Sowing Seeds of Sexual Health in the Philippines

In Palawan and across the Philippine archipelago, common myths such as “jumping up and down after sex prevents pregnancy” elucidates how pervasive misinformation surrounding sexual and reproductive health continues to be. 

Amina Evangelista Swanepoel and her mother Dr. Susan Evangelista began Roots of Health when Susan, a university professor at Palawan State University in the Philippines, grew increasingly disturbed by the high number of young women dropping out of university due to unplanned pregnancies. Amina noted, “They seemed completely surprised to be pregnant despite the fact that they were having unprotected sex.”   

Teen pregnancies and HIV, two of the most pressing issues in the Philippines, are shrouded in stigma. According to UNFPA, the Philippines has one of the highest teenage pregnancy rates among the ASEAN member states — more than 500 adolescents are becoming pregnant and giving birth every day. 

Amina’s mother had the idea to create a comprehensive sexual education program to improve the health of women and girls in Puerto Princesa and across the province by focusing on the basics — how pregnancies happen and how contraception works. Amina has a background in population and family health, so she decided to join forces with her mother on this mission.  

Since its inception in 2009, Roots of Health (ROH) has taught more than 85,000 young people comprehensive sex education; dispensed over 86,000 units of modern method contraceptives (pills, injectables, implants, and IUDs) to nearly 66,000 women and girls; and cared for over 3,400 pregnant women and girls, ensuring better pregnancy and childbirth outcomes (Roots of Health Impact Report). 

Combating Stigma – Scaling Deep  

Conservatism has a strong grip on social norms in the Philippines, rendering topics such as sex and sexuality unspeakable and promoting “abstinence-only” approaches. Additionally, the Catholic Church has a long history of spreading misinformation surrounding contraceptives in the Philippines, claiming they cause cancer and a slew of other health issues.   

“There’s a huge swath of the population that believes contraception is the same as abortion. So there’s just a lot of problems because of the fact that so many people don’t have the correct knowledge and information about their bodies, about sexuality, about how pregnancy happens, and about how contraception works,” Amina explained. 

The shaming surrounding pre-marital sex is so pervasive that most women don’t want to admit to even themselves that they might have sex before marriage until they suddenly do. 

According to Amina, “We’re trying to change the norms to make it less of a taboo topic so that people talk about it and are a little bit more realistic.” 

Education on Empathy 

In response, Roots of Health harnesses the power of education to address this issue head-on. Critics argue that when topics surrounding sexual education are spoken about, it encourages people to have sex. In reality, silence leads to many young people engaging in behavior that can be dangerous and have serious, life-long effects, like contracting STIs and having unplanned pregnancies. 

Through school-based programs and teacher training, Roots of Health has reached 15,000-20,000 students per year who learn about sexual and reproductive health “through empathetic, scientific, and needs-based lessons that our teachers provide to high school and college students.” Additionally, ROH has trained 169 teachers and school heads throughout Palawan, providing them with modules that can be easily incorporated into their lesson plans. (Impact Report).  

Amina observed that the older a participant is during the teacher or healthcare training, the more judgemental and critical they can be. Through activities, they try to push participants into a different frame of mind. During one game, participants organize themselves, without speaking to each other, by the time they first did something like having their first crush, kiss, or boyfriend.  

Amina explained, “We believe it is helpful to remind older people of what it’s like when you’re younger and to remind them of the things they felt and what they did when they experienced these firsts.” 

Beyond formal lessons in schools or through trainings, ROH also focuses on building a network of peer educators who provide fellow young people with information around these topics, as they are often difficult to discuss with adults.  

Growth Through Collaboration – Scaling Out  

Roots of Health’s success relies on building relationships and partnerships with stakeholders from individual provinces, so Amina believes that the best way to scale out will be to position the organization as a training center. This would allow any other provincial government or organization to replicate ROH’s work in their own provinces and hire Roots of Health to train them on how to conduct programs and services and build from their own communities. 

Amina maintained, “we have always been very open and collaborative, always sharing our training modules. Our hope is to become more well known so more people hear about our work and see the data and impact we have had so that other provinces will notice and decide that they want that as well.” 

Due to the high number of small, rural, and hard-to-reach communities in Palawan, not everyone can access their clinics. So, Roots of Health comes to them on contraceptive missions, administering long-lasting but reversible contraceptive methods like implants and IUDs.  

Strengthening Systems to Scale Up  

HIV rates and teen pregnancies have continued to rise in the Philippines despite the passing of the Responsible Parenthood and Reproductive Health Act of 2012, which “guarantees” universal access to methods on contraception, fertility control, sexual education, and maternal care. Since towns in the Philippines are figuratively and literally islands, and the responsibility of implementation falls on fragmented local leadership, these guarantees have not come to fruition.  

Amina remarked, “The Philippines has a ton of really great laws — the problem is always with their implementation.” 

As the only reproductive health organization in Palawan, ROH is well-positioned to institutionalize reproductive health education and services and push for enforcement through a mix of legislative support, trainings, and mentoring for stakeholders across communities.  

Another mechanism of improving reproductive health is through Municipal Implementation Teams, which are involved in local-level legislation discussions to ensure that existing RH programs are enforced. This includes identifying and engaging all stakeholders in local governments such as the health boards, department of education, and elected officials to train them on issues of adolescent health issues that extend to budgeting, healthcare staff, and teachers.  

Looking Forward 

Roots of Health’s pillars of education, services, and systems collude to tackle the visible and invisible effects of misinformation and stigma surrounding sexual and reproductive health.  

In 2020 alone, 18,383 women and girls were provided with their contraceptive of choice, ensuring that they do not have an unplanned pregnancy; over 75 pregnant women and girls were supported, 2,859 prenatal checkups occurred, and 189 clients screened for HIV. Harnessing the power of social media, ROH reached a total of 3.6 million social media users with information on reproductive health and answered 12,577 questions about reproductive health received on their clinic pages. 

Roots of Health’s holistic strategy for framework change is working: over the past ten years, teenage pregnancies in Palawan have decreased by a third.