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)

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)

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)

In a nod to Zuellig Family Foundation’s (ZFF) programs on Universal Health Care (UHC), the Department of Health’s Center for Health Development in Region 8 (DOH-CHD 8) collaborated with ZFF to accelerate UHC implementation and address nutrition challenges in the region. The DOH-CHD 8 has been a ZFF partner since 2013 under health governance leadership and municipal leadership programs.

The virtual ceremonial signing of the memorandum of understanding (MOU) held on November 29, 2022, marked the start of a new partnership under the Bayang Malusog program. The leadership development program will capacitate DOH regional leaders to support provincial leaders in creating effective and responsive province-wide health systems supporting the national health agenda.

Among those who signed the MOU were: Dr. Exuperia Sabalberino, DOH Eastern Visayas Regional Director; Austere Panadero, ZFF Executive Director; Dr. Anthony Faraon, ZFF Deputy Executive Director; Dr. Joyce Viar, ZFF Nutrition Portfolio Director; and Dr. Catherine Chung, ZFF Local Health System Portfolio Director.

In his message during the ceremonial signing, Dr. Abdullah B. Dumama Jr., Health Undersecretary of DOH’s Field Implementation and Coordination Team (FICT) for Visayas and Mindanao, highlighted the importance of collective action to realize UHC. He emphasized DOH’s commitment to working closely with local government units (LGUs) and partners by supporting local initiatives and providing technical assistance.

Similarly, Health Undersecretary Camilo Cascolan of DOH-FICT Visayas echoed DOH’s commitment to work with LGUs in achieving UHC saying that UHC will help resolve health inequities.

To cap the ceremonial signing, Faraon expressed optimism that the MOU signing will not only be the start of a new partnership but the start of collaborative work toward delivering better health outcomes in Region 8. He said that UHC must be realized through more and better services. With the Bayang Malusog program, Faraon hoped to realize the message, “Tayo ay bayang malusog—bayang hangad ang mabuting kalusugan ng lahat.” (We are a healthy nation—a nation that desires good health for all.)

(Published December 20, 2022)

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)

Provincial leaders in northern Luzon sharpen their knowledge on how to attain Universal Health Care (UHC) by improving health services and overall health systems. ZFF’s BayangMalusog: Provincial Leaders for UHC Acceleration program gave leaders, which included nine governors in attendance, insights on navigating the challenges UHC demands.

For Dr. Manuel Dayrit, former health secretary and a ZFF trustee, the UHC is the culmination of all health-related laws enacted since the 1950s because it calls for the health of all Filipinos.

He reminded governors and other provincial leaders that “investing in health is investing for the future” and the return on investments includes “decreased premature deaths” and “increased quality of life.”

Dr. Israel Francis Pargas, PhilHealth senior vice president, said the agency is designing its programs “to have a more comprehensive outpatient primary care package” to comply with the UHC law, which calls for every patient to pass through primary care physicians whose gatekeeping role is to ensure proper referral of cases. Ideally, therefore, all diseases are diagnosed at the primary care level.

In closing his presentation, Dayrit voiced his hopes that the governors leave a legacy of better health in their provinces.

The Department of Health (DOH) Centers for Health Development in the Cordillera Administrative Region (CAR) and Region 1 sponsored the module runs in Baguio City and Laoag City, respectively. Lending their time to support their provincial teams were DOH CAR Director Rio Magpantay, M.D., and Region 1 Director Paula Paz M. Sydiongo, M.D. Caraga Regional Director Cassion, M.D. was also present in the Baguio City module run to join Agusan del Sur Governor Santiago Cane Jr. who shared his bridging leadership journey with the other governors and the accomplishments of his province in UHC. His province has met all requirements for the preparatory level of UHC maturity—a set of standards set by the DOH—and hopes to attain the highest level of UHC functionality before his second term as governor ends in 2025.

For more on Agusan del Sur’s achievements in UHC, listen to https://spoti.fi/3zlTYRX.

CAR and Region 1 provinces will have their next module in March 2023 after an intensive practicum period which will see ZFF-trained regional leaders coaching and mentoring the governors and their teams. The provinces are expected to meet specific milestones designed to lead them toward UHC
attainment.

CAR governors present were Apayao Gov. Elias Bulut Jr., Benguet Gov. Melchor Diclas, Kalinga Gov. James Edduba, Ifugao Gov. Jerry Dalipog, and Mountain Province Gov. Bonifacio Lacwasan. For Region 1, Ilocos Norte Gov. Matthew Manotoc and La Union Gov. Raphaelle Veronical Ortega-David attended the event, which switched to hybrid following the strong quake in Northern Luzon last Oct. 25. Aklan Gov. Jose Enrique Miraflores, a first-termer whose province has been a ZFF partner since 2016, joined the Region 1 event online. Region 6 Director Adriano Suba-an was in Laoag City.

(Published December 9, 2022)

The Senate of the Philippines passed unanimously the “Girls Not Brides Act” or Senate Bill No. 1371, after the third reading.

Sen. Risa Hontiveros, who chairs the Senate Committee on Women, Children, Family Relations and Gender Equality, filed the bill in March 2020.

Quoting data from the United Children’s Fund (Unicef), Hontiveros said on her Twitter account “the Philippines is the top 12th country in terms of the number of child brides. A shocking 726,000 of our girls have been contracted into marriages they never asked for.”

The bill states that “anyone who arranges, facilitates, or officiates child marriages” will serve a prison sentence of up to 12 years and has to pay a fine of P50,000. Violators also will be held liable under Republic Act No. 7610, or the Special Protection of Children Against Abuse, Exploitation and Discrimination Act.

“It is our duty to protect them. Our girls now and tomorrow deserve better,” Hontiveros said.

Partner-LGUs of the Zuellig Family Foundation (ZFF) in Mindanao, undergoing Youth and Leadership Governance Program (YLGP), have introduced or drafted ordinances prohibiting child and forced marriages. Five municipalities in Region 12 and five in Lanao del Sur started the program in 2019, with Module 1 launched in August 2019 in Sarangani and Sultan Kudarat.

YLGP Sarangani-Sultan Kudarat has a municipal ordinance (Malungon, Sarangani) on anti-child and forced marriage. Columbio (Sultan Kudarat) and Malapatan and Maitum (Sarangani) followed Malungon’s lead and are currently drafting a similar ordinance. Kalamansig, also in Sultan Kudarat, plans to draft the same ordinance.

ZFF’s YLGP, in partnership with the United Nations Population Fund, is a five-year leadership capacity-building initiative that engages members of Sangguniang Kabataan. Their participation in the Bridging Leadership aims to build their competencies to boost their local government’s adolescent sexual reproductive health (ASRH) program, which is hoped to reduce teenage pregnancy. Participants are expected to take part in their local government’s efforts to improve ASRH programs and policies that are inclusive and responsive to the needs of the youth.

Located at the southern tip of Bataan Province, Mariveles is home to the Freeport Area of Bataan (FAB). In 2018, it was the second richest municipality in the Philippines, according to a Commission on the Audit report. Job-seekers from other provinces flock to the area.

A fifth of Bataan’s population lives in Mariveles, making it the most populous of the province’s 11 municipalities and one city. Yet health services for its residents used to be limited to those provided by the rural health unit, barangay health stations, private clinics, and the Mariveles Mental Health Hospital. The nearest hospital was over an hour’s drive away in Balanga City.

Ria (name withheld upon request), a long-time Mariveles resident and whose husband works in a FAB locator, recalls how she had to fight for space in a packed bus to get to the Bataan General Hospital and Medical Center (BGHMC) in Balanga City, where she gave birth to her first-born in 2019. Each two-way trip that included tricycle rides would cost her almost P200, which for Ria was “too much, especially since we’re on a tight budget.”

White elephant to white knight

Governor Albert Garcia acknowledged the deficiency, saying in a February 2018 interview with ZFF, “There are RHUs (rural health units), lying-in clinics but no hospital so when an accident occurs, they still need to bring the victim to Balanga. Plus, the Freeport is there, the workers, the population, so it needs a functioning hospital,” then he added, “That is why by hook or by crook this year (2018), the hospital will open” referring to the then-unused hospital, which had its roots to the vision of the governor’s late father.

As a congressman in 2011, Enrique Garcia introduced a bill to build a Mariveles hospital, which led to remodeling and then a retrofitting in 2017 of an existing building that stood idle since, earning it the monicker Mariveles Display Hospital.

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But the Mariveles District Hospital (MDH) would finally open in September 2018. It rendered out-patient and emergency services. And once it opened, its progress was fast.

In August 2019, it was licensed to operate as an infirmary. In March 2020, it was upgraded to a licensed Level 1 hospital just two weeks after it was designated a COVID-19 referral hospital.

It has discharged the province’s youngest COVID-19 patient (3 years old) and the oldest couple (80 years old).

Tracing infected and looking after their welfare

Ria was among MDH’s COVID-19 patients. She was exposed to a friend who had the virus. She was immediately tracked, tested in the RHU, and picked by MDH personnel after results showed she was positive. At the MDH emergency room, hospital personnel explained the tests and treatment she would be undergoing. For Ria, everything happened quickly, efficiently.

Thanks to ZFF’s interventions, the provincial government had the proper protocols in place.

“Our added knowledge because of our partnership helped us to cope better with the pandemic,” Garcia said during the governors’ learning forum last June 30.

For Ria, the two-week hospital stay was made easier by the health workers.

“I gained another family there,” said Ria, who praised her doctors and nurses for their patience, courtesy, and genuine service. “You can feel they were there to serve and not merely work.”

From her first day until her discharge, Ria did not have to shell out money. “I had my medicines. I was fed on time. They gave me masks and soap for handwashing. Upon my discharge, I did not have to pay for anything. Plus, when I was discharged, they gave me a set of easy-to-understand tips to avoid COVID-19.”

Fortunately, too for Ria, she did not suffer any discrimination when she returned home. The same cannot be said of MDH health staff, who were not welcome in their neighborhoods. So the Mariveles government and community responded. The local government opened a dormitory for the staff. Community members gave them meals and comfort food like milk tea. A FAB locator manufactured face masks for the health front-liners.

Service delivery network

Thankfully, too, its health service delivery network (SDN) has finally improved. MDH chief Dr. Hector Santos, who also oversees the Orani District Hospital, said the functional SDN has made it easier to refer and track all patients and not just those with COVID-19.

Governor Garcia said likewise, “There is that highly elusive service delivery network during normal times when it was a challenge for all LGUs to cooperate toward an efficient SDN. Because there was a crisis, and with help from our partners, we were able to integrate this health system that is now addressing our COVID response.”

Bataan’s proximity to Metro Manila contributed to its numerous COVID-19 cases. Acting swiftly and decisively to the crisis, however, has kept the pandemic manageable.

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