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)

At least 495 babies are born every day to Filipino girls aged 10 to 19 years, according to the 2019 data of the Philippine Statistics Authority. To address this, Malacañang declared as a national priority the implementation of measures to prevent teenage pregnancy through Executive Order (EO) No. 141, which further mobilized government agencies, the youth, and the community to work together in addressing the root causes of the problem.

Ahead of the EO signed on June 25, an additional 10 cities already heeded the call of The Challenge Initiative (TCI) in the Philippines to reduce teenage pregnancies. TCI aims to establish adolescent-friendly health facilities that promote positive health-seeking behavior and improve access to family planning programs.

Related story: Establishing adolescent and youth-friendly cities seen to help curb teenage pregnancies

Started in 2020, the TCI in the Philippines is co-managed and co-funded by the Zuellig Family Foundation (ZFF) and the Bill and Melinda Gates Institute for Population and Reproductive Health. The five-year project has been implemented in three pilot sites (Dipolog, Cagayan de Oro, and Puerto Princesa cities) in collaboration with the Commission on Population and Development (Popcom).

10 scale-up cities
The 10 scale-up cities are Santiago (Isabela), Baguio, San Jose (Nueva Ecija), Biñan (Laguna), Naga (Camarines Sur), Tacloban, Iloilo, Tagum (Davao del Norte), Tacurong (Sultan Kudarat), and General Santos. These were selected based on high political commitment, available budget and other resources, health system readiness, size of potential impact, and identified stakeholders.

The participating cities will be given technical assistance and guidance on TCI’s proven high-impact approaches on leadership and governance, quality adolescent and youth sexual and reproductive (AYSRH) health services, youth engagement, and demand generation.

Interventions include comprehensive sexuality education, inter-generational dialogue, policy development, and information and service delivery network for adolescent health and development.

Related story: Youth-led participation of religious sector in reducing teenage pregnancies

Having the third-highest adolescent fertility rate in Southeast Asia, the Philippines is faced with diverse urban reproductive health problems. Available figures show that every year (as of 2016), an estimated 210,000 babies are born to teenage mothers[1], which translates to 12% of all births every year [2].

The launch of “The Challenge Initiative (TCI) to establish adolescent and youth-friendly cities towards the reduction of teenage pregnancies” in the Philippines today aims to address the country’s adolescent and youth sexual and reproductive health (AYSRH) issues. TCI envisions cities with responsive governance mechanisms, a sufficient budget, and strong community support for the continuous provision of AYSRH services and information.

The Zuellig Family Foundation (ZFF) as TCI’s Philippine accelerator hub will work closely with select cities to support and guide in the establishment of adolescent and youth-friendly cities.

Bill & Melinda Gates Foundation

TCI Philippines has investments from ZFF and the Commission on Population and Development (PopCom). TCI is an urban reproductive health platform that leverages donor investments. Worldwide, TCI is supported by the Bill & Melinda Gates Foundation, private philanthropists, and bilateral donors.

TCI Philippines will be instrumental in the improvement of governance mechanisms needed at the local level to strengthen the AYSRH system. TCI is a “business unusual approach” that provides life-saving reproductive health and family planning information and services to underserved urban communities.

TCI also recognizes the importance of meaningful and active engagement among the adolescent and youth in decision-making on issues that affect their health and holistic development.

The online launch highlighted the need for a collaborative effort of the national government, local government units (LGUs), civil society organizations (CSOs), communities, adolescents and youth, and other stakeholders in finding solutions to the increasing cases of teenage pregnancies.

“ZFF, through the TCI Philippines, will guide local leaders in co-creating a responsive health system to address teenage pregnancies faster,” said Mr. Austere Panadero, Executive Director, ZFF.

For the Philippine efforts, the cities of Cagayan de Oro, Dipolog, and Puerto Princesa will be the pilot areas for the initiative.

“Cagayan de Oro City enacted an ordinance mandating the creation of the Oro Youth Development Council that will govern the operation of the 12 youth and teen centers in the city,” said Mayor Oscar Moreno.

“We are developing our very own Comprehensive Population and Development Code anchored on population development framework to harmonize existing policies and programs for adolescents and youth. I believe that adolescents and youth are key to achieving progressive development,” said Mayor Lucilo Bayron of Puerto Princesa City.

Optimize partnerships

TCI will maximize existing efforts and optimize established partnerships that involve high-impact interventions.

For example, in Puerto Princesa, TCI will be able to help intensify the efforts of Roots of Health (ROH), a CSO which has established a program that empowers female reproductive and overall health through education. TCI will build up on ROH’s track record in helping further reduce teenage pregnancy in the city.

“The city has 23 active partners in ensuring that sexual and reproductive health information and services are available and accessible to adolescents and youth,” said Dr. Rachel Dilla, city health officer of Cagayan de Oro City and the chairperson of ISDN for ASRH of the city.

“We believe TCI will serve as a key platform in strengthening collaboration among city stakeholders in addressing teen pregnancies,” said Mayor Darel Dexter Uy of Dipolog City. “Opportunity is also ripe for TCI to firm up the city’s child-friendly policies and interventions and social protection programs for teen parents.” 

TCI has five hubs across the world including the Philippines. It is led by the Bill & Melinda Gates Institute for Population and Reproductive Health in the Department of Population, Family and Reproductive Health at the Johns Hopkins Bloomberg School of Public Health.

1 – Philippine Statistics Authority, 2016
2 – Natividad and Marquez, 2016