Leadership for Adolescent and Youth-Friendly Cities

The Leadership for Adolescent Youth-Friendly Cities Approach (LAYFC) is an executive leadership and governance training program that has been designed for city mayors, local chief executives or the city leadership team, barangay leaders and youth group leaders. The aim is to help local leaders to develop more responsive leadership and governance systems for the immediate reduction of teenage pregnancy rates.

Anchored on ZFF’s Bridging Leadership framework, the LAYFC program has designed different but complementary training tracks for each of following stakeholders:

• City Mayors: The visionary, caller and integrator of the issues concerning adolescents and health in the city.
• City Leadership Team (CLT): This includes heads and/or key coordinators of respective city government departments, counterparts from national agencies counterparts, such as the Commission on Population (POPCOM), the Department of Health (DOH) and representatives from civil society organizations (CSOs) and non-governmental organizations (NGOs). The CLT can either be a new body created for the sole purpose of managing, implementing and monitoring TCI evidence-based practices or an existing coordinating body or board. It could be the city implementation team or the local health board. The mayor heads the CLT.
• The Barangay Leaders in the poorest barangays: This consists of Barangay Captain, Barangay Council for Health, Medical Officer/Nurse/Midwife who is in charge of the supervision of the health facility in the barangay, selected Barangay Health Worker (BHW), selected Barangay Service Point Officer (BSPO), Sangguniang Kabataan (SK) Chairman and other relevant stakeholders identified, such as principal or head teacher of the high school situated in the village, representatives from CSOs, NGOs and private sector who are currently working on adolescent and youth sexual and reproductive health (AYSRH)
• Youth Group Leaders: This includes both elected and non-elected youth group leaders serving the identified poorest barangays and/or those actively implementing programs on the city level. This may include SK Chairman (or a representative), active youth group leader of an organization in the city working with communities (including volunteer work and community projects) to promote AYSRH or adolescent and youth health and development (AYHD) and youth influencers in the city that have a following and network and is willing — and passionate — to advocate public health programs.

The LAYFC leaders will build “adolescent and youth-friendly cities” and strengthen intersectoral collaboration and encourage the involvement of the community and youth leaders.

The LAYFC approach, together with the other 11 approaches in the Philippine Toolkit, will serve as critical inputs to achieve the desired outcome of a reduction in teenage pregnancy in the shortest timeframe as possible.

What are the benefits of this approach?

• Leadership and governance capacity strengthening of LCEs and CLT members will ensure that new and existing adolescent and youth sexual and reproductive health (AYSRH) programs are based on evidence as to what works in terms of proven and promising interventions.
• LAYFC will give CLT members, who are already experts in their fields, the formal training on leadership and governance for AYSRH. This will allow them to assess existing interventions and decide whether to continue, end, adapt or design new ones.
• By making decision makers and implementers owners of the teenage pregnancy issue, it is hoped that they will fast-track the implementation of proven and promising interventions.
• This approach will give them opportunities to improve leadership while they:
  • sustain existing good practices
  • access and replicate TCI’s high-impact practices and ongoing programs by the national government
  • ideate and iterate out-of-the-box solutions
• LAYFC for CLT is a parallel approach to the LAYFC of the city mayors, barangay leaders, and youth group leaders. It is tailored to help participants reach targeted Bridging Leadership competencies while considering their baseline competencies.
• The approach will improve and strengthen relationships with internal and external stakeholders who share the same vision.
• This approach will serve as the overarching approach and framework for the introduction and implementation of the other approaches in the TCI Philippine Toolkit as the practicum activities of the engaged leaders in the TCI partnership.

How to implement

Indicators for success

Most of these indicators are similar across the different audience segments for the LAYFC. They should be disaggregated by barangay and coming from the CHO and its barangay health stations/rural health unit, local population office, the Department of Health (DOH), Commission on Population and Development (POPCOM), the Department of Education (DepEd), and Local Youth Development Office.

• % of training participants with improved BL competencies
• % increase of annual unified Barangay budget related on AYSRH
• Total Barangay Population disaggregated by age and sex
• Adolescent birth rate (per 1,000 adolescents) (% of girls under 19 years old who have had a live birth or are pregnant with first child)
• Number of births among adolescents disaggregated by age and parity
• Barangay Modern Contraceptive Prevalence Rate disaggregated by age (10-14,15-19, 20-24 and overall)
• Barangay Modern Contraceptive Prevalence Rate disaggregated by age (10-14,15-24 and overall) and by wealth quintile
• Number of adolescents/youth participated in youth activities and received AYSRH information
• % student drop-out rate per school year in high schools
• % reintegrated adolescents mothers and partners

Resources needed

• Food, training venue and accommodation (if applicable) during face-to-face training or food package during virtual facilitated sessions
• Internet connectivity, hardware and software infrastructures for virtual training
• Training team: Team of resource persons and or facilitator, training officer and documentalist
• Printing costs of training materials and manuals and/or workbooks

Evidence of Impact

• Leadership and governance in building a health system involves ensuring that strategic policy frameworks exist and are combined with effective oversight, coalition-building, regulation, attention to system design and accountability (WHO 2010).
• WHO (2007) states that Leadership and Governance of health system—also called stewardship, is “about the role of the government in health and its relation to other actors whose activities have an impact on health. This involves overseeing and guiding the whole health system, private as well as public, to protect the public interest. It requires both technical and political action” (WHO, 2007).
• According to the study of Labarda (2019), leadership and governance has a significantly positive correlation with the other five building blocks of health namely human resources for health, health financing, access to medicines and technology, health information system, and health service delivery. The practice of dialogue, multi-stakeholder engagement, systems and complexity thinking, design thinking, and quick prototyping all yield positive externalities outside of the local health systems, including issues of poverty, unemployment and access to education and social opportunities.
• Labarda cited Heifetz (2009) and described the practice of adaptive leadership to combat adaptive challenges—challenges that can only be addressed through changes in people’s priorities, beliefs, habits and loyalties. Cited too was Kotter (2012) who described an eight-stage leadership process amid changes in the context of the 21st century.
• Purtle et. al (2019) shows 30% of mayors and 8% of health commissioners only believed that city policies could have little or no impact on disparities. Thus, it concludes that many mayors, and some health commissioners, are unaware of the potential of city policies to reduce health disparities. Ideology is strongly associated with opinions about disparities among these city policymakers.
• Based on the 5-Year Progress Report on Mayor’s Teen Pregnancy Prevention Council (2012), the creation of the Mayor’s teenage Pregnancy Prevention Council in New City Haven resulted in the contribution on decreased rates of teen pregnancy. The following changes to the leadership and organization structure should be considered: formalizing the governance and membership structure to include set term limits, guidelines for leadership succession, and expectations for council involvement. There is also a need to reinforce the advisory, advocacy, and policy-oriented focus of the Council; thus, a need to appoint additional members to the TPPC with expertise in areas that can further the mission of the Council such as appointing members from the Board of Education, the business community, foundations, marketing and advertising firms, the media, and the religious community.