In the coastal town of Sta. Monica in Siargao Island, the local government has long been committed to addressing nutrition issues, but new efforts to strengthen the roles of stakeholders are showing promising results. 

While the town has existing nutrition programs, their partnership with the Zuellig Family Foundation (ZFF) through its Municipal Nutrition Governance Program (MNGP)-Nutrition and Health Leadership (NutriHeaL) under the Ahon Siargao initiative took a more focused approach. This program aims to enhance coordination and equip local leaders to take more impactful actions in addressing malnutrition, particularly stunting.

Sta. Monica faces a pressing issue with child stunting, having ranked among the top three municipalities in Surigao del Norte for the condition, according to the National Nutrition Council (NNC). Despite having nutrition programs like supplemental feeding in place, the prevalence of stunting among children under two was still at 32.17% in 2021. 

Sta. Monica is a coastal town with a population of 9,554 people spread across 11 barangays. Most of the residents rely on fishing for their livelihood, which often leaves them vulnerable to economic instability. Dr. Arlene Sebastian, Municipal Health Officer, believes that poverty is a major contributor to the ongoing problem. “Poverty is not merely the absence of adequate food on the table; it’s also the struggle to sustain any progress made, even with supplemental feeding, due to the ongoing challenges faced by families and caregivers,” said Dr. Sebastian. 

A Deep Dive into Local Realities

To better understand the local context, Sta. Monica’s leadership participated in a Deep Dive, a guided community immersion, which involved visiting a family in Barangay Mabuhay. This event opened the eyes of local leaders to the harsh realities families face. Mayor Arwela Dolar shared that the experience deepened her empathy and reshaped her understanding of nutrition’s importance. Before participating in the program, she had viewed nutrition as the responsibility of health and nutrition officers. However, she now sees it as a broader issue that involves education, poverty, and awareness.

Dianette Evangelista, Budget and HR Officer, observed that one of the main problems is a lack of nutritional knowledge among mothers, even though they may know what they should be doing. Many families struggle to implement proper nutrition practices, and there is a general misconception that nutrition is only a concern during Nutrition Month every July, rather than an ongoing responsibility.

Leadership Actions for Change

With a renewed sense of urgency, the Sta. Monica team started adopting more comprehensive strategies to tackle nutrition. The Municipal Nutrition Action Plan (MNAP) for 2023-2025 was introduced, providing a clear roadmap for addressing nutrition needs in the coming years. The town also implemented national policies like the Kalusugan at Nutrisyon ng Mag-nanay Act, which focuses on improving the health and nutrition of mothers and children, and the Milk Code, which promotes breastfeeding.

Regular quarterly meetings of the Municipal Nutrition Committee (MNC), led by Mayor Arwela, have become a vital platform for planning and evaluating nutrition-related initiatives. These meetings allow stakeholders to align their efforts and ensure progress. Additionally, the town has invested in nutrition monitoring tools such as salter scales, laptops, and record books to improve data collection and evidence-based planning.

The local government is also focused on strengthening the roles of local leaders through training. This includes the Barangay Leadership and Planning for Nutrition Security (BLPNS) Training, which was rolled out to all barangays in December 2023, helping local leaders understand the importance of nutrition security.

Community Engagement and Policy Development

To ensure the sustainability of these efforts, the Municipal Nutrition Action Officer (MNAO), Medelyn Dolar, has been advocating for increased community participation and involvement in nutrition planning. The town’s focus is not only on government intervention but also on empowering barangay leaders and residents to take responsibility for improving nutrition outcomes.

Trainings for Barangay Nutrition Scholars (BNSs) and Barangay Health (BHWs) Workers were also conducted on various aspects of nutrition, including lactation management, mental health, and healthy lifestyles, all aimed at equipping the community with the knowledge they need to make better nutrition choices.

Positive Outcomes and Progress

Sta. Monica has made notable progress in improving nutrition indicators. Stunting among children aged 0-59 months decreased from 32.17% in 2021 to 20.00% in 2022, though it slightly increased to 21.10% in 2023. Wasting also saw a reduction from 7.68% in 2021 to 2.40% in 2022, though it rose again to 4.70% in 2023. This fluctuation can be linked to the increase in the coverage of Operation Timbang Plus, which grew from 66.09% in 2021 to 86.61% in 2023.

The town now conducts monthly monitoring of key nutrition indicators, ensuring that early interventions are made for malnourished children. Through these efforts, the Supplemental Feeding Program (SFP) continues to provide crucial nutrition support to children aged 6 to 59 months, with multivitamins being distributed to pregnant women as well.

As Sta. Monica continues its work to improve the health and nutrition of its residents, there is hope that with sustained efforts, the prevalence of malnutrition will decrease. By engaging parents, strengthening leadership at all levels, and improving community awareness, Sta. Monica is paving the way for better health outcomes for its children and families.

Related articles:

• Building Stronger Nutrition Systems in Siargao: The Ahon Siargao Experience
• Empowering Barangays and Communities through Nutrition Governance: Pilar’s Journey
• Leveraging Multi-stakeholder Collaboration to Improve Nutrition Services in Burgos, Siargao

 

The municipality of Burgos, located in the northeastern part of Siargao Island, relies primarily on copra production and fishing for livelihood. However, as a fifth-class municipality, Burgos has faced persistent health and nutrition challenges, falling short of national standards for stunting and wasting. The devastation caused by Typhoon Odette in 2021 further worsened these issues.

Burgos, comprising six barangays and home to 4,185 residents, has a network of 43 Barangay Health Workers (BHWs) and 10 Barangay Nutrition Scholars (BNS). Upon taking office in 2022, Mayor Angie Arcena recognized the presence of existing nutrition programs led by former municipal health officer Dr. Christel Mendoza. However, despite these initiatives, malnutrition rates remained concerning.

Recognizing the Problem

In May 2023, the Burgos Nutrition Core Team participated in a Deep Dive activity, a guided community immersion, under Zuellig Family Foundation’s (ZFF) program, a part of the Ahon Siargao collective efforts. This experience highlighted the severity of Burgos’ nutrition challenges and underscored the need for a more coordinated response.

Sangguniang Bayan Member and Health Committee Chair Pedrita Domiños admitted that prior to the program, the local government unit (LGU) focused more on post-typhoon infrastructure recovery rather than nutrition policies. Likewise, Mayor Angie said, “I was not even aware of who and what a Municipal Nutrition Action Officer (MNAO) does before,” she said. “All the while, I thought it was just the team of Dr. Christel that had the responsibility for the nutrition situation of Burgos.”

The data stressed the urgency of intervention. Stunting prevalence among children aged 0 to 59 months in Burgos rose from 5.33% in 2021 to 19.16% in 2022.

Strengthening Coordination and Leadership

One of the first steps taken was improving communication and coordination among stakeholders. Mayor Angie and the LGU prioritized enhancing nutrition services by mobilizing resources and strengthening collaboration with government agencies and private organizations.

The Municipal Nutrition Committee (MNC) was reorganized to meet quarterly, ensuring regular updates and coordinated planning. Budgetary challenges persisted, with funds originally allocated for nutrition redirected to typhoon recovery. Despite this, Burgos sought external support through the Ahon Siargao convergence program and resource mobilization efforts.

Government agencies such as DOH-CHD and NNC Caraga Region provided technical assistance, including the establishment of a Super rural health unit (RHU). The Super RHU is a facility that integrates maternal and child health and nutrition (MNCHN) services, ensuring better service delivery. The municipality also benefited from the NNC’s Tutok Kainan Dietary Supplementation Program (TK DSP) for pregnant women.

Partnerships for Nutrition Improvement

Burgos engaged multiple private organizations to support its nutrition programs:

• The Assisi Development Foundation provided MannaPack Fortified Rice for children and pregnant/lactating women.
• The MCHS71 Movers funded additional ingredients for feeding programs in child development centers.
• The SeaOil Foundation implemented its “Tugon sa Gutom” Program, training residents on sustainable home gardening.
• Tanglaw ni Teresa Inc. trained Child Development Workers and provided instructional materials and water purifiers for childcare centers.

Workshops and awareness activities were also conducted in partnership with local organizations. For example, Calls Over Ridges held nutrition workshops at San Mateo Elementary School, and Nature Kids’ Siargao engaged students in interactive nutrition education.

Capacity Building and Data Improvement

To enhance service delivery, the municipality launched the Barangay Leadership Program for Nutrition Security (BLPNS), training local leaders on nutrition governance. This led to the development of Barangay Nutrition Action Plans (BNAP) across all six barangays, each with dedicated budget allocations.

Efforts were also made to improve data accuracy. The MNAO, Mardy Arones, implemented a hands-on approach to monitoring data quality, ensuring standardized weight and height measurements. The Measles-Rubella Supplemental Immunization Activity (MR-SIA) campaign was integrated with Operation Timbang Plus (OPT+) to streamline health and nutrition initiatives.

Additionally, the municipality strengthened its referral system for severely acute malnourished (SAM) and moderately acute malnourished (MAM) children, as well as nutritionally-at-risk (NAR) pregnant women. Identified cases were immediately referred for appropriate interventions, including supplementary feeding programs.

Institutionalizing Nutrition Programs

Burgos established the BHW and BNS Academy to provide annual training for frontline health workers. This initiative contributed to improved OPT+ coverage, which increased from 64.17% in 2022 to 86.36% in 2023.

The municipality also appointed breastfeeding advocates in each barangay to promote and support early childhood nutrition. These efforts reflect Burgos’ commitment to creating a sustainable and community-driven approach to nutrition improvement.

Through multi-stakeholder collaboration, Burgos has made great progress in addressing malnutrition. Preliminary data suggests a positive trend in reducing stunting rates, with a recorded 13.74% stunting rate in 2023 from 19.16% in 2022, and a goal to further reduce it to 11.5% by 2025. This progress reflects the collective efforts of health leaders and workers, and community members. By institutionalizing these efforts and continuing to build partnerships, Burgos is paving the way for a healthier future for its residents.

Related articles:

• Building Stronger Nutrition Systems in Siargao: The Ahon Siargao Experience
• Empowering Barangays and Communities through Nutrition Governance: Pilar’s Journey

“A dream come true for my municipality.”

For Mayor Liza Resurreccion, having a real-time data platform to track the health and nutrition status of her municipality has always been a dream. Now, with the Zuellig Family Foundation (ZFF) Pook Malusog Dashboard, that dream is a reality.

Pilar, a fifth-class island municipality, faces constant challenges, from natural disasters to financial limitations. But Mayor Liza saw an opportunity in digitization. With the support of ZFF, she ensured that every Pilarnon could access quality health and nutrition services.

During a Local Health Board meeting, she stressed the importance of data-driven and evidence-based governance. She urged local leaders, including 15 barangay captains and health teams, to use data in making decisions that directly impact their communities.

The pilot implementation in Pilar covered five barangays and recorded vital data: 428 children (0-59 months), 36 pregnant women, and 357 households. Through the ZFF Pook Malusog Dashboard, they monitored nutritional improvements and identified areas needing urgent intervention, leading to better health promotion, referrals, and coordination for food security and social assistance.

The platform created a sense of urgency among health workers, allowing them to visualize the extent of the problem in real time. Local councils, such as the Municipal Nutrition Committee, used the data to advocate for immediate interventions and budget prioritization.

Pilar has a history of strengthening its health system. The municipality completed ZFF’s Municipal Leadership and Governance Program (MLGP) in 2016-2017 and later joined ZFF’s Nutrition and Health Leadership (NutriHeaL) Program under the Ahon Siargao initiative in 2023. With increasing need for a reliable data system that can withstand natural disruptions, Pilar is now focusing on strengthening its Health and Nutrition Information System (HNIS).

A total of 29 health and nutrition workers—including Rural Health Unit (RHU) midwives, nurses, and barangay nutrition scholars—were trained under ZFF’s program on data collection and database management. As a result, Pilar successfully deployed the tool across five pilot barangays, enabling midwives, nurses, and nutrition scholars to track children and pregnant women in real time. The system also mapped household profiles, allowing for a deeper analysis of health determinants like socio-economic conditions, water and electricity sources, and access to health insurance and social protection programs.

This 2025, Pilar initiated its annual Operation Timbang (OPT) survey equipped with the ZFF Pook Malusog Dashboard. What began with five pilot barangays has now expanded to 15, achieving municipal-wide HNIS coverage. With ZFF’s continued support, Pilar serves as a model for other LGUs in their own OPT monitoring and similar activities.

Related articles:

• Empowering Barangays and Communities through Nutrition Governance: Pilar’s Journey
• Building Stronger Nutrition Systems in Siargao: The Ahon Siargao Experience
• Child and Maternal Health Data Made Easy: Introducing the ZFF Pook Malusog Dashboard

Before becoming a municipality in 1953, Pilar was a barrio (village) of Dapa in Siargao Island. Today, it has 15 barangays with a population of nearly 11,000 as of 2023. Farming, mainly copra and rice, remains the primary livelihood in Pilar and its neighboring towns.

As a fifth-class municipality, Pilar has received support from various organizations, including the Zuellig Family Foundation (ZFF). Mayor Liza Resurreccion first joined ZFF and the Department of Health’s (DOH) Municipal Leadership and Governance Program (MLGP) in 2016-2017, which helped her understand the deeper connections between health and social factors. While she initially focused on improving healthcare in general, she later realized that nutrition needed special attention.

Pilar was later included in ZFF’s Municipal Nutrition and Governance Program (MNGP)-Nutrition and Health Leadership (NutriHeaL) under the Ahon Siargao initiative. This support came at the right time, as the municipality faced worsening nutrition challenges, especially after Typhoon Odette.

“My involvement in ZFF’s program changed how I saw healthcare in Pilar,” said Mayor Liza. “But I soon realized that nutrition, particularly among children, was another urgent issue that needed action.”

Understanding the Problem

Marifi Villa from the Municipal Social Welfare and Development Office (MSWDO) explained that malnutrition in Pilar stems from poverty, food insecurity, unemployment, and lack of nutrition knowledge. Cultural practices also play a role in shaping eating habits.

Dr. Ethel Dominique Lausa, Municipal Health Officer and part of DOH’s Doctors to the Barrio (DTTB) program, noted that some parents struggle to accept new ideas. “Some parents are eager to learn about nutrition and its impact on their children,” she said. “But others believe that as long as they can feed their families three times a day, it doesn’t matter what kind of food they eat.”

Despite government efforts, some parents remain uninterested in initiatives like backyard farming, and many teenage parents lack the knowledge needed to provide proper nutrition for their children.

In 2023, Pilar’s stunting rate for children under two years old increased to 10.94% from 9.34% in 2022. Wasting also rose to 5.14% from 2.66%. However, these higher numbers may reflect improved data collection after barangay health workers and nutrition scholars received better tools for measuring children’s height and weight.

Taking Action

Under Mayor Liza’s leadership, barangay officials strengthened their Barangay Nutrition Committees by passing ordinances and executive orders (EOs). They also held regular Municipal Nutrition Committee (MNC) meetings to coordinate efforts.

The Sangguniang Bayan of Pilar adopted the RA 11148 (Kalusugan at Nutrisyon ng Magnanay Act) and EO 51 (Milk Code). They also passed a Municipal Nutrition Code, ensuring a more structured approach to nutrition programs. Recognizing the need for proper funding, Mayor Liza doubled the nutrition budget to 500 thousand pesos in 2023 and further increased it to 1 million pesos in 2024.

Pilar also trained local leaders through the Barangay Leadership Program for Nutrition Security (BLPNS), equipping Barangay Nutrition Committees with the skills to address malnutrition at the grassroots level. As a result, all 15 barangays developed their Barangay Nutrition Action Plans and allocated funds for nutrition programs.

Community Efforts

A daily Supplemental Feeding Program now helps malnourished children aged 0-59 months, with a 120-day feeding program in Day Care Centers and additional feeding sessions in barangays. Barangay Datu even launched a feeding program specifically for nutritionally at-risk (NAR) pregnant women.

To address food insecurity, barangays are promoting backyard farming, allowing families to grow their own nutritious food. Employment programs also prioritize parents from low-income families, particularly those under the Department of Social Welfare and Development’s (DSWD) 4Ps program.

To improve awareness, Pilar plans to integrate nutrition counseling into pre-marriage seminars, ensuring that future parents understand the importance of proper nutrition.

Monitoring Progress

Pilar has embraced data-driven approaches to track nutrition trends and improve services. A monitoring tool for pregnant women helps ensure they receive essential health and nutrition services, while another tool for children aged 0-23 months allows for early detection of health risks.

To centralize health and nutrition data, Pilar adopted ZFF’s Pook Malusog Dashboard, a Health and Nutrition Information System (HNIS), making it easier for stakeholders to access relevant data. The municipality partnered with ZFF to train barangay health workers and midwives on using the Dashboard, and Mayor Liza allocated 150 thousand pesos for purchasing mobile devices to support its implementation.

Results and Future Plans

While nutrition indicators still fluctuate, Mayor Liza and her team see changes in parental behavior as a significant achievement. “When parents saw that their local officials truly cared about their children’s nutrition, they became more open to change,” said MSWDO Villa.

Awareness about nutrition has grown beyond mothers and children, reaching the wider community. To further strengthen these efforts, the municipality is working to create a permanent position for the Municipal Nutrition Action Officer (MNAO) to ensure continuity in nutrition programs.

One of Pilar’s biggest milestones is the establishment of a Super Rural Health Unit (RHU) with expanded services, including antenatal care, immunization, and nutrition-focused interventions. This facility will also house the MNAO office, centralizing Pilar’s nutrition governance efforts.

Related articles:

• Building Stronger Nutrition Systems in Siargao: The Ahon Siargao Experience
• Child and Maternal Health Data Made Easy: Introducing the ZFF Pook Malusog Dashboard

In December 2021, Typhoon Odette tore through Siargao, leaving widespread destruction. Homes, farms, and businesses were destroyed, forcing local governments to focus on rebuilding roads and infrastructure. But amid these challenges, another critical issue remained: nutrition.

Siargao’s economy relies heavily on tourism, but agriculture is also essential for many residents. The typhoon made food security an even bigger problem. Food prices were already high because many goods had to be transported from the mainland. The storm’s impact worsened this situation, making it harder for families to access nutritious food.

The State of Nutrition in Siargao

From 2019 to 2022, the stunting rate in Burgos, Pilar, and Sta. Monica fluctuated, reaching medium public health concern levels (10%-<20%) based on World Health Organization (WHO) classification. Wasting rates were lower but still needed attention. While these municipalities had an 85% Operation Timbang Plus (OPT+) coverage on average, improving screening and data collection was necessary to understand and address nutrition challenges better.

Ahon Siargao: A Community-Led Nutrition Initiative

In response, the Ahon Siargao Capacity Enhancement (CAPE) Program was launched. Led by the Alumni Association of the Asian Institute of Management (AAAIM) and supported by private organizations and civil society groups, including the Zuellig Family Foundation (ZFF), the program aimed to improve nutrition for pregnant women and children under two years old.

The initiative built on lessons from past nutrition programs and followed ZFF’s 8 Critical Knobs of Nutrition Governance. It focused on three key areas:

1. Strengthening Municipal Nutrition Committees
2. Investing in nutrition planning and programs
3. Training barangay leaders, health workers, and volunteers

Efforts included regular Operation Timbang Plus sessions, pregnancy tracking, prenatal services, immunization, and feeding programs for at-risk mothers and children. Through these, Siargao’s local nutrition teams became more cohesive, working together towards shared goals.

Stronger Nutrition Systems, Better Outcomes

Through the ZFF’s Municipal Nutrition Governance Program (MNGP)-Nutrition and Health Leadership (NutriHeaL), Burgos, Pilar, and Sta. Monica improved their OPT+ coverage from 2022 to 2023. Better data allowed for informed decision-making, leading to:

• More accurate tracking of malnutrition cases
• Stronger referral systems for severe and moderate acute malnutrition (SAM and MAM)
• Higher rehabilitation rates for malnourished children

Key Leadership Lessons

The three municipalities learned that effective nutrition governance requires:

• Collaboration: Engaging local governments, national agencies, private organizations, and NGOs to ensure comprehensive nutrition services. Regular meetings led by mayors helped address emerging challenges.
• Legislation: Establishing Barangay Nutrition Committees through ordinances and adopting key nutrition laws like the Municipal Nutrition Code and RA 11148 (First 1,000 Days Law).
• Data-Driven Decisions: Using technology to improve health and nutrition planning, ensuring programs are based on real community needs.
• Strong Leadership: Having a dedicated Municipal Nutrition Action Officer (MNAO) to coordinate programs and ensure sustainability.
• Community Involvement: Encouraging barangay leaders to take active roles in promoting health and nutrition initiatives.

Challenges and Next Steps

While progress has been made, reducing malnutrition remains a challenge. By 2025, Burgos aims to lower stunting to 11.5%, while Pilar and Sta. Monica target rates below 10%. To achieve this, local governments plan to:

• Maintain a full-time, well-trained MNAO
• Secure permanent employment for Barangay Nutrition Scholars (BNSs) and Barangay Health Workers (BHWs)
• Strengthen programs addressing teenage pregnancy and malnutrition
• Increase parental involvement in health and nutrition education
• Empower barangay leaders to champion nutrition efforts
• Ensure nutrition programs continue despite leadership changes

The Ahon Siargao initiative has proven that with strong leadership, collaboration, and commitment, communities can rebuild not just infrastructure, but also the systems that keep children healthy. Siargao’s journey shows that even in the face of disaster, investing in nutrition can pave the way for a healthier future.

Related articles:

• Child and Maternal Health Data Made Easy: Introducing the ZFF Pook Malusog Dashboard

Puerto Princesa City, known for its stunning beaches and rich biodiversity, is also tackling a major public health issue: adolescent pregnancy. In 2019, the rising number of teenage pregnancies in the Philippines led the government to declare it a national social emergency. By 2020, the MIMAROPA region recorded 4,707 births among girls aged 19 and below. Palawan accounted for 32% of these cases, with Puerto Princesa contributing 397 births.

Mayor Lucilo Bayron saw the need to improve adolescent health services, particularly in reproductive health. His vision: investing in youth health today will build a stronger and more progressive city for the future.

A Citywide Approach to Youth Health

Puerto Princesa was among the first cities to join The Challenge Initiative (TCI) when it launched in the Philippines in 2020. TCI, a global program co-managed by the Zuellig Family Foundation (ZFF) and the William Gates Sr. Institute for Population and Reproductive Health, helps local governments implement and sustain reproductive health programs for the youth.

Working with the Commission on Population and Development (CPD) and the Department of Health (DOH), the city aimed to create a youth-friendly environment and lower adolescent pregnancy rates. The initiative strengthened partnerships among local government units, schools, health workers, and youth leaders, making reproductive health services more accessible.

Strengthening Leadership and Coordination

To enhance collaboration, Mayor Bayron established the City Leadership Team (CLT) for Reproductive Health. This team, trained in governance and leadership, took charge of coordinating youth health programs. Analiza Herrera, Population Program Officer, said that TCI helped unify different efforts across city offices and partners, ensuring better service delivery without duplication.

A Referral System for Youth Services

Before TCI, many young people in Puerto Princesa did not know where to seek help for physical, mental, or sexual health concerns. Service providers also lacked a clear system for referrals. In response, the city created the Integrated Service Delivery Network (ISDN), linking agencies such as the City Health Office, City Social Welfare and Development Office, Ospital ng Palawan, the Philippine Mental Health Association, the police, schools, youth councils, and NGOs.

With this network in place, the city formalized the ISDN Referral Flow in November 2024, a guide for barangay leaders and health workers to connect youth to the right services.

Creating Safe Spaces for Youth

Youth involvement has been crucial in expanding health services. The Leadership for Adolescent and Youth-Friendly Cities (LAYFC) program gathered barangay leaders and youth representatives to identify local issues and solutions. One major result was the creation of youth-friendly spaces, including the “Barkada Hub” in Barangay San Jose. This center offers reproductive health services, counseling, and a safe place for young people to gather.

Today, Puerto Princesa has youth-friendly clinics in 8 satellite health centers, 11 schools, and 58 barangay health stations. Youth councils also organize educational sessions on reproductive health, HIV awareness, and family planning.

Using Technology to Improve Services

To address data gaps, the city launched the Comprehensive Household Information System (CHIS), an Android-powered app that collects real-time household data, including health and family planning information. CHIS, implemented in all 66 barangays, helps track adolescent reproductive health trends and identify areas needing intervention.

Sandra Guiyam, Population Program Officer, explained that CHIS provides accurate data to guide health programs, while Carlyn Badilla added that it ensures reliable records for women of reproductive age and family planning services.

Investing in the Future

In 2024, Puerto Princesa allocated 17.5 million pesos for adolescent and youth sexual and reproductive health programs. The city also provided 60 million pesos in incentives for Barangay Service Point Officers (BSPOs) who collect health data, ensuring consistent and reliable reporting. Starting next year, BSPOs will receive an increased monthly allowance of 6,000 pesos, making Puerto Princesa the only locality in MIMAROPA to offer such support.

Puerto Princesa is projected to achieve an adolescent birth rate of 34, below the national target of 37. The city’s approach—empowering youth, strengthening healthcare systems, and leveraging technology—has transformed it into a model for adolescent health programs.

In 2018, Cagayan de Oro (CDO) faced a serious issue: a high rate of adolescent pregnancies among 15- to 19-year-olds, both residents and transients. The city recorded 80 births per 1,000 adolescents—well above the national target of 37. Even when excluding transients, the rate was still at 47.

To address this, city leaders partnered with the Zuellig Family Foundation (ZFF) and the United States Agency for International Development (USAID) to implement programs aimed at reducing adolescent birth rates (ABR). Their efforts gained momentum with The Challenge Initiative (TCI), a program focused on Adolescent and Youth Sexual and Reproductive Health (AYSRH), introduced in 2021.

Leadership and Collaboration

A City Leadership Team (CLT), made up of local agency heads, was formed to coordinate efforts. When Mayor Rolando “Klarex” Uy took office in 2022, he emphasized teamwork in addressing teen pregnancy. ZFF, through TCI, provided training and mentoring for the CLT, equipping them with leadership skills focused on shared responsibility and collaborative solutions.

Data-Driven Action

CDO’s Information and Service Delivery Network (ISDN), established in 2018, played a key role in gathering and analyzing data. With TCI’s guidance, the network streamlined efforts, making it easier to distinguish ABR among residents and transients. This allowed for more targeted interventions to prevent first and repeat pregnancies and delay sexual activity among the youth.

City Health Officer Dr. Rachel Daba-Dilla stressed the importance of accurate data: “Data is power! We have the highest rate (in Northern Mindanao) simply because we find them. This helps us understand and address the problem.”

Strengthening Health Services

The ISDN also improved the city’s referral system, integrating services related to adolescent reproductive health, mental health, and substance use. Recognizing the need for accessible health services, the city expanded its adolescent-friendly health facilities (AFHFs) to 65 facilities, offering education, counseling, vaccinations, and antenatal and postnatal care.

Engaging the Youth and Community

Mayor Uy ensured that youth organizations, particularly the Sangguniang Kabataan (SK), were actively involved in governance. Youth leaders became peer educators, helping to promote AYSRH programs. Barangay officials and health workers also received training, strengthening community-based family planning initiatives.

Mayor Uy personally engaged parents in discussions, encouraging them to support AYSRH programs and modern contraceptives. This led to increased awareness and use of free family planning services available in health centers.

Family Planning and Data Quality

Through TCI, the City Health Office enhanced family planning services with better data management and community outreach. The city also improved access to long-acting reversible contraceptives (LARCs), such as implants and IUDs, with support from the Department of Health (DOH) and community health organizations.

Despite progress, challenges remain. Changes in the Family Health Information System (FHSIS) mean that the modern contraceptive prevalence rate (mCPR) is no longer reported. Instead, tracking will focus on current users and demand satisfaction, requiring updated tracking forms and additional funding.

To adapt, CDO is embracing digital health solutions like Wireless Access for Health. This transition aims to improve efficiency and sustainability by ensuring better tracking, financial protection for services through PhilHealth reimbursements, and additional income for local health facilities.

Sustaining Progress

Mayor Uy’s administration has steadily increased budget allocations for AYSRH and family planning, with a 15% rise in 2024. Of the allocated 12.5 million pesos, 88% was used for these efforts.

Even with CDO graduating from the TCI program in 2024, sustainability remains a challenge. However, strong leadership, effective collaborations, and continuous learning ensure that the city remains on track. Commission on Population Development (CPD)-Region 10 Director Neil Aldrin Omega noted, “The key difference between TCI sites and non-TCI sites is the leadership development among local officials. This ensures their commitment to addressing early pregnancy.”

Related articles:

• Five Cities Celebrate Milestone in Adolescent Health and Family Planning Efforts
• Sustainable Solutions: Dipolog City’s Comprehensive Fight Against Adolescent Pregnancy
• Turning the Tide: San Jose’s Comprehensive Approach to Adolescent Health

Baguio City, a popular destination for tourists and students in the Cordillera region, has made impressive strides in improving the health and well-being of its young people. In 2019, the city’s adolescent birth rate (ABR) stood at 25 per 1,000 live births, lower than the national target of 37, but still a concern. Recognizing the need for change, Mayor Benjamin Magalong took action by joining Zuellig Family Foundation (ZFF)’s The Challenge Initiative (TCI) in 2021, a global program aimed at reducing teenage pregnancies. Thanks to this partnership, Baguio has seen improvements in its Adolescent and Youth Sexual and Reproductive Health (AYSRH) services.

A Focus on Education and Health

Baguio City, home to over 68,000 adolescents, is a highly urbanized city and a key educational center in Northern Luzon. Mayor Magalong is deeply committed to ensuring that young people remain in school and avoid early pregnancies, which can derail their education and future opportunities. “Adolescents are the future of today’s generation. Giving them the best education and concentrating on their welfare will secure the survival of the country,” he emphasized in a speech.

In 2022, the mayor formed a City Leadership Team (CLT) tasked with improving the city’s approach to adolescent health. That same year, Mayor Magalong and other CLT members attended ZFF’s Leadership for Adolescent Youth and Friendly Cities (LAYFC) training, which helped them strengthen their leadership skills and focus on providing the best possible health services to young people.

A Multi-Pronged Approach to Health

As part of its efforts to improve AYSRH services, Baguio City trained health workers through programs like Adolescent Health Education and Practical Training (ADEPT) and Family Planning Competency-based Training (FPCBT). These programs gave healthcare providers the skills they needed to offer better support to adolescents, whether they were seeking reproductive health services or psychosocial support.

A key milestone in Baguio’s progress was the certification of its 16 health facilities and the Baguio City General Hospital and Medical Center (BCGHMC) as adolescent-friendly health facilities (AFHFs). These facilities now meet high standards for offering AYSRH services, ensuring that young people can access the care they need in a supportive and understanding environment.

Bringing Services to the People

Baguio did not stop with improving its health facilities; it also reached out to communities, especially in remote areas. Through mobile outreach programs, the city has conducted 236 activities, serving over 9,600 women, including adolescent parents. This initiative helps bring essential services right to people’s doorsteps, ensuring that no one is left behind.

In 2023, the city council passed an ordinance aimed at preventing adolescent pregnancies and providing social support to young parents. This ordinance includes measures such as integrating Comprehensive Sexuality Education (CSE) into schools and training teachers and health workers to better address adolescent health issues. Additionally, the city has established adolescent health centers and is using social media to promote sexuality education.

Empowering Youth

Baguio City recognizes that peer support plays a vital role in addressing adolescent health. As part of its program, 74 student leaders have been trained as peer educators, enabling them to provide guidance to their fellow students. 130 barangay health workers have also been trained to promote family planning and sexual health services within their communities.

By 2023, the city’s modern contraceptive prevalence rate (mCPR) increased to 30%, up from 27% in 2022, reflecting the positive impact of these efforts.

Teenspired: A Place for Adolescents

Post-pandemic, Baguio City’s hospital-based adolescent health center, Teenspired, reactivated its youth-centered activities. These programs encourage adolescents to visit the hospital’s wellness center, even if they are not sick, to learn about proactive health practices. Over 500 adolescents now regularly visit the center.

Investing in the Future

Baguio City has also significantly increased its budget for family planning and adolescent health programs, investing Php 20.5 million in 2023, up 175% from previous years. This funding has allowed the city to deliver more effective services and reach more young people in need.

A Holistic Approach

Baguio City’s holistic approach to adolescent health—combining sexuality education, peer support, community empowerment, and well-trained healthcare providers—has led to a notable decrease in adolescent pregnancies. The city’s ABR has decreased by 16% since 2019, which is a notable achievement considering the increase in migration to the city.

A Bright Future Ahead

Dr. Flor O. Brillantes, the city’s Health Officer, credits the partnership with TCI for the city’s progress, saying, “The partnership brought an era of change and speedy action to impact our adolescents.” The efforts have not only improved health outcomes but also restored confidence in the healthcare system.

Mayor Magalong’s commitment to adolescent health serves as a model for other cities in the Philippines and beyond. By focusing on the well-being of its young people, Baguio City is building a brighter, healthier future for all.

Related articles:

• Five Cities Celebrate Milestone in Adolescent Health and Family Planning Efforts
• Baguio City: Towards Zero Adolescent Pregnancy
• Sustainable Solutions: Dipolog City’s Comprehensive Fight Against Adolescent Pregnancy

Before working with The Challenge Initiative (TCI), San Jose City in Nueva Ecija had a high rate of adolescent pregnancies. In 2020, the city recorded 43 births per 1,000 girls aged 15 to 19—higher than the national target of 37 per 1,000.

Jaira, a 15-year-old girl with dreams of becoming a flight attendant, got pregnant after a relationship with an older partner. She now lives with her parents and works on a farm to support her child. While she cannot change the past, she hopes for a better future for her and her family.

Mayor Mario “Kokoy” Salvador understood the link between poverty and teenage pregnancy. He wanted to address both by improving education and economic opportunities for young people. “Poverty grows when young people can’t finish school, so I wanted to find ways to reduce poverty,” he said.

San Jose City, located in Luzon, is a major transportation hub. Students from nearby towns like Rizal, Lupao, and Carranglan come to study here, contributing to high adolescent pregnancy rates.

Partnership with TCI

San Jose City in Nueva Ecija has made great progress in improving youth health through its partnership with Zuellig Family Foundation (ZFF), through TCI. City leaders say that TCI’s programs, especially the Leadership for Adolescent and Youth-Friendly Cities (LAYFC) training, have helped strengthen their adolescent and youth sexual and reproductive health (AYSRH) programs.

At first, city and health officials were hesitant to join TCI. It was a new program in the country, and San Jose was one of the first cities to participate. But after learning about TCI’s successful strategies, they saw how it could help address the city’s urgent health issues.

San Jose’s partnership with TCI began in 2021. Mayor Salvador and his City Leadership Team (CLT) took part in LAYFC training, a key requirement set by TCI. This training gave them the knowledge and skills to lead the city’s AYSRH programs.

The CLT, made up of officials from different local government offices, was established through Executive Order 36, series of 2021. Despite delays caused by the COVID-19 pandemic, the team remained dedicated. They updated their plans based on community input, ensuring their efforts directly benefited young people.

Making An Impact

By 2023, San Jose City’s adolescent birth rate (ABR) had dropped to 30 per 1,000, meeting the national target. The City Health Office (CHO) expects it to fall further to 27 per 1,000 by the end of 2024.

San Jose City worked with the Department of Health (DOH), Commission on Population and Development (CPD), public hospitals, and private health facilities to expand family planning (FP) services. Engaging private hospitals and lying-in clinics helped increase the modern contraceptive prevalence rate (mCPR) from 31% in 2022 to 32% in 2023, surpassing the national target.

The city trained healthcare workers and collaborated with private groups, providing them with FP supplies in exchange for monthly reporting. The city also built a strong data reporting system to track progress and adjust strategies as needed.

The Mandanas Ruling allowed San Jose to procure its own FP supplies, strengthening public-private partnerships and expanding access to contraception.

Empowering Healthcare Workers

All ten health facilities in San Jose City are now certified as adolescent-friendly health facilities (AFHFs). The city also launched the first Teen Information Center in the region, a hub where young people can access reproductive health information and support.

Training healthcare workers was a key strategy. In 2023, 37 workers completed programs like Adolescent Development Enhancement and Practical Training (ADEPT) and Family Planning Competency-based Training (FPCBT). They also received training in handling sensitive adolescent health issues. These efforts ensure that teens and young adults receive the best care possible.

Strengthened Policies and Budget Commitment

The local government passed five resolutions, two executive orders, and one city ordinance to sustain these efforts. One resolution authorized the mayor to sign an agreement with TCI. Ordinance 20-032 supports young mothers and helps prevent repeat pregnancies among teenagers.

The city also significantly increased funding for adolescent health. In 2023, it allocated PhP 1.6 million. By 2024, the budget had risen nearly 200% to PHP 4.6 million, with 92% of it already spent on training, service expansion, and making health facilities more youth-friendly.

Building a Future for Young People

San Jose City continues to expand its programs, ensuring young people have access to the information and care they need. The City Population Office and the Department of Education (DepEd) have partnered to implement Comprehensive Sexuality Education (CSE) in schools. The CHO is also working with private birthing centers and clinics to improve FP services.

The city has launched several initiatives to promote responsible parenting and family planning:

• Kalalakihang Tapat sa Responsibilidad at Obligasyon sa Pamilya (KATROPA): Encourages male involvement in family planning.
• Batang Ina at Batang Ama (BIBA): Supports teenage parents in raising their children.
• Information and Service Delivery Network (ISDN): Dispels myths and misinformation about contraception.

San Jose’s experience provides valuable lessons for other cities, especially those with growing migrant populations that may face similar challenges.

A New Dawn for San Jose’s Youth

“I am thankful to the RHU for always checking in on me and my family. When I miss a check-up, they send a barangay health worker to remind me, bring vitamins, and share information so I can prevent another unplanned pregnancy,” Jaira said.

Her involvement in the Usapang BIBA program has inspired her to help others avoid the same mistakes. “I want young people like me to know that we can turn our lives around after a mistake.”

Jaira’s journey shows the power of support and guidance. San Jose City’s work with TCI is a model for communities addressing similar issues. By prioritizing youth health, cities can create a better future for the next generation.

As Mayor Salvador put it, “We are proud of what we’ve achieved, but there’s still more to do. With the help of TCI, our community, and our partners, we’re confident that we can build a better future for the youth of San Jose City.”

Related articles:

• Five Cities Celebrate Milestone in Adolescent Health and Family Planning Efforts
• Sustainable Solutions: Dipolog City’s Comprehensive Fight Against Adolescent Pregnancy