Known as the “Heart of Bicol,” Naga City is celebrated for its rich history, deep religious roots, and strong sense of community. With a population of 209,170 (2020 census), it is the second most populous city in the Bicol Region. However, like many growing urban centers in the Philippines, Naga has faced pressing social issues, including a rise in adolescent pregnancy that has challenged youth development and local health efforts.

Rising to the Challenge

Over the past five years, Naga’s adolescent birth rate (ABR) has fluctuated. It was 21 per 1,000 births in 2020, rose sharply to 106 in 2021, and remained high at 110 in 2022. Mayor Nelson Legacion recognized that tackling adolescent pregnancy required bold and coordinated action. Limited access to reproductive health services, a lack of youth-friendly spaces, and prevailing social stigma made the problem even more complex. The COVID-19 pandemic further strained outreach efforts and health services.

In November 2021, Naga partnered with The Challenge Initiative (TCI), a global platform focused on supporting local governments to implement high-impact family planning (FP) and adolescent and youth sexual and reproductive health (AYSRH) programs. This collaboration led to the formation of a City Leadership Team (CLT), which began coordinating the city’s response. Naga graduated in from TCI’s direct support in May 2025.

Joy Macaraig, Assistant Department Head of the City Population and Nutrition Office (CPNO) in Naga City, shared:

We’ve had adolescent-focused initiatives in the past, but they were not well-coordinated or harmonized.”

With 26 years of experience in the CPNO, Macaraig noted that family planning and adolescent health are integrated within the office, allowing it to manage both demand generation and service delivery. Since the CLT’s establishment, other departments have also taken leadership roles, aligning their priorities with AYSRH and FP goals.

By 2023, Naga’s ABR dropped to 71, and in 2024, it declined further to 20, surpassing the national target of 37.

Building Leadership for Community Action

TCI began with pilot programs in three barangays, but Mayor Legacion expanded the initiative to six. Central to this effort were the Barangay Service Point Officers (BSPOs) under the CPNO, who became focal points for FP at the community level. Their work includes maintaining a master list of adolescent mothers, submitting monthly reports, and ensuring that mothers and their children receive appropriate care. Recognizing their impact, the city expanded the program to all 27 barangays, with 53 BSPOs working to strengthen AYSRH services.

Working alongside the BSPOs, trained health workers also played a crucial role. Janet Beloro, a midwife at the City Health Office, emphasized that community health workers witness firsthand the struggles of the population, making it essential for them to be well-equipped to address the community’s needs. TCI’s online learning platform, TCI University (TCI-U), has provided training, practical tools, and real-life examples that have enhanced the team’s effectiveness in delivering quality FP and reproductive health services. Reflecting on her experience, Beloro shared:

When clients return and tell me they will practice family planning, that’s when I realize I’ve made a difference – that I’ve been an effective provider. I see their health literacy improving, and for young people especially, I notice their growing awareness.”

A Groundbreaking Policy: Naga’s AYSRH Ordinance

To institutionalize these efforts, Naga passed City Ordinance No. 2023-025, formally establishing the Adolescent and Youth Sexual and Reproductive Health Program. Authored by CLT member Councilor Gayle Abonal-Gomez, the ordinance aims to prevent teenage pregnancy and improve access to reproductive health services through dedicated funding and structured implementation.

The ordinance led to the creation of an Integrated Service Delivery Network (ISDN) for adolescent health, coordinated by the CPNO. This network links barangay health workers, schools, hospitals, and NGOs to provide timely and appropriate care through a unified referral system.

Safe Spaces for Youth in Schools and Barangays

One of the ordinance’s most transformative elements is the establishment of teen hubs and centers in public schools and barangays. These provide safe spaces where adolescents, including out-of-school youth, can access reproductive health services without judgment.

At Concepcion Pequena National High School, teacher Dessa Bermejo ensures their Teen Hub is a welcoming space. Although the hub shares space with the school clinic, its focus on mental health, emotional support, and peer facilitation has built trust among students. With TCI’s support, trained peer facilitators and navigators are on hand to offer guidance.

Dessa hopes that in the future every school in Naga, whether public or private, will have its own Teen Hub. Right now, teen centers have already been established in Barangays Balatas and Calauag. She shared:

With teenage pregnancy remaining a pressing concern, young people need a safe space where they can confide in someone they trust – someone who will listen without judgment and provide the guidance and support they need.”

Strengthening Communication and Youth Empowerment

Raising awareness among young people is essential, and making a holistic approach to adolescent health communication crucial.  To address this, the Commission on Population and Development Region V launched the Hearts and Minds campaign, led by Director Joyce Dela Paz-Hilvano. This pre-orientation initiative on adolescent health and development focuses on self-awareness, emotional well-being, and personal growth – empowering youth to make informed decisions. Designed as a pre-orientation to adolescent health and development programs, the campaign fosters self-discovery, emotional well-being, and informed decision-making, empowering young people to navigate adolescence with confidence and care.

Thanks to these efforts, Naga’s modern contraceptive prevalence rate (mCPR) remains strong, with only a slight dip after 2022. The data suggest that integrated FP and adolescent health programs continue to drive high contraceptive use, exceeding national benchmarks.

Investing in a Sustainable Future

Since joining TCI, Naga City has built a self-reliant and sustainable model for adolescent health programs, significantly increasing investments in AYSRH services. The city’s commitment for FP and AYSRH programs grew from USD$40,600 in 2023 to USD$120,073 in 2025, supporting teen hubs, training programs, contraceptive distribution, and capacity-building for barangay health workers.

The 2023 ordinance also ensures long-term funding through the city’s general fund and annual investment plan. By strengthening partnerships across barangays, schools, and regional agencies, Naga has fostered a resilient, community-driven approach that will endure beyond political changes. Ongoing impact tracking, strategic communication, and integrated education continue to reinforce the program’s success.

Through strategic planning, local leadership, and community engagement, Naga City has emerged as a model for addressing adolescent health. Its experience shows how smart investments and strong partnerships can create lasting, impactful change for young people.

👉 Watch presentation about Naga City below