From setting up teen hubs and centers in every public school and village to the creation of a council that will drive all programs for adolescents, Naga City is taking bolder yet wiser steps to curb teenage births through a newly passed ordinance.

Known as the “AYSRH Ordinance,” the measure was enacted last month, a critical move that would finally institutionalize and bring harmony to the city’s wide-ranging adolescent and youth sexual and reproductive health programs and services.

“The ordinance is like an arm or an instrument for us to be able to achieve our purpose, which is for adolescent girls to avoid being pregnant and for them to better prepare themselves for the years ahead because this lay down the acts that we have to do,” said Naga City Mayor Nelson Legacion.

Naga City’s adolescent birth rate has continuously dropped for the last four years, from a high of 30.21 in 2019 to 20.10 in 2022. But it has observed an uptick in repeat pregnancy in teenage mothers from a low 39 in 2020 to 56 in 2021 and 62 last year.

The mayor is pushing for zero teenage pregnancy in three years as it works under the guidance of The Challenge Initiative (TCI), a program co-managed by the Zuellig Family Foundation (ZFF) with the Bill and Melinda Gates Institute for Population and Reproductive Health.

Launched in 2020, the program aims to stem teenage pregnancies in the country by improving access to family planning programs and promoting positive health-seeking behavior among youth and adolescents.

Road to ‘zero’

Legacion expressed confidence that the “ambitious target” was doable with an ordinance that will strengthen the city leadership team and its information service delivery network (ISDN), composed of various stakeholders that will journey with the city government to achieve such dream, and with the continued support of TCI and ZFF.

Among the many things the ordinance would set in motion are the creation of the City Adolescent and Youth Sexual and Reproductive Health (AYSRH) Council, which will act as the advisory, planning, and policy-making body for the full implementation of the law, and the provision of a comprehensive culture-sensitive, age- and development-appropriate sex education in schools and the communities.

The law also obliges the city government to provide sufficient funding annually for all its AYSRH programs and services and to strengthen the capability of barangay health workers, nutrition scholars, and other frontline health and social workers in providing care and education tailored to the needs of adolescents and the youth.

Since joining the TCI, the city gradually increased its investments in ASYRH services from Php728,000 in 2020 to over P1 million in 2022, the start of the program implementation. It quadrupled to P4.1 million in 2023.

Adolescent-friendly spaces in all schools and villages

The ordinance also mandates the establishment of teen hubs in all public schools and teen centers in the barangays that will give adolescents and out-of-school youths an exclusive schedule to avail of reproductive health services with confidence and privacy.

So far, teen centers or adolescent-friendly facilities have been created in Barangays Concepcion Pequeña, Balatas, and Calauag.

“Part of the services we ask from teen centers and teen hubs is to address the stigmatization because it is one of the reasons why there is poor health-seeking behavior among our teenagers,” said Councilor Gayle Abonal-Gomez, author of the ordinance.

She also said the city was looking forward to getting private schools on board to set up their own teen hubs and mining data from its body of research on ASYRH to further improve the local government’s programs.

Underscoring the importance of the role of parents in teenage pregnancy prevention, the ordinance shall also see the implementation of a family support program that will provide parents of adolescents with the necessary education and support that encourage parental involvement.

“We are closely monitoring the rise in repeat pregnancies among teenage mothers…and based on observations and with our dealings with the barangays, the role of the family and parents plays a big part in this,” she said.

Widening of networks and programs

Another major component of the ordinance is the formal establishment of ISDN that will “harmonize all existing services and program interventions” on ASYRH in the city.

Under the newly enacted law, the City Population and Nutrition Office will spearhead gathering and linking up various stakeholders involved in the provision of ASRYH services to form a referral system and provide health services tailor-fit to the specific needs of adolescents.

“Before this ordinance, we already have many public and private partners and linkages, there are many programs and services [on ASYRH] available in the city. But the concern was that efforts were not institutionalized and harmonized,” said Abonal-Gomez.

“One advantage of this ordinance is that it will unify all our actions and with everyone officially on board, we will be able to grow our networks and the programs itself,” she added.

This article first appeared on the official website of the City Government of Naga.

(Published June 9, 2023)

By Cristina Eloisa Baclig

MANILA, Philippines—As the country continues to address teenage pregnancies among Filipino girls, two cities—Cagayan de Oro and Dipolog City—have already started seeing a significant decrease in the birth rate for adolescent mothers through effective interventions.

After a year since the prevention of teenage pregnancies had been declared a “national priority,” the adolescent birth rate (ABR) in Dipolog City fell from a high 73.8 per 1,000 girls (aged 15-19 years) to 30 in 2022.

Similarly, Cagayan de Oro has observed a huge reduction in its ABR from 47.4 five years ago to 34 in 2022.

The decline in the number of Filipino women in Dipolog and Cagayan de Oro cities who are confronting pregnancy at an early age was attributed to “data-driven innovations and high-impact programs” that heavily focused on youth involvement.

Among these programs undertaken by the city governments to provide solutions to curb teenage pregnancies was The Challenge Initiative (TCI), a five-year urban reproductive health program co-managed by the Zuellig Family Foundation (ZFF) and the Bill & Melinda Gates Institute for Population and Reproductive Health.

The program, which started in 2020, encouraged several areas nationwide to transform into adolescent-friendly cities that actively address the sexual and reproductive health needs of the youth in their communities to reduce unintended teenage pregnancies.

It also aimed to enhance the accessibility of family planning programs and promote positive health-seeking behavior among Filipino youth and adolescents.

Successful interventions

In just two years after Dipolog City joined an earlier ZFF program, which spanned from 2017 to 2020, the local government was able to address and reduce the growing cases of teenage pregnancies in the city.

In October 2020, Dipolog City was accepted as one of the pilot cities under TCI, which led to high-impact interventions to engage city governments, health providers, communities, adolescents and youth, and other stakeholders in providing adolescent and youth sexual and reproductive health (AYSRH) information and services in urban communities.

As part of the initial batch of cities engaged with TCI in the Philippines, the local government of Dipolog launched the “Team Batang Ama Batang Ina Initiative” or BABII—a task force created to address Adolescent and Youth Sexual Reproductive Health (AYSRH) issues including teenage pregnancies in the city.

The Child and Youth Code, “which included provisions on health education for the youth, addressing mortality and morbidity of teenage pregnancy, and promoting reproductive health and family planning for youth parents,” was enacted into a local ordinance last year.

Aside from the city’s well-developed and well-functioning AYSRH system, the local government also increased the modern contraceptive prevalence rate (mCPR) from 39 percent in 2018 to 53.72 percent last year.

This year, the city was given resources—around P9M in investments—to create more family planning programs to further bring down cases of teenage pregnancy in the city.

Cagayan de Oro City, also among the early TCI sites, has also recorded an increase in mCPR from 29 percent in 2020 to 36 percent in 2022—an achievement attributed to “engaging the youth through various programs that speak their language.”

Several youth-led initiatives were also launched in the city through the ZFF’s Youth Leadership and Governance Program—which trained youth leaders of the Sangguniang Kabataan, or youth council, to lead in the creation and implementation of AYSRH programs in different areas in the city.

“The TCI is a vital driver to help us expand our initiatives to become an adolescent- and youth-friendly city as we create a safe space where young girls and boys can easily access ASRH services and engage in programs for comprehensive health development,” said Cagayan de Oro Mayor Rolando “Klarex” Uy.

From one concern to another

Latest figures showed that cases of teenage pregnancy are already declining, not only in Dipolog and Cagayan de Oro cities, but also in other cities across the country.

According to data from the Philippine Statistics Authority (PSA), there were 5.4 percent of women 15 to 19 years of age who have been pregnant in 2022, lower than 8.6 percent in 2017, 10.1 percent in 2013, 9.9 percent in 2008 and 8 percent in 2003.

However, the Commission on Population and Development (PopCom) stressed that pregnancies among 10 to 14-year-olds saw an increase from 2,113 cases in 2020 to 2,299 in 2021—citing data from PSA and the Department of Health (DOH).

“Our concern now are births from [aged] 10 to 14 – the much younger teenage girls. The statistics vary depending on the source of data, but they are all worrying. And If I may emphasize, the 10 to 14 [age group] is now something that we need to look into,” said PopCom executive director Lisa Grace Bersales.

This article first appeared on INQUIRER.net.

(Published April 27, 2023)

At least 495 babies are born every day to Filipino girls aged 10 to 19 years, according to the 2019 data of the Philippine Statistics Authority. To address this, Malacañang declared as a national priority the implementation of measures to prevent teenage pregnancy through Executive Order (EO) No. 141, which further mobilized government agencies, the youth, and the community to work together in addressing the root causes of the problem.

Ahead of the EO signed on June 25, an additional 10 cities already heeded the call of The Challenge Initiative (TCI) in the Philippines to reduce teenage pregnancies. TCI aims to establish adolescent-friendly health facilities that promote positive health-seeking behavior and improve access to family planning programs.

Related story: Establishing adolescent and youth-friendly cities seen to help curb teenage pregnancies

Started in 2020, the TCI in the Philippines is co-managed and co-funded by the Zuellig Family Foundation (ZFF) and the Bill and Melinda Gates Institute for Population and Reproductive Health. The five-year project has been implemented in three pilot sites (Dipolog, Cagayan de Oro, and Puerto Princesa cities) in collaboration with the Commission on Population and Development (Popcom).

10 scale-up cities
The 10 scale-up cities are Santiago (Isabela), Baguio, San Jose (Nueva Ecija), Biñan (Laguna), Naga (Camarines Sur), Tacloban, Iloilo, Tagum (Davao del Norte), Tacurong (Sultan Kudarat), and General Santos. These were selected based on high political commitment, available budget and other resources, health system readiness, size of potential impact, and identified stakeholders.

The participating cities will be given technical assistance and guidance on TCI’s proven high-impact approaches on leadership and governance, quality adolescent and youth sexual and reproductive (AYSRH) health services, youth engagement, and demand generation.

Interventions include comprehensive sexuality education, inter-generational dialogue, policy development, and information and service delivery network for adolescent health and development.

Related story: Youth-led participation of religious sector in reducing teenage pregnancies

Providing access to the right information on adolescent sexual reproductive health (ASRH), family planning, and education through traditional and cultural approaches to reduce teenage pregnancies—this is the vision of Janifah Unda, 24, a youth leader in Masiu, Lanao del Sur. She takes part in the Zuellig Family Foundation’s (ZFF) Youth Leadership and Governance Program (YLGP), a partnership with the United Nations Population Fund (UNFPA) since 2018.

In 2019, an estimated seven girls aged 10 to 14 gave birth every day in the Philippines–a three-fold increase from 2000–according to the Commission on Population and Development (POPCOM). The YLGP aims to help reduce adolescent pregnancies in 10 rural municipalities of Sarangani, Sultan Kudarat, and Lanao del Sur by molding competent youth leaders who can spearhead and engage their community in youth-related health programs. Interventions include leadership and technical training, practicum, coaching, and mentoring.

Islam-compliant ASRH programs
Sharing during the mid-practicum presentation as part of the two-day YLGP virtual workshop held last February 18 and 19, Unda said that there was a common misconception that using family planning is against the teachings of Islam. Through the deep dive activities, she witnessed how poverty and lack of access to proper ASRH information and education have led to early marriages and teenage pregnancies in their municipality.

Deep dives are integral in the ZFF training, wherein leaders immerse themselves in unfamiliar environments and different contexts to gain a wider perspective of the real situation and build relationships with stakeholders. Unda talked to pregnant adolescents, witnessed their circumstances, and learned the lack of ASRH programs both at the barangay and municipal levels.

Stepping up to her role as Sangguniang Kabataan (SK) vice president in providing and engaging the youth in ASRH programs, Unda—together with the other SK leaders in Masiu—sought the engagement of Muslim Religious Leaders (Ulama Council) in the promotion of SRH to young people, particularly family planning from the Islamic perspective. The youth and their parents as well were able to debunk the notion that family planning equates to killing an unborn child in the mother’s womb, which is forbidden in the practice of Islam. They learned that family planning can be done to prevent conception. This helped them to be more open and understanding of the issues of early marriage and teenage pregnancy.

Related article: ‘Girls Not Brides’ Act Reinforces ZFF’s ASRH Initiatives

Decreased teenage pregnancies
Though limited to the records of pregnant women who visit their health centers, teenage pregnancies in Masiu dropped from 34 in 2018 (start of YLGP) to 25 in 2020. Unda’s team plan to continue the implementation of the Adolescent Pregnancy Tracking and Profiling, which they started in December 2020, to get more accurate data on teenage pregnancies.

Other accomplishments include having a functional Local Youth Development Council, and increased numbers of adolescent- and youth-led activities in SRH and adolescents reached with information and life skills on SRH.

Participating LGUs in the YLGP are guided by a technical roadmap that represents the status of their current system. With the desired impact of reducing pregnancies among adolescents and young people, an array of services should be provided, including health education, life-skills building, health promotion of available services, and provision of actual preventive services.

Related article: Establishing adolescent and youth-friendly cities seen to help curb teenage pregnancies

Continued youth engagement and LGU support
Faced with weak participation from other SK leaders and limited funding amid a pandemic, Unda and her team are still determined to achieve “a secure and diverse community that respects, empowers, nurtures, educates, and encourages a healthy and responsible youth population.” They are set to seek local government funding for ASRH programs such as the Peer Education Roll-out, which aims to create more youth leaders who can share the right information on SRH.

The YLGP is ZFF’s pilot program for engaging youth leaders. It was supposed to run for 18 months ending in December 2020, but the pandemic led to its extension until October 2021.

Know more about the ZFF health leadership training programs here: Public Health Leadership Formation.