TCI collaborated closely with the City Leadership Team to implement family planning and AYSRH interventions.
In 2020, Population Officer Johana Gabriel witnessed firsthand the heartbreaking consequences of adolescent pregnancy in Santiago City. She saw shattered young dreams and futures put on hold. That year, the city topped Region II with the highest rate of adolescent births: a staggering 47 per 1,000 girls aged 15 to 19. This silent crisis unfolded in the shadows of a global pandemic, even as Santiago’s modern contraceptive prevalence rate (mCPR) stood at 39 percent, notably higher than the national average.
Empowering Together
Recognizing that change required more than just statistics, Mayor Sheena Tan proactively sought strategic partnerships and expert guidance. She collaborated with The Challenge Initiative (TCI), a global platform designed to implement high-impact family planning interventions at the local level.
The first and most crucial step in this journey was the establishment of a City Leadership Team, intentionally integrating leaders from across diverse sectors of the city government. Far from being confined to health officers, it brought together essential representatives from education, youth development, planning offices, and community leaders. Critically, young people themselves were placed at the center of decision-making processes, ensuring their voices were not just heard but truly valued and acted upon.
This collaborative approach aligned seamlessly with Santiago City’s existing KAISAKA Development Strategies, founded on four pillars: Kabuhayan (Livelihood), Kalusugan (Health), Karunungan (Wisdom/Education), and Kaayusan (Order/Governance). This alignment ensured that adolescent and youth sexual and reproductive health (AYSRH) was addressed holistically, not in isolation.
Transforming Youth-friendly Healthcare
Santiago City’s existing health infrastructure wasn’t built for its youth. Adolescents seeking care often encountered judgment, a lack of privacy, and services that felt more like barriers than support. The system’s fragmented and isolated operations forced young people to navigate complex bureaucratic pathways, hindering access to care when they needed it most.
One of 22 school-based teen centers to support AYSRH.
Recognizing this critical gap, the city didn’t just upgrade facilities; it reimagined the concept of youth-friendly healthcare. Santiago invested in a new generation of healthcare spaces that prioritized confidentiality, respect, and accessibility. This shift led to the creation of 37 community-based and 22 school-based teen centers. Once intimidating spaces became trusted, welcoming entry points where adolescents could access comprehensive health services and information.
The true breakthrough, however, came from empowering the youth themselves. Each of the 59 Teen Centers is now operated by youth with adult mentorship, creating environments where adolescents feel ownership, not intimidation.
To ensure lasting impact, the city institutionalized the Information Service Delivery Network (ISDN) through Ordinance No. 11THCC-089 in July 2023. This landmark ordinance guarantees the sustained, coordinated, and youth-friendly delivery of health and development services across the city.
Limited Number of Trained Family Planning Service Providers
The partnership with TCI introduced transformative methodologies. The RAISE (Reflection and Action to Improve Self-Reliance and Effectiveness) tool helped the team analyze the root causes of adolescent pregnancy. Through the Leadership for Adolescent and Youth Friendly Cities and Health Leadership Management Program, city leaders adopted the Bridging Leadership approach. This empowered them to lead with youth, giving young people genuine seats at the table and authentic voices in policy discussions.
A key result of this youth empowerment was the training of 638 Santiago City Teen Facilitators (SCTFs) as peer leaders, significantly expanding access to youth-friendly health information and support across communities.
Beyond Teen Centers
The establishment of teen centers was a critical step, but their success did not occur in isolation. With TCI’s support, Santiago City implemented a suite of complementary strategies to transform these centers into hubs of responsive, high-quality, youth-friendly care.
At the heart of this approach was a commitment to meeting national standards for youth-friendly care. Santiago prioritized the accreditation of all 37 Barangay Health Centers and existing teen centers as Adolescent-Friendly Health Facilities (AFHFs). This effort included finalizing the Santiago City Youth Code, developing the Local Youth Development Plan, and linking these centers to broader public health services. To encourage youth leadership, the city launched the KABATAAN Awards to recognize and incentivize excellence among Sangguniang Kabataan (Youth Councils), youth organizations, and the teen centers themselves.
Santiago City trained 638 peer facilitators to deliver specialized, adolescent-responsive care.
Santiago also worked to equip frontline workers and peer educators with the skills needed to deliver adolescent-responsive care. Trainings included Family Planning Competency-Based Trainings 1 and 2, Adolescent Health Education on Practical Training, and Healthy Young Ones. The ISDN Ordinance further strengthened referral systems, ensuring smooth transitions between teen centers and other health facilities.
The city also pursued demand generation strategies for family planning, especially long-acting reversible contraceptives. Key initiatives included the Samahang Teenage Nanay na Dakila Project for adolescent mothers, the Kalalakihang Tapat sa Responsibilidad at Obligasyon sa Pamilya program for male involvement, and Project DREAM: Developing a Responsive Environment for AYSRH Movement. Direct house-to-house outreach, social media campaigns, and youth-tailored Social and Behavior Change Communication materials helped deliver accurate information directly to communities.
From Commitment to Impact
In just three years, Santiago City has made significant progress in adolescent and youth sexual and reproductive health. The adolescent birth rate dropped from 47 in 2020 to 30 in 2024, and the city’s mCPR remained above national targets. With trained, responsive health workers and peer-led, judgment-free services, adolescent health-seeking behavior also improved markedly.
Adolescent birth rate per 1,000 births for 15 to 19 year olds.
These collective efforts led to not only improved health outcomes but also a stronger quality of life for the city’s youth. Santiago advanced its vision of becoming a resilient, equitable, sustainable, and innovative community. As of 2025, Santiago City has officially graduated from TCI, proof of its readiness to sustain and scale these efforts independently, and a proud milestone in its journey toward youth-centered health leadership.
‘KAISAKA namin kayo’ (we are with you) is more than a slogan. As Gabriel emphasized, it reflects the city’s genuine commitment to walk alongside its youth. By going beyond teen centers and investing in the systems, policies, and people who sustain them, Santiago has laid a strong foundation for healthier, more empowered futures.
Increase in local government commitment in Santiago City from 2022 to 2025
This progress would not have been possible without the support of the Commission on Population and Development, the Department of Health, and local champions who continue to stand with Santiago’s youth.
Santiago City’s journey is far from over. The city remains dedicated to mentoring, coaching, and empowering leaders and young people alike. This commitment ensures that improved health-seeking behavior is not just a goal, but a lived reality for every adolescent.
