General Santos City (GenSan) had trained health workers, functioning facilities, and national support for family planning (FP). Still, many families—especially in far communities—had limited access to modern contraceptives, particularly long-acting reversible contraceptives (LARCs), which can protect women for years. 

During the pandemic in 2020, modern contraceptive use was only 30%, and LARC use was low across the city. Beyond distance, a key problem was that offices worked in silos, leading to fragmented services and unclear data.

City leaders and advocates also saw gaps in data. Judith Janiola, Head of the City Population and Management Office (CPMO); Desiree Garganian, Regional Director (RD) of the Commission on Population and Development (CPD) Region XII; and Angelina Paule, President of the United Private Midwives of GenSan City, Inc. (UPM), shared that weak and inconsistent reporting hid the real picture of contraceptive use and adolescent pregnancy. This made it harder to design programs based on evidence.

Related article:

• Nine Cities Recognized as Global Self-Reliant Cities in Reproductive Health

 

In 2023, the city issued Executive Order No. 95-A creating the Family Planning Itinerant Team (FPIT) to reach underserved areas.

With support from the Zuellig Family Foundation through The Challenge Initiative (TCI)-Philippines, the Department of Health (DOH)-Region XII, and CPD-Region XII, GenSan also revived its City Leadership Team (CLT). Backed by former Mayor Ronnel Rivera and Mayor Lorelie Pacquiao, the CLT brought together health, education, social services, youth leaders, and community groups. The review confirmed that offices were not sharing data and that adolescent needs were often overlooked.

GenSan responded by aligning departments around shared data and goals. As RD Garganian noted, “General Santos was willing to lead, build capacity, and maximize TCI’s role in addressing these fundamental challenges.” A city directive required offices to share health data, helping teams see gaps and plan together. Providers were trained through the Family Planning Competency-Based Training (FPCBT), which gave hands-on skills in LARC insertion and removal, and strengthened adolescent-friendly, respectful care.

Trust and community outreach were central. “Earning the trust of clients is crucial,” Paule shared. “Our Enhanced Usapan sessions worked well because they didn’t just inform people about family planning—they also connected them directly to services.” Janiola added, “Family planning is not just about providing methods. It’s about improving quality of life. That’s why we emphasize informed choice and voluntarism.” Barangay nutrition scholars conducted house-to-house visits, and all facilities were upgraded to meet DOH standards for adolescent-friendly services.

The results were clear. All 46 identified providers completed postpartum FP training, and all health facilities earned DOH certification as adolescent-friendly. With cleaned and harmonized data, GenSan established accurate baselines. Modern contraceptive prevalence rate (mCPR) rose from 30% in 2020 to 34% in 2024, exceeding the national target of 30%. LARC use more than doubled—from about 8,000 users in early 2021 to over 20,000 by mid-2025.

GenSan’s experience shows that lasting gains come from system-wide coordination, strong leadership, trained providers, and shared data. As RD Garganian emphasized, “The GenSan experience was unique… showing that the city’s sustainability can go beyond external support.” For Janiola, the work continues: “With General Santos in such a strong position, we can only hope for more—more policies supporting family planning and adolescent health, and more advanced data collection and monitoring systems.”

Banner photo: GenSan mobile implant outreach

Tagum City, the capital of Davao del Norte, is a fast-growing urban center in Mindanao. Alongside its growth came persistent challenges in reproductive health, especially the unmet need for family planning (FP)—referring to women who want to delay or avoid pregnancy but are not using any modern FP method due to barriers such as limited access, lack of information, or social norms.

In 2023, the City Government of Tagum, under Mayor Rey Uy, partnered with the Zuellig Family Foundation through The Challenge Initiative-Philippines (TCI), the Department of Health (DOH)-Region XI, and the Commission on Population and Development (CPD)-Region XI to strengthen FP and adolescent and youth sexual and reproductive health (AYSRH) programs. 

Related article:

• Nine Cities Recognized as Global Self-Reliant Cities in Reproductive Health

 

Putting Communities and Youth at the Center

Even before TCI’s support, Tagum had community health efforts in place. However, limited resources meant these efforts were often fragmented. The city saw the need for a more coordinated and data-driven approach—one that addressed both demand for and supply of services.

Through the City Leadership Team (CLT), local offices, health providers, and community partners aligned around a shared strategy. This included Teen Tambayan Centers and the revitalized Usapan Serye, which brought structured and culturally sensitive discussions on FP and AYSRH to barangays and schools.

Youth played a key role as peer educators, especially in geographically isolated and disadvantaged areas (GIDAs). Their involvement helped normalize conversations on topics often seen as taboo.

“What began as a campus health forum for high school students has grown into a citywide movement—reaching elementary students, college youth, parents, and communities. By partnering with schools, the Parent-Teachers Association, Sangguniang Kabataan, and youth volunteers, Usapang Youth has expanded from classrooms to the streets, ensuring that health education and support truly meet young people where they are,” shared Edu Macabatas, Head of the Tagum Youth Development Office.

Community sessions complemented school-based activities. Dr. Dainah Casintahan Fajardo, City Health Division Chief, emphasized, “Because the city chooses to invest in its young people, with the help of TCI, we’ve grown from focusing only on the highest-need areas to now reaching all 23 barangays. With sustained funding for adolescents, we bring advocacy from schools to communities, ensuring every young person in Tagum is informed, empowered, and protected.”

Engaging Men and Shaping Shared Responsibility

Tagum also made sure men were part of the conversation. Through KATROPA (Kalalakihang Tapat sa Responsibilidad at Obligasyon sa Pamilya) and the locally developed Mr. GAD-PEGAD (Men’s Responsibility on Gender and Development–Parent Education on Gender and Adolescent Development), male leaders were engaged on gender equality, responsible parenthood, and reproductive health.

Messages That Reach and Resonate

To reach more people, Tagum invested in localized communication. Radio programs, social media posts, and printed information, education, and communication (IEC) materials used local language and real stories to build trust.

“Young people are naturally curious, and their questions—no matter how unexpected—deserve clear, honest answers. With localized IEC materials in their own language, we can bridge gaps in understanding, spark meaningful conversations, and guide them toward informed choices in family planning and adolescent health,” shared Charlene Gastanes Lanoy-Osido, Adolescent Health Development Program Coordinator.

Bringing Services Closer

Access to services improved through institutionalized Fixed-Day Services (FDS) at health facilities and mobile outreach for GIDA barangays. These ensured regular availability of both short-acting and long-acting contraceptives.

The city also responded to rising human immunodeficiency virus (HIV) cases among young people by offering free testing. “Rising HIV cases remind us how vital awareness and early testing are—especially for the young. By offering free HIV testing, we turn fear into action, empowering people to know their status and protect their future,” shared City Population Officer Dulce Amor Alcaraz.

With TCI support, midwives and nurses were trained in long-acting reversible contraception (LARC), including postpartum intrauterine device (IUD) insertion.

“Because of TCI’s support in training our family planning providers, services are now within reach. In every barangay, trained nurses are ready to serve, making quality care accessible right where families live. When a trained provider is just a few steps away, family planning becomes a choice everyone can freely and safely make,” Alcaraz added.

Continuous mentoring strengthened provider confidence and client-centered care. “Through Family Planning Competency-based Training (FPCBT), we’ve learned that counseling is just as important as the procedure itself. When clients fully understand their choices, they make informed decisions that protect their health and future—ensuring family planning is not just available, but truly empowering,” shared Archilee Cortado, FP Coordinator.

Results That Last

Tagum embedded FP and AYSRH into local policies, plans, and budgets—moving them beyond short-term projects. The City Health Office and City Population Office continue to lead multisectoral coordination through the CLT.

This approach led to measurable gains. The modern contraceptive prevalence rate (mCPR) steadily improved—from 35% in 2020 to 45% by 2024—exceededing the national target of 30%. The adolescent birth rate (ABR) rose from 38 per 1,000 live births in 2020 to 51 in 2022—above the benchmark of 37. By 2024, it dropped sharply to 32, meeting the national standard and reflecting the impact of sustained interventions.

Additional results include a 95% quality implementation score for postpartum FP, 83% gender integration in FP programming, and the inclusion of FP High Impact Practices in the city’s Annual Operational Plan and budget.

A Model Rooted in People

Tagum’s experience shows that lasting change begins with listening—using local language, trusted messengers, and data to guide action. By engaging youth and men, strengthening services, and embedding programs into governance, the city built a resilient and people-centered health system.

Tagum City’s journey proves that with strong local leadership and genuine community engagement, family planning can move from policy to practice—one conversation, one service, and one family at a time.

Banner photo: A Teen Tambayan Center of Tagum City

The Indonesia landscaping workshop last December 2025, in partnership with Jalin Foundation and supported by The Challenge Initiative (TCI)-Philippines and global colleagues, offered a rare glimpse into a country with a rich family planning (FP) history and a health system in active transition. Designed to help local partners prepare for the launch of the new TCI Indonesia Hub, the workshop surfaced valuable insights about Indonesia’s strengths, complexities, and emerging opportunities for impact. 

A Strong National FP Foundation 

Indonesia’s national FP program reflects decades of progress and remains one of the strongest in the region. The 2024 Family Data Update highlights a modern contraceptive prevalence rate (mCPR) of 62.38% among married women, alongside a stable method mix dominated by injectables and pills, with gradual growth in implants and IUDs. These indicators demonstrate a solid foundation on which cities and districts can continue expanding FP access and strengthening quality of care. 

A notable structural feature is that these indicators apply only to married women, as public facilities provide FP services exclusively to married clients. Adolescents and unmarried women typically rely on private providers and pay out of pocket—a big difference from the Philippine context, where FP services in public facilities are universally available regardless of marital status. 

City-Level Diversity as an Opportunity 

Beneath Indonesia’s strong national picture lies significant variation across cities, not as weaknesses, but as opportunities for more tailored, context-driven strategies. mCPR among married women ranges from 37.9% in Central Jakarta to 61.2% in Bandung, while unmet need* ranges from 16.0% to 35.0%. Several cities are already surpassing national targets for long-acting reversible contraceptives (LARC) uptake, while others show steady upward trajectories. 

This diversity underscores the value of localized action plans and city-led decision-making—precisely the environment where TCI’s coaching approach can help accelerate progress. 

Urban Realities: A Unique Set of Challenges and Strengths 

Indonesia’s cities present a mix of robust service platforms and distinct implementation challenges. With more than 53,000 FP service points, the country benefits from wide availability of services. A unique feature is the strong presence of independent midwife practices, which provide FP services to 36.46% of married women, a larger share than in the Philippines, where public health centers are the primary FP providers. 

Workshop discussions highlighted several key opportunities for Indonesia’s cities: 

• Supporting FP method continuation in fast-paced urban environments.
• Strengthening counselling and side-effect management to reduce switching and discontinuation of FP methods.
• Enhancing postpartum FP, especially given the country’s high postpartum visit coverage (77.63% nationally). 

These are natural challenges in any large, diverse urban setting—the very challenges that TCI aims to help cities address through practical tools, coaching, and evidence-based interventions. 

A Decentralized System With Parallels, and Distinctive Features 

Indonesia, like the Philippines, operates a decentralized governance system where districts and cities oversee FP implementation. The two countries share common experiences related to varying local priorities, the importance of local champions, and the need for strong coordination across sectors. 

However, Indonesia’s system also has distinct characteristics, including: 

• Centralized procurement of FP commodities handled by BKKBN (Badan Kependudukan dan Keluarga Berencana Nasional, “National Population and Family Planning Board”), ensuring national-level consistency in supply. 
• Implementation led by district and city health offices, creating a clear division between national procurement and local service delivery. 
• Strong community-based cadres, such as the TPK (Tim Pendamping Keluarga, “Family Support Team”), who play an active role in family development and outreach. 

These features shape Indonesia’s FP landscape in unique ways and offer a clear structure for where TCI support can add value. 

FP at the Center of Human Capital Development 

One of Indonesia’s strongest assets is its ability to position FP within a broader development vision.  Under BKKBN’s 2025–2029 Transformation Priorities, FP is deeply connected to: 

• reducing stunting, 
• supporting youth development, 
• strengthening family resilience, 
• driving digital innovation through tools like SIGA (Sistem Informasi Keluarga, “Family Information System”), and 
• advancing community-based behavior change. 

This framing aligns FP with Indonesia’s long-term human capital goals, creating a powerful foundation for TCI to build upon as it supports cities in designing integrated, family-centered FP strategies. 

Looking Ahead 

The workshop revealed a country that is not only committed to FP, but also fully prepared to take its next strategic leap. Indonesia’s strong policy environment, extensive service delivery platforms, and energized local actors create an ideal landscape for the establishment of the TCI Indonesia Hub. 

The momentum is clear: city leaders, local health offices, community cadres, and national counterparts all demonstrate readiness to adopt practical, and scalable approaches. With TCI’s coaching support, Indonesia is well-positioned to accelerate the translation of national priorities into city-level results, particularly in expanding choice, improving service quality, and reaching underserved urban populations. 

* Unmet need refers to the proportion of women of reproductive age who want to delay or stop childbearing but are not using any method of contraception.

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

The Zuellig Family Foundation (ZFF) celebrated the graduation of nine cities under The Challenge Initiative (TCI)-Philippines: General Santos, Iriga, Isabela de Basilan, Lapu-Lapu, Pasig, Mandaluyong, Quezon City, Tacurong, and Tagum. 

The Batch 3 Colloquium, themed “Sustaining Momentum: Transformative Reproductive Health Impact through Data-Driven Leadership,” took place on October 14, 2025, at the Park Inn by Radisson in Quezon City. The event gathered local government leaders, health officers, and partners from across the country to celebrate how cities strengthened their family planning (FP) and adolescent and youth sexual and reproductive health (AYSRH) programs through evidence-based leadership.

ZFF President and Executive Director Austere Panadero congratulated the cities for their progress. Across the nine cities, data show significant gains: all surpassed the national target for adolescent birth rates or incidence of teenage pregnancy (below 37 births per 1,000 women) and most exceeded the 30% modern contraceptive prevalence rate (mCPR) benchmark. “These are not just numbers,” said Panadero, “Ito ay mga kwento ng pagbabago—of stronger systems, more capable leaders, and communities that now make informed and empowered choices.”

Dr. Anthony Faraon, Chief of Party of TCI-Philippines at ZFF, presented key reproductive health trends, warning that while births among 15–19-year-olds are declining, births among girls below 15 are increasing. He challenged the audience: “Will we act now with the urgency this crisis demands or will we wait until the effects are irreversible?”

Related articles:

• Batch 1: Five Cities Celebrate Milestone in Adolescent Health and Family Planning Efforts
• Batch 2: Eight Cities Share Success in Family Planning and Adolescent Health

Panel 1: Family Planning Demand Generation and Service Innovations

Cities showcased innovative approaches that expanded access and inclusivity in family planning services:

• Tagum City – Mobilized grassroots leaders and youth advocates through Usapang Youth and KATROPA sessions, engaging men and youth as champions of reproductive health.
• General Santos City – Expanded outreach to underserved women through Family Planning Itinerant Teams and long-acting reversible contraceptives (LARCs).
• Lapu-Lapu City – Empowered barangay health workers as frontline FP service providers.
• Iriga City – Promoted culturally sensitive family planning among 21 Indigenous Peoples (IP) tribes.
• Isabela de Basilan – Localized reproductive health materials into 16 languages to reach more communities.

Panel 2: Adolescent Sexual and Reproductive Health (ASRH) Innovations

Cities also implemented programs that placed young people at the center of reproductive health advocacy:

• Mandaluyong City – Organized Healthy Young Ones lectures and the Adolescent Congress to create peer-driven learning spaces.
  Quezon City – Institutionalized prevention programs through Ordinance No. SP-3128, s. 2021, establishing the Information and Service Delivery Network for Adolescent Health and Development (ISDN4AHD).
• Pasig City – Developed a rights-based referral system to link services across agencies.
• Tacurong City – Integrated adolescent-friendly health services across all barangay centers.

Representatives from the graduating cities shared Leadership Narratives, reflecting on their efforts to sustain reproductive health reforms amid political transitions. They emphasized collaboration, data use, and strong community partnerships as key to their success.

In his closing message, Dr. Manuel M. Dayrit, ZFF Chairman, congratulated the cities for achieving global self-reliance: “You are all part of a global movement called TCI, covering hundreds of cities worldwide. Our local experience has global significance.” 

As of September 2025, ZFF and its partners under TCI-Philippines recorded the following results across 24 cities: 

• 947 Master Coaches trained nationwide;
• 209,574 additional family planning clients served;
• 21,589 outreach and demand-generation activities conducted;
• 577 health facilities certified as adolescent-friendly; and
• 780 facilities offering post-pregnancy family planning services.

These accomplishments reflect a shared lesson from the colloquium: that locally led, evidence-based, and community-rooted approaches can sustain reproductive health gains and inspire other local governments across the country.

The Challenge Initiative (TCI)-Philippines, implemented by the Zuellig Family Foundation (ZFF), will hold its Batch 3 Colloquium on October 14, 2025, bringing together nine cities that have made strides in improving family planning (FP) and adolescent and youth sexual and reproductive health (AYSRH).

The event, themed “Sustaining Momentum: Transformative Reproductive Health Impact through Data-Driven Leadership,” celebrates the achievements of General Santos, Iriga, Isabela de Basilan, Lapu-Lapu, Pasig, Mandaluyong, Quezon City, Tacurong, and Tagum, the final cohort of TCI-Philippines.

Over the past three years, these cities have shown how innovation, local leadership, and data use can translate into tangible gains—raising modern contraceptive prevalence rates (mCPR) and reducing adolescent birth rates (ABR). Their experiences highlight that locally led and evidence-based programs can drive lasting impact, even amid political and social changes.

Through the support of TCI-Philippines and ZFF, local governments designed and implemented tailored initiatives addressing their communities’ specific needs:

• Tagum City engaged men and youth as advocates, increasing awareness and participation in FP.
• General Santos City expanded access to modern contraceptives by deploying FP Itinerant Teams to reach underserved communities.
• Lapu-Lapu City strengthened service continuity by empowering barangay health workers to deliver FP services.
• Iriga City and Isabela de Basilan improved inclusivity by tailoring FP efforts to indigenous peoples through localized communication strategies.
• Mandaluyong City reduced  adolescent pregnancies through community group engagement 
• Quezon City institutionalized adolescent pregnancy prevention through an ordinance, creating a coordinated network for youth health and development.
• Pasig City improved adolescent-friendly health services through a comprehensive Information and Service Delivery Network (ISDN).
• Tacurong City integrated adolescent needs into regular health services, ensuring continued access to reproductive health care.

These innovations build on the lessons of previous TCI-Philippines batches in Cagayan de Oro, Dipolog, Puerto Princesa, Baguio, San Jose, Iligan, Naga, Santiago, Biñan, Mandaue, Manila, Iloilo, and Las Piñas, whose experiences affirm that sustained political commitment, data use, and community engagement are key to improving reproductive health outcomes.

Click to join us via Zoom

As TCI-Philippines concludes its final cohort, the Colloquium aims to showcase city achievements, share best practices, and inspire other local governments to adopt scalable and sustainable approaches to FP and AYSRH.

Related articles:

• Batch 1: Five Cities Celebrate Milestone in Adolescent Health and Family Planning Efforts
• Batch 2: Eight Cities Share Success in Family Planning and Adolescent Health

The Zuellig Family Foundation, through its The Challenge Initiative (TCI)-Philippines team, met with Mandaue City Mayor Thadeo Jovito “Jonkie” Ouano, City Health Officer Dr. Debra Maria Catulong, and the dedicated staff of the City Health Office. The discussion highlighted the city’s steady progress in advancing family planning and adolescent health services over the past two years, while also laying out a shared vision to sustain and build on these gains in the years to come. 

Bringing Services Closer to Families 

When Mandaue City first joined TCI  in 2023, access to family planning was limited. Only five midwives in the entire city had the skills to provide certain contraceptive services, and residents often had to travel far or wait for schedules to receive care. Today, that situation has been transformed. All 27 barangay health centers now have trained midwives, nurses, and doctors who can provide modern contraceptives on a daily basis. 

This decentralization of services has had a direct impact on families. The city’s modern contraceptive prevalence rate has risen from 19 percent in 2020 to 30 percent in 2024—meeting the national target. Behind these numbers are women who are better able to space their pregnancies, parents who can provide for their families with greater stability, and adolescents who can make informed choices about their futures. 

Related articles:

• Mandaue City Redefines Reproductive Care through Women’s Health Caravan
• Eight Cities Share Success in Family Planning and Adolescent Health

Making Services Adolescent-Friendly 

The city also recognized early on that adolescents face distinct barriers when seeking health services. Young people often hesitate to ask for help because of stigma or fear of being judged. To address this, Mandaue invested in adolescent-friendly health services (AFHS), redesigning facilities to ensure privacy and training staff to listen and respond without judgment. 

As of today, ten barangays have already achieved certification from the Department of Health as adolescent-friendly, and the rest are moving toward the same goal. With these changes, adolescents in Mandaue are finding spaces where they feel welcome, safe, and respected. 

Integrating Family Planning into Everyday Care 

A significant innovation in Mandaue has been the integration of family planning into the full range of health activities. Whether through immunization drives, cancer screenings, or women’s health check-ups, family planning has become part of routine care. This approach helps normalize conversations about reproductive health and ensures that no opportunity is missed to provide information and services. 

Investing in Sustainability 

The city has also demonstrated strong political and financial commitment. From 2.5 million pesos in 2024, the budget for family planning and adolescent health rose to 12 million pesos in 2025—a fivefold increase. This reflects both the prioritization of reproductive health and the recognition of its importance in improving overall well-being. 

At the same time, Mandaue is pursuing PhilHealth accreditation for its facilities and providers. This will allow reimbursements to flow back into the health system, creating a financial cycle that sustains services over time. Coupled with the Special Health Fund under Universal Health Care, the city is positioning itself for long-term continuity of family planning and adolescent health programs. 

Key Lessons from Mandaue’s Experience 

Several lessons stand out from Mandaue City’s journey. Strong local leadership, led by the mayor and supported by the city council, has been central to accelerating reforms. Systems change is possible when local governments commit to decentralization, integration, and youth-friendly service delivery. Listening to adolescents and families has helped ensure that services are relevant and stigma-free. Finally, financial sustainability must be built deliberately, as demonstrated by the city’s budget increases and its pursuit of PhilHealth reimbursements. 

Looking Ahead 

Despite these successes, challenges remain. The city aims to achieve adolescent-friendly certification across all barangays, expand peer education networks, and continue strengthening data quality and use. Ensuring a consistent supply of commodities and fully utilizing available budgets will also be critical to sustaining progress. 

What is most notable is the sense of ownership within Mandaue City. Local leaders, health workers, and communities see these programs not as external projects but as their own responsibility. This perspective is the clearest sign that sustainability is within reach. 

Mandaue City’s story is one of determination, innovation, and leadership. From expanding access to family planning, to creating youth-friendly spaces, to embedding sustainability through financing, the city has demonstrated how local governments can drive meaningful health reforms. 

By making services more accessible to families and more welcoming to adolescents, Mandaue is showing what it means to build a healthier and more empowered community. Its experience serves as a model for other cities in the Philippines—and beyond—on how to combine political will, systems strengthening, and community-centered design to achieve lasting impact. 

Meeting photos from: Mandaue City Public Affairs Office

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

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. 

Related articles:

• Iloilo’s Youth Health Movement in Action
• Eight Cities Share Success in Family Planning and Adolescent Health

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 Expanded Youth Leadership and Governance Program (EYLGP) in Southern Leyte is helping young people and local officials work together to reduce adolescent pregnancies.

A joint initiative of the Zuellig Family Foundation (ZFF) with support from the United Nations Population Fund (UNFPA) and the Korea International Cooperation Agency (KOICA), EYLGP equips both youth leaders and local governments to work side by side in improving adolescent health.

When the program started in 2022, Southern Leyte already had a lower adolescent birth rate (ABR) than the national average. UNFPA challenged the province to aim higher: bring adolescent births down to zero by 2026. With this ambitious goal, the EYLGP scaled up lessons from Mindanao—where ZFF’s youth leadership programs helped lower teen pregnancies—by also including mayors, health officers, and community leaders in capacity-building. The idea was that with both youth champions and competent local governments, results could be achieved faster.

Now on its 22nd month, the program has shown strong results:

• All 10 partner local government units (LGUs) reduced adolescent births, with the provincial cohort ABR dropping by 29%—from 35.8 per 1,000 girls aged 15 to 19 in 2022 to 25.4 in 2024.
• This decline is nearly triple the national target rate of 10% per year, showing that Southern Leyte is moving faster than expected.
• Liloan and Tomas Oppus reported zero adolescent births in 2024, while six other LGUs are already below the 2026 program target of 21 per 1,000.

On contraceptive use, the province’s modern contraceptive prevalence rate (mCPR) for adolescents reached 3.6%. This is already enough to cover adolescent mothers but shows room to expand access so that sexually active teens who are not yet mothers can prevent their first pregnancies.

Much of this success came from innovations, including the TrucKabataan mobile health service, wider access to adolescent-friendly health facilities, and stronger multi-sectoral governance bodies that meet regularly to address youth concerns.

Youth are at the center of the program. They lead peer education, information campaigns, and initiatives to keep girls in school, showing that when given the chance, adolescents can be powerful advocates for their own health and future.

Despite these gains, challenges remain. Births among girls aged 10 to 14 years old increased, often linked to gender-based violence and access to harmful online content. These cases show the need for stronger child protection policies and community awareness.

The program will continue until 2026, with ZFF and partners coaching LGUs to sustain and expand initiatives. Technical support will also be provided so municipalities can strengthen their health facilities, access PhilHealth reimbursements, and integrate adolescent health into broader development plans.

As Dr. Dorie Lyn Balanoba, EYLGP Director at ZFF, emphasized during the EYLGP Colloquium in Southern Leyte last August 13, 2025, the ultimate goal goes beyond reducing pregnancies: “We also look forward to more empowered adolescents making healthy choices that allow them to achieve their goals and bright future.”

Southern Leyte’s experience shows that the EYLGP model—youth leaders working with responsive LGUs—can deliver results and transform local systems for adolescent health.

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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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