Financing The RH Needs of Filipinos

The Human Development Legislator
The Philippine Legislators Committee on Population and Development Foundation, Inc. (PLCPD) evolved out of the Philippine
The Human Development
Parliamentarians Conference on Human Survival: Population and Development Plan of Action (PARLCON) convened in 1988. PLCPD was formally established in December 1989 as a non-stock, non-prot foundation dedicated to the formulation of viable public policies on population and human development.
L E G I S L ATO R
EDITORIAL COMMITTEE
PLCPD Co-Chairpersons
Sen. Rodolfo Biazon Rep. Nerissa Corazon Soon-Ruiz, M.D. Ramon San Pascual Romeo C. Dongeto Ma. Cecilia de los Reyes Elenor de Leon Abigail Acuba-Cainglet Christopher Estallo Shelley Francisco Rene Llorin Ethel Mendiola Vincent Hermogeno Marlou Abaja (ECOP) Nora Oliveros (DBM) Ed Tamayo (DKT) Dodie Lucas
MAIN OFFICE:
2/F AVECSS Building #90 Kamias Road. cor. K-J Street, East Kamias, Quezon City, 1102 Tel. nos.: (+632)925-1800 (+632)436-2373 E-mail: plcpdfound@plcpd.org.ph Website: http://www.plcpd.org.ph
Editor-in-Chief Managing Editor Editor ASSOCIATE EDITOR Contributors
CONGRESSIONAL OFFICES:
RM 611 Northwing Bldg., House of Representatives Batasan Complex, Quezon City, 1126 Tel. Nos.: (+632)931-5354 (+632)931-5001 loc. 7430 Mezzanine, Senate Commissary GSIS Compound, Financial Center Roxas Boulevard, Pasay City Tel. No.:(+632)552-6601 loc. 1208
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The Human Development Legislator is a quarterly publication of the Philippine Legislators Committee on Population and Development Foundation, Inc. (PLCPD) with support from The David & Lucile Packard Foundation. Copyright 2001 by the Philippine Legislators Committee on Population and Development Foundation, Inc. All Rights Reserved No part of this publication may be reproduced, stored in retrieval system, or transmitted in any form or by any means without prior written permission of the publisher.
Financing the reproductive health needs of Filipinos
CONTENTS
4 5 18 23 24 Straight Shot Consistently Inconsistent: Financing Reproductive Health and Family PLanning in the Philippines DOH Budget Execution Guidelines for the Family Planning Budget in the 2007 GAA Facts and Figures: Budget Lingo (1) Securing Budget for Reproductive Health Commodities and Services
Lagman talks about how the 2007 and 2008 GAAs came to include budget for RH
29 30 32 36
Facts and Figures: Budget Lingo (2) HDL Forum The Budget Process The Local Promise
Success stories in local reproductive health advocacy in the Philippines
43 44 48 51 52
Facts and Figures: RH Financing Governor Maximo Dalog: The Max-Champion of Reproductive Health in Mountain Province Pushing Development by Investing in Reproductive Health Facts and Figures: Government Spending for 2007 Financing Reproductive Health and Family Planning Programs in the Workplace: A Corporate Social Responsibility Program for Sustainability Annex A: Cagayan de Oro Chamber of Commerce and Industry Foundation, Inc. Workplace Family Health Program Policy* Annex B: Chiquita Unifrutti Philippines Bukidnon Family Planning Program Policy
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By Ramon San Pascual, MPH

Executive Director, PLCPD
hen it comes to showing genuine commitment, actually allocating money is usually the hardest part.
But based on the experience of the Philippine Legislators Committee on Population and Development (PLCPD), allocating money seems to come second to installing a policy. After all, the latter speaks of clear, outright commitment whereas the former can still seek refuge in ambiguity. Although the efforts of champions in Congress to insert allocations for the procurement of reproductive health commodities and provision of family planning services in the 2007 and 2008 General Appropriations Acts (GAAs) have been victorious, they are aware that they cannot just sit pat and perpetually bask in their achievement. Much work is still needed. It is not enough that money has been made available now; that would still leave us wondering and worrying about the future. A clear, comprehensive national policy on population management, reproductive health and family planning is what is badly needed in the Philippines. It helps that the advocacy at the local level is fast gaining ground. Already, there are 21 local ordinances on reproductive health all over the Philippines. In the end however, everything still boils down to the need for a comprehensive national policy, the tie that will strongly bind all efforts at managing the population and empowering the people to make informed choices related to their reproductive health.
This issue of the Human Development Legislator attempts to shed some light on how the budget allocation in the 2007 and 2008 GAAs came to be and how other actors from the public sphere, private sector, and civil society, like DKT Philippines, the Department of Budget and Management (DBM), as well as the Employers Confederation of the Philippines (ECOP), signicantly contributed in our advocacy effort. PLCPD is also nally reaping the fruits of its engagement at the local level, relating comprehensively for the rst time its victories at installing local policies nationwide. With our engagement in budget advocacy, PLCPD is maximizing yet another advocacy access point. With our champions continuing involvement in the budget process, making sure that it truly responds to the reproductive health needs of Filipinos, and unwavering commitment to the passage of a comprehensive national policy, the Philippines allegiance to international instruments such as CEDAW and the ICPD which, until now has remained mere lip service will soon be for real.
Consistently
INCONSISTENT
Financing Reproductive Health and Family Planning in the Philippines
By Ethel Mendiola, Christopher Estallo, Abigail Cainglet, and Elenor de Leon
republic torn between democracy and theocracy, a developing nation trapped in the darkness of the Middle Ages, the only Catholic nation in Asia that claims to uphold Christian values but remains deaf and blind to the deplorable plight of the poor. Struggling from its tag, sick man of Asia, the Philippines has aimed itself toward economic prosperity but largely, if not totally, neglected its rapidly ballooning population growth rate. The overall demand for family planning in the Philippines remains high at 69 percent.1 Use of contraceptives increased from 40 percent in 1998 to 49 percent in 2003 but still, about half of married women remain non-users of any contraceptive at all.2 There remains an urgent need to ensure that the countrys total unmet need, or the percentage of currently married women who either do not want any more children or want to wait before having their next birth but are not using any method of family planning,3 will be continuously reduced. While total unmet need has decreased from 20 percent in 1998 to 17 percent in 2003,4 the rate of improvement in meeting this unmet need has
Such is how the Philippines has come to look in light of the continuing struggle for a national comprehensive policy on population management and reproductive health. With the seemingly never-ending battle between progressive and enlightened legislators acting primarily on the needs of the people and of the country on the one hand, and regressive, ultraconservative groups led by the Catholic hierarchy on the other hand, it is mostly the poor and uneducated who stand to lose.
been excruciatingly slow. And with the USAIDs phase-out of contraceptive donations to the Philippines coupled with governments insistence on a program that focuses solely on national family planning, there is a huge possibility that even these small improvements may be negated unless a comprehensive national policy on population management and reproductive health, including family planning, is legislated with budget allocations for commodities and services.
The USAID, or the United States Agency for International Development, has been the largest donor of contraceptives in the Philippines for more than 30 years, providing 80 percent of the contraceptive supply for public sector use in the Philippines.5 But after US President George W. Bush recommended a huge cut in their international family planning fund,6 USAID was forced to gradually reduce
its commodity support to the Philippines.7 Condoms were the rst to be phased out in March 2003, followed by pills and injectables in 2007.8 The phase-out was gradual and designed in such a way as to give enough time for adjustments and policy changes. But despite its early announcement, no sincere efforts were seen from the national government to cover the gap left in the public sector.
Table 1. DOHs Schedule for Phasing out Hormonal Commodities Oral Contraceptives Year 2004 2005 2006 2007 2008 2009 Donations 10,552,000 6,632,000 2,609,000 689,000 0 0 % Market Covered 93 59 23 6 0 0 Injectables Donations Full supply 1,169,000 845,000 330,000 67,000 0 % Market Covered 100 82 59 23 5 0
Source: Connell, Peter, Cindi Cisek, and Joan Robertson. June 2005. Support to Contraceptive Social Marketing in the Philippines, Performance and Prospects. Bethesda, MD: Private Sector Partnerships-One project, AbT Associates Inc.
Instead of dealing with it, the national government distanced itself to the responsibility of providing for the reproductive health care and family planning needs of the people. As early as 2001, President Gloria Macapagal Arroyo has made her position on family planning very clear by saying that the government needs to adopt policies that will take into consideration population and reproductive health approaches that respect our culture and values In the 4th World Meeting of Families the following year, she laid down the four pillars of her administrations population policy, claiming that her stand is based on Christian formation and constitution. These four pillars are responsible parenthood, respect for life, birth spacing, and informed choice, making it very clear to all that her administration will favor natural family planning (NFP) methods.10 It was evident that the Executive was swaying to the interpositions of the Catholic hierarchy. In 2001, the Department of Health (DOH) formally announced its national family planning policy through Administrative Order No. 50-A, which primarily views family planning as a health intervention as opposed to a
Pres. Gloria Macapagal-Arroyo
Former Health Secretary Manuel Dayrit
way of reducing fertility and population growth.11 The following year, the DOH issued its National Natural Family Planning (NFP) Strategic Plan Year 2002-2006 to mainstream natural family planning as one of the modern methods of family planning.12 In 2003, then DOH Secretary Manuel Dayrit forged a questionable 50-million peso deal with the lay Catholic group Couples for Christ for trainings and seminars on natural family planning methods.13 Without letup in efforts to please the Roman Catholic hierarchy, the Presidents reach has come to include the Commission on Population (POPCOM), which nally bent to pressure with the launch of the Responsible Parenthood Movement in December 2006. Said to be designed to achieve a population size that is conducive to national
development, the Movements main activity is the conduct of classes on Responsible Parenting and NFP at the barangay level. Surprisingly, and somewhat dissonantly, the Philippines Medium-Term Development Plan (MTPDP) for 2004-2010 made strong statements on the crucial relationship between sound population management and development efforts, setting a targeted 1.9-percent slow down in the countrys population growth rate.14 Almost immediately, a group of UP economists came out with a paper claiming that such target is simply not feasible given the governments current stance on the population issue.15 According to them, achieving such target would mean increasing contraceptive use by 0.48 percent yearly and would require a drastic shift in contraceptive method mix from predominantly
Self-Reliance (CSR) policy, a program primarily designed to assist local government units (LGUs) in coping with the phase-out of contraceptive donations.20 It aims to diversify sources of both family planning services and commodities to the market and shift those who can afford to pay out of the public sector market while continuously protecting those who need access to free commodities.21 However, the CSR policy has been unable to respond to the unmet needs of the country. It has not yet led to at least one LGU providing 100 percent of the FP needs of its constituency, especially with its implementation that is highly dependent on the leanings of local chief executives, as strongly illustrated by Manilas experience under then Mayor Joselito Lito Atienza. Also serving as President of Pro-Life Philippines, Former Mayor Atienza imposed his religious beliefs on the residents of Manila by issuing Executive Order No. 003 in February 2000. Said EO directed hospitals and health centers to discourage the use of articial methods of contraception.22 It also prohibited the selling of modern FP commodities in the city. Moreover, rather than having one national entity forecasting the need for,
procuring and distributing contraceptives through established systems, the CSR policy will result to hundreds of LGUs, many without assistance, attempting to carry this out.23 This would mean lost opportunities for more favorable pricing for large quantities of commodities and may also lead to some LGUs being unable to obtain and provide contraceptives.24 FILIPINOS WANT GOVERNMENT SUPPORT FOR FAMILY PLANNING Various studies have shown the Filipino peoples preference for contraceptives in planning their families. Results of the National Demographic and Health Survey (NDHS), a series of surveys conducted every ve years since 1968 by the National Statistics Ofce (NSO), showed that contraceptive use among currently married women in the Philippines has more than tripled over the past 35 years.25 From 15 percent in 1968, it rose to 49 percent in 2003, mainly due to the rise in the use of modern contraceptive methods from 25 percent in 1993 to 33 percent in 2003.26 Similarly, results of the Family Planning Survey (FPS), a nationwide survey of women of reproductive ages conducted annually by the National Statistics Ofce (NSO) starting in 1995, have consistently
Former Manila Mayor Lito Atienza
traditional to predominantly modern.16 Moreover, the 30million allocation for articial family planning in 2006 under the DOH only included capability building, policy development, policy standards and guidelines development, advocacy and IEC, monitoring and evaluation, and distribution costs to the local areas.17 It did not include the procurement of contraceptive commodities since these have always been donated.18 In 2004, President Arroyo was quoted as saying that the implementation of family planning programs is the main responsibility of local government units (LGUs).19 According to the President, LGUs have been given the authority to decide on the methods that they will promote in their localities. In the same year, the national government launched its Contraceptive
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shown a high contraceptive prevalence rate, with the pill as the most preferred contraceptive method among married women.27 Moreover, surveys conducted before the elections in 2000, 2004, and 2007 by the National Statistics Ofce (NSO), Social Weather Stations (SWS) and Pulse Asia have consistently shown the Filipino peoples clamor for family planning and population programs and policies.28 In 1993, a survey conducted by the SWS showed that a great majority of Filipinos believe that the government should promote family planning more vigorously.29 In 1994, 78 percent of respondents said that the government should intervene in slowing the countrys population growth for development interventions to take effect.30 In 2000, 70 percent of SWS survey respondents said that they agree with the governments program that allows married couples the freedom to choose the method they would use.31 Pulse Asia also conducted its own surveys in 2000, 2004, and 2007. Data for 2000 showed 94 percent of Catholic respondents favoring candidates who are supportive of family planning.32 In 2004, Pulse Asia found 71 percent of Filipinos agreeing that a
fast increasing population impedes development, while 82 percent said they would support candidates who are in favor of a law or measure on family planning.33 In Pulse Asias 2007 Ulat ng Bayan Survey, 92 percent of Filipinos said they consider family planning important while 76 percent believed it should be included in a candidates program of action.34 HARNESSING THE BUDGET PROCESS Realizing the difculty of enacting a comprehensive national policy on family planning, reproductive health and population management, champions inside the halls of Congress saw the possibility of harnessing the potentials of the budget process and utilize it to further elevate the advocacy. After all, it is Congress that drafts and approves the General Appropriations Act (GAA), its most important piece of legislation. Each year, Congress is required to deliberate and submit a proposed national budget to the Executive. Seeing this opportunity, champion-legislators saw the need to ensure that there is allocation on the item of family planning, particularly the procurement of contraceptives, while waiting for the passage of a comprehensive national
Albay Rep. Edcel Lagman
policy on family planning, reproductive health and population management. In this way, it is guaranteed that services on these will still be available and delivered even without a national policy. Thus, with the leadership of Reps. Edcel Lagman (1st District-Albay and PLCPD Board Member) and Rodante Marcoleta (ALAGAD Party List and PLCPD Member) in the deliberations for the 2007 General Appropriations Act (GAA), championlegislators lobbied for an increase to the 30-million peso original allocation for family planning to 180 million pesos. The additional 150 million in congressional initiative would then be sub-allocated by the DOH to LGUs that will express intent to use said fund for the purchase of reproductive health commodities and
provinces and cities that they can access a specic amount of grant from the DOH. The 150-million allocation would be managed by the National Center for Disease Prevention and Control (NCDPC) and the 16 Centers of Health Development (CHDs) of the DOH37 while the remaining 30 million would be used to augment the maintenance and other operating expenses (MOOE) of the NCDPC and the 16 CHDs. LGUs, including the Autonomous Region in Muslim Mindanao (ARMM), may obtain grants from this facility to partly cover the costs of their purchase of RH commodities and conduct of FP seminars in local communities in relation to providing said services as part of their devolved functions.38 for the conduct of family planning seminars in local communities. The original 30-million allocation, on the other hand, will be spent for the regular functions of the DOH in support of family planning.35 The President, in her veto message, made instructions to the DOH to draft a guideline on how the fund can be accessed by the LGUs before the release of the actual budget.36 However, the guidelines took months before it was approved and set extremely difcult
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criteria for LGUs that would want to access it. Sufcient information dissemination among LGUs about the fund and the guidelines is also extremely lacking. 2007 GUIDELINES The allocation in the form of grant facility was designed to be released by the DOH through their Centers for Health Development (CHD) and/or regional ofces to LGUs as additional funds for their budget on the procurement of contraceptive commodities. Accordingly, the CHDs should inform the
The 150 million would be divided among the 17 regions based on their estimated number of women of reproductive age (WRA) who are poor (please refer to attached DOH Budget Execution Guidelines on page 18). The NCDPC, in consultation with the 16 CHDs, would then assess the eligibility of clusters of LGUs to access their portions in their regions share of the grant subject to two rules. Rule 1 states that the allocated grant will only be accessible when the cluster
of LGUs meets the minimum standards on local availability and access to NFP. Sufcient display of effort in making NFP generally available is the DOHs prerequisite in providing grant for articial FP. Rule 2, on the one hand, stipulates that the grant released to the cluster that meets Rule 1 shall be based on additional evidence on the levels of effort and costs already shouldered by the LGUs concerned in making a range of FP services available to poor clients. Upon meeting the specied requirements, each group of LGUs shall then be given access to 0 percent, 30 percent, 60 percent or 100 percent of the grant amount allocated to it depending on its overall rating on levels of evidence about the extent of effort and costs the group has collectively borne in ensuring safe motherhood, including the provision of free FP services to poor clients. A set of criteria has been drafted to rate each group of LGUs (please refer to Annex A of DOHs Budget Execution Guidelines on page 21). REPEAT EFFORT IN 2008 In the 14th Congress, champion-legislators continued their initial success in 2007. With much assistance from Rep. Lagman, the new Chair of the Committee on Appropriations, allocation for family planning in the
2008 GAA ballooned to 2 billion pesos. Of this amount, 1.2 billion pesos would be devoted to the procurement of contraceptive commodities by LGUs, while 800 million pesos would be spent for awareness and capacity-building on family planning. Almost a year after the approval of the 2007 GAA, the supposed 150million allocation for the procurement of contraceptive commodities and seminars on family planning remains unutilized. If this remains unspent by December 2009, the money will be sent back to the National Treasury. On the one hand, the 2008 allocation has remained unused because of the delay in the formulation of the implementing rules and guidelines by the DOH. LOCAL FLAVOR Putting your money where your mouth is may be too old a political clich for some, but in reality, it is what measures political will among local government executives and local legislative councils. Often, local ofcials are faced with overwhelming social services obligations on the one hand, and a constricting resource base on the other. As a result, local governments are pushed to limit priorities in resource allocation to the most urgent and most politically practical.
This brings us to question how LGUs value reproductive health (RH) as one of the must haves of their constituents. By looking at how they spend for reproductive health information and services, we can gauge their resolve to act and respond to a seemingly unpopular and politically intangible budgetary concern. Since the national government refuses and continues to deny the need to purchase contraceptive supplies and commodities because of its bias for natural family planning (NFP) methods, LGUs must bear the burden of providing much needed supplies of RH commodities at the local level. This is further compounded by the pullout of major international donors of RH commodities and supplies. With little to no support coming from the national government for the purchase of contraceptives, the LGUs have to take on the responsibility of purchasing supplies for their constituents. Because of this, resource mobilization for population and development has become one of the cornerstones of the Philippine Legislators Committee on Population and Developments (PLCPD) policy advocacy efforts both at the national and local levels. The organizations local initiatives resulted to a number of LGUs
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materials on family planning, responsible parenthood, and safe motherhood as well as pre-marriage counseling are provided in all barangay centers.45 To help families achieve their desired family size, the City government has more than doubled its family planning budget from PhP 3 million in 2006 to PhP 6.9 million in 2007.46 For 2008, the City doubled this budget to PhP 12 million47 to further intensify its initial success of reducing the number of births by almost 17 percent in just two years. Quezon Citys PhP12 million family planning budget is the rst and the highest budget allocation made for family planning among LGUs in the country. However, the need to institutionalize the Citys population management and reproductive health care program remained. So on February 23, 2008, despite much criticism and
Quezon City Mayor Sonny Belmonte
Quezon City Vice Mayor Herbert Bautista
showing increased budgetary allocations for reproductive health, family planning, and gender and development. The following are stories of three local government units that showed exemplary interventions on resource generation for RH commodities and supplies. QUEZON CITY SHOWS THE WAY While efforts to institutionalize a comprehensive national policy on population management go under way at the national level, the countrys richest local government unit39 silently goes about its RH and FP programs. Quezon City is one of the highly urbanized cities in the Philippines and also one of the largest in terms of population size, comprising 21.9 percent of the 9.9 million population of the National Capital
Region.40 In 2000, it registered a 2,173,831 population.41 In 2007, after just seven years, its population ballooned to 2.68 million.42 But in spite of this, the local government of Quezon City has been demonstrating to all how effective governance should also translate to sound population management. Quezon Citys family planning and reproductive health programs are localized in its barangays.43 Pills, IUDs, condoms, tubal ligation, and counseling on both natural and articial family planning methods have been given for free to 141, 691 residents, 99,585 of whom are regular users of such family planning methods prescribed by the City Health Department through its 59 health centers all over the City.44 Likewise, information and education
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harassment from conservative groups led by the Catholic Church, Mayor Feliciano Sonny Belmonte approved Sangguniang Panglunsod (City Council) Ordinance No. 1829, Series of 2008, otherwise known as the Ordinance Establishing a Quezon City Population and Reproductive Health Management Policy. This local measure nally institutionalized the Citys long time executive programs and services on reproductive health, specically on family planning. Its main sponsor, Councilor Joseph Juico, and co-sponsors, Councilors Bernadette Herrera-Dy and Lala Sotto, stood their ground and prioritized their constituents needs over political considerations. With this ordinance, Quezon City now joins the ranks of the cities of Olongapo, San Fernando (La Union), Angeles, Marikina, and Naga that have all institutionalized
their commitment to better serve their people through a reproductive health care, responsible parenthood, and family planning policy. The Quezon City Reproductive Health Ordinance mandates the implementation of a holistic reproductive health program that will not only help people make informed choices, but also afford them access to vital reproductive health and family planning services such as ligation and vasectomy for indigents, and free family planning commodities located in health centers. It seeks to avoid maternal and infant deaths caused by unplanned pregnancies and related complications - problems that are more common among the poor because of malnutrition, ignorance and lack of funds for medical care. The ordinance clearly states that abortion is not a recognized method of family planning. It highlights the illegality of abortion as provided under Articles 256, 257, 258, and 259 of the Revised Penal Code of the Philippines. It affords women the ability to choose between natural and articial methods of family planning, a decision that will ultimately depend on their personal beliefs and conscience. Under the new ordinance, city health workers and barangay ofcials will be required to undergo training on family planning service delivery.
The ordinance also provides for Adolescent Health Education in public secondary schools using a standard curriculum to be crafted by the City in consultation with health experts. The amount of 12 million pesos is required by the ordinance for the implementation of its provisions (Sec. 12, Ordinance No. SP 1829, S-2008). ZERO MATERNAL DEATH IN ISULAN At the farthest tip of Mindanao in the Province of Sultan Kudarat is another municipality worth emulating by other local government units. With assistance from the 6th Country Program (20052009) of the United Nations Population Fund (UNFPA), PLCPD was able to continuously provide technical assistance to pilot LGUs in terms of policy development and RH budget allocations for programs and services. One such LGU is the municipality of Isulan. Despite the absence of a local RH ordinance, the Municipal government of Isulan has been making sure that its peoples RH and FP needs are being provided for by allocating funds for these. In fact, as shown in Table 2, there has been a steady increase in funding for RH services and commodities from the LGU through the
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Table 2. Allocation of funds for FP commodities in Isulan, Sultan Kudarat Year 2006 2007 2008 Purpose Purchase of FP & RH commodities PhP 100,000 Purchase of FP and RH commodities PhP 130, 000 Purchase of FP and RH commodities Amount PhP 50, 000 Source Annual General Fund Annual General Fund 5% of Gender and Development fund
years. The local government of Isulan has also been zeroing in on eliminating maternal deaths through its Safe Motherhood Program. The Safe Motherhood Program started in 2003 and immediately resulted to zero maternal deaths the following year. As its major strategy, the program maintained the ideal population to midwife ratio of 5,000:1, which translates to 1 midwife per barangay, 1 main health center in each barangay, and 20 barangay health stations. The 3 barangays with the biggest populations were assigned 2 midwives each. Isulans Rural Health Unit (RHU) likewise encourages facility-based delivery through the preparation of a birth plan for pregnant women that details the person who will assist in the delivery, the specic birthing center, and the nancing of the delivery. The RHU also organizes maternal health teams in each barangay. The team is composed of a midwife, barangay health worker, nutrition scholar, traditional birth attendants, and barangay kagawad on health. The team advocates policy support for RH and forges partnerships with other stakeholders in the community; ensures continuous upgrading of birthing facilities in the municipality; and implements a monitoring and evaluation plan.
Table 3. Additional funding for the Safe Motherhood Program of Isulan Year 2005 Amount P80,000 Purpose Improvement of Barangay Health Stations --Used by Barangay Health Stations to improve their FP rooms which are also utilized as birthing rooms. Improvement of the birthing facilities at the main health center Upgrading of facilities for PhilHealth accreditation Source 20% Development Fund
2006
P120,000
2007
P189,000
20% Development Fund 20% Development Fund
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The program also hosts an annual Buntis Congress and conducts free screening tests for pregnant women that include urinalysis, blood count, blood typing, and dental exam. These programs are maintained and funded partly from the municipal governments Maintenance and Other Operating Expenses (MOOE) under special programs. Private and socio-civic organizations like the Soroptimist International and Rotary Clubs in the Province also make nancial contributions to said program. The Municipality of Isulan also targeted the youth by constructing communitybased and school-based RH Teen Centers. Recognizing the importance of teaching adolescents responsible sexuality through peer education, these teen centers aim to reduce unwanted and early pregnancy by making young people aware of the consequences of risky sexual behavior. All teen centers are maintained by Volunteer Center Managers and peer educators who receive an honorarium of P500 a month from the LGU. Members of the Local Youth Government (Sangguniang Kabataan) act as peer educators and organizers. As of this writing, the local government of Isulan is preparing to construct two more teen centers while its people await the passage of their very own RH ordinance.
The local government believes that despite their active implementation of RH and FP programs and services, there remains a need to institutionalize these to ensure that these will be continued by succeeding administrations. WHERE LGU FUNDS COULD NOT, HOSPITAL EMPLOYEES CAN While Quezon City is blazing trails in the NCR with its RH and FP programs, in a 5th class, remote municipality in Ifugao, employees of the Tinoc District Hospital Multi-Purpose Cooperative (TDHMPC) are doing what they can to scale-up contraceptive self-reliance (CSR) in the municipality. With only twenty (20) employees, the TDHMPC was organized in 1990. In 2006, it was ofcially registered as a cooperative. The TDHMPC was primarily formed to address the problem of accessibility of medicines in Tinoc since there was no single pharmacy in the municipality at that time. Founding members recalled that they applied the concept of paluwagan, or a micro common trust fund, to purchase a medium-sized carton of assorted medicines for indigent patients. From then on, their share capital grew and later on evolved into a lending (salary, regular, emergency loans)
and consumer (pharmacy and goods) cooperative. Their membership has expanded to their immediate family and to the larger members of the community. Majority of the TDHMPC members are health practitioners. They are concerned about family planning in their community and have realized that the municipal and provincial government, given their meager allocation that is dependent on their Internal Revenue Allotment (IRA), could not provide for substantial budget allocation for sustaining the provision of family planning commodities in the event that there would be a phase-out of donations on these. In October 2007, an initial batch of Depot Medroxyprogesterone Acetate (DMPA), intrauterine devices (IUDs), and pills worth PhP 4,000 were purchased. The following month, a higher demand for IUDs was registered. Ofcers of the cooperative shared how, in the last quarter of 2007 and early 2008, the potential acceptors in the municipality and the nearby town of Benguet signicantly increased. However, TDHMPC ofcers lamented the scarcity of suppliers of IUDs and began to worry about sustaining their initiative. This year, TDHMPC ofcers are exploring
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other options to sustain their initiative. They are contemplating entering into a negotiation with the DKT Philippines Pop Shop to provide a steady source of reliable, effective, and safe family planning contraceptive commodities in Tinoc that will, at the same time, enable them to earn additional income. GENUINE COMMITMENT The budget insertions in the 2007 and 2008 GAAs are proof that there are other avenues to ensure the allocation of funds for RH and modern FP commodities and services. It is a great leap forward despite the absence of a comprehensive national policy addressing reproductive health, family planning, and population development concerns. However, the need to make sure that the allocation is institutionalized through the enactment of a comprehensive national policy on population management and reproductive health remains. For now, it is up to the LGUs to take the initiative to access the Sources:
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allocated funds and use it where it is really targeted at. It is up to them to make the move now and start laying the ground for their own reproductive health and family planning programs. The presence of local champions at the executive level, to a great extent, inuences the direct budget allocation to signicantly improve and sustain availability of contraceptive supplies at the local level. It is important that there be continuous development of champions at the local executive level to scale up local legislation and policy support in creating an enabling environment for sustaining contraceptive self-reliance (CSR) and better reproductive health and family planning programs at the local level. Allocating part of the national governments resources to modern family planning is not just simply an issue of buying contraceptives. Above it all is the issue of widening the choices of women and couples,
especially the poor, in matters relating to their health and founding a family. The Philippine government has claimed unity with numerous nations around the world in working toward the achievement of the Millennium Development Goals (MDGs). But how can the Philippines achieve these when it does not afford its women and couples, especially the poor ones, the freedom to make informed choices on the family planning method that they feel comfortable to use? It is said that resource allocation is an indicator of the governments commitment in achieving a certain target. If the government is true to its goals to slow down population growth rate, eliminate poverty and reduce maternal deaths, then it must go beyond mere pronouncements. The national government should concretize its commitment to respect and uphold the rights of its citizens by allocating part of its resources for the provision of services and commodities that they badly need.
National Statistics Ofce (NSO) [Philipines], and ORC Macro. 2004. National Demographic and Health Survey 2003. Calverton, Maryland: NSO and ORC Macro. Trinidad, Arnie. Policy Implications of the 2003 National Demographic and Health Survey: A Brieng Packet. Quezon City, Philippines: Philippine Legislators Committee on Population and Development Foundation, Inc. (PLCPD). 2004. NSO and ORC Macro xviii.
Trinidad. United States Agency for International Aid (USAID). (April 2003). Afrming USAID Support for the Philippine Family Planning Program [Fact Book]. Krisberg, Kim. August 2006. Global family planning efforts struggle with U.S funding cuts: Programs vital to womens health. The Nations Health, http://www.apha.org/publications/tnh/ archives/2006/08-06/Globe/2798.htm (accessed February 2, 2008)
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United States Agency for International Aid (USAID). (June 30, 2003). Towards Contraceptive Self-Reliance (CSR) in the Philippines (20022006). [Working Paper]. USAID 3.
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De los Reyes, Ma. Cecilia. Population and Reproductive Health: Ten Crucial Issues that Every Candidate Should Know. Philippines: Philippine Legislators Committee on Population and Development Foundation, Inc., 2004. Ibid. Ibid. Ibid. Ibid. Ibid. De Leon, Elenor, Ma. Cecilia de los Reyes, and Rene A. Llorin. Population and Reproductive Health: What Every Legislator Should Know. Philippines: Philippine Legislators Committee on Population and Development Foundation, Inc., 2008. Philippines. Ofce of the Secretary for Health. Budget Execution Guidelines for Programs and Activities under item III. Section C., Number 2.j of DOH Budget in RA 9401 (GAA 2007). Manila: Republic of the Philippines, 2007. General Appropriations Act, Fiscal Year 2007. Republic Act No. 9401. March 2007. Budget Execution Guidelines 3. Ibid. Ofcial Website of the Local Government of Quezon City. http://www. quezoncity.gov.ph/index.php?option=com_content&task=view&id=43&I temid=2 (accessed February 7, 2008). Philippines. National Statistics Ofce. Quezon City: The Philippines Largest City. October 8, 2002. http://www.census.gov.ph/data/ pressrelease/2002/pr02171tx.html. Ibid. Philippines. National Statistics Ofce. Total Population by Province, City, Municipality and Barangay: as of August 1, 2007 -- National Capital Region. http://www.census. gov.ph/data/sectordata/2007/ncr.pdf. City Government of Quezon City. Communication Coordination Center Quezon City: A City Where All Shall Win. 2007. Ibid. Ibid. Ibid. Ibid.
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Linangan ng Kababaihan, Inc. (Likhaan), Reproductive Health, Rights and Ethics Center for Studies and Training (ReproCen), and Center for Reproductive Rights. 2007. Imposing Misery: The Impact of Manilas Ban on Contraception. Ibid. Herrin, Alejandro N. Population Policy in the Philippines, 19692002, Discussion Paper Series No. 2002-08. Philippine Institute for Development Studies, September 2002. Ibid. Likhaan, ReproCen and CRR 15.
30
31
10
32
11
33
34
12
13
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National Economic and Development Authority. (2004). Philippine Medium Term Philippine Development Plan 2004-2010. Manila, Philippines. Alonzo, Ruperto P. et. al. 2004. Population and Poverty: The Real Score. Discussion Paper No. 0415. University of the PhilippinesSchool of Economics, Quezon City. Ibid.
38 36
15
37 16
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Apale, Dr. Florence, Medical Specialist 4, Family Health Division, National Center for Disease Prevention and Control-DOH. Phone interview. March 2008. Ibid.
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Agence France-Presse. 2004. GMA pledges to curb population growth. Manila Times, October 26, Top stories section. Connell, Peter, Cindi Cisek, and Joan Robertson. June 2005. Support to Contraceptive Social Marketing in the Philippines, Performance and Prospects. Bethesda, MD: Private Sector Partnerships-One project, Abt Associates Inc. Ibid. Jimeno, Jaileen F. In Manila, Pills and Condoms Go Underground. i-Report Online. May 2-4, 2005. February 6, 2008 www.pcij.org. Connell, Cisek, and Robertson 7. Ibid. NSO and ORC Macro xvii. Ibid. Please refer to the NSO website for the results of the Family Planning Survey (FPS) from 1995 up to 2006.
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Budget Execution Guidelines for Programs and Activities Under Item III. Section C., Number 2.j of DOH Budget in RA 9401 (GAA 2007)*
A. Legal and Administrative Background 1. The General Appropriations Act of 2007 (GAA 2007), or Republic Act 9401, includes as part of the authorized budget of the Department of Health-Ofce of the Secretary, the amount of P180,000,000 as maintenance and other operating expenses (MOOE) for Programs and activities under item III. Operations, section C. Health Operations, including Policy Formulation, Standards setting and Monitoring, number 2. Disease Prevention and Control and activity j. articial family planning. The total amount is composed of P30 million original allocation for reproductive health and an additional P150 million in Congressional initiative. 2. The same GAA 2007 contained the following inserted special provision: 12. Appropriations for Articial Family Planning. The amount appropriated for articial family planning shall be sub-allocated by the DOH to LGUs which shall apply for the utilization of the fund for the purchase of reproductive health commodities and the conduct of family planning seminars in local communities. It is understood that this inserted provision will be applicable to the P150 million in Congressional initiative, while the original P30 million allocation will concentrate on the regular and routine functions of DOH in support of family planning. 3. The Presidents Veto Message dated March 22, 2007 required conditional implementation of this special provision subject to issuance of guidelines so that DOH may determine its priority programs. Said guidelines shall recognize that: While Reproductive health Program continues to be one of the governments top priorities, DOH should be given necessary exibility in determining appropriate method to be used considering the needs of the community; Under budgeting rules and regulations, the sub-allotment of appropriations may only be issued to implementing agencies within the Executive Department; Local government participation may be secured through execution of a Memorandum of Agreement with the DOH. 4. The general category of services (i.e., family planning services) referred to by the said budget provision is among those specic services devolved to local governments under RA 7160 (Local Government Code of 1991). Under Section 17 of said law, among the basic services and facilities devolved to local governments are: For municipalities: primary health care; maternal and child care; womens welfare; family planning services; purchase of medicines, medical supplies and equipment needed to carry out devolved services For provinces: hospitals and other tertiary health services, population development services For cities: services for municipalities and provinces 5. DOH Administrative Order No. 50-A, s. 2001, previously issued September 17, 2001, under the current Administration, provides that family planning as a health intervention shall be made available to all men and women of reproductive age (15-44 years old) including those reproducing earlier or beyond this age bracket. It shall focus on the following modern FP methods: Natural Family Planning, Pills, Condoms, Hormonal Injectables (DMPA), Intra-Uterine Device (IUD), Lactational Amenorrhea Method (LAM), Voluntary Surgical Sterilization (VSS) such as Bilateral Tubal Ligation and Vasectomy. The specic technical and clinical standards for these methods have been dened by existing ofcial technical manuals issued by the DOH. The following denitions are derived from these provisions: Articial family planning shall be understood to include all the above modern FP methods, except Natural Reproductive health. Reproductive health commodities shall be understood as those commodities required and necessary, according to technical and clinical standards, to provide all the various methods characterized as articial family planning. 6. DOH Administrative Order No. 2006-0008, previously issued May 10, 2006, also under the current Administration, provides, among others, for the following: D.1 In order to assure that women without means to pay for care are nonetheless able to access and use family planning and maternal care services
* Reprinted with permission form the Department of Health (DOH)-Ofce of the Secretary.
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essential for them to avoid increased risks of maternal mortality, the DOH shall seek to install nationwide a safety net level of free reproductive health and maternal care services available at each locality supported by an adequate level of public funding and provided either through publicly nanced services of the private sector. D.2 Centers for Health Development shall arrange and assemble this safety net level of free (publicly funded) reproductive health and maternal care services at each locality by: (a) having the DOH budget and DOH hospitals cover part of the needed services; (b) securing provincial government support to cover another part through the provincial health budget; and (c) securing city and municipal governments support to cover the nal part through their respective city or municipal health budgets. This arrangement for safety net services in each locality should have specic quantitative target coverage, an agreed criteria for priority beneciaries and preferred users and explicit functional assignments among DOH, province, city/municipality funding and providers for each essential health service included in the package for women of reproductive age. Based on these provisions, the DOH shall allocate and use the budget for reproductive health Region commodities in support of LGUs providing a safety net of free (publicly funded) reproductive health services at their 1. NCR respective localities throughout the country. 2. Region 1 3. Region 2 B. Allocation of P180 million 4. Region 3 Lump Sum MOOE Provided 5. Region 4-A The total approved lump sum 6. Region 4-B MOOE of P180 million for articial family 7. Region 5 planning shall be allocated as follows: 8. Region 6 The P150 million corresponding 9. Region 7 to the Congressional initiative portion shall be constituted into 10. Region 8 a grant facility to be managed by 11. Region 9 the National Center for Disease 12. Region 10 Prevention and Control (NCDPC) 13. Region 11 and the 16 Centers of Health Development (CHDs) of the DOH. 14. Region 12 Consistent with special provision 15. CAR number 12 of the GAA, local 16. CARAGA government units, including the Autonomous Regional Development 17. ARMM of ARMM, may obtain grants from
this facility to partly cover the costs of their purchase of reproductive health commodities and conduct of reproductive health training/seminars in local communities in relation to providing reproductive health services as part of their devolved functions. The operation of this grant facility is further detailed in Section C below. The original P30 million portion representing the regular budget of DOH for family planning shall be utilized as follows: 1. P14 million shall augment the MOOE of the National Center for Disease Prevention and Control (NCDPC) as the unit with national program management responsibilities for reproductive health in order to undertake health operations, including policy formulation, standards setting and monitoring specically in relation to, among others, performing the technical support work in implementing the above mentioned grant facility supporting LGUs providing reproductive health as part of their devolved services. 2. P16 million shall be sub-alloted at P1 million each for the 16 Centers for Health Development (CHDs) of the DOH to augment their respective MOOE for Est. No. poor WRA 235,000 324,000 177,000 418,000 560,000 279,000 544,000 615,000 440,000 367,000 372,000 425,000 352,000 349,000 256,000 194,00 276,000 Total Amt. Allocated 7 million 8 million 6 million 9 million 11 million 8 million 11 million 12 million 10 million 9 million 9 million 9 million 9 million 9 million 8 million 6 million 9 million 150 million
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health operations, including disease prevention and control, specically in relation to, among others, performing the technical support work in implementing the above mentioned grant facility supporting LGUs providing reproductive health as part of their devolved services. C. Operation of the portion constituted into a DOH grant facility for LGUs The P150 million Congressional initiative for articial family planning shall be constituted into a grant facility managed by NCDPC and the 16 CHDs of DOH to partly cover the costs incurred by those LGUs that provide free reproductive health services to poor clients by, among others, purchasing reproductive health commodities and conducting reproductive health seminars in local communities, according to the following provisions: 1. DOH shall make available to LGUs from each of the 17 regions the following amounts based on dividing the P150 million total according to each regions estimated number of women of reproductive health age who are poor: ARMM shall be regarded, according to its governing law, as a special (region-wide) type of LGU and NCDPC shall make the grant for the whole ARMM via the DOHARMM. The utilization of the grant for ARMM to assist component LGUs of ARMM shall be undertaken by the DOH-ARMM under the autonomous regional government. The total amount was divided among the regions according to this procedure: rst, the estimated number of women of reproductive age of each region was multiplied by each regions corresponding poverty rate; second, the regions with the smallest estimated number of poor women of reproductive age was allocated a minimum amount of P6 million; third, regions with proportionately larger estimated numbers of poor women of reproductive age were given correspondingly larger amounts until the full amount was exhausted. The regional allocations range from a minimum of P6 million to a maximum of P12 million. 2. NCDPC, in consultation with the 16 CHDs and DOH-ARMM, shall determine the eligibility of clusters of LGUs to access their respective portions of the regions share of the grant based on evidence about the levels of effort and costs already incurred in securing safe motherhood outcomes in their localities, including assuring that pregnancies are desired and planned through
availability of a range of reproductive health services provided for free to poor clients. The details on implementing this rule are further described in the attached annex. 3. Each CHD shall rate the eligibility of groups of LGUs to secure corresponding amounts of grants by applying the above guidelines. As single municipalities or small cities are unlikely to be fully self-sufcient in the full range of RH services required, CHDs shall only rate clusters of LGUs, such as: a whole province (including its component municipalities and cities); or a cluster of municipalities comprising an inter-local health zone; or clusters of cities and contiguous municipalities comprising a metropolitan area as determined by the CHD. NCDPC shall rate the whole ARMM region in consultation with DOH-ARMM. CHDs may rate individual chartered or highly urbanized cities that are large enough to be self-sufcient in all the RH services. CHDs shall continue to monitor changes in the status of programs of their regions LGUs and, whenever appropriate, update the ratings to enable groups of LGUs that demonstrate further progress in their RH provisions to access additional percentages of the grant amounts. At the end of each quarter, CHDs shall report the ratings of clusters of LGUs in their regions and the corresponding releases of grant amounts corresponding to the ratings. 4. Each group of LGUs rated shall identify a sponsor that shall receive the grant amount that each group is eligible according to its rating. This sponsor shall sign a Memorandum of Agreement (MOA) with DOH to receive the grant amount, place the said amount in a trust account, disburse the grant proceeds received to different LGUs comprising the group, maintain necessary accounting records, and render required reports. The following may be designated as sponsor by participating LGUs: the provincial government for a whole province; a designated municipal government or a provincial district hospital for an inter-local health zone; or a city government in behalf of the city and surrounding municipalities or cities of a metropolitan area. 5. CHDs shall release the percentage of the grant amount corresponding to the rating of each group of LGUs. The grant proceeds shall be released to their sponsor in behalf of the group. The sponsor in turn shall disburse said grant proceeds to augment the health budgets or reimburse identied expenses of LGUs comprising the group in order to partly cover, rst, the costs associated with purchasing reproductive health commodities and, if the grant proceeds
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can still accommodate, the costs of conducting seminars in reproductive health at local communities. CHDs shall assist each group of LGUs entitled to receive funds from this grant facility to decide among themselves how the grant they obtain shall be divided among themselves how the grant they obtain shall be divided among themselves. It is hereby emphasized that paying for the costs of free reproductive health services at localities remains a responsibility of LGUs under the LGC of 1991. This 2007 grant provided under the DOH budget is not intended to substitute for sustained LGU expenditures to support local reproductive health services but is intended only to temporarily augment the budgets of those LGUs that have shown their best effort to fully meet this important responsibility for the benet of their poor constituents. 6. CHDs shall monitor the receipt, proper use, recording and reporting by the sponsors of the grant amounts released to them in favor of LGUs comprising their groups as stipulated in the MOAs. The CHDs shall insure that a complete paper
trail and documentation is available for each group of LGUs extended as grant consisting of the following: (a) ofcial rating of the group of LGUs in meeting the requirements of Rules 1 and 2; (b) written representation on the designation of the sponsor for the LGU group; (c) signed MOA between DOH and the sponsor in behalf of the LGU group; (d) release of grants corresponding to the rating; (e) receipt of grant proceeds by the sponsor and deposit in trust accounts; (f) disbursements by the sponsor of the grant proceeds to LGUs comprising the group; (g) reporting by the sponsor on the use and disposition of the grant proceeds. Failure to meet these requirements of acomplete paper trail and full documentation shall make the group of LGUs ineligible to obtain further releases of grants under this facility. (signed) FRANCISCO T. DUQUE, III, MD, MSc Secretary of Health
Annex A: Procedures on Grants to LGUs under These Guidelines

NCDPC and CHDs shall follow these procedures in making grants to groups of LGUs under these guidelines. NCDPC shall rate the whole ARMM in consultation with DOH-ARMM, while individual CHDs shall rate groups of LGUs in their respective regions. Step 1: Allocation of regions total grants among regions provinces and cities The CHDs and DOH-ARMM shall divide the total grant allocated to the whole region, under section C.1 above, among the regions provinces and highly urbanized cities using any one of the following options: (a) Equal shares: total amount is divided by the number of provinces and cities (b) Big and small shares: provinces and cities are grouped into two based on size of population ; the bigger ones get a higher equal share; the smaller ones get a lower equal share (c) Proportional share: the smallest province/city gets an amount and each province or city gets a proportionately bigger share according to population size. CHds shall choose the options based on the actual variations in provincial and city populations in their regions. The goal of the allocation is to have grant amounts that are sizeable enough for every province and city to be interested. Step 2: Informing provinces and cities The CHDs shall inform the provinces and cities that they can access a specic amount of grant from DOH based on how far their localities meet the two rules on the availability of the full menu of RH services for poor clients backed by sufcient LGU funding. They are also advised on the details of the application of two rules and the schedule of rating visit. Step 3: Applying the guideline under section C.2 above Each CHD shall determine how far provinces and cities within its region meet the guideline under section C.2 above. If provincial governments are not interested in being rated, clusters of municipalities in the province may also be rated. Each group of LGUs that meet the requirements shall be given access to 0%, or 30%, or 60% or 100% of the grant amount allocated to it depending on its overall rating on levels of evidence about the extent of effort and costs the group has collectively borne in order to assure safe motherhood, including provision of free RH services to poor clients. The rating of each group of LGUs under this rule shall be based on the following rating system:
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Criteria: 1. Public health professional(s) is/are responsible for managing maternal catre and family planning services throughout the cluster of LGUs. (10 points) 2. Local requirements for RH commodities are specied, projected and estimated. (10 points) 3. Activities to educate and counsel clients about responsible parenthood, family planning and safe motherhood are planned and organized. (10 points) 4. Local funding for RH commodities and education/counseling activities are budgeted. (15 points) 5. Local funding budgeted for RH commodities and education/counseling activities are utilized. (15 points) 6. Clients deemed eligible for free RH services are able to access services of their choice. (40 points) Groups of LGUs that earn 30 points can get 30% of the grant allocated to them. Groups of LGUs that earn 60 points can get 60% of the grant allocated to them. Groups of LGUs that earn 100 points can get 100% of the grant allocated to them. The overall rating of each group of LGUs shall be based on the most number of observations noted among them for the above criteria. Provinces/cities that do not meet the 30% requirements shall not be able to access the grant allocated to them. Step 4: Conduct of rating visit Teams from CHDs shall conduct a visit to arte each province and city using the above criteria. It is emphasized that the whole province, including its component municipalities and cities, is being rated. In some cases, provincial governments may decide to bear a larger burden of meeting the criteria than the municipalities; while in other cases, municipalities and cities may decide to bear a larger burden than the province; or in yet other cases, each level of government may share in the total burden. The rating should be on the overall result of the burden sharing rather than some pre-set notion of what each level must do or not do. The DOH rating should focus on the overall result for the whole population affected in terms of accessibility of a full menu of free RH services for poor clients. Step 5: Evaluating the results of rating exercises Teams from CHD shall not report the results of the rating visit immediately upon completion of the visit. Teams should assemble at the CHD and calibrate their results region-wide so that a fair and equitable judgment is reached in the ratings of all provinces and cities in the region. Once all the rating results are in, the CHD management shall hold
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an evaluation meeting that shall come up with the following results for each province/city rated: (a) Level of meeting the requirements of guidelines/Share of grant amount for release: 0%, 30%, 60%, 100% (b) Recommendations in order to obtain release of the next higher level of grant portion (i.e., from 0% to 30%, from 30% to 60%, from 60% to 100%) The CHD management shall insure that it has fairly rated all provinces and cities across the region and shall release the results for all provinces and cities in the region at the same time. Step 6: Communicating the rating result to provinces and cities CHDs shall ofcially communicate to provinces and cities the results of the rating and the appropriate information for next steps. Step 7: Negotiating and signing the MOA and release of the grant CHDs shall consult with the provinces and cities rated in order to determine the designated sponsor of each group of LGUs. Once a sponsor is identied, CHDs shall conclude a MOA with the sponsor in behalf of the group of LGUs. One the MOA is signed, CHDs shall release to the sponsor the amount of the grant that corresponds to the rating of the group of LGUs. CHDs shall inform all LGUs concerned about the signing of the MOA and the release of the grant proceeds. Step 8: Monitoring the use of grants released The CHDs shall assist the sponsor to disburse the grant proceeds to the LGUs based on the provisions of these guidelines. Based on mutual agreement of the LGU concerned, the grant proceeds received by the sponsor may be disbursed for the following uses: (a) reimburse participating LGUs for part of costs associated with providing free RH services to poor clients; (b) pay for properly procured contracts that provide goods or services necessary to provide free RH services to poor clients; (c) supplement MOOE of the health services units of participating LGUs providing free RH services to poor clients. Step 9: Updating the rating of provinces and cities at the request of LGUs or on the initiative of CHDs CHDs can undertake another rating of any province or city when there are indications that the service conditions may have changed sufciently to merit a re-evaluation. Step 10: Reallocating unused grants in favor of provinces and cities that move forward At the start of the last quarter, any unused grant may be re-allocated by the CHDs in favor of provinces and cities that have further improved their RH provisions.
Facts & Figures

Budget Lingo
Allotment Authorization issued by the Department of Budget Management (DBM) to an agency, which allows the latter to incur obligation for specied amounts contained in a legislative appropriation. Allotment to Local Government Units The share of LGUs from the internal revenue collections of the National Government (NG) special accounts and special funds, based on a sharing scheme computed for each Local Government Unit (LGU) provided for under the Local Government Code. Appropriation An authorization made by law or other legislative enactment, directing payment out of government funds under specied conditions or for specic purposes. Automatic Appropriations An authorization made annually or for some other period prescribed by law, by virtue of standing legislation, which does not require periodic action by the Congress of the Philippines. Continuing Appropriations An authorization to support obligations for a specied purpose or project, even when these obligations are incurred beyond the budget year. Reserves Appropriations Amount set aside to provide for contingencies and emergencies, which may arise later in the calendar year and which would otherwise require deciency appropriations. Supplemental Appropriation Additional appropriation authorized by law to augment the original appropriations, which proved to be inadequate or insufcient for the particular purpose intended due to current economic, political or social conditions. Capital Expenditures/Outlays Expenditures for the acquisition of xed assets and other goods and services the productive benets of which extend beyond the scal year. These include investments in the capital stock of government-owned and controlled corporations (GOCCs) and their subsidiaries and investment in public utilities and loans outlays. Capital Inows Private and ofcial inward ows of money to the country in the form of investments, grants, and loans. Capital Revenues Proceeds from the sale of xed or capital assets such as land, buildings, machinery, stocks and intangibles, including receipts of unrequited transfers for capital purposes from non-governmental sources. Commodity Grants Donations/contributions/gifts in kind received and which are subsequently monetized. The peso proceeds are thereafter deposited with the Bureau of Treasury (BTr) to be used or expended for projects specied in the grant documents between the donor and the NG.
Source: Department of Budget and Management. www.dbm.gov.ph/bestf2005/besf_2005_html_les/got.pdf
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Securing Budget for Reproductive Health Commodities and Services

Lagman talks about how the 2007 and 2008 GAAs came to include budget for RH
By Elenor de Leon Interview conducted by Shelley Francisco
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A congressional initiative, the additional 150 million pesos has been destined for allocation to local government units (LGUs) that will express intent to use it in the purchase of commodities and in the conduct of seminars on reproductive health (RH) and family planning (FP). And when long-time population and human development champion Edcel Lagman assumed the Chairmanship of the House Committee on Appropriations, advocates were in a state of suspended anticipation. Considered very powerful, the Committee on Appropriations has jurisdiction over all matters directly and principally relating to the expenditures of the national government including the payment of
1
hen the original 30-million peso allocation on family planning was increased to 180 million in the 2007 General Appropriations, advocates rejoiced. Despite the continuous absence of a national comprehensive policy on reproductive health and family planning, at least there is something to be thankful for. Rep. Lagman rst sat in the Committee on Appropriations during the 8th Congress as its Vice Chairperson. According to him, vice chairmen then were involved in the budget process. But he was somewhat dismayed to discover that they were no longer involved when he came back during the 13th Congress. Now you will notice that all of the vice chairpersons of each committee were given subcommittees. They were given responsibilities, Rep. Lagman shared. He is also proud to say that the House deliberation on the budget was expeditiously nished for the rst time. On record time, they were able to approve the 2008 General Appropriations Bill (GAB) on 3rd reading sometime in October 2007.
public indebtedness, creation, abolition and classication of positions in government, and the determination of salaries, allowances and benets of government personnel.1 But far from taking advantage of his new post, Albay Rep. Edcel Lagman introduced various innovations to the Committee that reect his progressive leanings. We have revived an abandoned tradition of empowering the various Vice Chairpersons of the Committee to conduct hearings at the subcommittee level. It is at this stage that the nitty-gritty of the proposed budgetary allocations comes under the Committee members scrutiny for eventual retention, augmentation, disallowance, reduction or realignment, Rep. Lagman proudly said.
House of Representatives Committee Information. http://www.congress.gov.ph/committees/search.php?congress=14&id=0504.
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Rep. Edcel C. Lagman

Civilly democratic Under Rep. Lagmans stewardship, the Committee broke tradition after it approved the participation of bona de peoples organizations (POs) and nongovernment organizations (NGOs) in public hearings on the GAB on September 17, 2007. Accordingly, on September 28, 2007, the Committee heard the presentation of an alternative budget by Social Watch and the Freedom from Debt Coalition, and took note of their recommendations. The traditional practice of limiting budget briengs and hearings solely to heads and representatives of government departments and agencies is an incomplete process. The people, who are the ultimate beneciaries of sufcient budgetary allocations -- or the casualties of meager or absent allotments -- should be given the opportunity to be heard through their non-elective and alternative representatives in the PO and NGO community, Rep. Lagman explained. Asked about his assessment of civil societys rst attempt to engage in budget advocacy during the 2008 budget deliberations, Rep. Lagman thinks that they have done fairly well. But I think they should be more realistic. Because if you ask for the heavens, it will be hard. Next time around, it should be more practical and realistic. And I think they should be able to truly justify their proposal, the Bicolano Congressman said. Clear and present advocacies As Chairperson of the Committee on Appropriations, Rep. Lagman pursued some of his steadfast advocacies in the crafting of the 2008 General Appropriations Bill. Two of these are the deation of debt service and the comprehensive management of the population growth rate, which is presently 2.36 percent per annum and among the highest in the world. I have repeatedly said in many fora that the twin problems besetting the country are both escalating -- the spiraling debt service payments both for principal amortizations and interest payments, which has a combined total of P598.188 billion for 2008, and the exploding population, Rep. Lagman said. For the rst time in almost a decade, the debt service allocation for interest payments was cut, paving the way for augmenting the appropriations for: (1) health, (2) education, (3) agriculture, (4) social welfare, (5) infrastructure, (6) local governance and development, (7) justice and judiciary, (8) labor and employment, (9) energization, (10) environment, and (11) public safety and security, among others. The reduction in interest payments for foreign loans totaled P25.9 billion and consisted of the following: a) P15.9 billion corresponding to savings as a result of the appreciation of the peso with the exchange rate recomputed at P41.00 to a dollar from a high assumption of 48:1 in the National Expenditures Program (NEP), or a P7.00 differential (A total of P2.272 billion in savings is generated for every peso appreciation); b) P5 billion in suspension of interest payments for loans, which are challenged as fraudulent, tainted and/ or useless pending the Executives renegotiation of the loans or their eventual condonation; and c) P5 billion in premature allocations for interest payments for program loans and bond issuances still in the pipeline.
PROFILE
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There is no comprehensive and national policy to contain the population growth rate and the budget for reproductive health has always been miniscule.
d) appropriation of P29.161 billion; Infrastructure allocation was increased by P12.982 billion for a total new appropriations of P94.729 billion; Justice and the judiciary allocation was increased by P1.236 billion for a total combined new appropriation of P16.570 billion; Social welfare and development allocation was increased by P.165 billion for a total new appropriation of P4.848 billion; Local governance and development allocation was increased by P3.5 billion for a total new appropriation of P16.253 billion; Public safety and security allocation was increased by P.859 billion for a total new appropriation of P53.242 billion; Labor and employment allocation was increased by P.236 billion for a total new appropriation of P6.272 billion; Energization allocation was increased by P.6 billion for a total new appropriation of P.922 billion; Environmental protection allocation was increased by P.184 billion for a total new appropriation of P8.118 billion; and Sports development allocation was increased by P.059 billion for a total new appropriation of P.360 billion. Aside from infrastructure development, the health, education, and agriculture sectors were the biggest beneciaries of the bicameral augmentation with respective increases of P5.790 billion, P4.829 billion and P1.872 billion. Sports development got the highest percentage increase (19.6 percent or P59 million) to propel Filipino athletes in their quest for gold in the Beijing Olympics in August 2008. No more lip service to population management Rep. Lagman opines that the countrys inordinate population growth rate impedes and constricts our overall socioeconomic growth. He believes that the problem of a huge population adversely impacts on all indicators of human development like education, health, shelter, employment, food security, and the environment. He regretfully pointed out, however, that in the past, both the Executive and the Legislative branches have given mere lip service to population management.
e)
f)
In addition to the debt service cut, proposed appropriations for slow-moving projects, excess allocations and other miscellaneous allotments totaling P12.638 billion were likewise slashed. The total cuts amounting to P38.5 billion were realigned to the budgets of the following agencies and programs, among others, to increase their respective appropriations as originally proposed in the NEP: a) Basic and higher education allocation was increased by P4.829 billion for a total new appropriation of P158.602 billion; b) Health allocation was increased by P5.790 billion for a total new appropriation of P25.847 billion; c) Agriculture allocation was increased by P1.872 billion for a total new
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g)
h)
i)
j)
k)
l)
Rep. Edcel C. Lagman
PROFILE
The problem is that local government units dont have the funds. They might have the authority to purchase but if they do not have the funds to purchase, thats a useless authority. Thats why we are appropriating this year P2 billion for reproductive health and family planning.
There is no comprehensive and national policy to contain the population growth rate and the budget for reproductive health has always been miniscule, Rep. Lagman said. In the General Appropriations Act of 2007, a budget of P180 million was allocated for articial family planning, which could be accessed by local government units since the national government has prohibited the procurement and dissemination of family planning commodities like condoms, contraceptive pills and injectables. Regrettably, it was only on February 12, 2008 that this amount of P180 million had been released through a belated Special Allotment Release Order (SARO). To compound the problem, even the Commission on
Population was not aware of this tardy release to the Department of Health, Rep. Lagman lamented. For this year, through the initiative of the House of Representatives and with the concurrence of the Senate, a total of P2 billion has been allocated in the GAA for reproductive health and family planning. Of this amount, P800 million is allocated for reproductive health and family planning seminars to be conducted nationwide by the DOH in coordination with LGUs to enable women and couples to make informed choices regarding the family planning method that is best suited to their needs, personal convictions, and religious beliefs. The remaining P1.2 billion is appropriated for the purchase of modern natural
and articial family planning methods and devices. Purchasing power-less The national government has rmly kept its policy not to purchase reproductive health commodities, devolving the responsibility to local government units. The problem is that local government units dont have the funds. They might have the authority to purchase but if they do not have the funds to purchase, thats a useless authority. Thats why we are appropriating this year P2 billion for reproductive health and family planning, Rep. Lagman explained. He claried that his effort will not go head-on with conservative opinion.
27
The urgent need to pass a comprehensive national policy on RH and FP remains, without which all our efforts would remain under threat from individual whims and beliefs.
I think this new thrust is not offensive to the Catholic hierarchy because it is an impartial advocacy for family planning. The government will pursue both natural and modern family planning and at the same time, address our commitment to the Millennium Development Goals (MDGs) as prescribed by the United Nations, Rep. Lagman said. According to him, the increases, which the House of Representatives have introduced for health, education, agriculture and the environment, have addressed the countrys commitment to the attainment of the MDGs on eradicating extreme hunger and poverty, achieving universal primary education, promoting gender equality, reducing infant mortality, improving maternal health, combating HIV/AIDS and tuberculosis, and ensuring environmental sustainability. For the rst time, an allocation of P100 million was appropriated for the prevention and management of HIV/AIDS. Another P600 million was given for the prevention and treatment of pulmonary tuberculosis, with P400 million given to the Department of Health and the remaining P200 million allocated to the Department of Education for the treatment of teachers and non-teaching personnel in public schools who are aficted with tuberculosis and tend to spread the disease to their pupils and students, Rep. Lagman proudly shared. However, the staunch champion legislator who also serves as PLCPDs Board Secretary believes that the two-billion peso allocation is not enough to cover the family planning needs of the people, especially the poor. With many women and couples of reproductive age in this country, 2 billion is not enough. But that is a sizeable amount to start with because for the rst time, we are having a budget that big for reproductive health, family planning, and population management because I have injected my advocacy into the budget group, Rep. Lagman said.
28
Lingering challenge The insertions in the 2007 and 2008 GAAs prove the truth behind the maxim if theres a will, theres a way. Far from being overwhelmed by the legislative challenge, legislator-champions along with civil society groups have gone beyond what is obvious, extending their reach to Congress another important function and maximizing its potential to attain a noble goal. But rejoicing over this new victory should not make advocates and leaders lose sight of the remaining challenges ahead. The urgent need to pass a comprehensive national policy on RH and FP remains, without which all our efforts would remain under threat from individual whims and beliefs, Rep. Lagman said. For now, while Rep. Lagman, along with other legislatorchampions and advocates, awaits the fate of House Bill No. 17, or the Reproductive Health, Responsible Parenthood and Population Development Act of 2007, he has committed to continuously ensure that the succeeding GAAs will contain allocations for RH and FP services and commodities.
Facts & Figures

Budget Lingo (2)
Commodity Loans Foreign loans in the form of goods received, which are subsequently monetized to nance programs and projects of implementing agencies. Peso proceeds are thereafter deposited with the Bureau of the Treasury (BTr) to be used or expended for projects specied in the loan documents. Debt Service The sum of loan repayments, interest payments, commitment fees, and other charges on foreign and domestic borrowings. Fiscal Policy The part of government policy, which is concerned with raising of resources through taxation and borrowing and deciding on the level and pattern of expenditures. General Fund Fund which is available for any purpose to which the legislative body may choose to apply, and is composed of all receipts or revenues, which are not otherwise accruing to other funds. Public Debt Includes the total indebtedness of the National Government, local government and government corporations or nancial institutions from industries, corporations or nancial institutions, whether private or government, foreign or domestic, which are fully supported and guaranteed by NG. Special Allotment Release Order (SARO) A specic authority issued to one or more identied agencies to incur obligations not exceeding a given amount during a specied period for the purpose indicated. It shall cover expenditures, the release of which is subject to compliance with specic laws or regulations, or is subject to separate approval or clearance by competent authority. Special Purpose Funds (SPFs) Lump-sum appropriations that are governed by special provisions and/or requirements (e.g. Allocation to LGUs, Calamity Fund, Contingency Fund, Pension and Gratuity Fund, Priority Development Assistance Fund, etc). Releases out of these funds are generally subject to prior approval by the President. There are also SPFs that are intended to augment budget allocations of selected line agencies, such as those of the Departments of Agriculture (DA), Public Works and Highways (DPWH), and Transportation and Communication (DOTC). Unprogrammed Funds Standby appropriations allotted for activities without identied specic source at the time the General Appropriations Act is approved. This budgetary item shall be implemented only when: (a) revenue collections exceed target, or (b) when additional foreign project loan proceeds are realized. The rst condition is decit-neutral, that is, cash disbursement is kept within the level of actual revenue collections while the second condition gives an option to bloat the budget whenever proceeds from foreign loans are received.
Source: Department of Budget and Management. www.dbm.gov.ph/bestf2005/besf_2005_html_les/got.pdf
29
Kasama ba sa budget nyo

I dont buy contraceptives kasi hindi ko kailangan (because I do not need it). But I am more than willing to buy them kasi better ang maging protected especially when sexually active (because its better to be protected). Saka personally, di ko feel ang magka-anak pa (Besides, I personally dont think I want to have children yet). - Stephanie, 29, events organizer
Forum HDL F
M H LF
DL FORUM HDL FORUM HDL FORUM D D O O O O R ORUM HDL FORUM
O O O O M M M M H O O
ang pagbili ng contraceptives?

(Do you allocate part of your budget for the purchase of contraceptives?)
Normally, I dont include it in my budget as condoms can be accessed for free. The condoms that we sell that are nearly expiring are given out for free a few months prior to its expiry date.
- Oca, 40, Health NGO worker
Actually, hindi pa sa ngayon (not now) but Im thinking about it. Consult muna ko sa OB ko para mapayuhan ako ng most suitable way or brand ng contraception (Ill consult with my OB rst so I can be advised on the most suitable way or brand of contraception). Syempre pinagiisipan para safe (Of course, I think about it to be safe). Walang (No) hassle. Walang iniisip (No worries). I think theyre safe. Dapat nga ipromote (It should even be promoted).
- Jinky Garcia, 29, travel consultant
Im not yet using contraceptives.

- Ma. Katrina C. Fernandez,19, BA Commerce student
O O O O M M M M H O O
Hindi. Kasi libre yung condoms sa opisina. Kaya wala siya sa budget ko. (No. Because condoms are given for free in the office. That is why it is not included in my budget.)
HDL Forum
Heck no. I dont use condoms.
- Alvin, 28, student
- Udong, 31, development worker
Yup. Yan lang sagot ko (That is my only answer).

- Ming, 23, web programmer
Kung kinakailangan, kasama ang condom sa aking budget (If needed, purchase of condoms is included in my budget). Lagi akong may baon, di ko lang alam kung expired o sira na (I always have one with me, although I am not sure if its expired or damaged already).
- Igmata, 28, call center agent
Hindi, kasi takot akong magka-breast cancer o kahit na anong cancer (No, because Im afraid to get breast cancer or any other cancer).
No. Its just that many groups give it for free so I dont to have to include it in my budget ... hehehe.
- Aaron, 30, NGO worker
- Homer Nievera, 40, sales manager
THE BUDGET PROCESS T

By Dir. Nora Oliveros*
he budget is technically a planning document that reects and translates the governments policy priorities and scal targets in nancial terms. It is the result of a decision-making process and of the governments system for managing and assessing spending and tax policies including borrowing and debt servicing. This paper discusses the budget process, which consists of the major stages in making budget decisions, and implementing and assessing those decisions. The budget cycle has four stages: Budget Preparation - when the budget plan is formulated by the executive branch of government; Budget legislation - when the budget is debated, altered and enacted by the legislative branch; Budget Execution - when the approved budget is carried out by the government; and Budget Accountability - when the actual expenditures are accounted for and assessed for effectiveness. The government is currently undertaking reforms in expenditure management aimed at improving efciency and effectiveness in the use of resources. Some of the policy and process changes that have already been introduced into the budget system as a result of the reforms are incorporated in the discussion of each of the stages in the process. Budget preparation The formulation of the budget occurs within the executive branch of government and includes a number of actors. However, the whole process, which can take several months (usually seven to eight) prior to the constitutional deadline of submission to the legislative branch (within thirty days after the opening of congressional session), is led, managed, and coordinated by the Department of Budget and Management.
The following are the steps in the preparation of the budget: 1. The Development Budget Coordination Committee (DBCC) approves budget parameters 2. Budget Call 3. Budget Forum/Budget Hearings 4. Budget Review and Consolidation 5. Budget Validation/Conrmation 6. Approval by President and Cabinet 7. Submission of the Presidents Budget to Congress The development of the budget is holistic and is based on a three-year planning framework introduced recently as the Medium Term Expenditure Framework (MTEF). Total expenditures and revenue targets are initially determined and are inuenced partly by projections on key macroeconomic parameters such as economic growth, ination, demographic changes, exchange rate movement, and world market prices of oil, and partly by overarching scal goals such as maintaining a surplus, decit or debt at a certain level, raising or reducing taxes or increasing expenditures for certain priority areas. Initially, the determination of the expenditure program at the aggregate level may include the use of the current budget as baseline or starting point. The baseline, consisting of the cost of on-going policies, is indexed for ination and carried forward over the out years of the planning period. The
* Ms. Oliveros is the Director of the Budget and Management Bureau-E of the Department of Budget and Management.
32
No money shall be paid out of the treasury except in accordance with an appropriations made by law.
result of the process is thus called the Forward Estimates (FEs). Incremental changes to the FE may occur when the medium term revenue program exceeds the FE, resulting to a scal space. Reduction of the FE may occur when the reverse happens. In both cases, budget policies and sector priorities developed, debated and agreed upon by the DBCC for the ensuing budget year will determine the use of the scal space or the reduction of the FE. The resulting changes in the FE determine the aggregate, as well as the agency budget ceiling for the ensuing budget year. Agencies belonging to the priority sector may benet from the scal space and receive incremental budgets that may be used for new spending proposals. Those agencies with compelling reasons to justify incremental changes in their respective budgets, such as an activity or project that will enhance frontline services, may likewise be considered. The macroeconomic parameters and thrust of the budget agreed upon and approved by the President are communicated to the agencies and all stakeholders concerned through the issuance by the DBM of the Budget Call formalized in a National Budget Memorandum (NBM). The preparation of the budget at the agency level replicates the processes at the national level. The budget reects the agencys strategic plan that demonstrates the
policies and strategies in producing mandated goods and services based on clear statements of targets and intended results. The performance and results orientation of the budget is anchored on the concept of an Organizational Performance Indicator Framework (OPIF) that focuses spending to agency major nal outputs and measuring agency performance based on identied outcome and output indicators. Agency budget proposal is discussed with the concerned agency and is evaluated and debated on at the DBM. The completed and consolidated budget is called the National Expenditure Program (NEP), which sums up the national government agency budgets including government subsidy to state universities and colleges (SUCs), internal revenue share of local government units (LGUs), subsidy and equity contribution to government-owned and controlled corporations (GOCCs), interest payment, and a number of special purpose lump sum funds including standby appropriations. The budget is then sent to the
cabinet members for conrmation and subsequently submitted to the President for approval and submission to Congress. The NEP is supplemented by four (4) other budget documents, to wit: Budget of Receipts and Sources of Financing (BESF), Selected Programs and Projects, Stafng Summary, The Presidents Budget Message (PBM), and the OPIF Book. Budget legislation The legislation of the budget nds its ground on the constitutional provision that states, No money shall be paid out of the treasury except in accordance with an appropriations made by law. Thus, in summary, the following are the primary steps in the legislation of the budget: 1. House Hearings/Debate 2. House Approval and Submission to Senate 3. Senate Hearings/Debate 4. Senate Approval 5. Conference Committee 6. President Signs the General Appropriations Act (GAA)
33
The legislative branch at the lower house receives the budget within the deadline set in the Philippine Constitution. However, there is no prescriptive period in the enactment of the budget so its passage may take several months. In the process of legislation, Congress may introduce changes, but it is not authorized by the Constitution to increase the aggregate level of the budget. Budget technical discussions may happen simultaneously at both Chambers of the House wherein agency representatives and members of the DBCC are invited as resource persons. The technical discussions provide the venue for clarifying, validating, and testing the key macroeconomic parameters, policy directions, strategies, and assumptions underlying the formulation of the aggregate as well as agency budgets. Budget debates may likewise happen at both chambers with sponsorship of the budget by the respective chairpersons of the Committee on Appropriations at the House of Representatives and Committee on Finance at the Senate. Subsequently, a bicameral conference committee follows to provide a venue for addressing and nding solutions to contentious issues between the two chambers. The General
Appropriations Bill (GAB) is then passed and submitted to the President for signing into law that will eventually be referred to as the General Appropriations Act (GAA). The probability of a delay and failure to pass a new budget is recognized in the Philippine Constitution by providing for the reenactment of the preceding years budget until a new one is passed. This legal framework aims to avoid disruption in the delivery of government services. Budget execution The third phase of the budget process covers the various operational aspects of budgeting. The establishment of obligational authority ceilings, evaluation of work and nancial plans for individual activities, continuing review of government scal position, regulation of funds release, implementation of cash payment schedules, and other related activities comprise this phase of the budget cycle. The DBCC reviews the scal position regularly and adjusts the program accordingly during budget execution. The primordial concern is to ensure that spending requirements of government as
approved in the budget can be served. The appropriations authorized by the reenactment of a budget or the passage of a new one provides the legal cover for the release of funds by the DBM and the delivery of goods and services by government agencies. The release of funds is executed through the issuance of four (4) types of disbursement authorities, namely: Agency Budget Matrix (ABM), Special Allotment Release Order (SARO), Notice of Cash Allocation (NCA), and NonCash Availment Authority (NCAA). The execution of the budget is crucial in the implementation of agency plans. Thus, the submission by the agency of a comprehensive and detailed work and nancial plan (WFP) as well as a monthly cash program are essential to the release process. The DBM requires the WFP and cash program to serve as basis for allotment and cash releases. The ABM and SARO are instruments that authorize the agency to obligate and commit funds. Procurement cannot be done without a valid allotment such as
34
reallocating funds from one category or class of expenditure to another subject to limitations and rules in the GAA. Budget accountability Monitoring and evaluation of agency performance are management functions, which complete the budget process and provide inputs to budget decisionmaking processes. It is at this stage that accomplishments of the agency are measured and accountability for the use of funds are established through the work targets set in the budget preparation stage and conrmed at the onset of the budget execution. The progress or outputs delivered by the agency at any given time are periodically measured against work targets by the use of qualitative and quantitative indicators. Units of measure such as effectiveness and efciency in terms of cost and timeliness in the delivery of goods and services are used to account for funds and to assess performance of the agency. Budget Accountability Reports (BARs), as prescribed by the DBM, are required to be submitted as they become due. Reports of actual performance include the following information: 1. Disbursements arising from the issuance of NCAs, NCAAs among others; 2. Obligations and Balances summarizing allotments received and
corresponding obligations incurred from all sources by object of expenditures; 3. Physical accomplishments in terms of the targets set; and 4. Actual income collection from all sources. These reports may be used as bases in the conduct of the Agency Performance Review (APR) in validating the reasonable level of funding provided to the agency to accomplish its targets during the remaining quarters of the year. They may also serve as benchmarks in determining the budget level for the ensuing year. Conclusion The government budget system has been in a transition since DBM introduced the MTEF and OPIF two years ago in the preparation of the budget. These two major reforms are both works in progress as shifts in policies and processes become necessary to implement the new frameworks adopted. The change process is slow, but the DBM is optimistic that these changes will gain support not only from the bureaucracy but from all stakeholders, especially the general public to whom the benets of these reforms are dedicated.
the ABM and the SARO. On the other hand, the NCA is an authority for an agency to disburse funds for current expenditures as well as prior years payables. The NCAA is another disbursement authority generally applied for foreign-assisted projects. This instrument is generally issued to cover importation of goods and services, which are paid directly out of the loan/grant proceeds by the foreign donor or lender in behalf of the agency to the foreign contractor or supplier. The two-step process of obligating and disbursing funds serve as a control mechanism to regulate releases and effectively manage expenditures both at the national and agency levels. ABM and SARO can be released to the extent of available appropriations while NCA can be issued to the extent of available and valid allotments. The WFP is a living document, which may be revised during the course of implementation. When the need to revise the WFP arises, the agency may secure approval from DBM, which may issue a new SARO to effect the changes requested. The process is called realignment, which means
35
Local Promise
Success stories in local
The
reproductive health advocacy

in the Philippines
By Rene Llorin and Elenor de Leon
VISAYAS Municipality of Llorente, Eastern Samar Municipality of Carmen, Bohol Municipality of Ubay, Bohol Municipality of Talibon, Bohol Municipality of Makato, Aklan
LUZON Province of Aurora Province of Ifugao Municipality of Lagawe, Ifugao Municipality of Asipulo, Ifugao Municipality of Tinoc, Ifugao Mountain Province Bontoc, Mountain Province Sagada, Mountain Province Paracelis, Mountain Province Municipality of Placer, Masbate Olongapo City Angeles City Quezon City, NCR Naga City Province of Camarines Sur Sorsogon City Sorsogon Province
MINDANAO Municipality of Kapatagan, Lanao Del Sur Municipality of Lebak, Sultan Kudarat Province of Sulu Municipality of Jolo, Sulu Davao City
he enactment of Republic Act 7160, or the Local Government Code of 1991, presented two sides to a nation so used to having an imperial Manila making and administering decisions in all governance and scal matters. Described by University of the Philippines-National College of Public Administration and Governance (UP-NCPAG) Dean Alex Brillantes as the most radical and far-reaching policy that addressed the decades-old problem of an over-centralized politico-administrative system,1 RA 7160, or simply the LGC, laudably devolved much of the central governments powers to local government units (LGUs) including the delivery of basic services and drafting of local development plans. But while it provided for greater local autonomy, the LGC likewise presented greater pressure on LGUs and opened vast opportunities for them to either shine or shrink. The LGC bestows upon LGUs the right to enjoy genuine and meaningful local autonomy to enable them to attain their fullest development as self-reliant communities and make them more effective partners in the attainment of national goals.2 It also accords them the authority to establish an organization that shall be responsible for the implementation
36
of their development plans and gives them the power to create their own sources of revenue.3 But more than a decade since its enactment, a lot, as they say, remains to be done. Beset by a host of problems starting from its implementation to the general question of commendable leadership and governance from among our generation of local leaders, the accordance of greater autonomy to LGUs also presents vast potentials for policy advocates. Since its inception in 1989, the Philippine Legislators Committee on Population and Development (PLCPD) has been engaging legislators in the Senate and House of Representative for the passage of a comprehensive national policy on reproductive health and population management. Through the years and three congresses (from the 11th to the 13th Congress), PLCPD has vehemently fought for the enactment of this national policy. Sadly, though, its conscientious effort to help elected legislators acknowledge the urgency of enacting said policy is continuously, repeatedly and consistently being blocked by conservative groups led by the Roman Catholic Church hierarchy. But the overwhelming challenges faced by our population and reproductive health (pop/RH) advocacy in the legislative arena have not dampened the enthusiasm and commitment of legislatorchampions and advocates. The Philippines population growth rate remains high compared to our Asian neighbours despite its recent drop from 2.36 percent to 2.04 percent in 2007.4 Filipino women still bear an average of 3.5 children in their lifetime5 while maternal mortality remains at a high 162 for every 100,000 live births.6 Poverty has also been found to be strongly linked to family size. According to a recent study, only 23.8 percent of families with four members are poor compared to 48.7 percent of families with seven members.7 Faced with difculties of enacting a comprehensive national policy on population and reproductive health, PLCPD consolidated its partners at the local level and directed their effort toward the realization of a broad initiative in improving the state of reproductive health service delivery and signicantly contribute to the management of the countrys population. Initial engagement Even when then PLCPD CoChairperson and Aurora Lone District Representative
Bellaor Angara-Castillo rst led the reproductive health bill in Congress in 2001, the group already realized the need for complementary actions at the local level. The advocacy for a national population management and reproductive health policy was clearly in need of support across the country and not just from a handful of champions and civil society groups based in Metro
37
policy. After several years of advocating for a national RH policy in Congress, newly-elected Aurora Governor Bellaor Angara Castillo, respected former Chairperson of PLCPD, vowed to stay committed to the advocacy and carry it home to her province. True enough, on June 1, 2005, the Provincial Council of Aurora enacted the landmark Reproductive Health Care Code (Provincial Ordinance No. 125, Series of 2005) authored by Vice Governor Annabelle C. Tangson and Board Member Zenaida S. Querijero. The Code encompasses most, if not all, of the elements of RH complete with mechanisms and appropriations to ensure its continuous implementation. Given Auroras success, PLCPD began setting its sights on the promotion of similar local reproductive health ordinances by working with local legislators in other areas in the country and developing them into local champions. Consequently, these local champions organized themselves into the Local Legislators League on Population, Health, Environment and Development or the 3LPHED. Formally established in 2005, the 3LPHED now has seven provincial chapters with over 200 members who support the enactment of local policy proposals on environment, children, gender, and health. In 2005 and in early 2006, with support from the Management Sciences for Health-Local Enhancement and Development (MSH-LEAD) for Health Project,
38
Manila. Moreover, the demand for better services and supplies emanates from the grassroots in the provinces and municipalities. Any policy, therefore, would have to be implemented practically by local leaders. After the 2004 elections, during the inauguration of the 13th Congress, PLCPD assessed its intervention at the local level. It was also the time when several civil society groups were clamoring for population management and reproductive health advocacy to go local, a logical step considering the opposition encountered in Congress. And so, complementing its national advocacy efforts on population management and reproductive health, PLCPD
expanded and strengthened the advocacy at the local level. During its early years of local advocacy work, PLCPD engaged its legislator-champions vis--vis local government units in the districts that they represented. The intervention focused on building sustainability mechanisms at the municipal level to provide solutions to the insufciency of family planning (FP) and reproductive health services and entailed the creation of advocacy teams and ensuring resource allocations. Turning point It was in 2005 when a speck of silver lining illuminated the dragging advocacy for a national
PLCPD conducted several Policy Development Writeshops for the local governments of Benguet and Pangasinan. Although the projects objective was to improve local health systems in specic areas like vitamin A supplementation, tuberculosis, and HIV/AIDS, among others, it also sought to improve contraceptive selfreliance strategies and policies that eventually resulted to increased local government response to the need for FP services. Meanwhile, policy development trainings and political mapping workshops were conducted in the 10 Pilot Provinces of the UNFPA 6th Country Program to help increase knowledge and skills in developing RH ordinances. Consequently, these areas successfully enacted their very own RH ordinances because of the strong support of local implementing partners as well as adequate provision of after-training technical assistance, such as the conduct of advocacy activities, political mapping, media advocacy, capability building, action research, and advocacy monitoring and review. The commitment of advocates and local legislators was harnessed through constant personto-person engagement and conduct of strategic leadership trainings on population and development. Victories here and there By 2007, many of the founding members of the 3LPHED have drafted and led their RH ordinances in their respective LGUs. Despite the intervening 2007 national elections, members of the 3LPHED continued its organizing
activities, with PLCPD providing comprehensive technical assistance on advocacy and policy development. Vice Mayor and Mindanao member of the 3LPHED National Organizing Committee Renato De Manuel of Lebak, Sultan Kudarat pushed for the passage of the rst ever Municipal Reproductive Health Ordinance. Today, the ordinance already has its implementing rules and regulations and is being enforced. Down south in Naga City, Councilor and 3LPHED Legal Counsel Miles Raquid-Arroyo led the pack toward the enactment of the Citys Women in Development Ordinance, which contains provisions for RH. Farther up in the north, then Ifugao Vice Governor and 3LPHED Executive Vice President Glenn Prudenciano worked toward the passage of the Ifugao Province Reproductive Health Ordinance while his colleague in neighbouring Mountain Province, then Vice Governor and 3LPHED Vice President for North Luzon Benjamin Dominguez secured the installation of the Mountain
Province Reproductive Health, Responsible Parenthood and Prevention of Abortion Ordinance. Not long after these successes in Northern Luzon were achieved, several members of the 3LPHED also led RH policy proposals in their respective LGUs. In Olongapo City, PLCPD rendered its expertise in population and RH policy advocacy through the conduct of a presentation in one of their public forums to help create better understanding of reproductive health and the need for corresponding policies. In Quezon City, PLCPD once again made use of its years of experience in the conduct of policy advocacy. By providing technical assistance and mobilizing a critical mass of supporters, PLCPD was able to help
39
the Quezon City local government push through with the passage of their Population and Reproductive Health Management Ordinance. As for General Santos, Gov. AngaraCastillos visit and inspirational talk on Auroras success in passing their landmark provincial RH ordinance moved the LGU to craft and enact their very own. At present, there are ve provincial, 13 municipal, and three city reproductive health ordinances. Aside from these are several related ordinances tackling women in development, family planning, and adolescent reproductive health that have been passed. Our continuing responsibility As of this writing, members of the 3LPHED are attending to the enactment of proposed RH ordinances before 2010. This is in line with achieving the targets set forth in the Millennium Development Goals (MDGs), specically MDG 5, which aims to improve maternal health, and MDG 4, which seeks to reduce child mortality. But despite the gains in the population management and
reproductive health advocacy at the local level, very few have ventured in actually allocating resources necessary for broader local advocacy actions in almost 1,500 municipalities, 81 provinces, and 80 cities all over the country. It remains important to inform policymakers about reproductive health. Many still believe that because of the erce opposition of the Roman Catholic Church, supporting RH policy initiatives would mean political suicide. Time and again, the Roman Catholic Church has claimed a Catholic vote in threatening politicians planning to seek re-election to public ofce. This, despite clear and strong evidences of the voting publics clamor for a comprehensive national policy on RH and FP. As shown by the March 2007 Pulse Asia Ulat ng Bayan survey, nine out of 10 Filipinos (92%) consider FP important while nearly eight out of 10 (76%) believe in the importance of including FP in a candidates program of action.8 Both the 2004 and 2007 surveys have shown that inclusion of RH and FP in a candidates platform of government is not a factor in losing.9 It is also important to create a multisectoral base of supporters from
local and external stakeholders that would prove to policymakers the existence of a huge and continuously growing demand for RH policies. Harnessing popular support can be sustained through the conduct of dialogues, conferences, discussions, and consultations. Finally, after a policy proposal on RH has been enacted, it is important to ensure that it is implemented. This would mean shifting the advocacy from the legislative arena to the executive branch, and toward the allocation of funds. Realizing outcomes or the objectives of a policy is a painstaking process. It is essential that certain processes and mechanisms be put in place to determine its success or the need for changes. Again, if there were sufcient investments on RH, the Philippines could have achieved several milestones in the delivery of comprehensive services and information on RH. This could also create a momentum that would lead to the realization of a national population and RH policy. Advocates are always hopeful whenever a province, municipality, or city enacts its RH policy. Success in LGUs, albeit still handful, only proves that enacting RH policies can be done. More actions than words are needed. Numerous best practices have gained positive results. The next step, obviously, is for local, national, and international stakeholders to invest the right amount of resources for RH and population advocacy.
40
Table 1: List of Reproductive Health Ordinances in the Philippines
Province/ City Municipality 1. Province of Aurora
Title An Ordinance Providing for the Aurora Reproductive Health Care Code of 2005 (Provincial Ordinance No. 125, Series of 2005)
Author
Date passed
Initiated by Governor June 1, 2005 Bellaor Angara-Castillo Authored by: Vice Governor Annabelle C. Tangson and Board Member Zenaida S. Querijero Provincial Board Member Khalil Hajibin
2. Sulu
3. Ifugao
Ordinance No. 012008 An Ordinance Providing For the Sulu Reproductive Health Code of 2008 Ordinance No. 2006033 The Ifugao Reproductive Health and Responsible Parenthood Ordinance
February 5, 2008
4. Mountain Province
5. Olongapo City 6. Quezon City, NCR* 7. General Santos City, Province of South Cotabato 8. Tinoc, Ifugao
9. Talibon, Bohol
10. Lebak, Sultan Kudarat
Reproductive Health Responsible Parenthood and Prevention Of Abortion Ordinance Of Mountain Province (Provincial Ordinance No. 76, Series of 2006). Olongapo City Reproductive Health Care Code of 2007 An Ordinance Establishing a Quezon City Population and Reproductive Health Management Policy An Ordinance Establishing the General Santos City Population and Reproductive Health Management Policy Resolution No. 8742007 Resolution Adopting the Provincial Ordinance No. 2006-003 known as the Ifugao Reproductive Health and Responsible Parenthood Ordinance Ordinance No. 200820 The Talibon Reproductive Health and Responsible Parenthood Ordinance No. 06107 An Ordinance Providing for the Lebak Reproductive Health Care Code
Former Governor and July 7, 2006 Vice Governor Glenn Prudenciano; Provincial Board Members Joseph Odan, Nora Dinamling (currently Vice Governor), and Maritess Tumapang Initiated by then Vice 2006 Governor Benjamin Dominguez, Sr.
City Councilor Joseph P . Juico City Councilor Pedro Acharon Municipal Councilor Victor V. Calya-en, Sr.
September 17, 1997 2008
2008
August 10, 2007
Municipal Councilor Thomas Cornelio Municipal Councilor Manuel Frieres
January 8, 2008 August 18, 2006
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11. Llorente, Eastern Samar
Mun. Ordinance No. 3 Series of 2007, Reproductive Health Ordinance of the Municipality of Llorente 12. Ubay, Bohol Ordinance No. 092006 The Ubay Reproductive Health Care Code 13. Sagada, Ordinance No. 042007 Mountain Province RH Ordinance of Sagada 14. Lagawe, Ifugao Municipal Ordinance No. 97 The Lagawe Reproductive Health and Responsible Parenthood Code 15. Municipality of An Ordinance Providing for the Kapatagan, Lanao Reproductive Health Code of Kapatagan Del Sur 16. Municipality of Asipulo Reproductive Health and Asipulo, Ifugao Responsible Parenthood Ordinance (Municipal Ordinance No. 02, Series of 2007) 17. Municipality of An Ordinance on Reproductive Health of Bontoc Bontoc, Mountain Province (Ordinance No. 118, Series of 2008). 18. Municipality of An Ordinance on Responsible Parenthood Paracelis And Prevention of Abortion of Paracelis, Mt. Province. (Ordinance no. 2006-018) 19. Municipality of An Ordinance Providing for Reproductive Carmen Bohol Health and Population Management Policy. 20. Municipalities of Maydolong An Ordinance on Womens Welfare (Includes provisions on reproductive health)
Municipal Councilor Rosario Coral Municipal Councilor Rose Lima Abapo Municipal Councilor Regina Tambiac Municipal Councilor Marior D. Dipia-o Municipal Councilor Sansarona Bansil Municipal Councilor Denis P . Gumangan
November 26, 2007 June 27, 2006 July 30, 2007 March 11, 2008 2007
2007
Municipal Councilor Eva Mila F . Fana-ang Municipal Councilor Bello M. Banggot
January 7, 2008 December 18, 2006
Vice Mayor Jocel Trabajo and Municipal Councilor Nathaniel Binlod, Vice Mayor Renato Palce
December 29, 2006
2007
Sources: 1 Brillantes, Alex B. Jr. and Donna Moscarel. 2002. Decentralization and Federalism in the Philippines: Lessons from Global Community. Discussion paper presented at the International Conference of the East West Center, July 1-5, in Kuala Lumpur, Malaysia. 2 Tabunda, Manuel S., and Mario M. Galang. 1992. A Guide to the Local Government Code of 1991. Manila: Mary Jo Educational Supply. 3 Ibid. 4 National Statistical Coordination Board (NSCB). Sectoral Statistics: Population. http://www.nscb.gov.ph/secstat/d_popn.asp 5 National Statistics Ofce (NSO) [Philipines], and ORC Macro. 2004. National Demographic and Health Survey 2003. Calverton, Maryland: NSO and ORC Macro. 6 Result of the 2006 Family Planning Survey (FPS) as cited in a press release by the National Statistics Ofce (NSO) dated March 17, 2007. http://www. census.gov.ph/data/pressrelease/2007/pr0718tx.html 7 Result of a study conducted by Aniceto Orbeta Jr. entitled Poverty, Vulnerability and Family Size: Evidence from the Philippines (ADB Institute Discussion Paper No. 29, June 2005) as cited in PLCPDs Population and Reproductive Health Primer: What Every Legislator Should Know. 8 De Leon, Elenor, Ma. Cecilia de los Reyes, and Rene A. Llorin. Population and Reproductive Health: What Every Legislator Should Know. Philippines: Philippine Legislators Committee on Population and Development Foundation, Inc., 2008. 9 Ibid.
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Facts & Figures

RH Financing
Despite the non-passage of the National Reproductive Health (RH) Care Code in the Philippine Congress, the provinces of Aurora, Mountain Province, Ifugao, Masbate and Tawi-Tawi have supported and enacted their respective RH ordinances. These provinces also allocated budget for RH and family planning (FP) services, especially Aurora and Masbate, which allotted P1 million each for services and commodities. In 2006, the province of Albay allocated 7.6 million pesos for RH and FP services and commodities. According to the Bureau of Local Government and Finance (BLGF), local government units (provinces, cities and municipalities combined) spent P17.52 billion for health, nutrition and population management in 2004 or 10.91 percent of their combined total budget. In September 2005, DOH Assistant Secretary Mario C. Villaverde estimated a P7.52-billion annual budgetary gap for the financing of RHrelated Millennium Development Goals, or MDGs. These are on infant and child health, maternal mortality, HIV-AIDS, malaria, and TB. According to ASec. Villaverde, the total budgetary need for RH-related MDGs is P8.99 billion, and that only P0.69 billion was funded by the Department of Health (DOH) and P0.78 billion from Official Development Assistance (ODA).
Costing and Budget Gaps for the Health-Related MDGs (Annual) MDGs Total Cost (in Pesos) 1,469,938,544 DOH Funding 370,544,000 107,880,277 208,976,667 ODA 3,500,000 11,230,000 768,978,810 GAP 1,095,894,544 4,706,817,950 1,714,278,080
Reduction of Child Mortality Improve Maternal 4,825,928,227 Health Combat HIV-AIDS, 2,692,233,557 Malaria and other Diseases GRAND TOTAL 8,988,100,328
687,400,944
783,708,810
7,516,990,574
Source: DOH, September 2005 as cited by Carlos H. Aquino Jr. in Translating RH Commitments to Budgetary Appropriations: Philippine Experience, PLCPD Policy Brief, 2006.
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GOVERNOR MAXIMO DALOG:

The Max-Champion of Reproductive Health in Mountain Province
By Christopher B. Estallo
I believe in putting more effort in educating the people on the pros and cons of having many children, and on the importance of making informed choices, especially when it comes to family planning. I believe that the people would know best what is and what is not good for them. We in government should merely guide them .
ountain Province Governor Maximo Dalog recalled the relatively smooth passage of his provinces reproductive health ordinance. It was a cooperative effort. The members of the Provincial Board and local religious groups, including the Catholic Church, were all cognizant of the ordinances importance to the development efforts in the province, the Governor said. An active member of Couples for Christ, Knights of Columbus, and other religious and civic organizations in Mountain Province, Gov. Max, as he is fondly called by his constituents, also wasted no time in making allies out of its leaders and members. I explained to them that the provincial governments various initiatives on reproductive health (RH) and family planning (FP) value respect for human dignity and uphold the right of every person to have access to relevant and
44
accurate information and services that will, in turn, enable them to make informed choices and decisions in accordance with their religious convictions and cultural beliefs, he said. In his talks with various stakeholders, the governor would often clarify the provincial governments aim to ensure the health of child-bearing women. We do not discourage couples to have children. What we merely want is for them to observe proper birth spacing and pregnancy care, Gov. Max explained. Coming from a big family himself, Gov. Max knows perfectly well how hard it was for their farmer-parents to raise several children. I have 7 siblings and our life then was not as comfortable as the lives of other families, Gov. Max related. He explained that, when faced with challenges in passing ordinances pertaining to RH and FP, he would always
Gov. Maximo Dalog
PROFILE
Table 1: RH-related issuances in Mountain Province EXECUTIVE TITLE ISSUANCES (Number and Year Issued) Executive Order No. Protection of Child11, Series of 2005 Bearing Women Administrative Order Creation of Mountain Province No. 17, Series of 2006 HIV/AIDS Council OBJECTIVE (FUNCTION)
Directing all pregnant women to undergo complete prenatal consultations and that all deliveries should be attended by health workers. Tasks the Provincial Health Board to function as the Provincial AIDS Council in line with R.A. 8504 (AIDS Law). The main function of the Council is to oversee the planning, implementation and monitoring of HIV/ AIDS programs and services in Mt. Province. The administrative order was made in support to RA 9262 or the Anti-Violence Against Women and Their Children Act, and to RA 9208 or Anti-Trafcking in Persons Act. Monitoring and strict implementation of RA 9208 and RA 9262
Administrative Order Organize Councils No. 18, Series of Against Trafcking in 2006 Persons and Violence Against Women and Children
The administrative order will create and establish systems on surveillance, investigation, and rescue to ensure effective and efcient coordination among the concerned agencies. Executive Order No. Exemption from Birthing mothers are exempted from paying all 30, Series of 2007 Payment of Services in hospital services while conned in any of the All Hospitals Managed hospitals under the operation and management of and Operated the Provincial Government of Mountain Province. by the Provincial Government of Mt. To enhance womens reproductive health and be a Province potent factor in ensuring that no birthing mother shall die due to pregnancy-related causes.
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The provincial governments policy and program initiatives are in line with, and supportive of, the Millennium Development Goals, specically the goals on child mortality, womens reproductive health, and prevention of HIV/AIDS, malaria and other diseases.
think about his people and what their needs really are. They entrusted me to serve them, Gov. Max stressed. Taking the lead It has been my advocacy that there should be no infant and maternal death in Mountain Province on account of delayed, inadequate or incompetent medical assistance. A staunch RH and FP supporter, Gov. Max has been proving his commitment to better serve his people by addressing population concerns vis--vis development initiatives. As the provinces chief executive, Gov. Max has been instrumental in institutionalizing local laws protecting child-bearing women, ensuring safe motherhood, preventing HIV/AIDS, and addressing trafcking in persons and violence against women. The province is also implementing programs aimed at reducing maternal mortality and increasing access of mothers to reproductive health services. Upgraded services in district hospitals have also encouraged pregnant women to avail of obstetrics care. A healthy lifestyle is being promoted by hospital workers, and the Provincial Population Ofce has been constantly conducting and providing family planning education, counseling services, and contraceptives provision to both men and women. The provincial governments policy and program initiatives are in line with, and supportive of, the Millennium Development Goals, specically the goals on child mortality, womens reproductive health, and prevention of HIV/AIDS, malaria and other diseases, Gov. Max explained. The governor also commended the municipalities of Bontoc, Sagada, and Paracelis for passing their respective municipal reproductive health ordinances. This is Mountain Provinces share in achieving the MDGs, Gov. Max proudly stated. Money matters Programs on health are always placed at the center stage of the provincial governments list of priorities. However, the discontinuation of contraceptives donation from the United States Agency for International Development (USAID) puts the province at a dilemma. But with the 10 percent capitation from PHILHEALTH of provincial and district hospitals allocated, Gov. Max believes they can manage.
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Gov. Maximo Dalog
PROFILE
We are dependent on Mother Nature for our sustenance. It is only right that we make sure that she is not harmed by our similar quest for survival.
The budget appropriated is rather small, but if it is utilized well, it would be a great help in the realization of our RH and FP programs, the governor said. At present, the provincial government is experiencing difculties allocating their meager income. Despite this, the provincial government has earmarked 12.5 million for the different programs related to the development of women and childrens health. This amount also includes support to midwives and aid to barangay health workers. Overall, our budget is not enough to nance all of these programs. We are grateful to the United Nations Population Fund (UNFPA) for providing invaluable support to our RH and FP Programs. PHE and development Dubbed as La Montaosa by our Spanish conquerors, Mountain Province is part of the rugged but magnicently endowed Cordillera region. It takes its share in Northern Luzons vast and elaborate watershed system and plays host to the famous Mount Data forest reserve. With these natural riches in mind, Gov. Max all the more emphasizes the need to harmonize efforts at managing the population and protecting the environment. Speaking in the organizational orientation and induction of ofcers of the Local Legislators League on Population, Health, Environment, and Development (3LPHED)-Mountains Province Chapter, Gov. Max stressed the need to capacitate local legislative bodies in crafting laws that are responsive to the needs of the people and of the environment. We are dependent on Mother Nature for our sustenance. It is only right that we make sure that she is not harmed by our similar quest for survival, Gov. Max said. The 3LPHED is an issue-based and people-centered league of local legislators that champions, articulates, and concretizes appropriate and sustainable responses to population, health, environment, and development (PHED) issues affecting Philippine Society. Gov. Max hopes that with the support of such groups as the Philippine Legislators Committee on Population and Development (PLCPD) and the 3LPHED, efforts at accelerating Mountain Provinces development will soon come to fruition and leave behind the tag of being one of the countrys poorest provinces.
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Pushing development by investing in reproductive health

By Ed Tamayo*
s this article is written, the National Statistical Coordinating Board (NSCB) reports that the countrys poverty incidence increased from 24.4 percent in 2003 to 26.9 percent in 2006. In actual numbers, some 3.8 million more Filipinos fell below the poverty threshold from 2003 to 2006. The release of the NSCB report coincided with the call of visiting former World Bank President James Wolfenson for the Philippines to make greater investments in education and health, which can lower poverty levels by 10 to 15 percent. Such investments are precisely what DKT Philippines, Inc. is implementing by promoting reproductive health and family planning.
DKT and the Filipinos reproductive health needs Founded in 1990, DKT is a registered, non-stock, non-prot Filipino NGO with the mission of making affordable, high-quality reproductive health products and information available to low-income couples throughout the country. DKT carries out its mission through social marketing and social franchising. Social
marketing utilizes the resources and techniques of the established private medical and commercial sectors to promote, distribute, and sell essential health products at affordable prices through commercial and non-commercial outlets that are convenient and accessible to target groups. Social franchising, on the one hand, is a development approach, which applies modern commercial franchising techniques to achieve social rather than commercial goals and is therefore analogous to social marketing, which has been used to good effect in the promotion and distribution of preventive and curative health products.1
A pioneering organization, DKT has built a track record as the acknowledged market leader with a multi-brand, multi-product portfolio. DKTs most dramatic performance occurred in the past ve years, reaching a 184-percent growth rate in sales volume. Its market share ranges from 65 to 85 percent in each product category, accounting for 80 percent of units sold and 36 percent of peso value in the Philippine market. In lling the gap between the public sector that is facing access and availability issues and the private sector where products
*Mr. Tamayo is DKT Philippines PR Consultant. 1 Smith, Elizabeth. 2002. Social franchising reproductive health services: Can it work? A review of the experience. Paper made for the Marie Stopes International Global Partnership.
48
are available but not cheap, DKT has helped ensure the supply of quality products while simultaneously expanding product choice to include more formulations, keeping prices low, generating greater awareness on, and interest in, family planning and its importance, and increasing focus on maternal and child health care as well as adolescent reproductive health. It has increased access and availability through better coverage, especially in rural areas, and has played a key role in promoting information on reproductive health and family planning. Its POPSHOP Franchise has been reaping successes as a micro-enterprise system that meets the contraceptive needs of the community by offering a viable and immediate option to procure and distribute contraceptives with a built-in cost-recovery mechanism to ensure sustainable operations. Challenges and issues Despite efforts exerted by DKT and its allies, the countrys contraceptive and reproductive health needs remain daunting. According to the 2003 National Demographic and Health Survey, the Philippines contraceptive preva-
lence rate remains low at 49 percent, unmet needs remain high at 17.3 percent, and almost half (44 percent) of all births are unwanted. HIV/AIDS incidence is hidden and growing. Furthermore, an estimated 400,000 abortions take place every year despite being illegal. And in a study of hospital cases of abortion complications, 36 percent of these are young women (15-24 years old). The pursuit of Philippine reproductive health needs is confronted by several challenges and issues. Strong religious lobby and inuence on the hearts and minds of those most in need aggravate efforts to increase demand and translate it into access, purchase, and usage. There is also the difcult operating environment that includes opposition from gatekeepers in the medical community and the pharmacy sector, and regulatory restrictions on promotions. For its part, DKT faces strong-arm tactics from commercial competitors, e.g., in the form of cease-and-desist orders instigated by competitors intended to impede its operations. The USAID phase-down of contraceptive donations also pose a serious concern, particularly the
prevention of drop-outs among users. With 40-50 percent of Filipinos earning less than US$2 daily and dependent on access to contraceptives through the public sector, there remains a very large cohort of poor Filipinos who cannot afford to and will not buy contraceptives from commercial drugstores. By way of an alternative, DKT is attempting to sustain product delivery at the level of Local Government Units (LGUs) through POPSHOPs. In addition, DKT is concentrating distribution and coverage in poor areas, partnering with NGOs and midwives at the local level, and targeting education and information efforts at hard-to-reach segments. The challenge is how to create demand, which involves policy implications and requires an appropriate policy environment. Possibilities for legislation From DKTs point of view, there are a number of areas in which legislators can make an impact in meeting reproductive health needs. The most important one is to work for the change in status of oral contraceptives to make them available over-the-counter (OTC) even while the actual action will require Bureau of Food and Drugs (BFAD) implementation. Oral contraceptives are the most researched products in the pharmaceutical industry, its safety and use endorsed by international agencies such as the World Health Organization, various donor agencies and the academe. Such a reclassication will signicantly help generate awareness, interest and usage, and promote new channels for distribution, sales, education, information and promotions.
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There is also a need to reform the policy environment to make it more conducive to the promotion of family planning and eliminate or reduce duties and VAT on reproductive health products. Legislators may also emulate Quezon Citys recent feat by enacting an ordinance on population and reproductive health management that could provide for a 100 percent condom use policy in cooperation with the LGU; encourage LGUs to allocate budget for contraceptive procurement; permit emergency contraception; enable the Department of Health (DOH) to facilitate importations of contraceptives; strengthen reproductive health education in schools through the Department of Education (DepEd) and Commission on Higher Education (CHED); and allow for a 100-percent condom use and availability policy in drugstores, convenience stores, and entertainment establishments in their locality. Private sector initiative In promoting reproductive health, members of the private sector can initiate a range of important efforts: More vigorous implementation of the Labor Code by industries and businesses with regard to the provision of reproductive
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health services for employees, i.e., family planning programs and access to contraceptives; In the commercial sector: more aggressive education efforts and price restraint, with retail outlets embracing a full complement of modern contraceptives, to promote affordability and availability of modern contraceptives; On the part of private schools: incorporating reproductive health comprehensively in curricula to promote awareness and acceptance of sexuality as an integral aspect of young peoples growth and development; Among gatekeepers such as doctors, pharmacists, and teachers: dissociating religious beliefs from the dissemination of information and options addressing reproductive health needs; and For opinion leaders and inuencers, even at the community level: to highlight the benets and merits of reproductive health and family planning. From hard experience, DKT has realized the importance of remaining highly focused on the goals involved in meeting reproductive health needs, of maintain-
ing condence in approaches that have been validated, and of staying on the course in implementing strategies. There is no room for fear in the process of pushing the envelope, of creating debate, because this is what advocates of reproductive health must do, including and especially legislators who will be making a worthwhile investment in progress as they help their constituents meet relevant needs. The current Philippine environment has been the most restrictive one there is for reproductive health promotion for the last 40 years. There is ample reason for grave concern with respect to unmet reproductive health needs, as witnessed by the percentage of unwanted pregnancies, the high abortion rate, and the number of young children and fetuses abandoned in public places. Insufcient attention is being paid to macro issues that can be addressed by providing information and product access as bases for decision-making for those of reproductive age. Yet, doing so will clearly yield substantial benets in addressing poverty and related issues such as housing, the depletion of resources, and the impact of population growth in negating economic and human development. o0o
Facts & Figures

Figure 1: Government Spending for 2007 (in billion pesos)
Debt Service
612.8
Education, Culture and Manpower Development Health
164.1 53.81 55.3 35.55 18.36 2.5 8.83
Natural Resources and the Environment Agriculture and Agrarian Reform Social Security, Welfare and Employment Housing and Community Development Military
More than 64 percent of the governments total spending in 2007 went to debt service while a measly 1.9 percent (P2.5 billion) was spent on health. This translates to a mere P 206.93 per capita. From only 36.8 percent of the total appropriations in 2002, the governments special purpose fund grew to more than half (50.9%) in 2008. Unprogrammed funds comprised a mere 3.7 percent of total new appropriations in 2002, but grew to 11.7 percent in 2008.
Sources: Freedom from Debt Coalition (FDC). Debt Snapshots, as of end-2007. http://www.fdc.ph/index.php?option=com_ docman&task=doc_view&gid=53&tmpl=component&format=raw&Itemid=89 (accessed March 6, 2008). Congressional Planning and Budget Department (CPBD). An Analysis of the Presidents Budget for Fiscal Year 2007. November 2006. House of Representatives. http://www.congress.gov.ph/download/cpbd/2007_Budget_ Analysis.pdf (accessed March 6, 2008). Congressional Planning and Budget Department (CPBD). Special Purpose Funds. In Facts in Figures. January 2008 (No. 1). House of Representatives. http://www.congress.gov.ph/download/cpbd/fnf_2008_01_spf.pdf (accessed March 6, 2008).
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Financing Reproductive Health and Family Planning Programs in the Workplace: A Corporate Social Responsibility Program for Sustainability
By Marlou Abaja* In order to encourage responsible parenthood, and promote maternal & child health consistent with the companys mission to enhance the working conditions of its workers, CUP-Bukidnon recognizes the need to provide FP services namely, education, counseling and supply dispensing among its workforce. Referral mechanisms are in place to sources of products and services outside the workplace. The FP services would address spacing needs of workers in the 24-35 age range and preventive measures for unplanned pregnancies among single workers. This will also serve as an advocacy project for small sized families directed towards workers with more than 3 dependents, highlighting health and economic benets of small sized families vis--vis disadvantages of large families. Intended result is acceptance of longer-term spacing methods or permanent sterilization method. Culled from Chiquita-Unifrutti Philippines Family Planning Program Policy.
he business sector has, for a long time, viewed the provision of family planning and reproductive health information and services as the governments responsibility. Although the law requires those business establishments mandated to set up clinics and inrmaries to provide free family planning (FP) services as well to their employees,1 many
of them remained stuck to the provision of general health services. In 2003, the Department of Labor and Employment (DOLE) issued Department Order No. 56-03 of 2003 to further rationalize the implementation of the governments Family Welfare Program (FWP). The FWP is part of DOLEs effort to promote productive and
gainful employment, advancement of workers welfare, and maintenance of industrial peace. It has 10 dimensions: (1) reproductive health (RH) and responsible parenthood; (2) education/gender equality; (3) spirituality or value formation; (4) income generation/ livelihood/cooperative; (5) medical health care; (6) nutrition; (7) environmental protection, hygiene and sanitation; (8)
sports and leisure; (9) housing; and (10) transportation.2 As the business sectors response to the challenges of population, family planning and reproductive health, the Employers Confederation of the Philippines (ECOP) adopted a resolution calling on the business sector to contribute to a rounded discussion and advocacy contributing
* Mr. Abaja is the Advocacy Specialist of the Employers Confederation of the Philippines Corporate Social Responsibility-Project Management Unit (ECOP-CSR-PMU). 1 The Labor Code of the Philippines. Art. 134. 2 NATLEX. International Labour Standards Department. International Labour Organization (ILO). http://www.ilo.org/dyn/natlex/natlex_browse.details?p_ lang=en&p_country=PHL&p_classication=01.03&p_origin=COUNTRY&p_sortby=SORTBY_COUNTRY (accessed July 30, 2008).
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to the attainment of a manageable population size.3 ECOP concretized this mandate through its Population and Development Strategies, Integrated RH in the workplace and Family Planning and MCH programs in the workplace. In pursuing these programs, ECOP has adopted a two-pronged approach. One is the mobilization of business leaders to support and advocate for a sound national and local population policy while the other is helping companies install or strengthen their FP and RH programs in the workplace. In 2005, ECOP deepened this commitment with the United Nations Population Fund (UNFPA) grant under its 6th Country Assistance Program (6th CAP). Through this program, ECOP tapped several companies to install RH programs through Workplace Oriented Reproductive Health Knowledge and Services (WORKS) and local business organizations to advocate for local population policy. ECOP has recruited 25 companies and 25 local
3
Policy dialogue with Sultan Kudarat Chamber of Commerce and Industry. In photo are: Mr. Jose Roland Moya, ECOP Deputy Director General; Mr. Vispo Ramos, SKCCIFI President, and Ms. Abigail Cainglet, PLCPD Project Ofcer (Photos courtesy of ECOP).
business organizations to the project. On policy advocacy Several local chambers of commerce passed resolutions calling on their local governments to prioritize RH and population issues and reiterated the need for a policy to sustain the dissemination of information and provision of services to all, most especially to poor women and indigent communities. The Sultan Kudarat Chamber of Commerce, Tawi-Tawi Chamber of Commerce, Metro Cotabato Chamber of Commerce, Gensan Chamber of Commerce, BaguioBenguet Chamber of Commerce, Malaybalay City Chamber of Commerce and Marawi Chamber of Commerce
are among the local business organizations that adopted and passed a resolution on population and RH. The local chambers of commerce and industry are actively engaging their ofcers, members, and constituents by organizing various forums, dialogues and consultations with LGUs and other stakeholders in their respective areas. In General Santos City, for instance, the GenSan Chamber of Commerce led the advocacy for the passage of their City RH ordinance, which was eventually enacted in November 2007 (Please see Annex
can inuence the local policy environment. And most of the time, local ofcials listen to the recommendations of business sectors on policies and programs in their respective LGUs. WORKS as a sustainability mechanism The Workplace Oriented Reproductive Health Knowledge and Services, or WORKS, is ECOPs program that targets the health of both the employers and employees, meaning it covers their general health and reproductive health (RH) as well. This project helps companies install and/or strengthen their existing family welfare, FP, and RH programs.
A: Oro Chamber Family Welfare Policy).
ECOP believes that the business sector
Employers Confederation of the Philippines (ECOP). Omnibus Resolutions: Making Entrepreneurship Work for the Nation. A Resolution Arrived at at the 26th National Conference of Employers, May 17-18, 2005, Manila Hotel, Manila, Philippines.
53
Oro Chamber of Commerce and Industry conducting RH Orientation with members of the business sector in Cagayan de Oro City (Photos courtesy of ECOP).
Under the UNFPA 6th CAP, ECOP piloted 10 companies for the WORKS Program. These are PhilBest Canning Corporation in General Santos City, Marco Polo Hotel and New City Commercial Center in Davao, ChiquitaUnifrutti Philippines in Bukidnon, Alturas Group of Companies and BQ Corporation in Bohol, Cebu Mitsumi and Lear Corporation in Cebu, Fujitsu Manufacturing Corporation in Cavite, IndoPhil Group of Companies in Bulacan, and Manila Peninsula in Manila. ECOP has conducted focus group discussions in these companies primarily to determine their employees specic RH concerns. After the FGDs, ECOP trained the companys human resources ofcers
54
and service providers on Integrated Reproductive Health in the Workplace using WORKS as a platform for drafting their action plan. Attendees to the training developed a work plan where specic activities were focused on the results of the FGDs conducted in the workplace. As a sustainability plan, ECOP also trained company HR personnel in developing effective RH or FWP policies. As a result, several companies adopted FWP policies to include RH and FP services in the workplace. These policies are very important in sustaining what they have achieved. Chiquita Unifrutti Philippines, for instance, has allocated P1 million per employee as
B: Chiquita Unifrutti Philippines Family Planning Program Policy).
annual contraceptive subsidy. This is considered a milestone for FP programs in the midst of dwindling foreign support and governments reluctance to provide comprehensive information and services to the Filipino people (See Annex
and document best practices. It also seeks to encourage wider business sector support for workplace RH programs as part of corporate social responsibility (CSR) and promote a harmonious working relationship between employers and employees leading to the attainment of higher level of commitment on, and responsibility for, RH in the workplace that would result to better productivity and competitiveness. Previous winners include the PHILEXPORT Region 12 (1st), Cagayan de Oro Chamber of Commerce (2nd Place), and PCCI Cavite (3rd) in Chamber category. For Company category, the winners were Cebu Mitsumi (1st), Cenral Azucarera Don Pedro, Inc. (2nd), and University of the Cordilleras (3rd). The awarding ceremony was held during the 33rd Philippine Business Conference and Exposition (PBC and E) at the Manila Hotel. No less than President Gloria MacapagalArroyo presented the awards to the grand winners. For 2008, ECOP and PCCI will recognize
Recognition of best practices In 2007, in cooperation with the Philippine Chamber of Commerce and Industry (PCCI), ECOP initiated the search and award for Best Workplace Reproductive Health Policies and Programs. This annual recognition, begun in 2007, aims to highlight the business sectors RH programs in the workplace
Cebu Mitsumi Executive Director Atty. Januario Seno and Company Physician Dra. Regina Tan accepting the rst place award from President Gloria Macapagal-Arroyo and ECOP Ofcers (Photos courtesy of ECOP).
workplace programs that have integrated demographics and soci-economic interrelationships in the formulation of development plans, policies, and programs. They will recognize a wider scope of stakeholders such as corporations, local chambers, small and medium enterprises (SMEs), corporate foundations, and industry associations. Redefining Corporate Social Responsibility (CSR) ECOPs effort to promote RH and FP in the workplace is not only in compliance with the law; it is also in fulllment of corporate social responsibility (CSR).
CSR is a buzzword in the business community that means doing over and above what the law provides. It is the continuing commitment by business to behave ethically and contribute to economic development while improving the quality of life of the workforce and their families as well as that of the local community and society at large. And similarly for ECOP and its ally business entities, CSR means empowering the people, widening their choices, and uplifting their lives. Through many efforts and initiatives of
these business entities, the CSR concept was redened to mean people empowerment and community empowerment, among others. Sustaining gains Based on the experience of ECOP and other business organizations, the business sector has the capacity to sustain RH and FP programs in the workplace. They have the resources, they have the needed structures and networks that when mobilized, will facilitate the sustainability of these programs. However, RH and FP advocates should keep in mind that businesses exist primarily
for prot. Every businessman/woman wants their business to be productive and their employees efcient. Linking RH and FP to efciency and productivity, therefore, is a sure way to mobilize the business sector in adopting RH and FP programs in their respective workplaces. FP or RH programs in the workplace can only be sustained with structures in place and a policy that will provide direction and guidelines in all the interventions.
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Annex A
CAGAYAN DE ORO CHAMBER OF COMMERCE AND INDUSTRY FOUNDATION, INC. WORKPLACE FAMILY HEALTH PROGRAM POLICY*
A. RATIONALE
ORO CHAMBER believes that employees performance at the workplace is directly related with their circumstances at home. Having a sound family life will make them more focused and as such, will translate to increased productivity that will ultimately benet the company in the form of a positive bottom line. Hence, the Oro Chamber created its Workplace Family Health (formerly Family Welfare) Program to primarily address its problems on staff absenteeism, lapses in performance, low productivity, and high turn-over rate through an information and education campaign (IEC) on family planning, responsible parenthood, and maternal and child health. Such is also pursuant to the provisions of Article 134 of the Labor Code of the Philippines. The other components of the Chambers WFH Program, in observance of DOLEs Department Order No. 56-03 (series of 2003), will include the following: 1. 2. 3. 4. 5. 6. Education/Gender Equality Value Formation Livelihood Medical Health Care Nutrition Enviromental Protection, Hygiene and Sanitation 7. Sports and Leisure 8. Housing 9. Transportation more equipped and t to take on work challenges. On the other hand, the programs indirect beneficiaries are the Chambers member companies and their corresponding employees, with the end view of helping the member companies at enhancing respective productivity levels to become protable and sustainable. Though the rst year of program implementation will be dedicated to Chamber staff development and IEC for stakeholders, trainings for member companies especially on family planning and population concerns will also be conducted, on a partial scale. However, it is good to note that for the first three (3) years of program implementation, priority will be given to member companies employing 200 or more staff. For the succeeding years, efforts will be geared toward encouraging even the small and medium enterprises to also install respective Family Welfare Program.
B. OBJECTIVES
The WFH Program is designed: 1. To plan for the appropriate family planning intervention for Chamber employees and companies located in Cagayan de Oro and Misamis Oriental; 2. To advocate for the adoption of Family Welfare/Health Program by all companies and enterprises in the City of Cagayan de Oro and Province of Misamis Oriental; and 3. To educate member large companies as to the benets of settingup a Family Welfare/Health Program at their respective companies.
C. COVERAGE
There are two (2) classications of the WFH Program beneciaries 1) direct and 2) indirect. The direct beneficiaries are Chamber employees, both regular and contractual. Through the various trainings conducted for them, Oro Chamber believes that in a year or two, it will be able to transform its personnel into happier, more focused and service-oriented professionals by not only attaining respective desired family size but also by becoming
D. SERVICES
The WFH Program of Oro Chamber is predominantly on IEC and policy advocacy. Along this, below are activities that will have to be undertaken covering all the 10 Program components, to wit:
* Published with permission from the Employers Confederation of the Philippines (ECOP) and Cagayan de Oro Chamber of Commerce and Industry Foundation, Inc.
56
Cagayan de Oro Chamber of Commerce and Industry Foundation, Inc. (Oro Chamber)
Starting 2005
1. Annual Stakeholders Meeting 2. Training of Trainers on Family Welfare during the rst two years of program implementation 3. Training for Chamber staff on Family Welfare and Health 4. Policy Advocacy 5. Annual Monitoring & Evaluation of Program Results 6. Annual Good Business Fora
Starting 2006
1. Training for Chamber Board and Management on Family Welfare/Health 2. Annual Trainings on How to Set-up a Workplace Family Planning Program for Chamber staff and member companies 3. Annual Peer Educators Training 4. Annual Trainings for Company Physicians and Nurses
Starting 2007
1. Annual Trainings on Entrepreneurship/Livelihood 2. Annual Trainings on EcoProt 3. Annual Values Formation Trainings 4. Annual Maternal and Child Health Trainings 5. Workplace Diseases Prevention Trainings 6. Annual Training on Gender Sensitivity
Oro Chamber will also invest heavily at capacitating its own personnel to be able to extend not only free but as well as fee-based services to members especially on program installation consultancy work, capacity-building of member firms and project development services on family welfare and health. Also, it shall develop its own directory of health and family planning service providers for ready referral purposes.
Workplace Family Planning Program Since the priority component of the Oro Chambers WFH program, at least within the rst ve (5) years of program implementation is family planning encompassing concerns on reproductive health, responsible parenthood and maternal and child health that emphasis is given on Workplace Family Planning for Chamber employees and member rms and the latters employees. It is a well-recognized fact that almost all employees with large family size are struggling to make both ends meet. This makes them pre-occupied and nancially inadequate affecting their productivity at work and ultimately the companies bottom line. Along this, Oro Chamber will highlight the following in its WFH Program: PhP 2,500 medicine allowance for Chamber staff including family
planning supplies purchases; Family Planning Counseling; Dissemination of Family Planning materials; Trainings/ information campaign on gender-related topics and family planning concerns for staff and Chamber members; Policy Advocacy Campaign on Family Planning; and Organizational Meetings with partner organizations.
On Program Advocacy
Oro Chamber shall send regular communications to partner organizations on its WFW Program especially on the implementation of related activities. Within the organization, Oro Chamber shall conduct regular Board and Management and staff meetings, send Family Welfare tips thru the emails, pay slips and messages featured at the Bulletin Board in addition to reports submission and the conduct of trainings.
E. SUSTAINABILITY PLAN
In order to sustain its WFH Program, Oro Chamber will undertake networking and proposal-for-funding development activities to ensure that resources requirement will be met and services will be continuously offered to Chamber staff and member rms. Oro Chamber will also be establishing its own pool of trainers on family welfare and health. This will enable the Chamber to serve the health requirements of staff and member rms because of its ready expert support.
On Proposal-for-funding Development
Oro Chamber shall develop proposals on Family Welfare Program installation for potential funding partners so that needed resources for the successful implementation of the WFW Program will be made available.
57
Annex B
CHIQUITA UNIFRUTTI PHILIPPINES BUKIDNON

Family Planning Program Policy*
RATIONALE The company prides itself not only for its pursuit of excellence in advanced and environment-friendly agricultural technology but for its Godcentered management principle centering on values formation and its commitment to the constituents via its corporate social responsibility program. Two main programs directed towards promoting employee welfare are the Values Formation Program-where weekly sessions on life skills and spiritual development are conducted and the In-house Comprehensive Health Plan which covers all health needs of employees. In carrying out its corporate social responsibility, CUPBukidnon is committed to promote employee welfare through its family planning program within workplaces. The purpose of this policy is to create an FP Program that
will provide knowledge on the available family planning options to workers with unmet family planning needs. GENERAL POLICY STATEMENT In order to encourage responsible parenthood, promote maternal & child health in consistent with the companys mission to enhance the working conditions of its workers, CUP-Bukidnon recognizes the need to provide FP Services namely, education, counseling and supply dispensing among its workforce. Referral mechanisms are in place to sources
of products and services outside the workplace. The FP Services would address spacing needs spacing needs of the workers in the 24-35 age range and preventive measures for unplanned pregnancies among single workers. This will also serve as an advocacy project for small size families directed towards workers with more than 3 dependents, highlighting health and economic benets of small sized families vis-vis disadvantages of large families. Intended result is acceptance of longer-term spacing methods or permanent sterilization method.
* Published with permission from the Employers Confederation of the Philippines (ECOP) and Chiquita Unifrutti Philippines-Bukidnon.
58
IMPLEMENTING STRUCTURE Management of the family planning programs fall under the Human Resources Department
which is under Mr. Wenceslao B. Plamus, Vice President for Corporate Management Services. Implementation is handled by site personnel
(Organic HR Departments and Nurse/s per site. As mentioned, site personnel are included in the planning. Line-staff structure are as follows:
VP-Corporate Management Services Deliberation and Approval
Corporate Human Resource Manager
MKADC Plan and Implement
BHPI
MKAVI
Medical Personnel
Site HR Personnel
Medical Personnel
Site HR Personnel
Medical Personnel
Site HR Personnel
SERVICE DELIVERY EDUCATION/COUNSELING/ DISPENSING o Unifrutti Program Team shall identify and train FP educators, counselors and dispensors from the various plantation HR Units to ensure standardized delivery of FP Management services and sustained FP education activities. o Unifrutti Program Team shall ensure quality assurance through continuous education, trainings and skills prociency of its FP implementers.
o Unifrutti Program Team through its plantation HR units shall maintain close coordination with family planning practitioners and other health providers as well as partner organizations (cooperatives, LGUs, RHUs) to maintain quality and efciency of its FP programs. BENEFITS o Commodity Assistance CUP shall provide the annual complete contraceptives worth Php. 1,000.00 to all employees gratis.
o Medical Examination during Diagnosis during Diagnosis and Follow-up Company Doctor and Medical Staff shall schedule a preapplication check-up and follow-up consultations and examinations during contraceptive usage. FINANCING The companys annual health budget shall include an allocation for FP promotions and FP management activities to cover medical assistance, training, education sessions, contraceptives and other administrative related expenses.
59

Financing The RH Needs of Filipinos

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The Human Development Legislator

The Human Development

Editor-in-Chief Managing Editor Editor ASSOCIATE EDITOR Contributors

Financing the reproductive health needs of Filipinos

By Ramon San Pascual, MPH

Financing the reproductive health needs of Filipinos

The Human Development Legislator

Financing the reproductive health needs of Filipinos

Pres. Gloria Macapagal-Arroyo

Former Health Secretary Manuel Dayrit

Former Manila Mayor Lito Atienza

Financing the reproductive health needs of Filipinos

The Human Development Legislator

Financing the reproductive health needs of Filipinos

Quezon City Mayor Sonny Belmonte

Quezon City Vice Mayor Herbert Bautista

Financing the reproductive health needs of Filipinos

The Human Development Legislator

20% Development Fund 20% Development Fund

Financing the reproductive health needs of Filipinos

Financing the reproductive health needs of Filipinos

The Human Development Legislator

Financing the reproductive health needs of Filipinos

Financing the reproductive health needs of Filipinos

Annex A: Procedures on Grants to LGUs under These Guidelines

The Human Development Legislator

Facts & Figures

Securing Budget for Reproductive Health Commodities and Services

House of Representatives Committee Information. http://www.congress.gov.ph/committees/search.php?congress=14&id=0504.

Financing the reproductive health needs of Filipinos

Rep. Edcel C. Lagman

The Human Development Legislator

Rep. Edcel C. Lagman

The Human Development Legislator

Facts & Figures

Kasama ba sa budget nyo

DL FORUM HDL FORUM HDL FORUM D D O O O O R ORUM HDL FORUM

ang pagbili ng contraceptives?

Im not yet using contraceptives.

- Udong, 31, development worker

Yup. Yan lang sagot ko (That is my only answer).

- Homer Nievera, 40, sales manager

THE BUDGET PROCESS T

Financing the reproductive health needs of Filipinos

Financing the reproductive health needs of Filipinos

The Human Development Legislator

reproductive health advocacy

Financing the reproductive health needs of Filipinos

The Human Development Legislator

Financing the reproductive health needs of Filipinos

Table 1: List of Reproductive Health Ordinances in the Philippines

Province/ City Municipality 1. Province of Aurora

10. Lebak, Sultan Kudarat

September 17, 1997 2008

August 10, 2007

Municipal Councilor Thomas Cornelio Municipal Councilor Manuel Frieres

January 8, 2008 August 18, 2006

The Human Development Legislator

11. Llorente, Eastern Samar

Municipal Councilor Eva Mila F . Fana-ang Municipal Councilor Bello M. Banggot

January 7, 2008 December 18, 2006

December 29, 2006

Financing the reproductive health needs of Filipinos