Breaking the Cycle: How Mandaluyong is Addressing Adolescent Pregnancy
Mandaluyong City often stands out as a story of economic growth. In 2002, the Department of Trade and Industry (DTI) and the Asian Institute of Management Policy Center named it the “Tiger City” of Metro Manila. More than two decades later, the city continues to rank among the top five highly urbanized cities (HUCs) in per capita gross domestic product.
As the city grows, many residents still struggle. Migration continues to rise, informal settlements expand, and a large transient population makes long-term programs harder to sustain. One of the city’s most urgent concerns is adolescent pregnancy.
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Mandaluyong has kept its adolescent birth rate (ABR) below the national target, but progress has remained uneven. The ABR reached 19% in 2020, dropped to 13% in 2021, then climbed again to 18% in 2022. Poverty, unstable housing, and cultural differences linked to migration place adolescents at greater risk. For many young people, this reality means broken families, stigma when seeking health services, and limited spaces to talk openly about adolescent and youth sexual and reproductive health (AYSRH).
The city also struggles to improve the use of modern contraceptives. Uptake remains below the national target of 37%. National policies restrict adolescents’ access to contraception, allowing only age- and development-appropriate counseling, which limits prevention options.
Working with Communities
City Health Officer Dr. Arnold Abalos partnered with The Challenge Initiative (TCI), implemented in the Philippines by the Zuellig Family Foundation, to strengthen the city’s response to adolescent pregnancy. Together, they advanced Community Group Engagement, an approach that brings communities together through dialogue and education to promote healthy sexual relationships and influence social norms.
The city focused its efforts on three groups: adolescents, their peers, and the care providers who serve them.
Adolescent Health and Development (AHD) Program Coordinator Dr. Camille Almodiente-Mascardo shared, “Finding the right balance is really the key. One of our key messages is: they still have a choice and a future.”
Reaching Adolescents Where They Are
Mandaluyong invested in community-centered strategies that respect adolescents’ age, development, and lived realities. One key initiative, the annual Adolescent Congress, brings together around 1,000 public school students from across the city.
The congress gives young people a safe space to talk openly about sexuality, reproductive health, and life skills. Sessions on AYSRH and development help students understand physical, mental, and sexual changes. Activity booths run by peers, health workers, and local leaders add practical and relatable insights. The event also serves as a one-stop medical mission, offering dental services, vision screening, and physical exams. Over time, students have come to look forward to the congress not only for its services, but also for the chance to connect with peers.
The city also runs the Healthy Young Ones (HYO) lecture series, an information, education, and communication program for adolescents aged 10 to 19. The series covers eight modules, including puberty, sexual health, sexual orientation and gender identity, sexually transmitted infections, human immunodeficiency virus (HIV), acquired immunodeficiency syndrome (AIDS), and personal safety and well-being.
Over the past three years, with support from TCI, the Mandaluyong City AHD Program unit, in collaboration with the City Population Development Office, has implemented the lecture series in schools.
Youth Leading Youth
The city also strengthened the role of the Sangguniang Kabataan (SK). Mandaluyong trained SK officials and barangay youth leaders as peer educators, allowing them to share AYSRH information in ways that feel familiar and credible to their peers.
The city also encouraged SK leaders to act as governance partners. With access to resources and the authority to design programs, they launched youth-centered activities that complement the AHD Program, address physical and mental health concerns, and reduce stigma around seeking care. This approach connected formal governance with community action and ensured that youth voices shaped services.
Building Adolescent-Friendly Services
Mandaluyong recognized that adolescents will only seek care if services feel safe and welcoming. The city trained health workers, teachers, and school personnel to strengthen communication skills, address personal bias, practice empathy, and protect confidentiality—alongside technical competencies.
The city also invested in program leadership. Managers of adolescent health programs joined Health Leadership and Management Training (HLMT) to clarify their vision, take ownership of adolescent pregnancy challenges, and work together on practical and sustainable solutions.
Signs of Change
Progress has not followed a straight line, and challenges such as poverty and migration remain. Still, the city has begun to shift its approach. Adolescents now take on roles as educators, leaders, and advocates. Health workers act as allies rather than gatekeepers. Communities increasingly understand that adolescent pregnancy is a public health issue that calls for care, understanding, and shared responsibility.
Recent data show early gains. ABR has stabilized at 13%, while modern contraceptive use has steadily increased to 24%. Although more work lies ahead, these results show that Mandaluyong has made real progress in protecting adolescents’ health and future.
For Mandaluyong, the story continues. But in the voices of young leaders and adolescents who now claim their right to health, one thing is clear: the cycle can be broken.
From Momentum to Milestone: Mandaluyong City’s TCI Journey
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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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.