The Province of Kalinga proudly graduated from the Roberto R. Romulo (RRR) Fellowship for Public Health Leadership and Governance last March 2025, joining Aklan, Davao de Oro, and Dinagat Islands in completing a year-long journey of transformative leadership. The program, led by the Zuellig Family Foundation (ZFF) in partnership with the University of the Philippines (UP) College of Public Health and the UP National College of Public Administration and Governance, helped local leaders sharpen their governance skills and tackle real health system challenges.

“Our leadership journey has not been easy—it mirrors the long and winding road of achieving Universal Health Care,” said Kalinga Governor James Edduba. “But along the way, we’ve seen real progress, and we celebrate both the small and big wins.”

Governor Edduba’s fellowship journey focused on three critical areas: reducing maternal deaths, improving emergency response, and strengthening mental health programs. His team finalized a province-wide referral manual and mobilized Community Health Action Teams (CHATs) to serve as on-the-ground health coordinators. “We capacitated our health workers to identify knowledge gaps and improve services where it matters most,” he explained.

To address the rise in road traffic injuries, Kalinga established an emergency response team and developed a province-wide accident reporting system. “Before, reports were fragmented. Now we use standard forms for all vehicular incidents—this allows us to make better, evidence-based decisions,” he said.

For mental health, the province passed an executive order mandating government offices to support mental health initiatives. A technical working group was formed to lead suicide prevention efforts, ensure data privacy, and guide media reporting. “We’re building systems to support the mental wellness of our people,” Gov. Edduba added.

Partnerships have been key to Kalinga’s progress. The province secured over 200 million pesos in medical assistance and signed agreements with apex hospitals to expand access to specialized care. “We engaged nearby provinces, private clinics, and national agencies. Our success is built on collaboration,” said the governor.

Governor Edduba’s commitment to health leadership started long before the RRR Fellowship. “When I was still Mayor, my nephew got sick and was sent to the ICU. I remember praying in the chapel beside him, promising I’d do everything in my power to improve health in our province. That moment changed me,” he shared.

Now, with better systems in place and a stronger network of partners, Kalinga is more equipped than ever to continue its health reform journey. As Governor Edduba said, “No single leader can do it all. But together, we can truly do great things.”

“Health is not just the government’s job—it’s everybody’s concern.” – Hon. Nilo Demerey, Jr., Dinagat Islands Governor

The province of Dinagat Islands graduated from the Roberto R. Romulo (RRR) Fellowship for Public Health Leadership and Governance last March 2025, joining three other provinces—Aklan, Davao de Oro, and Kalinga—in celebrating the end of a year-long journey to improve local health systems. With the support of the Zuellig Family Foundation (ZFF), in partnership with the University of the Philippines (UP) College of Public Health and the UP National College of Public Administration and Governance, the RRR Fellowship equipped local leaders with the tools to transform their health governance and make Universal Health Care (UHC) a reality in their communities.

 
Governor Nilo Demerey, Jr. led the province’s efforts with bold ideas and concrete actions. “Our province, though small, has faced significant challenges,” he said. “But with the right leadership, collaboration, and innovative strategies, we have made great progress in ensuring better health care for our people.”

Dinagat tackled major health concerns, including malnutrition, maternal deaths, low immunization coverage, and lack of access to hospital services. In 2024, stunting stood at 11.6% and wasting at 2.5%. There were also three maternal deaths recorded in the first quarter of 2025. In response, Governor Demerey’s team introduced several programs—most notably, a zero-billing policy on health services.

Under the fellowship program, the province launched the Remedy Aksyon Center to handle emergencies across all 100 barangays. They also expanded the Provincial Health Board and rolled out the Senior Citizen Health and Wellness Caravan, door-to-door healthcare services, and weekend medical missions. The province also distributed Remedy Cards—smart IDs with QR codes—to track every resident’s health history and services received. “We realized that those who need health care most are the ones who can’t reach hospitals,” Governor Demerey shared. 

Dinagat also invested in nutrition-sensitive policies, making backyard gardening a requirement for government aid. The province is also enrolled in ZFF’s Nutrition Leadership and Equity Acceleration Program (NutriLEAP) to further improve its nutrition governance and address malnutrition more effectively. 

Thanks to the RRR Fellowship, Governor Demerey said Dinagat’s health governance matured significantly. “This program helped us implement evidence-based policies that are practical and impactful,” he said. “We’ve moved from being a 4th class to a 2nd class province.”

“The public health tradition is not just about policies and programs,” Governor Demerey said in closing. “It is about commitment, collaboration, and compassion.”

In 2020, Santiago City faced a serious problem. Its adolescent birth rate was the highest in Region II—47 births per 1,000 girls aged 15–19. That meant too many young lives were being disrupted by unplanned pregnancies. For Population Program Officer Johanna Gabriel, these were not just numbers. She saw dreams put on hold and young futures changed overnight. This crisis unfolded during the COVID-19 pandemic, despite the city having a modern contraceptive prevalence rate (mCPR) of 39%, which was already above the national average of 30%.

 

A Unified Response: Empowering the Whole Community

Mayor Sheena Tan knew that stopping adolescent pregnancy meant involving the whole city. She reached out to The Challenge Initiative (TCI)-Philippines, co-managed by the Zuellig Family Foundation and the Bill and Melinda Gates Institute for Population and Reproductive Health. The first step was creating a City Leadership Team (CLT)—not just made up of health officials, but also representatives from education, planning, youth sectors, and even young people themselves.

The city’s response fit perfectly with its KAISAKA Development Strategies, which focuses on four pillars:

• Kabuhayan (Livelihood)
• Kalusugan (Health)
• Karunungan (Education)
• Kaayusan (Good Governance)

This meant adolescent and youth sexual and reproductive health (AYSRH) was addressed alongside other core priorities, and not treated as a separate issue.

Making Healthcare Youth-Friendly

Before the intervention, adolescents often felt judged or misunderstood at health centers. There was a lack of privacy, and services were not designed for youth. Santiago City changed this by building 37 community-based and 22 school-based teen centers—safe, respectful spaces designed with and for young people.

Importantly, these centers are now run by trained youth facilitators with guidance from adult mentors. This gives young people ownership and confidence. In 2023, Ordinance No. 11THCC-089 institutionalized the Information Service Delivery Network (ISDN)—a system to make sure youth services remain accessible, consistent, and effective across the city.

Related articles:

• Eight Cities Share Success in Family Planning and Adolescent Health
• Cities Lead the Way in Family Planning and Adolescent Health—Webinar Series to Spotlight Local Innovations

Training and Expanding Youth Reach

One of Santiago’s biggest challenges was the limited number of trained service providers in family planning. The city responded by using TCI tools to identify root causes of high adolescent pregnancy. It also adopted ZFF’s Bridging Leadership approach, empowering local leaders to work with young people in shaping policy.

The results were powerful:

• 638 Teen Facilitators were trained as peer leaders.
• Health workers received essential training in Family Planning Competency-Based Training (FPCBT 1 and 2), Adolescent Health Education (ADEPT), and Healthy Young Ones (HEYO).

At the same time, the city upgraded all Barangay Health Centers and teen centers to Adolescent-Friendly Health Facilities (AFHFs). These were linked to the broader public health system and supported by the Santiago City Youth Code and the Local Youth Development Plan.

Community Programs and Campaigns

The city knew awareness was just as important as access. It launched a range of youth-centered initiatives including:

• Samahang Teenage Nanay na Dakila (STAND) Project – for adolescent mothers
• Kalalakihang Tapat sa Responsibilidad at Obligasyon sa Pamilya (KATROPA) Program – to involve young men
• Project Developing a Responsive Environment for AYSRH Movement (DREAM)

Outreach strategies included house-to-house campaigns, social media content, and tailored Social and Behavior Change Communication (SBCC) materials to bring the right messages directly to young people and their families.

A Brighter, Healthier Future

Santiago City’s bold moves produced real results:

• Adolescent birth rate dropped from 47 in 2020 to 30 in 2024
• The city’s mCPR stayed strong at 36% in 2024, continuing to exceed the national standard of 30%
• More adolescents are confidently seeking care from health providers and peer facilitators

“KAISAKA namin kayo” (“we are with you”) is the heartbeat of Santiago City’s movement. From teen centers to city ordinances, from peer facilitators to youth awards, every initiative is rooted in a belief that adolescents deserve to be supported, informed, and empowered.

As Gabriel shared, it is about building a future where health-seeking behavior is a way of life, and where every young person has the tools and support they need to thrive. Santiago City’s journey continues—with commitment, compassion, and the confidence that change is not only possible, but is already happening.

Las Piñas City has come a long way from its humble beginnings as a fishing village. Now a bustling urban center in southern Metro Manila, the city’s population reached 628,652 by 2025, according to the Department of Health. Among these, 107,113 adolescents aged 10 to 19—or 17% of the population—represent both a major opportunity and a growing challenge for the city.

Las Piñas has built a strong infrastructure for adolescent health: 30 health centers, all accredited as Level 1 Adolescent Friendly Health Facilities, three Teen Centers, a social hygiene clinic, and a birthing clinic. But behind this network was a serious problem: services for young people were often uncoordinated.

Programs from health, education, and social welfare sectors operated in silos. This meant young people often had to navigate confusing or disconnected services—leaving many without the help they needed.

 

A Closer Look at the Numbers

City records show the adolescent birth rate (ABR) rose from 16 births per 1,000 among girls aged 15 to 19 in 2021 to 18 in 2022. But what was more alarming was the gap between reported pregnancies and actual deliveries. Dr. Justine Hernandez from the City’s Adolescent Health and Development Program explained, “Many pregnant adolescents, fearing stigma and judgment, sought to give birth outside the city or concealed their pregnancies entirely, often delivering in distant provinces.”

This trend distorted data and revealed that many young mothers did not feel safe or supported locally. The modern contraceptive prevalence rate (mCPR) stood at just 12% in 2022.

Without a system that connects services, the city risked letting more adolescents face health issues, early pregnancy, and long-term social difficulties.

Why the System Was Not Working

Three key gaps held the city back:

1. No unifying policy to align different sectors and prioritize adolescent welfare.
2. No clear leader or champion for coordinated action.
3. No referral system to guide adolescents from one service to another when needed.

These missing pieces led to duplication, confusion, and many young people falling through the cracks.

Related articles:

• Eight Cities Share Success in Family Planning and Adolescent Health
• Cities Lead the Way in Family Planning and Adolescent Health—Webinar Series to Spotlight Local Innovations

A Turning Point: The Challenge Initiative

In 2023, Las Piñas joined The Challenge Initiative (TCI)-Philippines, a global program co-managed by the Zuellig Family Foundation, the Bill and Melinda Gates Institute for Population and Reproductive Health, and Bayer, with technical support from the John Hopkins Bloomberg School of Public Health.

This partnership gave Las Piñas not just funding, but a framework and technical support to fix the system.

Led by Mayor Imelda Aguilar and City Health Officer Dr. Juliana Gonzalez, the city formed a City Leadership Team (CLT). This brought together the City Health Office, Social Welfare Office, Local Youth Development Office, Public Employment Service Office, the Department of Education, the Philippine National Police, and the Sangguniang Kabataan (SK)—all committed to working together for adolescent health.

Creating the Information and Service Delivery Network (ISDN)

To connect fragmented services for adolescents, Las Piñas created the Information and Service Delivery Network (ISDN)—a system that links health, education, social welfare, and security services into one coordinated referral network.

By 2023, the city developed a referral algorithm and began drafting protocols to ensure that adolescents could easily access the right services, regardless of where they first sought help. Frontline workers were trained to screen adolescent concerns and refer cases—such as mental health issues or adolescent pregnancy—quickly and appropriately.

The process started with mapping all adolescent-serving agencies and assessing service gaps. Then, in December 2023, a three-day workshop facilitated by the Commission on Population and Development (CPD) helped align partners and establish shared referral processes and data-sharing agreements.

With a clear system in place, the city empowered frontliners and introduced monitoring tools to track referrals, improve service delivery, and ensure accountability across the network.

Strengthening Coordination and Passing Policies

To further institutionalize the work, Las Piñas aligned ISDN with the Department of Health’s Key Assistance for Developing Adolescents (KADA) Network. In September 2024, a local ordinance officially created the KADA Network, ensuring long-term policy support.

The networks were launched on December 6, 2024, complete with service catalogs, referral guides, directories, and resource maps.

Las Piñas did not stop at planning. The city rolled out activities to make the system effective and responsive:

• Regular Adolescent Case Management Conferences help network members jointly solve difficult cases like cyberbullying and sexual exploitation.
• Enhanced Usapan sessions improved counseling, contributing to a steady rise in mCPR.
• Dedicated Family Planning Implementers were deployed to barangays, reaching more adolescents and families directly.

A Model Worth Replicating

Las Piñas backed its reforms with dedicated budgets, policies, and leadership structures. The referral system is now embedded in how the city works—simplifying workflows and ensuring adolescents can get help wherever they first seek it, whether in school, a clinic, or a barangay hall.

Monitoring is led by the Health Promotion Unit, and the CLT regularly reviews progress and listens to feedback from the youth themselves. “These gains translated into better access,” said Dr. Hernandez, “as more families were able to choose and obtain their preferred contraceptive methods at the right time.”

And the results are starting to show. By 2024, ABR had dropped to 13 per 1,000 births among girls aged 15 to 19. Meanwhile, mCPR rose to 19%.

More than just improving services, the city built a model that centers adolescents, builds community trust, and connects systems. From policy to practice, and planning to grassroots action, Las Piñas has become a leading example of how local governments can transform health systems for the next generation.

Davao de Oro joined Aklan, Dinagat Islands, and Kalinga in celebrating a key achievement last March 2025—the successful completion of the Roberto R. Romulo (RRR) Fellowship for Public Health Leadership and Governance, a program led by the Zuellig Family Foundation (ZFF) in partnership with the University of the Philippines (UP) College of Public Health and the UP National College of Public Administration and Governance.

For Davao de Oro Governor Dorothy Gonzaga, the year-long fellowship was a transformational journey. “Coming from the judiciary and only entering politics in 2022, I never imagined how complex the health system really is,” she said. “This program helped me understand the power of leadership in turning health challenges into opportunities.”

Davao de Oro faced five key health concerns:

1. Child immunization coverage remains critically low. Only 63% of children were fully immunized in 2024—far below the national target of 95%. This gap leaves many children vulnerable to preventable diseases.
2. Teenage pregnancy continues to rise. In 2024, the rate reached 51 per 1,000 adolescents, which is significantly higher than both national and global benchmarks. 
3. The province’s hospitals are overwhelmed. The four provincial hospitals have a 315% occupancy rate, far above the ideal 80–85%, putting strain on both patients and health workers.
4. The province struggles with limited funding to properly manage its hospital system. To address this, the provincial government has proposed the renationalization of one hospital to improve funding and governance. 
5. Enrollment in the PhilHealth Konsulta program is still low. Only 8.4% of residents have had their first patient encounter, showing the need for stronger public awareness and engagement.

Despite the gaps, the province has made important strides. It tapped Barangay Volunteer Sanitation Inspectors to improve sanitation monitoring and prevent disease outbreaks at the community level. An information system was also developed that profiles and helps track Barangay Health Workers. 

The KoboCollect digital tool is being used to collect and manage data on water, sanitation, and hygiene. A provincial communication plan was also rolled out to improve field registration for primary health services.

In terms of services, the province exceeded national targets in prenatal care coverage, skilled birth attendance, and family planning. “These wins give us confidence that we’re on the right path,” she said.

The RRR Fellowship emphasized Bridging Leadership—the idea that real change happens when leaders bring people together. “I learned I can’t do it alone,” Governor Gonzaga reflected. “We need our mayors, health workers, and citizens to co-create solutions.”

Governor Gonzaga credits the Fellowship for sharpening her sense of purpose as a public servant. “I now see health not just as a service, but as a platform for empowerment and equity.”

Iloilo City, lovingly called the ‘City of Love’, has long been known for its cultural richness and educational institutions. But in recent years, it has also emerged as a national model for adolescent health reform. Faced with rising rates of teen pregnancy and weakened service delivery, the city responded with bold leadership, strong partnerships, and deep youth engagement—changing the story for its young population.

A Crisis in Continuity

In 2019, Iloilo City’s Adolescent Health and Development Program (AHDP) was in crisis. A leadership change at the City Health Office and the retirement of key personnel created disruptions in program continuity. At the time, the city had only one Level 2 Adolescent-Friendly Health Facility (AFHF) based in the Arevalo District. Despite support from the Integrated Service Delivery Network (ISDN) and local ordinances, the program remained fragile.

Even before the pandemic, adolescent health was already at risk. The city recorded an adolescent birth rate (ABR) of 36 per 1,000 girls aged 15–19 in 2019. One particularly alarming case involved a 10-year-old girl, the youngest known to give birth in the city—a clear sign of service gaps and unmet needs. By 2022, adolescents made up more than 18% of the city’s total population, amplifying the urgency.

Then COVID-19 struck, stalling what little progress had been made.

 

A Turning Point: Local Action Meets Global Support

Change began in earnest in 2022, when Iloilo City joined The Challenge Initiative (TCI)—a global program that supports local governments in implementing high-impact, sustainable family planning (FP) and adolescent and youth sexual and reproductive health (AYSRH) interventions. Co-managed by the Zuellig Family Foundation and Bill and Melinda Gates Institute for Population and Reproductive Health, TCI helped the city reframe adolescent health as a shared, multisectoral responsibility.

A City Leadership Team (CLT) was formed, expanding the existing Technical Working Group into a powerhouse of cooperation. Members included city government units, the Department of Education (DepEd), the Technical Education and Skills Development Authority (TESDA), local colleges, the Iloilo City Police, the Sangguniang Kabataan (SK) Federation, and community organizations. Using TCI’s assessment tool as a strategic guide, the CLT pinpointed gaps and co-created solutions rooted in local realities.

“Through the Health Leadership and Management Program, our people evolved from support staff into leaders,” said Florence Joy Rubido, AHDP Nurse Coordinator. “We have achieved substantial progress. All district health centers in Iloilo City now have at least one Adolescent-Friendly Health Facility, and all adolescent focal persons from our nine district health centers have been capacitated through the AHDP foundational course in October 2023.”

Related articles:

• Eight Cities Share Success in Family Planning and Adolescent Health
• Cities Lead the Way in Family Planning and Adolescent Health—Webinar Series to Spotlight Local Innovations

Youth Voices at the Center

Iloilo’s new approach centered on empowering adolescents to lead. Programs like KaTEenAran, a teen center at Nabitasan Integrated School, gave marginalized youth a safe, structured space. The NewscasTEENg competition and the AHD Film Advocacy Contest with UP Visayas allowed youth to use media and storytelling as advocacy tools.

The Teen AD Facebook page grew into a vibrant online community, connecting over 2,900 members to health information and services. Meanwhile, the Peer Helpers Training program built a cadre of trained young advocates offering peer-to-peer support.

“Young people were not just reached, they were engaged on their terms, in ways that truly resonate,” said Richard Magullado, Information Officer of Commission on Population and Development (CPD)Region VII. “From film contests and newscasting to vibrant digital platforms, youth voices drove the movement.”

Reaching Every Barangay

The city also strengthened its demand generation workforce. All 224 Barangay Service Point Officers (BSPOs) were re-trained to deliver up-to-date FP information. The city’s grassroots commitment was evident in events like the Adolescent Summits in June and November 2024.

Held in Brgy. Sooc, Mandurriao and Arevalo respectively, these summits reached over 330 adolescents with sessions on teen pregnancy, human immunodeficiency virus (HIV), child labor, and family planning profiling. Parents were also engaged through Parent-Teen Talks and Usapan Sessions, breaking down taboos and building trust.

During Youth Day at Ramon Avanceña National High School, 92 adolescents joined interactive workshops on mental health, HIV, and Violence Against Women and Children (VAWC), reinforcing their agency and access to support.

Policy Backing and Budget Growth

Iloilo’s local policies strengthened these efforts. Ordinance No. 2017-048 institutionalized the ISDN, while Executive Order No. 141 (2021) underscored adolescent pregnancy as a national priority. These enabled a coordinated response, backed by real investment: the city increased its adolescent health budget by 620% from 2024 to 2025.

The results speak volumes. Between 2019 and 2024, ABR dropped from 36 to 24 births per 1,000 girls aged 15–19. Meanwhile, modern contraceptive prevalence rates (mCPR) have consistently exceeded the national benchmark of 30% at 41% in 2024.

A Movement Built to Last

“Iloilo City shows that when local leadership is bold, young people are engaged as partners, and systems are built to last, transformation becomes not just possible but inevitable,” said Magullado.

The city’s journey is far from over—but the foundation is strong. With sustained leadership, empowered communities, and energized youth, Iloilo is not only protecting its adolescents—it is equipping them to thrive.

And in true Iloilo fashion, it is doing so with heart.

Aklan proudly marked the end of a transformative journey. Alongside Davao de Oro, Dinagat Islands, and Kalinga, the province graduated from the Zuellig Family Foundation’s (ZFF) Roberto R. Romulo (RRR) Fellowship for Public Health Leadership and Governance in March 2025.

The RRR Fellowship, named after ZFF’s founding chair and in partnership with the University of the Philippines (UP) College of Public Health and the UP National College of Public Administration and Governance, aimed to equip governors and local health leaders with skills to solve real-life health problems.

For Aklan Governor Jose Enrique Miraflores, this was a year of action, collaboration, and meaningful progress for the province. The Fellowship builds on the province’s involvement in ZFF’s other health leadership programs, which helped strengthen the local health system and prepared Aklan’s leaders for deeper, systems-oriented reform.

 

From the start, Governor Miraflores made it clear: implementing Universal Health Care (UHC) was his top priority. As one of the pilot areas for the Healthcare Provider Network (HCPN), Aklan was determined to improve health services for every Aklanon. All 18 primary care facilities in the province are now fully licensed by the Department of Health (DOH)—a first in Western Visayas.

This success came from strong local unity. “All the mayors of the 17 municipalities, kahit ‘kalaban’ pa namin na mayors, they grasped what we need to do,” he remarked. “It’s not only my job to implement UHC. Dapat sama-sama kaming lahat.”

Governor Miraflores also shared the province’s top health challenges. These included:

• Delays in PhilHealth contracting: Even with all the preparation and local budget support, national delays in PhilHealth’s processes held back fund releases and service contracting.

• Slow first patient encounter (FPE) rates: Although 400,000 Aklanons are registered with PhilHealth, only 12% have completed their first patient encounter—still far from the target of 50%.

• Digital health systems: While many primary care facilities now use electronic medical records (EMRs), Aklan’s hospitals still lack full digital systems.

• Lack of health workers: Aklan needs more doctors, nurses, and midwives. The province is now drafting a plan to address this.
• Rising mental health cases: Aklan has the highest suicide rate in Western Visayas. Mental health became Governor Miraflores’ focus during his Deep Dive, a guided community immersion, under the Fellowship.

Despite the challenges, Aklan has achieved impressive results:

• Successfully negotiated with PhilHealth to become an HCPN demonstration site.
• All LGUs contribute 1% of their development fund to the Special Health Fund.
• Six district health managers hired to lead health services in identified clusters.
• Strong partnership with the Sangguniang Panlalawigan, which passed the Aklan HCPN ordinance.
• Digital health partnerships that led to an increase in PhilHealth reimbursements—from Php 104,000 in 2022 to Php 66 million in 2024.
• For mental health, Aklan passed a provincial ordinance and encouraged municipalities to adopt it. In one inspiring case, a troubled child received help and is now serving as a barangay health worker.

Governor Miraflores emphasized the value of data in decision-making: “Kailangan talaga data-driven. Before we decide on things, we need to see the data first so we can learn what we need to do.”

He also credited his training under ZFF’s Bridging Leadership approach, which focuses on personal ownership, co-ownership with stakeholders, and co-creation of solutions. “Hindi ako doktor, but I have to understand what’s happening in our health issues. I shared this mindset with our mayors. That’s why it wasn’t hard to convince them to collaborate.”

As he closed his RRR Fellowship journey, Governor Miraflores reflected on the long-term impact of their work: “Since I became a leader, this is what I always say: ‘What we do in life echoes in eternity.’ This is not only about legacy. It’s about what we do now that will benefit future generations.”

Mandaue City, a bustling center in Central Visayas, is proving that when reproductive health becomes a priority, women’s empowerment follows. For years, reproductive health services in the city were sparse—available only once a week, with just five trained providers serving thousands. Women, especially working mothers and adolescents, struggled to access timely and respectful care.

Cultural stigma and logistical barriers only deepened the gaps. That began to change in 2023, when Mandaue City joined The Challenge Initiative (TCI)-Philippines, a global platform, co-managed by the Zuellig Family Foundation (ZFF) and the Bill and Melinda Gates Institute for Population and Reproductive Health, that helps cities implement evidence-based, high-impact practices for reproductive health. The city faced a wake-up call: city reports revealed that adolescent birth rates had jumped from 14 per 1,000 girls in 2021 to 35 per 1,000 in 2023—more than double in just two years.

 

From Problem to Purpose

To respond, Mayor Jonas Cortes mobilized a City Leadership Team (CLT) composed of healthcare professionals, barangay officials, NGO partners, and youth advocates. With TCI’s technical coaching, Mandaue began scaling up its family planning and adolescent and youth sexual and reproductive health (AYSRH) programs, embedding rights-based, client-centered care into the city’s health system.

One major innovation: the Women’s Health Caravan (WHC)—a mobile outreach program designed to bring care directly to women in their communities. Launched in March 2024, the WHC is rooted in a simple but powerful belief: healthcare should be accessible, convenient, and empowering.

Services under the caravan include:

• Free consultations and pre/postnatal care
• Contraceptive services including implants and intrauterine devices (IUDs)
• Cervical and breast cancer screenings
• Human Immunodeficiency virus (HIV)/ sexually transmitted infection (STI) testing and counseling
• Adolescent-friendly, age-appropriate health services
• Health education on mental health, body image, and informed choice

At each site, the caravan begins with open discussions on reproductive rights and agency. Women are not only given access to services—they are encouraged to understand and assert their right to choose.

Related articles:

• Eight Cities Share Success in Family Planning and Adolescent Health
• Cities Lead the Way in Family Planning and Adolescent Health—Webinar Series to Spotlight Local Innovations

Results That Matter

Since the caravan’s launch, Mandaue has seen promising results. According to City reports:

• The modern Contraceptive Prevalence Rate (mCPR) rose from 27% in 2023 to 30% in 2024, meeting the national target for the first time.
• The adolescent birth rate (ABR) decreased from 35 to 29 per 1,000 girls, signaling improved access to youth-responsive services.

To complement mobile outreach, Mandaue also opened the ‘Pink Corner’ at Parkmall—a permanent, woman-focused health space offering services such as breast check-up, pap smear, mental health consultation, and HIV testing in a welcoming environment.

Investing in Long-Term Impact

The city’s commitment isn’t just about short-term wins. From 2024 to 2025, Mandaue increased its local budget for reproductive health by 381%—a bold statement of political will. These funds support operations, training, outreach, and continued innovation in service delivery.

All 27 family planning providers across city health facilities have undergone Family Planning Competency-Based Training (FPCBT), focusing not only on clinical expertise but also on client dignity and respect. The Department of Health (DOH)-Central Visayas provided oversight to ensure quality and alignment with national health policies.

A Network of Support

Mandaue’s progress stems from strong partnerships:

• DOH-Central Visayas guided the city in integrating the ‘Life Stage Approach’ for UHC.
• Commission on Population and Development Region VII helped align services with population and development planning.
• Local women’s groups and schools extended outreach to underserved communities and young people.

Together, they created a system grounded in local realities, but aligned with national goals.

Looking Ahead

As Mandaue continues its journey, the Women’s Health Caravan is more than just a program. It is a declaration: that every woman, no matter her age, location, or income, deserves the right to make informed decisions about her health.

As City Health Officer Dr. Debra Catulong affirms, “this is what happens when healthcare is made human. When services are local, consistent, and rooted in trust, behavior change becomes possible—and lives are changed in the process.”

In Mandaue, the future of reproductive health is mobile, inclusive, and driven by choice.

Perseverance—the unwavering will to keep moving forward despite challenges—is what defines the life and service of a 71-year-old Barangay Kagawad from Barangay Mambajao, Maasin City, Southern Leyte. 

Felizardo Ramos is a retired community organizer of the Commission on Population and Development. He dedicated 17 years to grassroots work. Today, even in his retirement, he continues to serve—this time with a deep focus on preventing teenage pregnancy in his barangay.

As the head of the Barangay Health Committee, he sees every learning opportunity as a way to improve himself and his leadership. He completed training under Modules 1 and 2 of Zuellig Family Foundation (ZFF)’s Barangay Expanded Youth Leadership and Governance Program (BEYLGP)—a training series that equips local leaders with innovative strategies to address adolescent health and rights. 

These sessions are part of the Joint Program on Accelerating the Reduction of Adolescent Pregnancy (JPARAP) in Southern Leyte and Samar. The program is supported by the Provincial Government of  Southern Leyte, the City Government of Maasin, the United Nations Population Fund (UNFPA), and the Korea International Cooperation Agency (KOICA). 

In Barangay Mambajao, reported teenage pregnancies among 15- to 19-year-olds rose from zero in 2021 to 3 in 2022. The number slightly declined to 1 in 2023 but increased again to 4 in 2024 and 6 in 2025. These numbers reflect the urgent need for sustained action to protect and empower young people.

To Ramos, making a difference is not about numbers—it is about heart. “Even if we are only two or three, as long as we have the commitment and passion to help others—especially adolescents—we can make a difference,” he shared. Over time, they realized that holding just one symposium was not enough to create real change. This is why Ramos is now planning to allocate funds for the Adolescent Sexual and Reproductive Health and Rights (ASRHR) program in the barangay.

With a renewed sense of purpose, he is determined to carry out the plans created during the program and follow through even beyond the end of the project. His promise is clear: to continue the fight against teenage pregnancy so that every adolescent has a chance at a better future.