only 3% of women of reproductive age without children. This stark contrast suggests that once a woman becomes a mother, her ability to space and limit subsequent pregnancies becomes significantly harder to sustain, particularly those who are in the lower education and wealth quintiles. Yet data show that the majority of women want to space and limit childbirth. In practice, this means many mothers know they want to delay or avoid another pregnancy, but face real barriers, whether distance to a facility or simply not having the extra money for contraceptives when the family's other needs come first.

"As many mothers struggle to balance their own health with the immediate needs of their family, we must ensure that access to family planning does not become an additional burden," said Martha de la Paz, convener of Dare to Care Alliance.

Why access remains out of reach

Analysis shows that women experiencing RRP most often seek care at public facilities – rural health units, lying-in clinics, and public hospitals – many of them more than 30 minutes away. Facilities closer to where women live, like retail pharmacies, remain untapped sources of government subsidized family planning commodities.

Financing gaps compound this. PhilHealth currently covers long-acting reversible contraceptives (LARCs) but systematically excludes short-acting methods such as oral contraceptive pills and progestin injectables, despite 2022 NDHS data showing these are what younger women (15-39) actually use: 25% rely on oral contraceptives and 20% on injectables. PhilHealth's benefit package does not currently reflect the preferences of the women most at risk of RRP.

“Every woman—regardless of where she lives, her income, or her life circumstances— should have the information, services, and method of her choice when she needs them,” said Undersecretary Lisa Grace S. Bersales, Ph.D. "Women should be able to fully exercise their reproductive rights. At the Commission on Population and Development, we believe that expanding equitable access to contraceptives is an investment in healthier women, stronger families, and a more productive future of our nation. Every woman deserves the opportunity to plan for her health and well-being.”

An economic issue, not just a health one

Data from the NDHS also shows that mothers who experience RRP are more likely to be unemployed and less likely to have completed secondary education, narrowing their earning potential. If left unaddressed, RRP risks producing a generation less equipped to contribute to the country's workforce and economy. Conversely, access to family planning and proper birth spacing allow parents to provide better care for each child, translating into stronger socioeconomic outcomes for families and, in turn, the nation.

Our call to action

We call on PhilHealth to:

1. Include oral contraceptive pills in the Guaranteed and Accessible Medications for Outpatient Treatment (GAMOT) package. NDHS data show pharmacies are already women's most common source of family planning methods. With their GAMOT package, PhilHealth can provide access to an underused channel for reaching women at risk of RRP.

2. Include oral contraceptives and injectables in the Maternity Care Package (MCP). Women can begin these methods as early as six weeks postpartum. Because MCP providers already have continuous contact with women from antenatal care through delivery, they are uniquely positioned to close the loop on postpartum contraception without requiring an additional facility visit and prevent RRP.

With budget deliberations for the 2027 General Appropriations Act around the corner, we call on Congress to guarantee adequate funding for PhilHealth, including ensuring that sin tax revenues earmarked for health are fully remitted to the agency and that the premiums of indirect contributors are guaranteed by the General Appropriations Act. In this manner, the benefit expansions are not just approved on paper but funded in practice.

"Congress has a critical role in translating policy intent into funded reality," said Rep. Dadah Ismula. "Investments in family planning are investments in the economic future of Filipino women and their families, and the 2027 GAA must reflect that priority."

"We call on the Committee on Appropriations to make funding for the country's social health insurer a firm priority," said Action for Economic Reforms (AER)." Benefit expansions mean nothing if PhilHealth does not have the full resources to deliver them. It is imperative for Congress to close that gap."

As the country celebrates Family Planning Month this August, the theme “Panalo ang Pamilyang Planado!” cannot remain symbolic, but must be matched by concrete investments. The evidence is clear: women remain in need of modern family planning options that fit their realities, delivered through points of care within reach. It is now up to PhilHealth and Congress to meet that need and enable Filipino women and families to win, not just in observance, but in policy and in the 2027 budget.

Contact

Martha de la Paz, MPH | Convener, Dare to Care Alliance+ | martha.delapaz0828@gmail.com

Dare to Care Alliance+

Dare to Care Alliance+ brings together organizations and advocates who care deeply about advancing health and well-being in the Philippines. With a focus on sexual and reproductive health and rights, we support initiatives that listen to communities, respect diversity, and ensure everyone can access the care they need.