Teen pregnancy: A national social emergency

by Roberto R. Romulo (The Philippine Star ), 27 Nov 2020

The government declared in August 2019 that teenage pregnancy is a national social emergency on the back of clearly worrisome trends.

A recent report shows the scale of the problem and its consequences. According to the Philippine Statistics Authority (2017) an average of 538 babies are born to Filipino teenage mothers daily. At 5.99 percent, the Philippines has the second highest teen pregnancy in Southeast Asia based on Save the Children’s Global Childhood Report (2019).

All of these result in grave consequences on poverty and child health. Some 62 percent of teen mothers drop out of school. By age 20, they would be earning 87 percent less than an average 20-year old woman’s pay. Some estimates place this at P24 billion to P47 billion yearly in lost earnings.

The situation will worsen with the COVID-19 lockdowns. The UP Population Institute projects that for every month of quarantine, an additional 79,000 unintended pregnancies are expected. This may lead to an additional 18,000 more teenage pregnacies by the end of 2020 to the normal average.

It was, therefore, timely that last Thursday, Nov. 19, The Challenge Initiative (TCI) of the Bill and Melinda Gates Institute for Population and Reproductive Health (Gates Institute), was launched in the Philippines with the Zuellig Family Foundation (ZFF) and the Commission on Population and Development (PopCom) as country partners. The initiative – which was years in the making – aims to reduce teenage pregnancies in participating cities. The TCI blends the expertise that Gates has developed over the years and ZFF’s on-the ground experience.

ZFF started looking at teenage pregnancy in Hinatuan, Surigao del Sur. Its commissioned research in 2015 showed rising teen pregnancies especially among low income, low educational attainment households. Results showed a lack of sexuality education and poor access to reproductive health services and commodities.

The importance of adolescent sexual and reproductive health (ASRH) likewise showed up in the ZFF-Department of Health partnership program where 296 of the 320 participating municipalities had teenage pregnancies comprising more than 10 percent of live births, higher than the four percent national objective of the DOH.

Subsequently, ZFF entered into partnerships with PopCom, UNFPA (United Nations Population Fund), and the USAID (United States Agency for International Development) on family planning and reproductive health.

Another development joined this narrative. In 2016, Oying Rimon, director of the Bill and Melinda Gates Institute visited Manila to explore the creation of a mechanism, with funds raised from high networth individuals and matched with funds from the Gates Foundation. The team discussed the idea with me and with Daniel Zuellig, our trustee. We expressed interest considering that the fund was to promote, among others, family planning and reduction of teenage pregnancies. They spoke with many other business leaders, but unfortunately the initiative was placed on hold due to issues that could not be resolved immediately.

However, Oying kept in touch. He invited our management to present the ZFF work in health leadership and governance in Hanoi, and in Naypyidaw, Myanmar. He likewise invited ZFF trustee David Zuellig to be a presenter at the International Conference of Family Planning and Reproductive Health at Kigali, Rwanda, and to meet Christopher Elias, Gates Foundation president of the Global Development Division, to continue discussions on a possible collaboration between the two foundations. That meeting set into motion a series of actions culminating in the November launch.

A ‘business unusual’ approach

During the press conference after the launch, one reporter asked, “Considering the many initiatives in the past, what makes this initiative different?” Ernesto Garilao commented that he thought this was a most pertinent question considering there were various programs in place run by NGOs and government. This initiative complements what they are doing, which entails direct contact with the beneficiary and training teachers.

The unique value proposition of Gates’ TCI is its “business unusual” approach. It leverages the stakeholders’ strengths in support of local governments’ development of their policies and programs to more effectively scale up ASRH services. This was an approach ZFF had pioneered in its rural health development initiatives.

What sets the Philippine hub apart from other TCI hubs is that it will be co-managed and co-funded by the Gates Institute and ZFF.

It will build on the health and governance expertise and experience of ZFF in working with local chief executives.

The participating cities must self-select or volunteer to become part of TCI Philippines because the initiative requires leadership and commitment to achieve the desired results. So far, ZFF partner-LGUs (Dipolog, Cagayan de Oro, and Puerto Princesa) under its leadership programs are the pilot cities.

The cities will try out proven high-impact approaches from four other TCI hubs in the world. TCI has a database of evidence-based solutions that LGUs can modify. TCI University has a global toolkit that cities can use to plan, design, and implement a comprehensive urban family planning program.

With this mix, the initiative expects the cities to have responsive governance mechanisms, a sufficient budget, and strong community support for the continuous provision of ASRH services and information. With PopCom’s participation, we expect rapid diffusion to more Philippine cities.

ZFF’s newly-installed chairman and president Ernesto Garilao was cautiously optimistic, “We don’t expect an immediate drastic reduction, but we expect a reduction in year one,” adding, “You can come back to us after a year and see the gains of the initiative.”

As a national social emergency that is expected to get worse during the pandemic, addressing teenage pregnancy is a socio-economic challenge that has to be addressed now. We know that it helps perpetuate a cycle of poverty – and misery – that holds the country back. So everyone has a stake in it. To fasttrack improvements and scale up the program, there must be increased participation from all sectors of society, especially from the private sector.

As a Filipino, I believe the continuing Gates presence here will provide the institute and the private sector the window of opportunity to jointly participate in pandemics related challenges, such as the supply chain management of COVID-19 vaccines.