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MANILA (Reuters) - Philippine President Benigno Aquino is squaring off against his country's powerful Catholic church in a bid to give people free access to the means to limit the size of their families.
The predominately Catholic country has one of Asia's fastest-growing populations together with significant levels of chronic poverty. While neighbors have accelerated towards prosperity, the Philippines has lagged.
Economists say high population growth is a primary factor for that, but the church disagrees. It says population growth is not a cause of poverty and that people need jobs, not contraception.
Aquino, a Catholic like 80 percent of the population, has thrown his support behind a reproductive health bill that will, if passed by the two houses of Congress, guarantee access to free birth control and promote sex education.
That's something that Liza Cabiya-an might have benefited from, if she'd had the opportunity.
Cabiya-an, 39, has 14 children. The oldest is 22, the youngest just 11 months. Their home is a hut in a Manila slum.
"It's tough when you have so many children," said Cabiya-an, a shy smile revealing poor teeth. "I have to count them before I go to sleep to make sure no one's missing."
At one time Cabiya-an had access to contraception but Manila mayor Jose Atienza, a devout Catholic, swept contraceptives from the shelves of city-run clinics in 2000.
After that, Cabiya-an's efforts to limit the size of her family were patchy, restricted by her meagre resources. She went on and off the pill and resorted to an illegal abortion more than once.
With income of about 7,600 pesos ($180) a month from doing laundry and her husband's pay as a laborer, Cabiya-an has only been able to send five of her children to school. The others would appear doomed to join the quarter of the country's 95 million people stuck below the poverty line.
Contraceptives are generally available in the Philippines although they are not used as much as elsewhere.
In the Philippines, 45-50 percent of women of reproductive age, or their partners, are using a contraceptive method at any given time. Indonesia's rate is 56 percent and Thailand's 80 percent.
Population growth mirrors that. The Philippines population is increasing by 1.9 percent a year, while Indonesia's is 1.2 percent and Thailand's is 0.9 percent. China's population is growing at an annual rate of 0.6 percent.
"If you increase access to contraceptives for women ... you will have births averted," said Josefina Natividad, director of the University of the Philippines' Population Institute.
Though available in most places, the cost of contraceptives is prohibitive for many people. But that should change if the reproductive health bill is passed.
Aquino's government has promised what it calls inclusive growth and it sees slowing population growth as key to that.
"The president has already, at the risk of alienating the church, declared that the bill is a priority," Budget Secretary Florencio Abad said. "That message is very clear."
But it's a message the church doesn't like.
It says artificial contraception is immoral, and the bill will pave the way to legalizing abortion. The bill does not legalize abortion though it seeks to improve care for women suffering from complications after an illegal abortion.
The church says people should use natural family planning.
It says poverty is a cause, not effect, of a high birth rate. Children are being born into homes without enough food to eat because of the government's failure to end corruption and provide jobs, the bishops say.
"It's our firm belief that contraceptives will never be the answer," said Father Melvin Castro, executive secretary of the Catholic Bishops Conference of the Philippines' Episcopal Commission on Family and Life.
"They are poor not because they have no access to contraceptives but because they have no work. Give them work and it will be the most effective birth spacing means for them."
Economists say the church's persistent opposition has been the most important factor influencing population policy.
"The state ... has been immobilized from effectively addressing the issue by the Catholic hierarchy's hardline position," a group of 30 economists from the University of the Philippines said in a recent paper.
But despite the arguments of the church and political opponents who decry using state funds to finance contraception, a poll last year showed about 70 percent of people support the bill. Its backers want it passed during the term of this congress, which ends in June.
Economists say if the Philippines is ever to take advantage of a "demographic dividend", when a large, young workforce is generating the savings and investment to give the economy a sustained boost, it will have to bring down the fertility rate.
The median age in the Philippines is only 22.2 compared with 25 in Malaysia, India's 25.1 and Indonesia's 27.8.
Unlike aging countries such as Japan, where the elderly put a burden on the working population, in the Philippines it's the children who command the resources that could otherwise be diverted to savings and investment.
There are 58 dependents for every 100 working-age people in the Philippines, according to World Bank data, compared with 40 in Indonesia and 29 in Thailand.
"The demographic window will only open if fertility rates are going to go down in such a way that the young-age population will grow at a slower rate than the working-age population," said Arsenic Balisacan, socio-economic planning secretary.
Aquino might seem an unlikely champion of free contraception. His late mother, Corazon Aquino, rose to power at the head of a people power revolution, fostered by the church, that swept away old dictator Ferdinand Marco in 1986.
Marcos had made reining in population growth a priority beginning in the 1960s and enshrined family planning in a 1973 constitution. But Corazon Aquino, mindful of the church's help in the democracy movement, scrapped that clause when the charter was rewritten in 1987. ($1 = 42.0300 pesos)
Editing by Robert Birsel