Implementation of the international covenant on economic, social and cultural rights

Summary of Presidential Issuances, Total Areas and Total Number of Beneficiaries Per Year

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Summary of Presidential Issuances, Total Areas and Total Number of Beneficiaries Per Year




TOTAL AREA (hectares)






























PP - Presidential Proclamation AO- Administrative Order

EO - Executive Order DOC- Deed of Conveyance NHA & DOH)

MO - Memorandum Order

  1. Of the 96 proclaimed sites, an aggregate area of 26,336.65 hectares have been proclaimed as housing sites which provided security of land tenure to about 195,445 informal-settler families.

  1. The status of the 96 presidential issuances is as follows:

  • 49 sites have signed Implementing Rules and Regulations (IRRs) while 34 sites have completed the final draft and due for signing by the stakeholders; The IRR provide a set of uniform and adequate policies and procedures in implementing laws and Presidential issuances which proclaimed or declared certain government lands open for disposition under any government housing program.

  • 23 proclaimed sites have conducted census and tagging activities;

  • 23 proclaimed areas have undertaken boundary and subdivision surveys;

  • 18 sites have completed beneficiary selection activities; and

  • 14 proclaimed sites have awarded Certificate of Entitlement to Lot Allocations (CELAs) to the qualified beneficiaries.

  1. From 2001 up to the present, a total of 20,378 CELAs have been awarded out of the projected 195,445 CELAs which will be awarded upon the completion of the beneficiary selection activities for the 96 proclaimed sites.

  1. The following are the issues and concerns affecting the implementation of the provision of security of tenure to the intended beneficiaries:

  • Lack of budgetary support for the conduct of census and tagging activities and survey works (boundary, structural and subdivision);

  • Lack of manpower complement- HUDCC does not have physical representation in all proclaimed sites. This is the rationale why there is a need to transfer all HUDCC functions in the proclaimed areas to the NHA, who has sufficient manpower support and logistics to undertake post-proclamation activities;

  • Conflicts among peoples’ organizations within the proclaimed sites;

  • Difficulty in tapping LGU resources to support the implementation of various post-proclamation activities;

  • Land valuation- some proclaimed sites have prohibitive land assessment, e.g. GSIS-property in Sta. Mesa, Manila, wherein the GSIS offered price is P25,000 per square meter which is beyond the affordability level of the intended beneficiaries;

  • Difficulty in preventing the intrusion of informal settlers upon the issuance of the proclamation which makes the conduct of beneficiary selection activities more difficult to implement;

  • Overlapping of boundaries and presence of adverse claimants; and

  • Portions of some proclaimed sites are not suitable for residential purposes

Pag-Ibig Fund Housing Programs
a. Disposition of Real and Other Properties Owned and Acquired (ROPOA)

  1. Through this program, delinquent former owners or successors-in-interest occupying Pag-IBIG Fund foreclosed or acquired properties are given the opportunity to repurchase said properties, in either cash or installment basis. As of August 2006, 1,175 former owners or successors-in-interest have already reacquired their respective properties.

  1. Unoccupied properties, on the other hand, are made available to interested parties through sealed public bidding or negotiated purchase. Discounts are given to the winning bidder or negotiated sale offer or at the rate of 10 per cent for cash purchases and 5 per cent for purchases made through installment or housing loans.

b. Rent-to-Own Program

  1. The Rent-to-Own Program is aimed at providing Pag-IBIG members, whose current income cannot sustain the monthly amortization of a Pag- IBIG housing loan, with a facility that will provide affordable housing, and ensure home ownership by the time they are eligible for such loan.

  1. In this program, unoccupied units acquired by the Fund through foreclosure, dacion en pago, or cancellation of CTS are offered to Pag-IBIG members for lease at a monthly rate of at least PhP1,000, and for a term of at most five years. He/she is required to exercise his/her right to purchase not later than the end of the term of lease. A discount of about 3 to 5 per cent of the purchase price is also granted to the lessee, depending on the year that the option to purchase was availed. Over 7,000 members have already benefited from the program in the six years that it has been implemented.

c. “Magaang Pabahay, Disenteng Buhay” Program

  1. Under the “Magaang Pabahay, Disenteng Buhay” Program, the Fund’s ROPOA are put up for sale, initially to government employees, at reduced rates. Discounts of 15 per cent and 20 per cent are given to interested buyers who will purchase properties through housing loan and through cash payment respectively. An additional discount of 5 per cent is granted to the buyers if the properties they are acquiring are illegally occupied. Buyers who are opting to pay through housing loan enjoy 6 per cent interest rate for the entire term of the loan.

d. “Gabay Pabahay” Program

  1. The “Gabay Pabahay” Program seeks to assist Pag-IBIG borrowers protect their homes from foreclosure or cancellations of the CTS by providing them with the opportunity to restructure their loans with the Fund. A non-interest bearing scheme has been devised to deal with the borrower’s unsettled interest and penalties during the delinquency period. The borrower is also provided with a longer repayment term of 30 years, provided that it does not exceed the difference between his/her age at the time of loan application and age 65.

Program Performance/Accomplishments of Pag-Ibig Fund

  1. The Pag-IBIG Fund is the single biggest home financing institution in the country. As of December 2005, 34.94 per cent of the total accounts financed by different government and private financial institutions equivalent to PhP94.32 billion were generated by the Fund.

  1. The Fund was designed to make housing more affordable to its members. Firstly, interest rates have been reduced on certain loan packages. The loan ceiling on socialized housing has been raised. Borrowers are provided with a longer repayment term. Lastly, the loan-to-collateral ratio has been increased on particular loan packages. From 2001 to 2005, the Fund had extended housing loans amounting to PhP48.625 billion to 142,229 members to finance 141,091 units.

  1. In promoting sustainable source of housing finance as a financial institution, the Fund Housing continuously sustains its liquidity and flow of funds to finance the benefits of its members, as exemplified by 1) Fund Sources- Pag-IBIG Fund generates its funds mainly through membership contributions as well as short-term, housing and institutional loans. Collections from these sources have steadily grown through the years. In fact, it reached a total of PhP184.51 billion from 2001 to 2005 at an average of nearly PhP37 billion annually and 2) Short-term Investments/Borrowings. To supplement the company’s funding requirements, the Fund invests in government securities and other short-term investments, as well as in the flotation of Pag-IBIG Bonds.

  1. Extending private sector participation is an effort to meet the housing needs. The Fund continues to carry out consultations or dialogues with its clients in order to address their issues and concerns about the Fund’s programs, benefits, policies and guidelines.

  1. Earlier this year, the Fund had talks with developers’ organizations on ways to improve the Fund’s housing programs. The most notable outcome of these consultations is the enhancement and liberalization of our housing guidelines such as the Pag-IBIG Fund Circular No. 213 or the Revised Guidelines for the Pag-IBIG Housing Loan Program, and Pag-IBIG Fund Circular No. 212 or the Omnibus Guidelines Implementing the Pag-IBIG Takeout Mechanism under the Developers’ CTS/REM Scheme.

Programs of the National Housing Authority

  1. The NHA-Administered Resettlement Program involves the acquisition of large tracts of raw land to generate lots or core housing units for families displaced from sites earmarked for government infrastructure projects and those occupying danger areas such as waterways, esteros, and railroad tracks.

  1. The relocation of informal settler families living along railroad tracks to designated resettlement areas were undertaken through a beneficiary-led approach such as -- in-city/in-town relocation, formulation of regulations to govern relocation activities by inter-agency committees, direct provision of housing units through serviced lots, self-help construction of houses through the Housing Materials Loan Program, and provision of amenities and livelihood for the resettled families. 41

  1. The Housing Materials Assistance Program is integrated into the Resettlement Program as a component of housing development which will entail the provision of building materials to relocated families for the construction of houses using sweat equity in lieu of a completed housing unit developed by NHA.

  1. The Resettlement Assistance Program for Local Government Units is designed to assist LGUs outside Metro Manila to address the need of informal settlers living in danger areas or those affected by infrastructure projects for resettlement sites implemented as a joint undertaking of the LGU and NHA.

  1. The Slum Upgrading Program entails the acquisition and on-site improvement of occupied lands through the introduction of roads or alleys and basic services such as water and electricity. The issue on land tenure is resolved through the sale of homelots to bonafide occupants.

  1. The Sites and Services Development Program entails the acquisition and development of raw land into serviced homelots which shall serve as an alternative to informal settlements as well as catchment areas for in-migration and population growth. This approach is adopted in urban centers where population growth and overspill are anticipated and where beneficiaries intend to acquire housing on an incremental basis.

  1. The Core Housing Program entails the acquisition and development of raw land as the construction of housing units. This provides serviced lots with core housing designated to match the affordability of the target market consisting mostly of low-salaried government and private sector employees.

  1. The Medium Rise Housing Program is an in-city housing alternative which entails the construction of three-to-five-storey buildings. This is directly implemented by NHA utilizing the allocation for the Program under RA 7835 and units are made available through lease arrangement.

  1. The NHA acts as a conduit between community associations/cooperatives and financing institutions such as the NHMFC, the Home Development Mutual Fund (HDMF) and other government and non-government institutions offering liberalized financing for land acquisition and other forms of grants to people’s organizations.

  1. The NHA likewise extends technical assistance to the community association/cooperative or LGUs in terms of community organization, negotiation with the land owner, preparation of required development plans, formulation of disposition and collection schemes, and coordination with other national government agencies for the processing of required documents.

Accomplishments and Plans

  1. Under Administrative Order No. 111 issued on 04 November 2004, NHA was designated as the lead agency to implement the PNR Rail Systems Relocation and Resettlement Program.

  1. Under the Resettlement Program is the Northrail Project. This involves the relocation of settler families living along the railroad tracks of Metro Manila and Bulacan to make way for the development of a commuter system that will run from Caloocan to Malolos. A total of 21,023 informal settler families from Metro Manila and Bulacan segments were relocated to resettlement areas paving the way for the infrastructure development works for the railway system.

  1. The Resettlement Program also includes the Rail Project that involves the rehabilitation of the existing PNR Commuter Service Line from Caloocan to Alabang which will extend further to the south. A total of 7,404 families along Manila, Makati, and Cabuyao, Laguna segments, have been relocated.

  1. HUDCC and NHA utilized a beneficiary-led approach in relocating the families affected by the rail projects. This is to ensure that the families are given the type of assistance they need during the relocation activity so that proper delivery of housing services is achieved. This approach can be an in-city/in-town relocation approach to minimize dislocation, preparation of development plans to govern the relocation, extension of loans to directly acquire serviced lots from developers, self-help construction of houses through the Housing Materials Loan Program, and the provision of basic facilities and livelihood opportunities to uplift the living standards of the resettled families.

Role of international cooperation in the realization of the right to housing

  1. Official Development Assistance (ODAs) to assist cities/ local government units to improve their capacities in providing essential infrastructure and basic services to their constituents. Such projects constitutes the capability building of city administrators and city planners. Some of the ODAs projects are as follows:

  1. Development of Poor Urban Communities Sector Project (DPUCSP) under the Asian Development Bank. DPUCSP’s objective is to improve access by urban poor communities to secure land tenure, affordable shelter, basic municipal infrastructure and services, and financing for their shelter and livelihood needs. HUDCC is also supported by the Development Bank of the Philippines in this project.

  1. Cities Without Slum Initiative under the Cities Alliance. The project aims to enhance the capability of the community to participate in the preparation of their own shelter strategy. This project specifically targets Millennium Development Goals- in particular those relating to slum upgrading, water supply, health and education; and includes mechanism to ensure gender issues are adequately considered and addressed.

  1. The Metro Manila Urban Services for the Poor Project (MMUSP) under the Asian Development Bank. The project aims to strengthen the capability of local government of Metro Manila to plan and set up their own project for the urban poor and housing.

3 e. Right to adequate clothing

  1. The Philippines is a tropical country with warm weather conditions. The people therefore do not have serious clothing problems. Government intervention lies mostly in the area of regulating the entry of imported cloth and clothing in order to help local manufacturers. The Textile Research Institute is looking into the possible use of indigenous materials for the textile industry. The Department of Social Welfare and Development includes in its assistance programs for the indigent and victims of natural calamities emergency provisions for clothing.

Difficulties encountered

Right to food

  1. There was not much improvement in overall labor productivity in the agriculture sector. Comparative yield, production cost and price data on various agricultural commodities show that the gains posted by the country were hardly apace with those of its neighbors. Thus, the comparative advantage of Philippine agriculture continued to wane resulting in its increasingly becoming a net importer of agricultural products since 1994.

  1. A major reason for this is the higher cost of farm inputs and poor access to recommended packages of technologies. For instance, prices paid for the various fertilizers used by Filipino farmers were nearly double that of the world price. This may be partially due to possible monopolistic pricing since more than half of the supply of fertilizers in the market comes from a single company. There may also be cumbersome as well as inefficient application of regulatory procedures and requirements, thus, inordinately adding to the production and distribution costs of fertilizers. Consequently, there may be a need to evaluate the effectiveness in which the responsible regulatory agencies are overseeing the market for agricultural inputs. Other factors may include inefficiencies in farm inputs logistics systems and the devaluation of the peso. The same situation most likely exists for pesticides and other agricultural chemicals given that they operate within the same regulatory and logistics environment.

  1. In addition, there is limited access to certified high-yielding varieties due to supply and distribution constraints. There are relatively few farmers willing and able to grow certified rice seeds, for instance, partially due to inadequate know-how and skills as well as technical support. As a result, seed cost in the Philippines is higher than in Thailand, Vietnam, India and China.

  1. Another factor is the high post-harvest losses incurred by the country due to inadequate equipment, infrastructure and poor post-harvest handling practices. For instance, although the Philippines has a higher average rice yield than Thailand (3.2MT/ha v. 2.4MT/ha), its rice postharvest loses reach as high as 34 per cent while Thailand’s have been only around 15 per cent.

  1. The sustainability of these modest production and income growths also appears to be uncertain as well. The country’s environment’ and natural resource base, which largely determines the sustainable rate at which agriculture can grow, continue to generally degenerate. Various indicators show that the sustainability of the environment and natural resources continue to be either poor or low.

  1. Moreover, the output and income gains achieved during the period have yet to be translated into significant and commensurate rural sector-wide welfare gains. In spite of the more than a million jobs generated by agriculture from 1999 to 2002, rural unemployment and underemployment continue to be severe as over 1 million and 3 million rural workers remain to be unemployed and underemployed, respectively, every year.

  1. Meanwhile, agricultural extension service delivery as well as communal irrigation development and management were generally disrupted when these were devolved from the national government to the LGUs with the passage of the Local Government Code of 1991. Many LGUs lacked preparation, capacity and funding to effectively take over these functions.

Right to housing

  1. The Philippines continues to urbanize rapidly. Over half of the population is in the urban areas, and this proportion is expected to reach 60 per cent by 2010 if current trends continue. Affordable shelter and land markets have not kept pace with rapid urban growth: more than 40 per cent of urban families have to live in makeshift dwellings in informal settlements. Many of the urban poor living in informal settlements suffer from lack of access to basic services and infrastructure, poor-quality housing, insecure tenure, and high risks to public health. Complicated legal processes for obtaining legal title and the scarcity of urban land further prevent poor urban dwellers from using the necessary capital to rise from poverty, and financial services for the urban poor are virtually nonexistent in the formal sector. Generally, the housing finance system benefits only formal sector employees, and few Government housing programs are effectively targeted to the urban poor communities.

Future directions

  1. The following constitute the policy directions adopted by the Government for the housing sector:

  • Removing Institutional and Structural Distortions in the housing sector;

  • Determine programs that will help augment meager funds for housing, especially for bottom 30 per cent. Including the idea of upgrading of relocations sites as an alternative compliance to balance housing;

  • Put in place a sound housing finance system in the next three years that will serve as backbone for a sustainable housing. Directed the National Home Mortgage Finance Corporation to make sure that secondary mortgage market is being implemented;

  • Social Housing Finance Corporation to provide rational appraisal system in place;

  • National Housing Authority to pursue serious plans on all of NHA’s prime assets and improve its collection efficiency;

  • Housing and Land Use Regulatory Board to keep up with the changing times as far as standards and regulations are concerned; and

  • Pag-ibig Fund to provide the much needed liquidity in the market so that the housing finance engine (including securitization and guaranty) could run efficiently.


  1. Meeting the housing requirements of the informal settlers would entail: (a) scaling up proven multi-stakeholder and cost-effective housing programs; (b) improving the security of tenure of households, improving land registration process, and adopting and developing innovative tenure arrangements to address the affordability factor; (c) relocating informal settlers occupying danger areas in Metro Manila in a just and humane manner; (d) supporting LGUs and private sector-led housing programs; and (e) developing new centers of housing for Luzon, Visayas and Mindanao.

Pursuing an urban asset reform program

  1. In line with the MTDP 2004-2010, an urban asset reform program shall be pursued by providing property rights for informal settlers. This would involve unlocking “dead capital” or lands occupied by informal settlers through the granting of legal rights to the occupied lands. The informal settlers can use the rights to raise capital for micro-enterprises. This approach should be pursued as it provides both security of tenure and livelihood opportunities for slum dwellers.

Promoting sustainable source of housing finance

  1. To promote a sustainable housing finance, the Social Housing Finance Corporation (SHFC) should have adequate capitalization and authorized to enter into loans or issue bonds and other debentures to raise funds for socialized housing construction.

Expanding private sector participation in socialized housing finance and construction

  1. There is an urgent need to expand private sector participation in socialized housing (i.e., housing package below PhP225,000) finance and construction by: (a) establishing an active and liquid secondary mortgage market; (b) fast-tracking disposition of assets and non-performing loans to generate additional funds for housing; (c) rationalizing the subsidy mechanism for socialized housing to remove distortions and leakages; and (d) pursuing strategic linkages with client/sectoral groups, private developers for joint venture arrangements.

  1. The development of the secondary mortgage market is a scheme for fund generation in housing that is long awaited. There is a need to institutionalize an “on-budget” amortization subsidy scheme for socialized scheme to maintain its affordability and which should be kept separate from the housing finance market. Joint venture schemes with the private sector should also be developed for public housing for the informal sector (i.e., nonmembers of HDMF, GSIS and SSS) in government properties proclaimed for housing purposes. These approaches will redefine the role of government in housing finance to ensure a better distribution of responsibilities and risks with the other stakeholders.

Strengthening housing regulation

  1. There is a need to establish Local Housing Boards in every city and municipality. The proposed Local Housing Boards shall formulate, develop, implement and monitor policies on the provision of housing and resettlement areas on the observance of the right of the underprivileged and homeless to a just and humane eviction and demolition.42

Article 12
Question 1. Physical and Mental Health of the Filipinos

Physical Health Status

  1. In terms of general health conditions and survival prospects, Filipino males born in 1970 were expected to live for about 57 years while females were expected to live for about 61 years, on the average. In 1990, life expectancies increased to 62 years for males and 67 years for females. In 1995, these indices were estimated to have increased further to 64.5 years for males and 69.7 for females (NSCB, 1995). Further increase was noted in the following years to an average life expectancy of 68.6 years in 1999.

  1. Large variations in the average life expectancy occur among the different regions of the country. Central Luzon and Southern Tagalog have the highest life expectancy while the ARMM and Eastern Visayas have the lowest.

  1. In 1946, after World War II, the crude birth rate (CBR) was noted at 28.9 per 1,000 population. It went up to 30.5 per 1,000 population the next year and remained stable during the 1950s. The trend decreased in the 1960s, reaching the lowest rate ever recorded in 1972 at 24.8 per 1,000 population. Rates from 1973 to 1979 showed an increasing trend, soaring from 26.1 per 1,000 population in 1973 to a high of 30.7 per 1,000 population in 1979. From the 1980s and through the 1990s a continuous decline of the CBR was noted. The CBR for 1997 is 28.4 per 1,000 population. For 2002, the number has gone down to 25.6 per 1,000 population.

  1. A sharp decline of the crude death rate (CDR) was noted from the 15.1 per 1,000 population recorded in 1946 to the rate of 7.3 per 1,000 population recorded in 1959. From the 1960s until the 1990s, a slow but steady decline in the CDR was noted, form the rate of 7.8 per 1,000 population in 1960 to the rate of 6.1 per 1,000 population recorded in 1997. The recorded CDR remains at 6.1500 per 1,000 population in 2002.

  1. Death rates by age tend to be very high at infancy and early childhood, declining sharply by the age of 10. The rates remain low from this age, begin to climb around at age 40 years and accelerate beyond 50 years and above. In 1993, the mortality rate for males was 5.6 per 1,000 male population while that for females was 3.9 per 1,000 female population. There were more male than female deaths, accounting for a death sex ration of 147 males per 100 females dying.

  1. The total fertility rate (TFR) in 2001 is 3.4 children per woman. This is slightly lower that that TFR between 1995 and 1998, as estimated from the 1998 National Demographic and Health Survey (NDHS), which is 3.7 children per woman. Between 1990-93, TFR was 4.1 children per woman. For 2003, TFR was recorded at 3.5 children per woman.

  1. Infant mortality decline (IMR) slowed down considerably during the 1980s. After a decade of poor performance in mortality reduction, where infant mortality hardly went down, recent estimates suggest that infant and child mortality declined during the period 1990 to 1995. IMR declined from 56.7 per 1,000 live births in 1990 to 48.9 per 1,000 live births in 1995, while child (under five years) mortality declined from 79.4 per 1,000 children under five in 1990 to 66.8 in 1995.

  1. IMR varies with socioeconomic and demographic factors as determined in the 1998 NDHS. Within the 10-year period before the survey, IMR in urban areas was 30.9 while in rural areas it was 40.2. The lowest IMR was in Metro Manila (23.7) followed by Central Luzon (23.6) and Western Visayas (26.0). The three regions with highest IMR are Eastern Visayas (60.8), ARMM (55.1) and CARAGA (53.2). High IMR is noted among infants of mothers with no education, no antenatal and delivery care, and aged below 20 and above 40 years. IMR is also high among male infants, small or very small infants, birth order number seven and above, and previous birth interval below two years.

  1. Based on the reported maternal mortality rate (MMR) in 1970 to 1995, the country’s health situation barely improved unlike in other Southeast Asian countries. The Philippines has an MMR of 190 per 100,000 live births in 1970 and 179.7 in 1995. In 1995, it ranked second to Indonesia with an MMR of 312 to 385 and very far behind Malaysia, Japan and Singapore.

  1. The MMR in 2000 is 170 per 100,000 live births. This is slightly lower that the estimated MMR of 172 per 100,000 live births between 1991-97 as estimated from the 1998 NDHS. The 1993 NDHS estimated MMR at 109 per 100,000 live births in 1987-93. The MMR slightly improved from 209 per 100,00 live births in 1990 to 180 per 100,000 live births in 1995. The MMR was highest in ARMM and Northern Mindanao and lowest in the National Capital Region (NCR) and Southern Tagalog.

  1. Among Filipino women, the lifetime risk of dying from maternal causes is one in 100 (NSO, 1998). Maternal deaths made up less than one per cent of the total deaths in the country, but they contribute 14 per cent of all deaths in women aged 15-49.

  1. The IMR and MMR by provinces show large differentials. For example, in both 1990 and 1995, the top five high mortality provinces had infant mortality rates that were twice as high as the five lowest mortality provinces. Similarly, large maternal mortality differentials by province persist. In 1995, the five highest mortality provinces had maternal mortality rates twice as high as the five lowest mortality provinces.

  1. Although progress has been made in infectious disease control, diseases like pneumonia, tuberculosis, and diarrhea continue to be the leading causes of death of all ages constituting 21 per cent of total deaths. Side by side with the continuing importance of infectious diseases is the increasing importance of chronic diseases as major causes of death. These are the diseases of the heart, diseases of the vascular system and malignant neoplasms, which accounted for over 30 per cent of total reported deaths.

  1. Since the time the first Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) was reported in 1984, the documented HIV/AIDS epidemic has progressed slowly. As of May 2004, according to the HIV/AIDS registry of the National Epidemiology Center, a total of 2,073 HIV/Ab seropositive cases had been detected, of which four (4) per cent were below 19 years old.

  1. HIV infection is found in all regions of the country, although it appears to be concentrated in the urban areas of Luzon, Mindanao, and Visayas Islands. Sexual intercourse remains the predominant mode of transmission, accounting for up to 86 per cent of all infections. Mother-to-child and other modes of transmission, such as via blood and blood products, needle-stick injuries, and injecting drug use, account for smaller per centages of infections

Mental Health Status

  1. The magnitude of mental ill health and disorders is broad, and government resources are limited. The 1980 WHO Collaborative Studies for Extending Mental Care in General Health Care Services showed that 17 per cent of adults and 16 per cent of children who consulted at three health centers in Sampaloc, Manila have health disorders. Depressive reactions in adults and adaptation reaction in children were most frequently found. In Sapang Palay, San Jose Del Monte, Bulacan, the prevalence of adult schizophrenia was 12 cases per 1,000 population in 1988-89.

  1. In a study conducted for Region 6 (Iloilo, Negros Occidental and Antique) in 1993-94, it was found out that the prevalence of the following mental illness in the adult population were: psychosis (4.3 per cent), anxiety (14.3 per cent), panic (5.6 per cent). For the children and adolescent, the tope five most prevalent psychiatric conditions were: enuresis (9.3 per cent), speech and language disorder (3.9 per cent), mental subnormality 93.7 per cent), adaptation reaction (2.4 per cent) and neurotic disorder (1.1 per cent).

  1. According to the DSWD, in 2001 a total of 2,172 mentally retarded persons, psychotic vagrants, and mendicants were placed in appropriate institutions to facilitate their treatment or rehabilitation.

Question 2. National Health Policy

  1. The 1987 Constitution of the Republic of the Philippines ensures the right to health of every Filipino and enunciates the State’s resolve to see to it that this right is exercised and enjoyed by all with priority for the needs of the underprivileged, sick, elderly, women and children.

  1. Following the International Conference on Primary Health in Alma Ata in 1978, the Philippines crafted a primary health care strategy program anchored on the delivery of priority health care services.

  1. In 1993, the government’s commitment to PHC was underscored with the issuance of DOH Administrative Order No. 11, Series of 1993. AO 11, s. 1993, upheld PHC as the core strategy in the government’s health program. The DOH’s Community Health Service was given the prime responsibility in the implementation of the PHC Approach.

  1. Some significant milestones in the country’s public health care system in the past 25 years are: adoption of PHC Approach in 1979; implementation of a national health policy along PHC lines in 1981; integration of public health and hospital services in 1983 as per EO 851; re-organization of the DOH in 1987 in accordance with EO 199; and the devolution of health services in 1992 to local government units as mandated by the RA 7160.

  1. Of particular interest is RA 7160 which mandates that delivery of basic services and the operation and maintenance of local health facilities be devolved to LGUs consisting of provinces, cities and municipalities. Each local government unit is responsible for a minimum set of health services and facilities in accordance with established national policies, guidelines and standards. The devolution of health services conferred to the local government several major functions which were originally lies with the DOH.43

  1. While the delivery of basic health services has been devolved to local government units, the DOH continues as the lead agency for the health sector and convenor of all stakeholders to ensure strong collaboration for health promotion and disease prevention and control. Through the DOH, the government formulates and enforces national health policies, standards and regulations.

  1. In 1999, the DOH took a bold step towards improving the performance of the health sector by improving the way health services are being provided and financed. This program of change, known popularly as the Health Sector Reform Agenda, (HSRA) identifies five major reforms – (a) provide fiscal autonomy to government hospitals; (b) secure funding for priority public health programs; (c) promote the development of local health systems and ensure its effective performance; (d) strengthen the capacities of health regulatory agencies; and (e) expand the coverage of the National Health Insurance Program (NHIP).44

  1. In 1992, as a response to the growing HIV/AIDS endemic, the Government, through EO 39, created the Philippine National AIDS Council (PNAC). EO 39 mandated the PNAC to "advise the President of the Republic of the Philippines regarding policy development for the prevention and control of AIDS x x x x" PNAC also serves as a venue for intensive policy discussion between government and NGOs in policy development.

  1. Other legislative and executive issuances on health are summarized below:

  1. Republic Act No. 6675, Generics Act of 1988, decrees and requires the use of generic terminology in the importation, manufacture, distribution, marketing, advertising and promotion, prescription and dispensing of drugs.

  1. Republic Act No. 6972, Barangay Health Total Development and Protection of Children Act, stipulates a referral and health care system at the village level for pregnant mothers, delivery of infants, and neonatal care.

  1. Republic Act No. 7305, otherwise known as Magna Carta of Public Health Workers, aims to: (a) promote and improve the social and economic well-being of the health workers, their living and working conditions and terms of employment; (b) develop their skills and capabilities in order that they will be more responsive and better equipped to deliver health projects and programs; and (c) encourage those with proper qualifications and excellent abilities to join and remain in government service.

  1. Republic Act No. 7600, otherwise known as Rooming-In and Breastfeeding Act, stresses the provision of safe and adequate nutrition of infants through the promotion of rooming-in and breastfeeding of the newborn.

  1. Republic Act No. 7719, otherwise known as the National Blood Services Act of 1994, provides for the establishment of blood services network and aims to instill public consciousness of the principle that blood donation is a humanitarian act through a nationwide public awareness campaign.

  1. Republic Act No. 7846 amends PD 996 and requires compulsory immunization against Hepatitis B for infants in addition to the basic immunization services which include BCG against tuberculosis; diphtheria, tetanus, pertussis, vaccination; oral polio vaccine against poliomyelitis; and immunization against measles and rubella.

  1. Republic Act No. 7875, otherwise known as the National Health Insurance Act of 1995, endeavors to provide all Filipinos with a mechanism to gain access to health services, especially that segment of the population who cannot afford such services. The law provides for the creation of the NHIP which would serve as the means to help people pay for health care services. The Program aims to give the highest priority to achieving coverage of the entire population with at least a basic minimum package of health insurance benefits.

  1. Republic Act No. 7883, otherwise known as the Barangay Health Workers’ Benefits and Incentives Act of 1995, recognizes the Primary Health Care Approach as the major strategy towards health empowerment. The law emphasizes the need to provide accessible and acceptable health services through participatory strategies such as health education, training of barangay health workers, community building and organizing.

  1. Republic Act No. 8172, otherwise known as the Salt Iodization Nationwide Act, provides for the mandatory fortification of all human-grade salt with iodine. The full implementation of the law promises to reduce significantly pregnancy wastage as well as the risk of children from being born with lower IQ points or with physical and mental abnormalities and disabilities.

  1. Republic Act No. 8191 provides for the creation of the National Commission on Diabetes in pursuance of the government’s efforts to prevent and control diabetes mellitus in the Philippines.

  1. Republic Act No. 8203, otherwise known as Special Law on Counterfeit Drugs, seeks to safeguard the health of the people by protecting them against counterfeit drugs.

  1. Republic Act No. 8423, otherwise known as the Traditional and Alternative Medicine Act of 1997, encourages the development of traditional and alternative health care. The law seeks the integration of traditional and alternative medicine into the national health care delivery system.

  1. Republic Act 8504, otherwise known as the Philippine AIDS Prevention and Control Act of 1998, is the centerpiece of the national response to HIV/AIDS. Hailed as a landmark legislation, the law is often described as path-breaking for it prohibits mandatory testing of HIV; respects human rights including the right to privacy of individuals living with HIV/AIDS; integrates HIV/AIDS education in schools; prohibits discrimination against people living with HIV/AIDS in the workplace and elsewhere; and provides for basic health and social services for individuals with HIV.

  1. Republic Act No. 8749, otherwise known as the Clean Air Act of 1999, is a milestone piece of legislation that collects scattered rules and regulations on air quality and collates them into a single law. It contains stringent standards for ambient and source emissions, also known as technology-forcing standards.

  1. Republic Act No. 8976, or the Food Fortification Act, compensates for the nutritional inadequacies of the Filipino diet, which are more pronounced among young children. The law provides for the mandatory fortification of staples, i.e., rice with iron, flour with iron and vitamin A, sugar and cooking oil with any combination of vitamin A, iron or iodine.

  1. Republic Act No. 9211, otherwise known as the Tobacco Regulation Act of 2003, regulates the use, sale and advertisements of tobacco products in order to promote a healthful environment for the people.

  1. Republic Act No. 9334 has provisions which mandate the earmarking of the 2.5 per cent incremental revenue derived from the excise taxes imposed on alcohol and tobacco products to disease prevention and control programs of the DOH. Further, the aforesaid law further provides for the earmarking of 2.5 per cent of the incremental revenue to the PHIC.

  1. Executive Order No. 205 mandates the DOH and the DILG to form a national health planning committee and inter-local health zones throughout the country.

  1. As per EO 286, entitled Directing National Government Agencies and Other Concerned Agencies to Actively Support and Implement the Programs on the “Bright Child,” child-focused programs of the DOH, DSWD, and DepEd are promoted under one brand. The brand will be called the “bright child”. Pursuant to this order, immunization, nutrition, breastfeeding, day-care, pre-school and school programs were integrated under a label that gave families a better appreciation for all the requirements needed to raise a bright child – physical, emotional, social, educational.

  1. Jurisprudence which illustrates the right of the people to enforce their right to health are provided below – 45

  • Pollution Adjudication Board v. Court of Appeals, G.R. No. 93891, 11 March 1991

  • Rodriguez, Jr. v. Intermediate Appellate Court, G.R. No. 74816, 17 March 1987

  • Oposa v. Factoran, G.R. No. 101083, 30 July 1993

Question No. 3. Budget for Health Care

  1. For 2005, the total programmed appropriation for health is P9.8 billion. The aforesaid budgetary allocation is PhP154 million lower than that allocated in 2003. The 2003 budget is in turn lower than that provided for in 2002. In 2002, of the 781 billion-peso national budget, PhP14.5 billion pesos, or two (2) per cent of the total budget was allocated for health services.

  1. In 1997, DOH had a total appropriation of PhP11 billion. This appropriation was 18.47 per cent higher than that given in 1996 and represented 15.58 per cent of the social sector budget and 2.54 per cent of national total budget. However, this is only 0.43 per cent of the Gross National Product (GNP) of the same year at current prices. DOH ranked 6th among all other Government agencies in terms of its share of national budget.

  1. An annual average of 2.36 per cent of national government budget was allocated to the DOH during the period 1993 to 1997 which was lower than the 5.37 per cent of national government budget during 1988 to 1992. The reduction of the DOH share of the national government budget was due to the devolution of basic health care service delivery to the local government units, which was mandated by the Local Government Code.

Question 4.a. Infant Mortality Rate

  1. Data from various sources indicate a declining trend of IMR in the country. The 1998 NDHS estimated the IMR at 45.3 in 1985, 36.8 in 1990, and 35.3 in 1995. IMR slightly dropped from 57 in 1990 to 49 in 1995 as reported by NSCB. In the 1998 NDHS, IMRs was 35 per 1,000 births, while the neonatal death rate was 18 deaths per 1,000 live births. In 2001, IMRs was reported at 29 per 1,000 births.

  1. Live births in 2002 totaled 866,521 males and 800,252 females. Of these data, infant deaths numbered 13,955 males and 9,868 females. There are more deaths among males than among females.

  1. IMR varies with socioeconomic and demographic factors as determined in the 1998 NDHS. Within the 10-year period before the survey, IMR in urban areas was 30.9 while in rural areas it was 40.2. The lowest IMR was in Metro Manila (23.7) followed by Central Luzon (23.6) and Western Visayas (26.0). The three regions with highest IMR are Eastern Visayas (60.8), ARMM (55.1) and CARAGA (53.2).

  1. The 2003 NDHS indicates that mortality rates in urban areas still remain much lower than those is rural areas. Infant mortality rate in urban areas, for example, is 24 death per 1,000 live births compared with 36 deaths per 1,000 live births in rural areas.

4.b. Population access to safe water

  1. From 1960 to the present, there has been a significant increase in households with access to safe water at average rate of 2 per cent increase yearly. About 87 per cent of the total households have access to safe water supplies with 91 per cent of households in urban areas and 71 per cent of households in rural areas (NHDS, 1998). Drinking water supplies come from Level 1 (39 per cent), Level II (18 per cent), Level III (30 per cent) and doubtful sources (13 per cent).

  1. Water is distributed through the Manila Waterworks and Sewerage System and the water concessions in Metro Manila, the water districts, the LGUs, the cooperatives, the private sector and bulk water supplier. The reach of these systems, however, are limited and many Filipinos still do not have access to water that is clean and affordable.

  1. Access is greater in the urban areas at 87.2 per cent in 1998, compared with only 69.8 per cent in the rural areas. Moreover, access is 58 per cent for the poorest decile and 93 per cent for the richest decile of the population.

  1. A baseline study under the Urban Health and Nutrition Project in 1995 showed that the majority (72 per cent) of households among slum dwellers have access to piped water or tube wells. However, 36 per cent of the water were contaminated at the point of consumption that it had been at source (17 per cent). This was due to improper transport, handling and storage of drinking water.

4.c. Population Access to Adequate Excrete Disposal Facilities

  1. In 1998, about 19 per cent of households or 2.3 million households did not have access to sanitary toilet facilities. Around 92.3 per cent of the population had access to sanitary toilets compared to 69.8 per cent in the rural communities (NDHS). Among poor families, 67.4 per cent have access, while non-poor families have greater access at 89.4 per cent.

  1. It is also estimated that only about seven per cent of the population are connected to sewer. Access to sanitary toilet facility, either household or public toilet, remains a problem. According to the 1995 Urban Health and Nutrition Baseline Studies, some reasons for not having a toilet were lack of space and money to build one.

  1. For Metropolitan Manila, data for 2006 indicate that about eight per cent of its total population have access to sewerage facilities. This represents a total of 99,400 sewer service connections. The rest of the population is served by on-site sanitation. Majority of these households have toilets that are connected to septic tanks which provide primary treatment.

4.d. Infants immunized against diphtheria, pertussis, tetanus, measles, poliomyelitis and tuberculosis

  1. The Expanded Programme on Immunization began in 1976. Oral polio vaccine and tetanus were added in 1980 and measles in 1982. Twice yearly mass campaigns were held from 1977-1983. This was increased to four times yearly in 1984. At about the same time, clinic-based year-round delivery expanded gradually. The coverage rates for 1986 are as follows: BCG-51 per cent, DPT3-32 per cent, OPV3-37 per cent and measles-40 per cent. As a result, among children under five (5) years of age, incidence of all six diseases fell, especially polio, which fell down to 83 per cent, when compared with the per centage in 1980. Measles fell down to 20 per cent since 1982.

  1. In 1993, the Philippines achieved its highest level of coverage for Fully Immunized Child (FIC) at 91 per cent. This has declined to 86 per cent in 1995, possibly as a result of the devolution of health services to local government units. The coverage for FIC improved to 90 per cent coverage in 1996 and 1997.

  1. Immunization coverage in 2003 is higher for children living in urban areas than for those in rural areas (74 and 65 per cent, respectively). Slightly more females (71.3 per cent) received complete vaccinations than males (68.4 per cent).

  1. The Philippines was declared polio-free during the Kyoto meeting on Poliomyelitis Eradication in the Western Pacific Region in October 2000. Despite this, the Philippines remains vigilant in protecting its citizens from risks of acquiring poliovirus from other countries. Measures for sustained vigilance include strengthening of the surveillance system and capacity for rapid response to outside contamination, adequate laboratory containment of wild poliovirus and continuing routine immunization until global certification is achieved.

  1. The Polio Patak Campaign in 2002 immunized 12 million children twice over during the months of February and March. This campaign was designed to suppress the spread of the vaccine-derived poliovirus, which emerged when polio immunization rates dropped in the previous two years.

  1. The Measles Elimination Campaign dubbed Ligtas Tigdas drastically brought down the number of outbreaks and measles cases to the lowest level compared with previous years. The campaign achieved a high coverage of almost 95 per cent measles immunization among the nine months up to 15 years of age.

  1. The Follow-up Measles Immunization Campaign in February 2004 targeted 18 million children, aged 9 months to less than 8 years old. Ninety five per cent of target population was immunized.

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