COVID-19 Response: Building a better normal through the PHE approach

More than 50 days after the initial implementation of Enhanced Community Quarantine (ECQ) in Luzon and several areas of Visayas and Mindanao, the Philippine government has decided to extend the ECQ with modification (MECQ) in Metro Manila, Laguna, and Cebu City, while other areas that are moderate- to low-risk have been placed under General Community Quarantine (GCQ) and Modified GCQ.  Under ECQ, strict stay-at-home rules were implemented, mass public transportation services suspended, as well as non-essential businesses.

Photo from the Business Mirror

Photo from the Business Mirror

The MECQ has softened the rules a little bit, but most sectors of society remain closed. Only selected manufacturing and processing plants resumed operations while transportation and movement are still limited to essential goods and services.  Meanwhile, GCQ allowed government offices, industries, and public transport services to resume operations given that they strictly follow health protocols such as wearing masks, taking of body temperature, and physical distancing. On the other hand, guidelines on the implementation of Modified GCQ is yet to be released.

Overall, it is still too early to claim that community quarantine can be lifted in the Philippines especially since the ‘progressive’ mass testing of the Department of Health only started on April 14 and we are far from flattening the curve. Since the implementation of ‘progressive’ mass testing, less than one percent (1%) of the Philippines’ 106 million population has been tested. Mass testing is the key to flattening the curve. Without testing, we cannot isolate and treat individuals infected by COVID-19. Health experts warn that prematurely lifting community quarantine can pave the way for the second wave of infection.

While we continue our efforts to flatten the curve, there is also a need to prepare and plan for the “better normal” that we need to have once this pandemic is over. There is no going backward or indefinitely staying in this transition between the old and new normal. As the COVID-19 pandemic continues to challenge the country's healthcare systems, it has also brought into the spotlight pre-existing problems in our environment and society such as poverty, inequality, and weak human rights protections. It is only necessary that our path forward is towards better normal that will also address the root causes of our environmental and societal problems.

Population, Health, and Environment as a Development Approach

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The “Population, Health and Environment” (PHE) approach can be our light in this path. As a community development approach, PHE highlights the interconnectedness between people and their environment as well as the need for multisectoral collaboration and coordination.[1] The COVID-19 pandemic is continuing to teach us that the human population and the environment are linked. The human population affects the environment and in turn, the environment also affects the human population. As humans continue to clear forests for agriculture and natural resource extraction, environmental degradation becomes apparent and humans become more and more exposed to pathogens and viruses. Rapid population growth also puts unsustainable pressure on the environment as human consumption and the need for space continuously increase.

The PHE approach encourages and supports multisectoral collaboration and coordination, even among those outside of the population, health, and environment fields. Family planning and reproductive health, particularly HIV/AIDS, are the focus of population projects under the PHE approach. Health includes water, sanitation, malaria prevention, and child health projects. Environmental projects focus on biodiversity conservation and natural resource management, particularly in agriculture and fisheries. PHE can also work in the areas of development, poverty, and gender equity, among others. Multisectoral collaboration and coordination yield high-impact results, with more efficient implementation, because resources are pooled to achieve integrated PHE objectives, and the deep-rooted causes of problems are addressed.

PHE Success: Integration, Collaboration, and Community Empowerment

In 2001, PATH Foundation together with local government units (LGUs) and non-government organizations, implemented the flagship PHE project in the Philippines called the Integrated Population and Coastal Resource Management (IPOPCORM) Initiative. The project integrated the "human dimension in coastal conservation programs through the implementation of reproductive health/family planning activities and coastal resource management"[2] to address the rapid population growth and migration to coastal areas that affected the coastal ecosystems' biodiversity and productivity. The project garnered plenty of lessons and best practices that are being replicated by international PHE networks. One of these is encouraging youth involvement that regards the youth as beneficiaries and partners in project implementation, especially in advocating reproductive health/family planning and coastal-resource management programs and activities to their peers and family.

IPOPCORM also faced challenges in its implementation, for example in the lack of national policies on reproductive health and family planning at the time, and the strong opposition of influential church groups to contraception. Republic Act 10354 or the Responsible Parenthood and Reproductive Health (RPRH) Act was signed into law only in 2012 after being stuck in the Congress for 14 years.[3] Despite these challenges, IPOPCORM, through its partner LGUs, was able to organize and mobilize communities to work towards the objectives of the project and PHE integration. Community participation and behavioral change towards reproductive health and family planning sealed the project’s success.

Photo by Dennis M. Sabangan / EPA

Photo by Dennis M. Sabangan / EPA

The Local Government Code of 1991 provided the policy structure that empowered LGUs in local development planning and implementation of IPOPCORM. Similarly, empowered and highly-competent local governments have been paving the way for effective and efficient response amidst the COVID-19 crisis. The cities of Pasig and Valenzuela have stepped up in organizing their stakeholders and partners to address COVID-19 infections within their jurisdictions. Pasig City has taken this further as the city government decided to give financial assistance to around 150,000 families that were not covered by the national government’s Social Amelioration Program.[4] LGUs have also been sharing their best practices in providing accessible healthcare services and financial assistance to their constituents as well as in ensuring food security.

Mainstreaming and Popularizing the PHE Approach

The PHE approach gives us hope for a better normal. Now that a national reproductive health and family planning policy is in place, alongside a myriad of environmental laws, policymakers can actively use these to advocate for PHE integration in future policymaking, planning, and implementation.

Policymakers and LGUs also have the support of non-government organizations including the Philippines’ PHE Network, a diverse and dynamic network of organizations and individuals advocating for the integration of the PHE approach. Currently, the Network is conducting national and local policy workshops that advocate for the adoption of an integrated PHE approach. It further aims to increase the commitment of policymakers in pursuing a multisectoral approach and PHE policy change at both the national and local levels.

In October of 2019, the PHE Network conducted a workshop to discuss policy gaps and challenges on population, health, and environment in the development of a national policy agenda. The gains and challenges in the implementation of the RPRH Act were discussed during the workshop together with the National Climate Change Action Plan 2011-2028. Dr. Juan Antonio Perez II, MPH, Undersecretary of the Commission on Population and Development (POPCOM), and Dr. Esperanza Cabral, former DOH Secretary and Health Care Without Harm-Asia Chairperson, emphasized the linkages between adolescents’ reproductive health to population and development.

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Founded in 2000, the PHE Network envisions an equitable society of empowered and resilient communities living in a healthy environment. It is currently under the leadership of the Commission on Population and Development (POPCOM) and the Philippine Business for Social Progress (PBSP). To know more about the Network and its activities, you may visit their Facebook page at www.facebook.com/phe.network.philippines.

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COVID, Population, HealthSophia Caraldesophia, COVID-19, Population, Health