From setting up teen hubs and centers in every public school and village to the creation of a council that will drive all programs for adolescents, Naga City is taking bolder yet wiser steps to curb teenage births through a newly passed ordinance.

Known as the “AYSRH Ordinance,” the measure was enacted last month, a critical move that would finally institutionalize and bring harmony to the city’s wide-ranging adolescent and youth sexual and reproductive health programs and services.

“The ordinance is like an arm or an instrument for us to be able to achieve our purpose, which is for adolescent girls to avoid being pregnant and for them to better prepare themselves for the years ahead because this lay down the acts that we have to do,” said Naga City Mayor Nelson Legacion.

Naga City’s adolescent birth rate has continuously dropped for the last four years, from a high of 30.21 in 2019 to 20.10 in 2022. But it has observed an uptick in repeat pregnancy in teenage mothers from a low 39 in 2020 to 56 in 2021 and 62 last year.

The mayor is pushing for zero teenage pregnancy in three years as it works under the guidance of The Challenge Initiative (TCI), a program co-managed by the Zuellig Family Foundation (ZFF) with the Bill and Melinda Gates Institute for Population and Reproductive Health.

Launched in 2020, the program aims to stem teenage pregnancies in the country by improving access to family planning programs and promoting positive health-seeking behavior among youth and adolescents.

Road to ‘zero’

Legacion expressed confidence that the “ambitious target” was doable with an ordinance that will strengthen the city leadership team and its information service delivery network (ISDN), composed of various stakeholders that will journey with the city government to achieve such dream, and with the continued support of TCI and ZFF.

Among the many things the ordinance would set in motion are the creation of the City Adolescent and Youth Sexual and Reproductive Health (AYSRH) Council, which will act as the advisory, planning, and policy-making body for the full implementation of the law, and the provision of a comprehensive culture-sensitive, age- and development-appropriate sex education in schools and the communities.

The law also obliges the city government to provide sufficient funding annually for all its AYSRH programs and services and to strengthen the capability of barangay health workers, nutrition scholars, and other frontline health and social workers in providing care and education tailored to the needs of adolescents and the youth.

Since joining the TCI, the city gradually increased its investments in ASYRH services from Php728,000 in 2020 to over P1 million in 2022, the start of the program implementation. It quadrupled to P4.1 million in 2023.

Adolescent-friendly spaces in all schools and villages

The ordinance also mandates the establishment of teen hubs in all public schools and teen centers in the barangays that will give adolescents and out-of-school youths an exclusive schedule to avail of reproductive health services with confidence and privacy.

So far, teen centers or adolescent-friendly facilities have been created in Barangays Concepcion Pequeña, Balatas, and Calauag.

“Part of the services we ask from teen centers and teen hubs is to address the stigmatization because it is one of the reasons why there is poor health-seeking behavior among our teenagers,” said Councilor Gayle Abonal-Gomez, author of the ordinance.

She also said the city was looking forward to getting private schools on board to set up their own teen hubs and mining data from its body of research on ASYRH to further improve the local government’s programs.

Underscoring the importance of the role of parents in teenage pregnancy prevention, the ordinance shall also see the implementation of a family support program that will provide parents of adolescents with the necessary education and support that encourage parental involvement.

“We are closely monitoring the rise in repeat pregnancies among teenage mothers…and based on observations and with our dealings with the barangays, the role of the family and parents plays a big part in this,” she said.

Widening of networks and programs

Another major component of the ordinance is the formal establishment of ISDN that will “harmonize all existing services and program interventions” on ASYRH in the city.

Under the newly enacted law, the City Population and Nutrition Office will spearhead gathering and linking up various stakeholders involved in the provision of ASRYH services to form a referral system and provide health services tailor-fit to the specific needs of adolescents.

“Before this ordinance, we already have many public and private partners and linkages, there are many programs and services [on ASYRH] available in the city. But the concern was that efforts were not institutionalized and harmonized,” said Abonal-Gomez.

“One advantage of this ordinance is that it will unify all our actions and with everyone officially on board, we will be able to grow our networks and the programs itself,” she added.

This article first appeared on the official website of the City Government of Naga.

(Published June 9, 2023)

Good nutrition governance is good politics. This echoed as the main takeaway during Zuellig Family Foundation’s (ZFF) Learning Forum on Nutrition held on July 5, 2023, at the Heritage Hotel in Pasay City. The hybrid event gathered 110 in-person attendees and at least 130 more via Facebook Livestream and Zoom. 

ZFF-KGJF partnership

Titled “Stories of Co-Creation for Strengthening Food and Nutrition Systems,” the learning forum provided a venue not only to recognize the achievements of the 12 ZFF-trained mayors from Sarangani and Basilan but also to disseminate best practices toward the reduction of malnutrition in the country.  

The learning forum was part of the Provincial Nutrition and Governance Program (PNGP) partnership of ZFF and the Kristian Gerhard Jebsen Foundation, focusing on the first 1,000 days’ (F1KD) population—pregnant women and children under two years old. Stunting and wasting prevalence rates in all 12 municipalities under PNGP decreased in 2023. In Sarangani, the stunting prevalence rate has gone down to 3.2% in 2023 from 7.22% in 2020; while in Basilan, it decreased to 14.51% from 17.38% for the same period. 

PNGP has been providing leadership interventions to the provincial, municipal, and city leaders of Sarangani and Basilan since 2021. Their front-line service providers also received technical and mentoring support. PNGP will continue working with the two provinces and two of their municipalities, in piloting interventions on developing positive behaviors among households and communities.

For more information about ZFF’s programs on F1KD nutrition, visit https://zuelligfoundation.org/programs/nutrition/.

Good politics

Municipal Mayor Ma. Theresa Constantino of Malungon, Sarangani said: “When there is good nutrition, [it means] there is good governance. And when there is good governance, definitely, wala akong kalaban (I do not have an opponent). There is good politics.” Malungon had been a recipient of the National Honor Award from the National Nutrition Council (NNC); it has recorded low stunting and wasting prevalence rates of 1.7% and 0.02%, respectively, in 2023. Among the local government’s initiatives were the provision that all households have backyard gardens (to address food access and security) and access to sanitary toilets (to provide a clean and safe environment for the healthy growth and development of children). The local government also increased investments in nutrition human resources and even institutionalized the retention of barangay nutrition scholars and other community volunteers through a municipal ordinance.

Basilan Gov. Jim Hataman-Saliman commended his mayors for their success stories in addressing malnutrition noting that fear of losing was the biggest hindrance in nutrition governance. “Takot kaming matalo. Takot kami na ang aming initiatives ay hindi in lalo kung hindi sikat sa social media (We have a fear of losing. We fear that our initiatives will not resonate well to the crowd, especially if we are not popular in social media.),” he said.

To which, Dr. Maria Cecilia Acuin, a ZFF consultant, reassured that “Sa nutrisyong sapat, panalo tayong lahat (With proper nutrition, everyone is a winner.).” She cited a World Bank study that found every dollar invested in nutrition has the potential of yielding a $44 return.

Read more about the journey of the 12 municipalities at http://bit.ly/StoriesOnNutritionGovernance.

Panel discussions

The learning forum was divided into three panel discussions. The first discussion, “Strengthening Nutrition Governance and Financing to Improve Service Delivery,” tackled the pivotal role of effective governance in increasing investments and improving the delivery of nutrition services.

Aside from Constantino, four other local chief executives highlighted the importance of investing in health human resources.

Mayor Sitti Djalia Turabin-Hataman (Isabela, Basilan) prioritized the hiring of a registered nutritionist dietician and an additional six support staff for the city nutrition program. Likewise, Mayor George Falgui (Kiamba, Sarangani) created a plantilla position for Nutrition Officer III through a municipal ordinance, making Kiamba the first municipality in Sarangani to have a permanent municipal nutrition action officer.

Mayors Victor James Yap (Glan, Sarangani) and Roderick Furigay (Lamitan, Basilan) also emphasized the importance of health human resources as crucial sources and main providers of services.

The second discussion, “Bolstering Data Governance in Nutrition,” touched on using data to inform evidence-based decisions and actions.

Mayor Arcam Istarul (Tipo-Tipo, Basilan) used data to ensure that appropriate interventions and support are provided to those who need them most. Mayors Jul-Adnan P. Hataman (Sumisip, Basilan) and Hanie Bud (Maluso, Basilan) intensified efforts under their respective Operation Timbang (OPT) task forces to track, assess, and provide targeted interventions to malnourished children.

The final discussion, “Confronting Food Insecurity and the Underlying Causes of Malnutrition,” highlighted the importance of stakeholder engagement and collaboration in confronting the issue of food insecurity and the underlying causes of malnutrition.

Mayor Vic Paul Salarda (Alabel, Sarangani) shared how they established a Nutri-Bakery with a private nongovernment organization and the provincial nutrition office and supported by a tripartite memorandum of agreement. Likewise, Mayor Alexander Bryan Reganit, Jr. (Maitum, Sarangani) showcased their partnership with the Philippine Carabao Center to establish a dairy box for locally-sourced milk feeding that would provide access to dairy products in the market.

A recording of the learning forum can be found here: https://fb.watch/lHpEEaPaoO/.

The Zuellig Family Foundation is proud to be among the co-funders for the Asia Philanthropy Circle’s Regional Early Childhood Development (ECD) Landscape Research launched on July 6, 2023.

The time period from when a child is born up to six years old is crucial, laying the foundation for physical, emotional, and intellectual well-being. Giving children the best start in life requires access to comprehensive programmes and services supporting their health and developmental needs to ensure they get the best start.

This groundbreaking study comprehensively maps policies, programmes, and services in early childhood development across China, Indonesia, the Philippines, and Singapore, identifies gaps, and provides recommendations where philanthropy can make meaningful interventions to improve ECD outcomes in the region.

Download the full report here: https://asiaphilanthropycircle.org/regional-early-childhood-development-ecd-research/

Annual-Report-2022-1

Austere A. Panadero has been appointed as the new president of the Zuellig Family Foundation (ZFF), five years after joining the foundation as executive director.

The ZFF board of trustees has great confidence in Panadero’s ability to continue leading ZFF with integrity, competence, and agility toward its mission of achieving faster health outcomes.

Before joining ZFF, Panadero worked for the government for over three decades with most of that time spent at the Department of the Interior and Local Government (DILG), where he served as undersecretary from 2007 until his retirement in 2018. His public service experience has been instrumental in building ZFF’s partnerships with local government units and development organizations.

Ernesto D. Garilao will remain the chairman of ZFF.

(Published April 13, 2023)

By Cristina Eloisa Baclig

MANILA, Philippines—As the country continues to address teenage pregnancies among Filipino girls, two cities—Cagayan de Oro and Dipolog City—have already started seeing a significant decrease in the birth rate for adolescent mothers through effective interventions.

After a year since the prevention of teenage pregnancies had been declared a “national priority,” the adolescent birth rate (ABR) in Dipolog City fell from a high 73.8 per 1,000 girls (aged 15-19 years) to 30 in 2022.

Similarly, Cagayan de Oro has observed a huge reduction in its ABR from 47.4 five years ago to 34 in 2022.

The decline in the number of Filipino women in Dipolog and Cagayan de Oro cities who are confronting pregnancy at an early age was attributed to “data-driven innovations and high-impact programs” that heavily focused on youth involvement.

Among these programs undertaken by the city governments to provide solutions to curb teenage pregnancies was The Challenge Initiative (TCI), a five-year urban reproductive health program co-managed by the Zuellig Family Foundation (ZFF) and the Bill & Melinda Gates Institute for Population and Reproductive Health.

The program, which started in 2020, encouraged several areas nationwide to transform into adolescent-friendly cities that actively address the sexual and reproductive health needs of the youth in their communities to reduce unintended teenage pregnancies.

It also aimed to enhance the accessibility of family planning programs and promote positive health-seeking behavior among Filipino youth and adolescents.

Successful interventions

In just two years after Dipolog City joined an earlier ZFF program, which spanned from 2017 to 2020, the local government was able to address and reduce the growing cases of teenage pregnancies in the city.

In October 2020, Dipolog City was accepted as one of the pilot cities under TCI, which led to high-impact interventions to engage city governments, health providers, communities, adolescents and youth, and other stakeholders in providing adolescent and youth sexual and reproductive health (AYSRH) information and services in urban communities.

As part of the initial batch of cities engaged with TCI in the Philippines, the local government of Dipolog launched the “Team Batang Ama Batang Ina Initiative” or BABII—a task force created to address Adolescent and Youth Sexual Reproductive Health (AYSRH) issues including teenage pregnancies in the city.

The Child and Youth Code, “which included provisions on health education for the youth, addressing mortality and morbidity of teenage pregnancy, and promoting reproductive health and family planning for youth parents,” was enacted into a local ordinance last year.

Aside from the city’s well-developed and well-functioning AYSRH system, the local government also increased the modern contraceptive prevalence rate (mCPR) from 39 percent in 2018 to 53.72 percent last year.

This year, the city was given resources—around P9M in investments—to create more family planning programs to further bring down cases of teenage pregnancy in the city.

Cagayan de Oro City, also among the early TCI sites, has also recorded an increase in mCPR from 29 percent in 2020 to 36 percent in 2022—an achievement attributed to “engaging the youth through various programs that speak their language.”

Several youth-led initiatives were also launched in the city through the ZFF’s Youth Leadership and Governance Program—which trained youth leaders of the Sangguniang Kabataan, or youth council, to lead in the creation and implementation of AYSRH programs in different areas in the city.

“The TCI is a vital driver to help us expand our initiatives to become an adolescent- and youth-friendly city as we create a safe space where young girls and boys can easily access ASRH services and engage in programs for comprehensive health development,” said Cagayan de Oro Mayor Rolando “Klarex” Uy.

From one concern to another

Latest figures showed that cases of teenage pregnancy are already declining, not only in Dipolog and Cagayan de Oro cities, but also in other cities across the country.

According to data from the Philippine Statistics Authority (PSA), there were 5.4 percent of women 15 to 19 years of age who have been pregnant in 2022, lower than 8.6 percent in 2017, 10.1 percent in 2013, 9.9 percent in 2008 and 8 percent in 2003.

However, the Commission on Population and Development (PopCom) stressed that pregnancies among 10 to 14-year-olds saw an increase from 2,113 cases in 2020 to 2,299 in 2021—citing data from PSA and the Department of Health (DOH).

“Our concern now are births from [aged] 10 to 14 – the much younger teenage girls. The statistics vary depending on the source of data, but they are all worrying. And If I may emphasize, the 10 to 14 [age group] is now something that we need to look into,” said PopCom executive director Lisa Grace Bersales.

This article first appeared on INQUIRER.net.

(Published April 27, 2023)

The Zuellig Family Foundation (ZFF) is honored to share its on-the-ground experience and knowledge while learning from others in the independent advisory board created by the Department of Health (DOH) to fast-track Universal Health Care (UHC) reforms, with the appointment of Austere A. Panadero, executive director of the ZFF as a member.

DOH officer in charge Rosario Vergeire formed the Strategic Advisory Group of Experts for UHC Implementation (UHC SAGE) to build on the gains from the public-private, multi-sectoral participation
for COVID-19 response.

Other members of the board are ZFF trustee Dr. Esperanza I. Cabral representing the Philippine Heart
Center, University of the Philippines (UP) professor Antonio Dans, M.D., UP Professor Emeritus Ernesto
Domingo, M.D., Medical City consultant and former UP professor Mary Ann Lansang, M.D., Dr. Edwin
Mercado of the DMMC Institute of Health Sciences, UP Manila Chancellor Carmencita Padilla, M.D.,
and former UP School of Economics Dean Orville Solon, Ph.D.

Based on the DOH personnel order 2022-4852 creating the group, the responsibilities of the members include the provision of technical assessments and review of documents on the following:

• Nationwide adoption of the Philippine Health Facility Development Plan as an investment plan for health
• Implementation of fiscal streamlining in public hospitals
• Implementation of the Diagnosis Related Group-Based Global Budget and the Comprehensive Outpatient Benefit Package
• Reconciliation of the databases of the Philippine Statistics Authority and PhilHealth, and the conduct of a primary care census
• Creation of a Central Medicine Store for pooled procurement

• Development of a Pharmacy Benefits package that allows PhilHealth to accredit and pay for retail pharmacies
• Streamlining of accreditation and licensing for primary care facilities
• Implementation of healthy schools, communities, and workplaces

• Establishment of the DOH Action Center and hospital fast lanes for health care workers’ concerns and benefit compensation processing
• Creation of health scholarship opportunities and the Medical Reserve Corps

ZFF’s UHC program

By the time Universal Health Care became law in 2019, ZFF had designed a program to assist three provinces—Agusan del Sur, Aklan, and Bataan— in the UHC transition. ZFF’s earlier work with provinces prompted governors to establish a functional service delivery network involving both provincial and municipal health facilities. The gains during the program provided a backbone for the three provinces’ work on UHC and response to the COVID-19 pandemic.

Provincial health boards (PHBs), whose memberships expanded, were fully activated under ZFF’s pre-UHC program. During the pandemic, the PHBs quickened the pace in localizing policies, pushing for local health reforms, and engaging various stakeholders. These provinces increased health care capacities, upgraded medical equipment and laboratories, and kept their people informed.

With ZFF guidance, the provinces remained deliberate in meeting the government-set key result areas (KRAs) for UHC maturity during the pandemic. The three fulfilled all 12 KRAs under the preparatory level six months before the government’s end-2022 target.

The developments in ZFF’s provinces prompted then Health Undersecretary Myrna Cabotaje to ask ZFF for a similar program for regional health officials. The resulting partnerships for northern Luzon officials introduced the Leadership Development Program, which improved the capacities of regional officers in mentoring and coaching local chief executives and health officials. As a result, provinces and cities moved faster in meeting targeted KRAs. In three months, the partnerships expanded to have governors enroll in the ZFF program. Before 2022 ended, ZFF had partnerships with four regional offices of the DOH: Ilocos Region, Cagayan Valley, Cordillera Administrative Region, and Eastern Visayas. These involve 15 provinces: Ilocos Norte, Ilocos Sur, La Union, Pangasinan, Apayao, Kalinga, Mt. Province, Ifugao, Benguet, Northern Samar, Samar, Eastern Samar, Biliran, Leyte, Southern Leyte.

(Published March 2, 2023)

Two abstracts by Zuellig Family Foundation’s local health system (LHS) team were part of the poster presentation during the 25th University of the Philippines (UP) Manila National Institutes of Health Anniversary Conference held on February 27 and 28, 2023 at the UP Bonifacio Global City.

This year’s conference theme was “Transforming Health Systems Toward Universal Health Care (UHC) Through Research Partnerships.” It provided a venue to learn from the latest research and best practices and network with experts and colleagues.

Co-authored by Dr. Catherine Chung and Dr. Jenilyn Dabu, the two abstracts presented were: (1) “The role of regional UHC core teams in accelerating UHC in the provinces;” and (2) “Realizing Universal Health Care in the Barangays: The Dinalupihan Case Study.”

UHC core team training

Under the “Bayang Malusog” Regional Leadership Development Program, a capability development program co-designed with the Department of Health Field Implementation and Coordination Team of North Luzon, the leadership and technical competencies of the regional UHC core teams were enhanced to ensure quality facilitation of the UHC implementation in the provinces. After 10 months, all UHC sites in Ilocos, Cagayan Valley, and Cordillera Administrative regions achieved the national target for the preparatory level (above 70%) in the UHC LHS maturity standards set by the DOH.

Improving primary care

Under the Provincial Leadership and Governance Program, barangay officials and municipal health team leaders in Dinalupihan (Bataan) underwent capacity-building training for better primary care services. Their enhanced competencies resulted in improved health system monitoring that helped develop evidence-based decision-making and better primary care facilities in managing noncommunicable diseases.

Learn more about ZFF’s programs on improving local health systems: https://zuelligfoundation.org/programs/local-health-system/.

(Published February 28, 2023)