Naga City passes AYSRH ordinance to win campaign vs teenage births
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)
Panadero is new ZFF president
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)
Dipolog, Cagayan de Oro lead battle in curbing teenage pregnancy
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)
ZFF shares know-how with UHC advisory group
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)
ZFF shares best practices for UHC
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)
Siargao begins a quest for nutrition resiliency
Resilience to natural and man-made disasters tops the agenda of Siargao Island mayors after they witnessed the devastation of typhoon Odette (international name: Rai). To reach resiliency, the mayors are prioritizing health and nutrition improvements to ensure their constituents’ good health and safety even during emergencies. The Alumni Association of Asian Institute of Management (AAAIM) and the Zuellig Family Foundation (ZFF) partnered to bring the Municipal Nutrition Governance Program (MNGP) to five local government units (LGUs).
The first of the multi-modular training program was held from February 1 to 3. Taking time off from their busy schedules to attend the sessions were three mayors and one vice mayor: Mayor Angie Arcena of Burgos, Mayor Maria Liza Resurreccion of Pilar, Mayor Arwela Dolar of Sta. Monica, and Vice Mayor Wellybell Requirme of San Benito.
“We have a scheduled event in Manila but we chose to be here because we see the importance of looking into our nutrition system. At the end of the day, this is not for us but for the youth who will become our municipal leaders in the future,” shared Mayor Resurreccion.
The MNGP focuses on improving the nutritional outcomes during the first 1,000 days or from conception until a child reaches two years—a period of critical brain and body development.
The mayors had four other municipal members form their core teams for nutrition. The core team from the LGU of San Isidro was also present.
The teams identified specific steps they will be taking in the next 12 months to improve nutrition service delivery systems. Their progress will be monitored by AAAIM and ZFF, which will also provide coaching support.
Technical assistance will come from National Nutrition Council regional program coordinator Dr. Archie Labordo, who was present during the training.
Aside from ensuring actual steps are done from now until the next training in the third quarter of the year, ZFF and AAAIM will evaluate the program based on decreases in nutritionally at-risk pregnant women, low birth weight, stunting, and wasting.
The design of the MNGP is based on ZFF’s past nutrition programs in rural municipalities, cities, and provinces that immediately brought down cases of stunting and wasting.
(Published February 16, 2023)
5 Manila villages improve nutrition systems in 3 months
Just three months after attending the Barangay Leadership for Nutrition and Development (BL4ND), five barangays (villages) in Manila fulfilled needed nutrition reforms, including:
- the formulation of the Barangay Nutrition Action Plan with funding;
- the designation of the Barangay Nutrition Action Officer; and
- intensified tracking, profiling, and assessment of pregnant women and malnourished children.
Barangays 123, 212, 564, 598, and 733 attended the BL4ND on Sept. 27-28, 2022. Organized by the Zuellig Family Foundation (ZFF)-trained facilitators from Manila’s health department and Samaritan’s Purse, an international NGO, the two-day training helped the participants see clearly the gaps in their nutrition systems. The participants then organized their next steps with the end goal of improving the nutritional outcomes of their population—particularly pregnant women and children under two years old.
ZFF will be checking the progress again in March when barangays are expected to meet all of their targets.
Learn more about ZFF’s programs on nutrition, focusing on the first 1,000 days: https://zuelligfoundation.org/programs/nutrition/.
(Published February 14, 2023)
BARMM leaders and partners set to fulfill UHC
Bangsamoro Region’s health leaders and stakeholders gathered in a two-day summit to learn how Universal Health Care (UHC) has progressed in two implementation sites and the specific steps toward UHC’s full implementation in the region given its distinct structure and context.
Two cases were presented: Maguindanao where the health system is devolved to the Bangsamoro Autonomous Region in Muslim Mindanao (BARMM)—a setup shared by all provinces except one—and Basilan, the only province where the health system is devolved to the local government unit (LGU). As of January, Maguindanao fulfilled 100% of the key result areas under the preparatory level of the health system maturity while Basilan achieved 94%.
On the second day, a forum facilitated the development of a technical assistance plan to support and guide LGUs in their implementation. In response, development partners and other stakeholders presented their action plans supporting UHC implementation in the BARMM.
Jainab Abdulmajid, manager of the Zuellig Family Foundation’s ongoing USAID-funded BARMMHealth project with the University Research Co., presented ZFF’s leadership and governance training, which will have leaders from the regional management councils and provincial health boards of Basilan and Maguindanao as participants. Through the project, ZFF foresees faster UHC implementation that will result in improvements in public health policies and institutional support for services in maternal health, child health, and family planning.
The event, held last Jan. 30 to 31 in Davao City, was attended by Department of Health (DOH) Undersecretary Dr. Abdullah Dumama and BARMM’s Ministry of Health (MOH) top officials including Minister Rizaldy Piang, Deputy Minister Zulgarneyn Abas, and Assistant Secretary Abdulhalik Kasim, who will lead the newly created development partners coordination unit (DPCU) that will ensure a coordinated UHC effort among stakeholders.
Experts who shared their UHC knowledge at the summit included Mahidol University’s Dr. Sauwakon Ratanawijitrasin from Thailand and Dr. Rowen Galpo, former city health officer of Baguio City. Other attendees were representatives from the World Bank, United Nations Children’s Fund, International Organization for Migration, and Mindanao Organization for Social and Economic Progress.
(Published February 7, 2023)
Integrated family planning services for UHC
The importance of family planning (FP) in achieving Universal Health Care (UHC) was highlighted in the 2022 International Conference on Family Planning (ICFP) held in Pattaya City, Thailand from November 14 to 17, 2022.
At the said event, the Zuellig Family Foundation (ZFF) presented its leadership course on Minimum Initial Service Package for Sexual and Reproductive Health (MISP for SRH). A partnership with the United Nations Population Fund and funded by Australian Aid, the training course strengthened the competencies of provincial leaders to implement life-saving SRH information and services, including FP, during natural disasters and other public health emergencies.
While the MISP for SRH is provided for in the Magna Carta of Women (RA 9710) and the Responsible Parenthood and Reproductive Health Law (RA 10354), it is not yet widely implemented. Under ZFF’s pilot program, the provinces of Catanduanes, Laguna, and Maguindanao have crafted integrated MISP for SRH implementation plans as envisioned by the abovementioned laws.
Platform, movement, community
Sponsored by the Bill and Melinda Gates Institute for Population and Reproductive Health, the ICFP has been a strategic platform, movement, and community for countries, organizations, and individuals to make important commitments and celebrate innovations toward achieving FP access for all.
ZFF also shared lessons from the implementation of The Challenge Initiative (TCI), a partnership with the Gates Institute aimed at reducing teenage pregnancies. ZFF discussed how TCI used the Urban Health Equity Assessment and Response Tool1 for increased and targeted financing of adolescent sexual and reproductive health (ASRH) and FP delivery services. Using the Equity Matrix, Cagayan de Oro City (CDO) was able to bring down the adolescent birth rate to 35 in 2021 from 43 in 2020, and increase the modern contraceptive prevalence rate to 35 from 29 in the same period.
ZFF had two poster presentations on developing youth leaders to prevent adolescent pregnancies, and on building partnerships to scale up the implementation of the Philippine Population Development Plan in cities.
Awards
ICFP also conferred on the Zuellig family the 2022 Global Humanitarian Awards for Women’s and Children’s Health in recognition of the family’s investments in maternal and child health, nutrition, and reproductive health through ZFF. Men Form Zuellig, a ZFF trustee, received the award on behalf of Daniel and David Zuellig.
Meanwhile, Dipolog City Mayor Darrel Uy received the local champion award from TCI for “going above and beyond” in the city’s implementation of the program–investing $73,000 for 2023 (from $20,000 in 2021). Dr. Rachel D. Dilla, City Health Officer III of CDO, received the same award for mobilizing the city’s information and service delivery network.
1 An equity matrix using Urban HEART helps assess indicators of health outcomes and health determinants and identify health inequities in a specific city.
(Published December 19, 2022)