Iloilo City has been working hard to improve its Family Planning (FP) and Adolescent Sexual and Reproductive Health (ASRH) services since joining The Challenge Initiative (TCI)-Philippines in May 2023. With committed leaders and policies based on data, the city is making huge progress in bringing health programs closer to communities and solving long-standing problems with high-impact, locally adapted solutions. 

A recent trip to the field on August 20, 2025 gave a firsthand look at the progress being made and the energy that everyone is putting into it. 

Health in Action in the Community 

The opening of Iloilo City’s first PuroKalusugan in the Arevalo District was a big step forward for community-based service delivery. This program provides health services right to the purok, which is the smallest unit of a community. This makes healthcare easier to get, especially for people who don’t have access to it. 

At the launch, attendees had access to a full range of services, such as PhilHealth membership, consultations on maternity and child health, family planning counseling and provision, adolescent health services, nutrition support, and vaccinations. Putting services together shows that there is a plan to cover several health requirements in one easy-to-reach place. 

I met two young doctors, Earl Sevilla and Lysander Quintia, working as health center physicians in Iloilo. They are examples of what it truly means to serve the public. Even though they didn’t have a lot of resources and were dealing with problems like teenage pregnancy, rising cases of sexually transmitted diseases (STIs), and the growing trend of vaping among young people, Sevilla and Quintia were nevertheless very determined and passionate. Their choice to work in community settings instead of more lucrative jobs shows how strongly they care about public health and equity. 

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Leadership That Listens and Leads 

Strong leadership is setting Iloilo’s health agenda at the policy level. During a visit to City Hall, Vice Mayor Lady Grace Julie Baronda, a vibrant leader with legislative experience, showed great interest in learning more about the health concerns that need policy assistance or institutionalization. Her willingness to a dialogue shows that she believes in a style of government that values evidence, working together, and community voices. 

Grace Hofilena, representative from the Office of Mayor Raisa Trenas, said the same thing. She conveyed that the Mayor strongly supports the program and wants to keep working with TCI. This support from institutions is really important for sustainability and ensuring programs and policies have lasting effect. 

The City Leadership Team’s data shows the results of these concerted efforts. From 2020 to 2025, the modern contraceptive prevalence rate (mCPR) went up from 39% to 41%, while the percentage of demand satisfied* rose from 79% to 88%. Although the adolescent birth rate (ABR) has stayed the same at 19 per 1,000, it is evident that further action is needed. 

The city’s big budget increase for family planning—from 765,000 pesos in 2023 to 8 million pesos in 2025—may be the best indicator of political will. This jump shows that FP is not only a programming priority, but also a financial one, thanks to excellent leadership. 

Persistence and Progress 

When local leaders, health workers, and communities work together toward a common goal, like they did in Iloilo City, progress in public health is both attainable and realistic. But there are still challenges. Teenage pregnancies, STIs, and dangerous behaviors among teens are still putting a lot of stress on the system. To solve these problems, we need more than just technical fixes. We need to keep coming up with new ideas, work together across sectors, and get the community involved. 

The field visit showed not only what the city has done well, but also the qualities that support those achievements: compassion, resilience, and responsibility. Health workers are making services more accessible to people who live nearby. Local leaders are using policy and budgets to drive sustainability. And young professionals are putting service and making a difference ahead of their own interests. 

A Model for Local Health Governance 

The last two years have shown how powerful local governments can be in Iloilo City. They can achieve real, quick progress in important health areas when they have the necessary tools, data, and assistance. The city’s increasing investments in FP and ASRH demonstrate that robust political commitment, alongside community-driven innovation, can yield tangible outcomes. 

The lessons from Iloilo are clear: to improve family planning and adolescent health, we need more than just one-time action. It needs changes to the whole system, shared accountability, and working together. Iloilo City is a great example for other communities in the Philippines that want to invest in the health and future of their families and young people. 

—

 * Demand satisfied refers to the percentage of women of reproductive age who want to delay or avoid pregnancy and are actually using a modern contraceptive method.

Author: Dr. Anthony Faraon, ZFF TCI-Philippines Chief of Party

The road to a healthier future for Filipino youth is not a scenic route—it’s an expressway we need to build now. Last week in Bohol, at the Adolescent Health Learning Exchange (AdHLEx)—organized by the Department of Health (DOH) Adolescent Health Unit and DOH Center for Health Development VII—government leaders, health professionals, civil society, and young people gathered to map that route. 

The metaphor of roads—national highways, boulevards, crossroads, and yes, rough roads—showed both how far we had come and how far we had fallen off the track. On the “national highway” are broad policy frameworks like the Universal Health Care (UHC) Act and the Responsible Parenthood and Reproductive Health (RPRH) Law. On the “boulevards” are adolescent sexual and reproductive health (ASRH) services. At the “crossroads” stand local governments and multi-sectoral teams deciding whether to press forward or stall.  Far too many young Filipinos also find themselves on “rough roads” marked by early pregnancy, mental health struggles, and lack of access to care. 

National data gives us a mixed view. According to the Commission on Population and Development (CPD), adolescent birth rates (ABR) in the Philippines have generally declined in recent years—a sign that sustained interventions are working. However, there has been a rise in births among girls aged 10 to 14 years old, which is a real concern. These pregnancies are often the product of abuse and exploitation, and they can have lifelong consequences for the health, education, and well-being of these children. This is not just a statistic—it’s a warning sign. 

The lesson from Bohol is crystal clear: adolescent health cannot be treated as a side street. It must be central to our public health and development agenda. That means three things. 

First, integration. ASRH is not separate from mental health, nutrition, or protection from abuse—they are all part of the same path. A national plan that doesn’t reach the barangay health station or school clinic is a highway that ends in a dead zone. 

Second, youth participation. In Bohol, young leaders were not tokens on a panel; they were drivers of solutions—designing peer-led programs, confronting stigma, and reaching peers in ways adults can’t. We cannot plan adolescent health “for them” without planning it “with them”.

Third, scaling innovation. From peer education networks to mobile health clinics, the solutions already exist in pockets of the country. The challenge is not invention—it’s political will, financing, and replication at scale. 

This is where the work of The Challenge Initiative (TCI)-Philippines offers important lessons. In 24 cities across the country, TCI has worked with local government units (LGUs) to make high-impact practices for ASRH a permanent part of their work.  These include strengthening leadership teams, training health workers, making health facilities more welcoming to young people, and embedding adolescent health in local investment plans. 

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• Eight Cities Share Success in Family Planning and Adolescent Health

For example, in several LGUs where TCI support was sustained, adolescent birth rates among 15–19-year-olds dropped significantly within a few years. Cities have adopted referral systems linking schools, barangay health stations, and hospitals; improved commodity security for contraceptives; and launched social behavior change campaigns that reach both in-school and out-of-school youth. These are not just pilot initiatives that go away when funding ends—they are built into LGU budgets, policies, and processes. 

TCI’s approach proves that with local ownership, data-driven planning, and community engagement, adolescent health programs can produce measurable results. But the rise in pregnancies among the youngest girls shows there are still gaps in protection, prevention, and early intervention. LGUs need to strengthen links with child protection mechanisms, expand mental health services, and equip frontline workers to detect and respond to abuse swiftly. 

The Special Health Fund under the UHC Law offers an untapped opportunity. LGUs can earmark these pooled resources for adolescent health—financing outreach programs, peer education, and youth-friendly clinics. Schools can become gateways to care, not just sources of information, by partnering with health providers for on-site services. Communities can become safe spaces where adolescents access help without fear or shame. 

We are in a race against time. Every delay means another young life derailed by preventable pregnancy, untreated mental health issues, or violence. The choice is ours: keep patching potholes, or build the expressways our adolescents deserve.

At AdHLEx, we chose the latter. Leaders from national agencies, local governments, and the youth sector committed to accelerate progress, address the alarming rise in pregnancies among the youngest girls, and ensure every adolescent in the Philippines can grow up healthy, educated, and safe. 

The rest of the country must follow—not someday, but now. 

Author: Dr. Anthony Faraon, ZFF TCI-Philippines Chief of Party

When Mandaluyong City joined The Challenge Initiative (TCI)-Philippines in 2023, it did so with quiet determination and a clear sense of purpose. Mayor Benjamin Abalos Sr.’s letter of intent wasn’t just a formal document—it was a signal that the city was ready to invest in the future of its people, especially women and young people, by prioritizing access to quality family planning (FP) and adolescent and youth sexual and reproductive health (AYSRH) services. 

At the time, Mandaluyong’s modern contraceptive prevalence rate (mCPR) stood at 22%—still far from the national target of 37%. The adolescent birth rate (ABR) was 13 births per 1,000, better than the national average but showing an erratic pattern. These numbers gave us a snapshot: progress, but also room (and reason) to do more. 

Through a collaborative Program Design Workshop in November 2023, city stakeholders and the TCI team got to the heart of the matter. Together, three key challenges surfaced: fragmented coordination across departments, widespread myths and misconceptions about FP, and a lack of trained personnel. Familiar challenges, yes—but the way Mandaluyong tackled them was anything but typical. 

The city immediately set up a City Leadership Team (CLT), pulling in champions from different departments. This team wasted no time adopting five of TCI’s high-impact practices (HIPs): strengthening health leadership, engaging communities, making services more adolescent-friendly, improving post-pregnancy family planning, and empowering community health volunteers. Each intervention was locally driven and tailored to Mandaluyong’s needs. 

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• Eight Cities Share Success in Family Planning and Adolescent Health

Since then, it’s been a steady roll-out of smart, strategic, and scalable actions. Health workers have been trained on everything from informed consent to subdermal implants to intrauterine device (IUD) insertion. Youth leaders were engaged through the Sangguniang Kabataan orientation. Population workers, health leaders, and facility staff were brought into the fold through orientations, workshops, and coaching sessions. Alongside that, the city integrated FP and AYSRH programs into local events like the Adolescent Congress, Healthy Buntis Pageant, and Family Planning Month—turning awareness into action. 

Fast forward to today: the city has built a solid foundation for long-term self-reliance. There’s now a pool of Master Coaches mentoring others, a trained workforce offering quality FP and AYSRH services, a functional and empowered CLT, and an operational Health Management Information System that helps track performance and identify gaps. Even more affirming, the LGU has continued to increase its local investment in FP and AYSRH—a strong signal of ownership. 

The results are real: mCPR has gone up to 23.4%, and ABR has remained stable at 13. These may sound like small shifts, but they represent steady, measurable progress—especially in a field where change doesn’t happen overnight. 

And here’s what excites us even more: as of July 2025, there’s been a change in leadership in Mandaluyong. Mayor Carmelita “Menchie” Abalos, previously the Vice Mayor, is now at the helm. It’s clear that continuity is likely—especially with strong advocates like City Health Officer (CHO) Dr. Arnold Abalos and Assistant CHO Dr. Emily Detaro still championing FP and AYSRH from within. Their commitment, paired with Mayor Menchie’s openness to sustain the work already in motion, gives us confidence that the city’s momentum won’t just continue—it’ll grow. 

Mandaluyong’s journey with TCI is a solid example of what can happen when cities lead from the front—when political will, technical capacity, and community ownership come together with purpose. We’re looking forward to officially recognizing Mandaluyong as a self-reliant city on FP and AYSRH by September. 

Author: Dr. Anthony Faraon, ZFF TCI-Philippines Chief of Party

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.

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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.

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:

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• 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.

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.

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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.

Biñan City is proving that local government leadership, when paired with youth empowerment and data-driven strategies, can lead to measurable improvements in reproductive health. Once among the top 20 cities in the Calabarzon region for teenage pregnancies, Biñan has since emerged as a frontrunner in youth-focused family planning (FP) outreach, increasing its modern contraceptive prevalence rate (mCPR) from 71.3% in 2021 to 83.12% in 2024.

This progress did not happen overnight. Between 2016 and 2020, the Commission on Population and Development (CPD)-Calabarzon recorded 4,896 cases of teenage pregnancy in Biñan. In 2021 alone, there were 945 cases, with an Adolescent Birth Rate (ABR) of 47 per 1,000 girls aged 15 to 19—well above the national target of 30. These figures alarmed local leaders, prompting a full-scale response that combined service delivery improvements with strong demand generation.

 

Strategic Shift through Partnership

This urgent situation prompted Mayor Atty. Walfredo “Arman” Dimaguila Jr. and the local government to pursue a bolder, more integrated approach to reproductive health. A staunch advocate of youth development and a consistent champion for health equity, Mayor Dimaguila led the city in forming a partnership with the Zuellig Family Foundation (ZFF) under The Challenge Initiative (TCI)-Philippines in 2021. Through a formal Memorandum of Understanding, Biñan established a City Leadership Team (CLT) composed of representatives from the City Population Office, Department of Health (DOH), CPD, and ZFF. The CLT broke down previously fragmented programming and created a coordinated structure for adolescent health planning and implementation.

A key part of Biñan’s approach was the deliberate combination of supply-side improvements with demand generation strategies. The city knew that simply offering services was not enough—people needed to understand and trust them. To create demand, Biñan mobilized community actors, trained peer educators, and conducted sustained information campaigns. This was particularly important for youth, whose needs are often overlooked or misunderstood in reproductive health programming.

Engaging the Youth as Partners

Recognizing young people as equal partners rather than passive recipients, Biñan prioritized their active involvement. Through partnerships with the Department of Education, school leaders, and parents, the city supported peer education, values formation, and comprehensive sexuality education. Atty. Nora Pangan, Acting Department Head of the City Population Office, shared that the team began with school administrators to earn their trust, gradually involving parents and students in the process. 

Despite the onset of the COVID-19 pandemic, the city quickly pivoted to virtual platforms, ensuring continuity through online activities such as teenage pregnancy symposiums and adolescent health film dissemination. Once in-person activities resumed, Biñan organized blended, community-based events including the Pinsenya and Bunti’s Party, which used interactive learning to deliver maternal and reproductive health messages.

Teen centers became a cornerstone of the city’s youth strategy. School-based and community-based centers were designed to be safe, non-judgmental spaces for young people to access services, information, and mental health support. Formalized through Memoranda of Agreement with CPD-Calabarzon and educational institutions, three school-based teen centers were established across public and private schools. These centers also served as referral hubs under the Information Service Delivery Network (ISDN), linking adolescents to health providers and social support systems. Mental health, in particular, emerged as a recurring concern. Population Program Officer Hilario Pantua Jr. noted that the centers helped change how youth viewed mental health services, moving away from punitive associations with guidance offices and toward a model grounded in care and trust.

To expand reach and reinforce behavior change, Biñan trained peer facilitators and implemented youth-led sessions such as Breaking the Barrier Sessions (BTBS), Bunteens, Teenzania, U4U Teen Trail, and Parent-Teen Talks. These initiatives supported conversations on responsible parenthood, gender equality, and family planning—meeting adolescents where they were and speaking their language.

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

Building Demand, Strengthening Systems

Alongside youth engagement, Biñan strengthened its health service delivery system. Barangay health stations were upgraded and certified as Level 1 adolescent-friendly health facilities, while City Health Office I and II attained Level 2 certification. These facilities were staffed by adolescent health specialists and peer educators, ensuring services were accessible, inclusive, and age-appropriate.

At the core of these improvements was a commitment to data-driven planning. Through the Field Health Service and Information System (FHSIS) and the e-Plano platform, Biñan monitored service quality, contraceptive uptake, and teen pregnancy rates across all barangays. This digital infrastructure allowed for real-time tracking and responsive strategy adjustments, making program management more precise and impactful.

Complementing these efforts was the Serbisyong Arman Caravan, a mobile initiative delivering family planning and health services directly to barangays. The Caravan advanced the city’s rights-based FP messaging, promoting informed choice and correcting misconceptions about contraceptives. Rooted in grassroots engagement, the Caravan was instrumental in building community trust and addressing barriers to FP access.

Results and Sustainability

The results have been significant. City reports revealed that from an ABR of 47 per 1,000 in 2021, Biñan saw a sharp and steady decline: 22 in 2022, 16 in 2023, and 15 in 2024. This drop demonstrates the impact of the city’s combined efforts to build awareness, improve access, and nurture community support. Moreover, the rise in mCPR from 71.3 percent in 2021 to 83.12 percent in 2024 reflects not just improved availability of contraceptives, but also growing public confidence in family planning services.

To support this sustained progress, Biñan significantly increased its local investment in adolescent health. The city’s AYSRH budget rose from 625 thousand pesos in 2023 to 3.3 million pesos in 2024, and then more than doubled to 6.5 million pesos in 2025. These figures reflect the strong political will of Mayor Dimaguila and the City Council to institutionalize AYSRH programs and ensure that adolescent-friendly services are adequately funded across all barangays.

Biñan’s transformation is a testament to what is possible when leadership, data, and community action converge. Through its youth-led, multi-sectoral, and evidence-based approach, Biñan is building a future where every young person can access the services, information, and support they need to thrive—today and in the years to come.

For decades, access to reproductive health services in Manila was restricted by policy. Executive Order 003, enacted in 2000, effectively banned modern contraceptives in the city. Though it was eventually repealed, its replacement—EO 030 in 2008—prohibited the use of public funds for contraceptives such as pills, condoms, intrauterine devices (IUDs), and sterilization. These policies were only formally reversed in 2019. 

In 2020, City reports show that Manila’s modern contraceptive prevalence rate (mCPR) was just 6%—30 percentage points below the national target and among the lowest in Metro Manila. The adolescent birth rate (ABR) stood at 50 per 1,000 girls aged 15–19, 20 points higher than the national average of 30.

 

Rising to the Challenge

In 2023, the City Government of Manila joined The Challenge Initiative (TCI)-Philippines, co-managed by the Zuellig Family Foundation and the Bill and Melinda Gates Institute for Population and Reproductive Health. A structured roadmap was developed to address systemic issues and restore public confidence in reproductive health services.

Spearheading this transformation was Mayor Honey Lacuna-Pangan, who convened a City Leadership Team (CLT) to institutionalize reforms. The CLT addressed issues such as fragmented service delivery, outdated clinical protocols, weak data systems, low youth engagement, and lingering biases among providers.

Dr. Evelyn Rimando, Family Planning Coordinator at the Manila Health Department, captured the core of the problem: “How can we reach those in need of family planning if there is a shortage of trained staff, few people know that such services exist, and misconceptions about it are widespread?”

From Policy Paralysis to Grassroots Power

To overcome these barriers, the city launched the Bayanihan Outreach Program, modeled after the Filipino tradition of collective community effort. Small teams composed of trained midwives, supervisors, and barangay health workers conducted daily door-to-door visits in low-income communities, providing pills, implants, injectables, and condoms.

Dr. Rimando noted, “The response was overwhelming. For many, this was their first time accessing family planning services. Being met by someone they trust, right at their doorstep, changed everything.”

What began in just ten communities quickly expanded citywide.

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Training the Frontlines, Transforming the System

In parallel, the city invested in training to boost the quality and reach of reproductive health services. Through Family Planning Competency-Based Trainings (FPCBT):

• 20 midwives were trained in FPCBT Level 1
• 20 more learned to administer progestin-only subdermal implants (PSI)
• 15 health workers were certified as IUD trainers
• Another 15 became PSI mentors

These trainers helped capacitate 38 additional providers, helping Manila build a self-sustaining training network.

To boost demand for services, the Usapan series—structured group discussions—were rolled out in clinics. Midwives were trained to lead these sessions, tackling misinformation, and fostering informed choices.

Supporting Adolescents

Youth-specific interventions were introduced in 2025, starting with a training focused on the Adolescent Sexuality and Reproductive Health – Family Planning Module, grounded in the HEEADSSS or the Home, Education, Eating, Activities, Drugs, Sexuality, Suicidal Ideation, and Safety assessment framework. This globally recognized tool guides providers in addressing adolescents’ psychosocial and reproductive health needs holistically.

The training also featured the Adolescent Job Aid 2.0 (AJA), aligned with the Department of Health’s Omnibus Guidelines. However, a gap surfaced: out of over 50 public doctors in Manila, only four had prior AJA training.

Dr. Anthony Faraon, Chief of Party for TCI-Philippines, stressed, “Adolescent health training is essential, not optional.” He added that care for young people must be developmentally appropriate, respectful, and consistent.

To address training shortfalls, Manila is now seeking to scale adolescent health training locally and strengthen mentorship with ZFF-TCI and partners.

Systemic Reform from the Ground Up

Manila also tackled system-level bottlenecks:

• AYSRH services were made more youth-friendly
• Data-sharing agreements were formalized
• City Ordinance No. 9054 institutionalized the Key Assistance for Developing Adolescents (KADA) program, enabling stronger coordination across departments

The city’s long-neglected reproductive health infrastructure is now being rebuilt with intention and inclusivity.

A City Transformed

From a modern contraceptive prevalence rate of 6% in 2020, Manila surged to 35% in 2024. The adolescent birth rate fell from 50 to 15 per 1,000 in the same period. In recognition of these achievements, Manila was named a Global Self-Reliant City in family planning and adolescent health by ZFF-TCI. During the turnover, Assistant City Health Officer Dr. Gina Pardilla said, “This partnership empowers us to design interventions that truly respond to the evolving realities of families and young people. It is about meeting them where they are.”

Still, the work is far from over. Dr. Pardilla reflected, “If we are to sustain these gains, the commitment must go beyond training or funding. Our local systems must take ownership of reform, backed by national support.”

Where outdated policy once stifled progress, a spirit of bayanihan now fuels Manila’s drive toward equitable reproductive health. Families, adolescents, and providers are no longer sidelined—they are leading the change. This is Manila’s lesson: even the most entrenched public health challenges can be broken—one provider trained, one visit made, and one choice empowered at a time.

Naga City, the ‘Heart of Bicol’, is known for its rich history, deep religious heritage, and a strong sense of community. With a population of 209,170 as of the 2020 Census of Population and Health, it stands as the second most populous city in the Bicol Region. However, like many growing cities in the Philippines, it grapples with significant social challenges, including the rising concern of adolescent pregnancy, which continues to impact the youth and local development efforts.

Based on city reports, Naga’s adolescent birth rate (ABR) surged dramatically in recent years, climbing from 21 per 1,000 live births in 2020 to 106 in 2021, and even higher in 2022 at 110. This prompted local officials to rethink how they addressed adolescent reproductive health. Mayor Nelson Legacion recognized the urgency of the situation, particularly as young people struggled with limited access to reproductive health services and faced social stigma. The COVID-19 pandemic only made things worse by disrupting outreach programs and services.

 

A Strategic Partnership to Drive Change

In 2021, Naga City partnered with The Challenge Initiative (TCI)-Philippines, co-managed by the Zuellig Family Foundation (ZFF) and the Bill and Melinda Gates Institute for Population and Reproductive Health. This partnership led to the creation of a City Leadership Team (CLT), which helped harmonize and scale up family planning (FP) and adolescent and youth sexual and reproductive health (AYSRH) efforts.

“We’ve had adolescent-focused initiatives in the past, but they were not well-coordinated or harmonized,” said Joy Macaraig, Assistant Department Head of the City Population and Nutrition Office (CPNO). With 26 years in public service, she explained how the integration of FP and AYSRH under the CPNO helped streamline both outreach and service delivery. The CLT further empowered various departments to incorporate adolescent health into their work.

The results were striking: by 2023, Naga’s ABR had dropped to 71, and by 2024, it had plummeted to 20—well below the national target of 37 .

From Pilot to Full Coverage: Empowering Barangays

Originally launched in three barangays, TCI’s model was soon expanded to six through the mayor’s initiative, and later to all 27 barangays in the city. The backbone of this local effort was the Barangay Service Point Officers (BSPOs), who not only tracked adolescent mothers but also ensured these young families received critical health and nutrition services.

Healthcare workers were also equipped through TCI University, an online platform offering practical tools and real-world examples. Janet Beloro, a midwife at the City Health Office, noted the improvement in her service delivery. “When clients return and tell me they will practice family planning, that’s when I realize I’ve made a difference—that I’ve been an effective provider. I see their health literacy improving, and for young people especially, I notice their growing awareness.”

Institutionalizing the Vision: Naga’s AYSRH Ordinance

In 2023, Naga passed City Ordinance No. 2023-025, also known as the AYSRH Ordinance. Authored by Councilor Gayle Abonal-Gomez, a member of the CLT, the ordinance institutionalized adolescent health initiatives and created a dedicated local budget to fund them.

One key result was the establishment of an Integrated Service Delivery Network (ISDN), which strengthened referral pathways among barangay health stations, hospitals, schools, and NGOs. This made it easier for adolescents to access the care they need, when and where they need it.

Creating Safe Spaces for Teens

Another major achievement of the ordinance was the rollout of teen hubs in schools and barangays. These safe spaces provide young people—including out-of-school youth—with information, counseling, and support.

At Concepcion Pequena National High School, teacher Dessa Bermejo helps manage their school’s Teen Hub. “With teenage pregnancy remaining a pressing concern, young people need a safe space where they can confide in someone they trust—someone who will listen without judgment and provide the guidance and support they need,” she shared.

Teen hubs have already been set up in Barangays Balatas and Calauag, and the goal is to bring these hubs to every school in the city.

Empowering Youth Through Communication

To support a more holistic approach to adolescent well-being, the Commission on Population and Development Region V launched the ‘Hearts and Minds’ campaign, under Director Joyce Dela Paz-Hilvano. This pre-orientation program focuses on emotional well-being and self-awareness, laying the foundation for more informed decision-making in adolescence.

The result? Naga’s modern contraceptive prevalence rate (mCPR) has remained above national targets, signaling sustained progress in FP and AYSRH initiatives.

Funding the Future

Since joining TCI, Naga has grown its investment in AYSRH from Php 2.2 million in 2023 to Php 5.1 million in 2024. This increase supports teen hubs, healthcare worker training, and the continuous delivery of reproductive health services.

Importantly, the city’s general fund and annual investment plan now include AYSRH—securing financial sustainability beyond political cycles.

Naga City’s experience shows that tackling adolescent pregnancy demands leadership, coordination, and sustained investment. Its journey offers a clear message to other local governments: meaningful change is possible when adolescents are placed at the center of public health and development efforts.

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