Sexual health: The road less traveled

The issue of sexual and reproductive health in rural and indigenous communities is often akin to a road less traveled. Imagine a pregnant woman who had no choice but to traverse dangerous and slippery roads to reach the nearest health center. Or a mother who needs emergency treatment for her sick baby. Indeed, it is not an easy road to take. 

Even health providers also rarely pass these roads. Not because of low commitment to their job, but because there are simply too few of them to cover the number of communities in the remote areas. In rural Southern Philippines, the ratio is usually one nurse for three villages.

The pandemic makes the situation even more challenging. Because of mobility restrictions, nurses were able to visit the villages only once or twice a month. People from these rural and indigenous communities also have to shoulder higher transportation costs as only one passenger can ride the habal-habal or single motorcycles, which often cost a day’s income. While some municipalities have ambulances, these vehicles are usually used for other concerns and are not always available to ferry women to health centers. When patients need medical treatment outside their municipality, they typically cannot afford to pay for the necessary COVID-19 tests and other special permits required to move from one town to another.

These are just some of the challenges women encounter on the road to sexual and reproductive health services. It is no surprise then that cases of home births have increased during the pandemic. Homebirth is actually penalized by law both on the woman and the traditional birth attendant. In the end, weighing the costs and the COVID-19 scare, many might be more willing to pay for the penalty rather than go to health facilities. 

Prevailing gender norms are often about controlling a woman’s sexuality rather than acknowledging her sexual rights and needs, and expecting women to fulfill their role as mothers and caregivers. Hence, if a woman is to have the ability to decide over her body, society must confront social and cultural barriers, such as getting a male partner’s permission or getting parental consent for a young person’s access to contraceptives.

One example is the story of 29-year old Jenmer from the Subanen tribe in Clarin, Misamis Occidental. Her firstborn was not yet one year old when she got pregnant with her second child. She did not know that she has the right to decide on the proper spacing of children. She wanted to avail of family planning methods, but her husband was against it because he had heard rumors that they are harmful to women.  

It is the role of the government to address barriers and forms of discrimination for women to access sexual and reproductive health services. Through the Responsible Parenthood and Reproductive Health (RPRH) law, the government can set the proper road map to sexual and reproductive health, including access to services and comprehensive sexuality education for the youth.   

With the Sexual Health & Empowerment (SHE) Project that the National Rural Women Coalition and other organizations are implementing with support from Oxfam Pilipinas and Global Affairs Canada, new roads are paving the way for women to claim their sexual and reproductive health and rights. Jenmer was among those who attended community conversations of the SHE Project on the importance of women claiming their sexual and reproductive health and rights. With the right information, she convinced her husband on her right to decide over her own body. Before the year 2020 closed, she received an implant, and the new year opened to a better road for her and her family.  

Indeed, empowering women to decide over their bodies is one path that needs building and strengthening. There is no shortcut. It requires trust and safe spaces for women and girls to tell their stories and claim their rights. – Rappler.com

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This article is originally written by Daryl Leyesa, Project Coordinator of Pambansang Koalisyon ng Kababaihan sa Kanayunan, for Rappler, 24 September 2021: https://www.rappler.com/voices/ispeak/opinion-sexual-health-road-less-traveled/