Growing up in Northern Samar, Dr. Rommel Francisco knew the hardships of accessing public healthcare all too well. Daily, he watched as simple health concerns were often made worse due to a lack of access to basic healthcare services. He vividly recalls the two-hour boat rides taken by residents across the sea to receive basic medical help.

In college, he felt drawn to community medicine. “One subject that caught my attention was preventive medicine, where we were exposed to a community and I felt the people’s needs. I remembered my childhood years, growing up in the island community, with no doctors.”

After completing his medical education, he heeded his father’s advice to return home and be of service to his community. Dr. Francisco joined the provincial hospital, where he confronted the dire need for enhanced healthcare services in impoverished areas. This realization guided his decision to focus on public health, where he believed he could make a significant impact. In 2002, he began serving as the Municipal Department of Health (DOH) Representative assigned to a geographically isolated and disadvantaged area (GIDAs) in Northern Samar. He was back to his roots and ready to work. “Doing community work, I felt the need of the people,” Dr. Francisco says. “When I joined DOH, focusing on public health, I said to myself, this is my passion.”

Initial Efforts and Pressing Health Concerns

The healthcare landscape in Northern Samar was transformed through collaborative efforts. In 2010, a partnership between Northern Samar, the Zuellig Family Foundation (ZFF), the Department of Health (DOH), and the Center for Health Development was initiated to address the pressing health issues in the province. This collaboration focused on empowering local government units (LGUs) and integrating ZFF’s frameworks into provincial health strategies.

“We realized that the health sector cannot solve all the public health challenges. Collaboration and strong partnerships are essential in addressing these issues and creating a healthier and more equitable society for all,” Dr. Francisco says. “Healthcare providers, government agencies, political leaders, NGOs, and the private sector must work together. Combining resources, expertise, and influence allows us to address the root causes of health inequity.” Over the years, this partnership has grown and evolved, playing a significant role in the province’s healthcare improvements.

In 2012, the province recorded the highest maternal mortality rate in the region, highlighting the urgent need for effective interventions. Dr. Francisco prioritized addressing these maternal health issues through strong collaborations and partnerships with health NGOs and private stakeholders.

Reducing Health Inequities through UHC

Dr. Francisco’s advocacy for the Universal Healthcare Law (UHC) led to significant changes in Northern Samar’s healthcare landscape. The UHC Law brought several impactful changes. Northern Samar’s healthcare transformed through an innovative approach and comprehensive training, significantly improving its health service delivery. The province has seen a decrease in maternal mortality and better access to healthcare services.

The province’s health workforce has also benefited from the UHC Law, with initiatives aimed at training and deploying health workers to underserved areas. This has been complemented by innovations in establishing a Medical Scholarship Unit in 2020 to support local students pursuing medical education.

Building Resilience, Giving Back

Dr. Francisco’s journey is not over. He envisions a fut   ure where Northern Samar’s healthcare system is even more robust and accessible. His upcoming initiatives, such as enhancing the referral system and reducing the high costs of accessing healthcare services, are a testament to his unwavering commitment to continuous improvement. By the end of the year, he aims for 100% compliance with health standards and policies, a goal that inspires hope for a healthier future in Northern Samar.

One year into the Joint Program on Accelerating the Reduction of Adolescent Pregnancy (JPARAP) in Southern Leyte and Samar, we are seeing real progress. More adolescents are gaining access to sexual and reproductive health information and services, and the rates of adolescent births are dropping.

In Samar, the adolescent birth rate decreased from 37 births per 1,000 women in 2022 to 30 in 2023. However, in Southern Leyte, the rate rose from 15 in 2022 to 19 in 2023, highlighting the need for continued interventions to address the complex factors influencing adolescent pregnancy. While these numbers provide valuable insights, further studies are needed to fully understand JPARAP’s impact and identify areas for improvement.

Despite this progress, many adolescents in these provinces still face barriers to accessing their health rights. Tackling this issue was the focus of the Zuellig Family Foundation (ZFF)’s Provincial Expanded Youth Leadership and Governance Program (PEYLGP) held from September 16-18, 2024 in Tacloban City, as part of JPARAP.

During the event, leaders from Southern Leyte and Samar were introduced to concepts of Adaptive Leadership and advanced multi-stakeholder processes to enhance their leadership competencies. Participants included local government officials, youth development officers, and representatives from health and education sectors. These leaders are now tasked with strengthening collaboration, involving the youth in decision-making, and finding innovative ways to create lasting changes in their communities.

The training will soon extend to 20 municipalities across Samar and Southern Leyte, where local officials and youth leaders will continue working together to reduce adolescent pregnancy. Their hope is to engage families and communities to solve this pressing issue, as it takes everyone’s effort to make a difference.

While there is still a long way to go, the commitment of these leaders and the support of their communities are paving the way toward sustainable change.

Cagayan de Oro City once faced a troubling issue with student drop-outs due to teen pregnancy, with an adolescent birth rate of 47 per 1,000 in 2018. However, in just five years, that rate has dropped to 36 per 1,000 in 2023. The city’s modern contraceptive use also increased from 29% in 2020 to 33% in 2023, moving closer to its goal of becoming a youth-friendly city.

These positive changes are thanks to new approaches in adolescent sexual and reproductive health services and campaigns led by various agencies. The city has been part of The Challenge Initiative (TCI) Program of the Zuellig Family Foundation (ZFF) since 2020, which helped bring together a network of organizations, including the city health office, youth office, and schools, to work on these issues.

These innovative efforts were highlighted at the first National Highways for Adolescent Health Learning Exchange (AdHLEx) Forum in Metro Manila from August 12 to 15, 2024. The theme was “Building the Expressways Towards Adolescent Health and Well-Being”, organized by the Department of Health (DOH) through its Disease Prevention and Control Bureau.

Lord Saver Centina, Local Youth Development Officer in Cagayan de Oro, presented the city’s work in improving local health systems through the Information Service Delivery Network (ISDN). He co-authored a paper with Pearl Joy Catingub, City Technical Lead for ZFF-TCI. Their presentation focused on engaging and empowering Kagay-anon youth.

“TCI helped us to define clearer dimensions of multisector interventions, minimizing duplication of services, unified strategic directions, and increased budget allocation,”  Mr. Centina shared. He added that the Local Youth Development Office aims to bridge city-level issues by involving barangay youth leaders, particularly the Sangguniang Kabataan (SK) members and other youth groups. This initiative aims to improve local health systems and encourage youth participation in accessing essential health services.

Attending the forum were various dignitaries and Adolescent Health and Development representatives from across the country, including Dr. Rachel Dilla, City Health Officer and ISDN Chairperson; Dr. Aimee Grace Gemelo, Medical Officer, and Fe Sumagpao, Family Planning and Adolescent Health and Development Program Coordinator of DOH-Northern Mindanao.

The Adolescent Health Learning Exchange is a series of presentations aimed at promoting integrated actions for improving health outcomes for Filipino adolescents, especially in reducing common health issues and teen birth rates.

This event also featured a ‘motorcade’ showcasing adolescent health initiatives, sharing best practices from partners, academia, private sectors, civil society, and local governments. The goal is to raise awareness of the challenges faced by adolescents in schools, workplaces, and communities.

Forty municipal health and youth leaders from Marabut, Santa Rita, San Sebastian, and San Jose De Buan, Samar gathered at the Ramada Hotel in Manila for the second training module of the Municipal Expanded Youth Leadership and Governance Program (MEYLGP) from August 26-28, 2024. This training, organized by the Zuellig Family Foundation (ZFF) under the Joint Programme on Accelerating the Reduction of Adolescent Pregnancy in Southern Leyte and Samar (JPARAP) with UNFPA, focused on building leadership skills and celebrating progress in adolescent health and local governance over the past year.

The local government units (LGUs) shared their successes, highlighting increases in contraceptive use, reductions in adolescent pregnancies, and the creation of roadmaps to improve youth sexual and reproductive health.

Key Achievements and Changes

In Marabut, Mayor Percival A. Ortillo Jr. has been a strong advocate for tackling adolescent pregnancies. The town saw a troubling rise in teenage pregnancies in 2022, with 23 cases reported. Thanks to targeted programs and youth involvement, this number has dropped significantly to just 7 cases in 2024. This change demonstrates the effectiveness of their health initiatives.

One challenge has been encouraging young people to use contraceptives. Traditionally, only those who had given birth sought family planning. Now, Marabut has seen a 3.2% increase in modern contraceptive users from 2022 to 2024, indicating progress in changing attitudes.

Additionally, Marabut has maintained a zero maternal mortality rate from 2022 to 2024, showing improved access to healthcare services.

Mayor Ortillo’s team also focused on refining Marabut’s health strategy, reducing key problem areas from many to just three: comprehensive sex education, low prenatal care among teens, and limited contraceptive access. Efforts are ongoing to tackle these issues through cooperation with local schools and healthcare providers.

The Rural Health Unit (RHU) in Marabut is moving toward becoming a Level 2 Adolescent-Friendly Health Facility (AFHF), which will enhance its services for young people.

The KADA Network (Key Assistance for Developing Adolescents) has been launched to support adolescent health. This initiative, backed by the Department of Health, equips local leaders with resources to help youth make informed decisions about their health. Services will soon be expanded beyond schools to local barangays, making them more accessible.

While the budget is tight, Mayor Ortillo believes that dedication and support are key. His leadership is setting an example for other towns in Samar, encouraging them to prioritize youth health.

Learning from Each Other

At the training, leaders shared their experiences and strategies for improving adolescent health. This collaborative approach allows them to learn from each other’s successes and challenges.

In San Sebastian, Mayor Ferdinand T. Gaviola noted fluctuating trends in adolescent pregnancies over the past four years. After a drop to 7 cases in 2023, the number surged to 23 this year. The reasons are still being explored, but the mayor’s administration is now focusing on local policies to improve adolescent health and increase access to contraceptives.

In Santa Rita, the mayor, a former youth leader, is committed to fighting teenage pregnancy. The municipality has seen a rise in contraceptive use and maintained zero mortality rates since 2022. They have redesigned health programs to better serve teens and are integrating these initiatives into their governance plans.

Both municipalities are working on local roadmaps to guide their adolescent health initiatives and ensure lasting impact.

Ongoing Challenges

Despite progress, these towns still face hurdles, such as cultural resistance to family planning, financial limitations, and the impact of family dynamics and peer pressure on youth behavior. Issues like exploitation and early marriages also complicate efforts.

Addressing these challenges requires ongoing commitment and community engagement. Local leaders are determined to continue raising awareness and mobilizing resources to reduce adolescent pregnancies.

Commitment to Continued Progress

The training ended with each LGU creating six-month action plans to build on their achievements. Participants committed to strengthening local policies and increasing community involvement.

The training also featured research from the University of San Carlos, shedding light on challenges facing Filipino youth, such as child marriages. This insight emphasized the need for a comprehensive approach to youth development.

Looking Ahead

The MEYLGP Module 2 training showcased the power of local leadership and collaboration. A second batch of training is scheduled later this year with more LGUs joining the effort to improve adolescent health in Samar.

Mayor Vic Paul Salarda, born and raised in Alabel, Sarangani, has committed to improving the lives of his fellow residents. A former public school teacher for nine years, he was inspired by his parents, who were also dedicated teachers. He took office as mayor in 2016, after serving as a municipal councilor and vice mayor.

His mission is to tackle food insecurity and healthcare issues in Alabel, a town with vast agricultural land but recurring problems with food security and malnutrition. Shortly after becoming mayor, he joined the Zuellig Family Foundation’s (ZFF) Municipal Nutrition Governance Program to help address these challenges. His drive to serve intensified after his mother’s passing, leading him to take on the family’s political legacy with a focus on reform.

Poverty Plagues the Beach Town

When Mayor Salarda took office in 2016, nearly half of Alabel’s population was living in poverty, with a rate of 45%. The town’s poverty rate had been rising, reaching 46% in 2012 before slightly dropping to 44.7% in 2015. By 2017, the poverty rate had jumped to 64%, showing the severity of the situation.

Alabel’s terrain, mostly rolling hills and mountains, made farming difficult and attracted insurgents, though the military helped reduce their influence by 2015. Despite having vast agricultural land, Alabel faced food shortages, with local farmers producing only 40% of the needed food by 2022. Factors like a lack of farm machinery, no financing options, and selling land for industrial use worsened the problem.

Alabel’s population grew rapidly from 18,186 in 1975 to 88,294 in 2020, straining the town’s resources and services. A survey in February 2022 found that only 1% of families in Alabel were food secure.

Pressing Need to Amplify Interventions

In 2018, Alabel struggled in achieving its healthcare goals, particularly in maternal and child health. Key indicators like maternal mortality, antenatal and postnatal care, and skilled birth attendance were below target. Coverage for these services barely reached 60%, highlighting the need for better healthcare infrastructure and services.

The town also faced high malnutrition rates. Since 2017, over 22% of children were stunted, and 10.47% were underweight. Despite some improvements from 2017 to 2019, more comprehensive interventions are needed.

“What about the forthcoming years, the increasing population, and the conversions of agricultural lands? How would it affect our food supply?” Mayor Salarda asked. “How are we going to fill in the gaps? Should or can we always rely on food outsourcing? What will happen if LGU doesn’t act now? And what direction shall we take?” Early in his term, Alabel worked with ZFF, UNFPA, and the Department of Health to improve maternal care and ensure no mother dies during childbirth.

Deep Dive

Mayor Salarda and his team visited a family in Sitio Glamang, Barangay Datal Anggas, Alabel, where they found 4-year-old Joana severely malnourished and underweight. The area is remote, requiring a difficult two-hour journey with high transportation costs. Joana’s family, affected by a recent flood, had limited food and lived in cramped conditions. They ate mainly papaya and sweet potato tops, with rice being rare.

The core team members felt pity and frustration, realizing the difficulties posed by language, customary beliefs, and traditions in delivering services to the people. Rona Padilla of the Municipal Social Welfare and Development Office expressed disbelief that some children, particularly in geographically isolated and disadvantaged areas (GIDAs), are deprived of their right to education despite their efforts to promote early childhood care and development.

This encounter served as a reminder to Mayor Salarda and his core team of the need for a comprehensive plan of action to address poverty, hunger, and malnutrition in Alabel. They recognized the importance of collaboration with ZFF to achieve their goals and uplift the well-being of the community.

Taking action 

Alabel has received support from the Sarangani Provincial Health Office. Together they have strategized and allocated additional resources to enhance the local healthcare system and address the persistent challenge of malnutrition. This partnership aims to implement sustainable measures that will improve nutrition outcomes and ensure the overall well-being of the community. By focusing on comprehensive nutrition programs and interventions, Alabel is actively working toward alleviating the high incidence of malnutrition and promoting a healthier future for its residents.

 In 2021, Mayor Vic Paul Salarda launched the Municipal Food Security and Economic Recovery study and developed a 10-year food security plan. This plan aims to ensure that everyone in Alabel has access to safe, nutritious, and affordable food. To support this, Mayor Salarda set up a Food Security Council with committees focusing on production, technical skills, marketing, and linkages. The Council works to boost food production, build skills, and improve market connections.

Since 2022, Alabel has been implementing the plan, investing in farm machinery, supporting farmers with training and equipment, and improving food quality and access. They have partnered with organizations like Seaoil Foundation and Mahintana Foundation to provide nutritious food to schools and daycares.

Efforts also include targeting the poorest with scholarships, livelihood support, and financial assistance for farmers. The goal is to reduce food insecurity and poverty in Alabel through comprehensive and collaborative approaches.

Ensuring food security through the mobilization of barangay leaders

Mayor Salarda, with support from ZFF and Seaoil Foundation, met with all 13 barangay captains to discuss improving nutrition and food security. The captains agreed to support and guide local workers and adopt food security policies in their areas.

Salarda’s program, ‘Serbisyong Smile sa Barangay’, aims to help poor households, especially in remote areas, by providing health, social, and agricultural services. During the pandemic, the Jollibee Foundation’s community kitchen prepared hot meals for malnourished children using surplus produce bought by the LGU.

The new municipal food hub in Barangay Alegria helps local farmers sell their produce and provides a 100-peso fuel subsidy for deliveries. Efforts have reduced child stunting to 7.53% in 2022, benefiting 717 children.

Mayor Salarda plans to expand these initiatives and seeks more partners to improve infrastructure and support for farmers. Despite financial challenges in fueling their 10-year plan on food security and poverty alleviation, Alabel remains committed to making positive changes and further improving the well-being of its community members.

Dr. Feman Rene Autajay’s storied career in healthcare is marked by continuous learning. “In my 28 years of service, 23 years were spent as a Department of Health (DOH) representative to local government units (LGUs). I have learned so much about the different styles of governance and how to adopt them, to dance the way of politics, but still stick to your principles.”

Programs for Steady Progress 

Upon leaving his position as a Medical Officer for a hospital in Antique, Dr. Autajay decided to go into public healthcare when he transferred to Aklan. Filled with idealism and promise, Dr. Autajay supported Aklan’s series of innovative initiatives. He consistently participated in Provincial Health Board meetings, a platform for deliberating on and aligning Universal Health Care (UHC) implementation tactics. He ensured these tactics were synchronized with DOH budget allocation while considering community needs and concerns.

The province addressed health disparities among indigenous groups and underserved communities. By deploying Doctors to the Barrios (DTTBs) to serve the health needs of the Indigenous Peoples (Ati) in Boracay and mainland Malay, the province ensured access to vital healthcare services and also significantly enhanced their health outcomes, aligning with UHC’s objective of equal healthcare access and showcasing his dedication to health equity.

Dr. Autajay focused on expanding healthcare services by securing funding for infrastructure development. He is instrumental in completing the Yapak Mega Health Center in Boracay to meet the island’s increasing healthcare demands. He also prioritized enhancing the skills of healthcare workers through Basic Life Support (BLS) and First Aid training sessions. This project, backed by the DOH and the Provincial Health Office (PHO), improved the emergency response capabilities of healthcare professionals in Boracay Island and surrounding areas. 

Partnership with Zuellig Family Foundation

The Zuellig Family Foundation (ZFF) played a crucial role as a supporter and partner. ZFF’s programs supported the implementation of UHC in Aklan by providing essential technical assistance and resources. 

The Foundation’s emphasis on leadership and governance in healthcare also complemented Dr. Autajay’s work. ZFF’s assistance ran parallel to his commitment to upholding the UHC legislation by supporting Aklan’s engagement in the Provincial Leadership and Governance Program (PLGP) when it was introduced in July 2022. His support for the Governor and PHO in completing modules 1 and 2 of the Governor’s Executive Session, helped harmonize local strategies with UHC objectives and resulted in notable enhancements within Aklan’s healthcare system. 

Dr. Autajay’s involvement in the Bridging Leadership (BL) orientation workshop alongside appointed Development Management Officers also helped prepare them to guide LGUs under the Municipal Leadership Development Program (MLDP). The program explained the importance of integrating Province-Wide Health System (PHWS) for UHC and sharing UHC grants to build health facilities for the different municipalities. He effectively secured UHC grants to support provincial MLDP modules, with the University of the Philippines Visayas playing a pivotal role as educational partner. All his efforts in fostering a cooperative atmosphere for implementing UHC were all for the province of Aklan. 

Enhancing Resources and Building Strong Healthcare Networks

With Dr. Autajay’s guidance and the PHO team’s hard work, Aklan has made strides toward enhancing its healthcare infrastructure. This partnership led to the establishment of six District Health Boards in Aklan as model PHWS, Aklan being designated as one of the four Healthcare Provider Network (HCPN) demonstration sites, and the rise in Primary Care Facilities (PCFs), with operational licenses increasing from just one facility to 11 out of 17, aiming for complete coverage by May 2023—proving the importance of collaborations in successfully executing healthcare projects.

Looking to the Future

As Dr. Autajay gets ready for his next role, his contributions to Aklan are a testament to his unwavering dedication to excellence in healthcare. His innovative strategies, partnerships with stakeholders, and commitment to implementing UHC have helped set an example for maximizing learning while navigating the complexities of public healthcare systems. He intends to continue promoting UHC and utilizing his knowledge and skills to oversee healthcare facilities. He says, “I hope those I’ve worked with will continue to feel motivated to help the province. Because if we are not going to act, who else will?”

Working for the Department of Health (DOH) is Janriel Lavadia’s first job. A nurse by profession, Lavadia recalls, “My dream was to go into a clinical setting and be a nurse abroad. I was encouraged by some family members to join the DOH, and after some time, I realized that this is my calling.” Born and raised in Tuguegarao City, Cagayan Valley, it was only natural for Lavadia to serve his community.

Lavadia’s journey is marked by dedication and growth. His public health career began in 2013 as support staff for the DOH’s Kalusugan Pangkalahatan program. This initial role gave him a comprehensive understanding of DOH programs and the intricacies of public health. His exemplary performance led to his promotion to health program researcher, where he managed the immunization and disaster response programs of the Disaster Risk Reduction and Management Office (DRRMO).

By 2019, Lavadia was promoted to Universal Health Care (UHC) Regional Coordinator in his region. Lavadia says of his career path, “I guess with the experience I’ve had throughout the years and as a leader, if there’s a way for me to implement the program and how we engaged the different units, they saw I had the potential.” His administrative insights and ability to engage various stakeholders, including national agencies and local government units (LGUs), were recognized. Despite initial apprehensions due to the novelty and complexity of UHC, Lavadia embraced the challenge. “I was afraid to be part of the UHC,” he recalls. “Usually, doctors head the UHC, and there are no clear instructions, but I guess they saw that I don’t give up, so I took on the role.”

A Refreshing Take on Leadership

Leading the UHC initiative was a formidable task that required overcoming numerous hurdles. The transition to UHC needed to be improved, including resource allocation issues and resistance to change. However, appointing a dedicated unit for UHC under a new Regional Director helped streamline the process. This unit became the central hub for coordinating UHC activities, providing technical assistance, and building the capacities of LGUs. His leadership ensured this unit’s effectiveness, fostering collaboration between the central office and LGUs. “The dedicated unit helped push the UHC forward, because there was a way for all stakeholders to understand what was going on and to convene,” Lavadia says. 

Implementing UHC is no small feat, especially in a region with diverse needs and challenges. Janriel Lavadia recognized early on that the key to success lies in building trust and fostering a collaborative spirit among all stakeholders. He understood that effective communication was crucial in addressing the concerns and misconceptions surrounding UHC. By organizing regular forums and dialogue sessions, he ensured that every voice was heard and every concern addressed. His ability to foster a sense of ownership among his team members and partners was vital in maintaining motivation and ensuring continuous progress in UHC programs. His active engagement with LGUs and other government agencies advocated for a collaborative approach to health governance, reinforcing his commitment to making UHC a reality in his region.

One of the significant challenges Lavadia faced was the resistance to change. Many local officials and healthcare providers were accustomed to the system and apprehensive about the new UHC framework. To counter this, Janriel helped initiate capacity-building programs. These initiatives aimed to equip local healthcare providers and administrators with the necessary skills and knowledge to implement UHC effectively. He transformed skepticism into support, gradually building a solid foundation for UHC in Region 2.

A Crucial Part of UHC Implementation 

In 2022, the Zuellig Family Foundation (ZFF) partnership became instrumental in advancing UHC in Region 2. The programs, focusing on leadership and governance, addressed technical and adaptive challenges. He says, “We’ve included the best practices that we learned from ZFF. What to teach, what to adapt, how to transform those implementing UHC.”

Lavadia acknowledged the significant impact of ZFF’s Bayang Malusog program, emphasizing transformational leadership and adaptive strategies. It provided valuable insights into effective governance and political dynamics, crucial for UHC implementation. “It was a way to make our co-leaders feel that UHC is not just about technical know-how. It’s a way to approach a better way to implement it. I consider it a big help for them.”

Navigating the political landscape of Region 2 was one of Lavadia’s significant challenges. The region’s political rivalries often got in the way of the otherwise smooth integration of UHC programs. Lavadia worked diligently to help bridge these divides, advocating for a unified healthcare approach transcending political affiliations. His and the region’s efforts have resulted in increased cooperation and progress toward UHC goals. 

Vision and Legacy

Looking ahead, Lavadia is focused on helping further strengthen the healthcare system in Region 2. Realizing UHC would mean even the most remote and underserved communities can access quality healthcare. He is also keen on building stronger partnerships with private sector stakeholders, recognizing that a collaborative approach is vital for sustainable health improvements.

Lavadia is also committed to continuous learning and adaptation. He believes that staying abreast of global best practices and innovations in healthcare is crucial for successfully implementing UHC. Through encouraging learning and innovation within his team and the broader healthcare community, he aims to help ensure Region 2 remains at the forefront of healthcare advancements.

Janriel Lavadia’s story is about resilience, dedication, and visionary leadership. His journey inspires all those who aspire to make a difference in the field of public health, reminding us that with vision and perseverance, transformative change is possible. “I always have hope. I have always had this vision and will not stop until I get there. I want to create an environment where everyone accepts change.” He says, “No one should be afraid of it. It moves us to where we want to be. What we do now will affect our families and those around us. That’s what motivates me.”

Baguio City is not just known for its cool climate, scenic mountain views, and rich history but also for its pioneering efforts in adolescent health and development. The city has been grappling with the challenges of adolescent pregnancies, which, in 2018, saw an alarming adolescent birth rate (ABR) of 38.9 percent or around 809 girls aged 10 to 19 giving birth that year. This alarming situation prompted immediate action from the local government and concerned offices.

In 2021, Mayor Benjamin Magalong joined The Challenge Initiative (TCI)-Philippines to address this problem.  This platform in the country, co-funded and co-implemented by the Zuellig Family Foundation and the Gates Institute for Population and Reproductive Health, aims to improve the family planning and adolescent and youth sexual and reproductive health (AYSRH) services in the city. Through TCI-Philippines, Baguio City began working to lower its ABR and improve health services for adolescents.

Establishing Adolescent-Friendly Health Facilities

Creating health centers that cater specifically to adolescents and youth was a crucial part of this effort. In 2018, Baguio City did not have any certified adolescent-friendly health facilities (AFHFs). However, by the time the city’s initiative took full effect, all 16 health centers in the city were able to receive AFHF certification. Achieving this was not easy—it required thorough evaluations by the Department of Health (DOH), the Commission on Population and Development (CPD), and other important organizations. These assessments ensured that each facility met the necessary standards to offer services that are tailored to the needs of young people

Mayor Magalong highlights the importance of involving adolescents and youth in these efforts: “We want all adolescents to be well-educated rather than to rear and raise a child at an early age. The key is with our young leaders. We want the best for you, but you must help us, too.”

Schools as Safe Spaces

Another integral aspect of Baguio’s strategy is the integration of AYSRH education within schools. At Pines City National High School, Saturday mornings are dedicated to discussions on family planning, responsible parenthood, and sexual health. These sessions are led by peer educators, trained to provide relatable and approachable guidance to their fellow students.

Sheryl K. Anos, Population Program Officer at Lucban Health Center, emphasizes the importance of peer education: “It is good to train peer educators because we recognize adolescents are more comfortable opening up to their peers.”

Engaging the Community

Beyond the schools, the city also engages with barangays and conducts door-to-door visits to disseminate awareness. Health service providers, during medical outreach activities such as human papillomavirus (HPV) vaccinations, provide mini-lectures and follow up with interactive activities to make the sessions engaging for adolescents and youth.

Anos describes this multifaceted approach: “When it comes to our adolescents, we collaborate with barangays like during HPV vaccination for 9 to 14-year-olds in the barangay hall. We’ll have a mini-lecture, then games, and then vaccination. We also go to schools for advocacy campaigns. There are times when they are the ones who tap us. Mas maganda na kami din ang lumalapit sa kanila.”

Strengthening Youth Governance

One significant outcome of TCI’s work in Baguio City has been the strengthening of youth governance. The city council approved Ordinance 53 s. 2023, known as the “Baguio City Youth Code of 2023,” which aims to maximize youth participation, including out-of-school youth, in nation-building. This ordinance encourages civil society, non-government organizations, donors, the church, media, and the business community to fully engage the youth in community development. The ordinance underscores the city’s commitment to youth empowerment by emphasizing the need for enabling mechanisms and support systems that create opportunities to enhance and prioritize youth welfare. Recognizing the limitless potential of the youth,  Baguio City ensures that programs and policies geared towards their comprehensive development are being prioritized. This initiative, along with other targeted programming for various youth groups, affirms Baguio City’s dedication to nurturing its young population as future leaders and valuable contributors to society.

Collaborative Efforts and Results

The success of Baguio City’s initiatives becomes evident. By 2023, the city’s ABR had dropped to 14.5 percent from 20 percent in 2020. This remarkable improvement is attributed to the strong collaboration among the LGU, TCI, ZFF, and various stakeholders. “Apart from financial [support], when we talk with TCI-ZFF, we get suggestions and understand what can still be improved, what can be done. They guide us,” said Anos.

Former Adolescent Health and Development Program (AHDP) Coordinator Diana Aurora Delizo underscores the significance of comprehensive community involvement: “Through consultations and collaborations, we can see the perspective on the impact of our health centers on them and a wider insight on how effective our efforts are from the different viewpoints of our stakeholders.”

The Road Ahead

Despite the progress made, there are still challenges that need to be addressed. These include having enough staff for services related to adolescent health, creating dedicated spaces for young people, and sustaining the advantages of having peer educators. But the city is determined to keep getting better.  Sectoral meetings for health providers, sharing of good practices, and innovative approaches such as social media campaigns and participatory activities are all part of the ongoing efforts to enhance AYSRH services.

As the sun sets on another day in Baguio City, the journey towards zero adolescent pregnancies continues. The collaboration and unwavering commitment of Baguio’s health leadership give hope to the adolescents and youth.  Baguio City remains at the forefront of championing adolescent health and well-being.

The Bayang Malusog Provincial Leadership and Development Program (PLDP) Module 2, held in Tagaytay from June 18-20, 2024, brought together leaders from Laguna, Batangas, Quezon, and Lucena City to discuss the challenges and successes of implementing the Universal Health Care (UHC) program.

Laguna’s Strategic Navigation of Challenges

Dr. Rene Bagamasbad of Laguna Provincial Health Office (PHO) highlighted the province’s strong organizational structure and Local Health Systems (LHS) maturity despite financial constraints. Key challenges include reorienting newly elected Local Chief Executives, engaging private facilities, establishing Special Health Fund policies, and securing funding. Innovative strategies for Konsulta registration, such as medical caravans and PhilHealth coordination, are being implemented to overcome these hurdles.

Batangas’ Pursuit of Maternal Health Goals

Ms. Analiza Abrenica, UHC Focal Person for Batangas, reported on their efforts to reduce maternal mortality rates by improving pregnancy tracking and increasing public awareness. Successful partnerships with private facilities have been established, although integrating Local Government Units (LGUs) and sustaining the Health Care Provider Network (HCPN) remain challenges. Quezon stakeholders are interested in adopting Batangas’ HCPN model showing that collaboration is crucial for overcoming obstacles and building a sustainable healthcare system in the province.

Quezon’s Emphasis on Health Financing and System Strengthening

Dr. Kris Mangunay of Quezon PHO emphasized their focus on health financing and the Konsulta process, collaborating with various health offices. Challenges include PhilHealth’s responsiveness and the need for a stronger Health Information System (HIS). Quezon also faces challenges in convincing all component LGUs to integrate into the Provincial Working Health System and distinguishing between HCPN and Primary Care Provider Network (PCPN). They plan to develop a Provincial HIS and enhance health information campaigns to improve efficiency.

Lucena City’s Struggles and Collaborative Endeavors

Lucena City faces challenges such as hospital capacity and implementing an Electronic Medical Record (EMR) system. Ms. Lady Ticzon, UHC Coordinator for Lucena City, highlighted struggles with patient registration as a component city of Quezon province. Efforts to improve include partnering with hospitals, expanding the City Health Board, and seeking technical assistance from Quezon Province.

Key Takeaways and Moving Forward

The sessions underscored significant progress but also highlighted ongoing challenges. Key needs identified include: robust HIS; better engagement with PhilHealth; strengthened LGU integration; and optimized referral systems. Continued collaboration and resource sharing among the provinces are essential for enhancing healthcare accessibility and quality, fulfilling the UHC promise in CALABARZON.