Community health workers are trained in family planning and adolescent and youth sexual and reproductive health (AYSRH).

Before partnering with The Challenge Initiative (TCI), San Jose City in the Philippines faced a troubling rate of adolescent pregnancies. In 2020, the city recorded 43 births per 1,000 girls aged 15 to 19 – well above the national target of 37 per 1,000. Located in Luzon, San Jose is a transportation hub and an education center for nearby towns like Rizal, Lupao, and Carranglan. The influx of students contributed to the city’s high rate of adolescent pregnancies.

One such story is that of Jaira, a 15-year-old who dreamed of becoming a flight attendant. After getting pregnant by an older partner, she now lives with her parents and works on a farm to support her child. While she cannot undo the past, she remains hopeful for a better future – for herself and her family.

Mayor Mario “Kokoy” Salvador understood the deep link between poverty and adolescent pregnancy. He believed that improving education and economic opportunities for young people could help break this cycle:

Poverty grows when young people can’t finish school, so I wanted to find ways to reduce poverty.”

San Jose’s Partnership with TCI

TCI Director Kojo Lokko and the TCI team tour a facility in San Jose.

San Jose City began its partnership with TCI in November 2021 – one of the first cities in the Philippines to do so. At first, local leaders were hesitant – TCI was new to the country. But after learning about its success elsewhere, they saw its potential to help address San Jose’s urgent health challenges.

Mayor Salvador and his City Leadership Team (CLT) completed the Leadership for Adolescent and Youth-Friendly Cities (LAYFC) training – an essential part of TCI’s approach. This training equipped city leaders with the knowledge and skills to champion adolescent and youth sexual and reproductive health (AYSRH).

Through Executive Order 36 (series of 2021), the city formalized the CLT, comprising officials from various local departments. Despite delays caused by the COVID-19 pandemic, the team remained committed. They updated their plans based on community input, ensuring efforts directly addressed young people’s needs. City leaders credit the LAYFC training with strengthening their AYSRH programs.

Making An Impact

• By 2023, the adolescent birth rate had dropped to 30 per 1,000 – meeting the national target.
• The City Health Office projects a further decline to 27 per 1,000 by the end of 2024.

The city also worked with the Department of Health, Commission on Population and Development, and both public and private health providers to expand access to family planning. By engaging private hospitals and lying-in clinics, the modern contraceptive prevalence rate increased from 31% in 2022 to 32% in 2023 – surpassing the national benchmark. Healthcare workers received training and contraceptive supplies, while the city built a robust data reporting system to monitor progress and adjust strategies. Thanks to the Mandanas Ruling, San Jose can now procure its own family planning supplies – further strengthening public-private partnerships and expanding contraceptive access.

Empowering Healthcare Workers

All 10 health facilities in San Jose are now certified as adolescent-friendly health facilities. The city also launched the first teen information center in the region – providing a safe space for young people to access reproductive health services and information. In 2023, 37 healthcare workers completed training in:

• Adolescent Development Enhancement and Practical Training (ADEPT)
• Family Planning Competency-Based Training (FPCBT)
• Handling sensitive adolescent health issues

These efforts ensure that teens and young adults receive accurate, compassionate, and high-quality care.

Strengthened Policies and Budget Commitment

San Jose City Mayor Kokoy Salvador meets with TCI Director Kojo Lokko and the TCI team.

San Jose City has institutionalized its commitment to adolescent health:

• Passed five city council resolutions, two executive orders, and one city ordinance to sustain AYSRH initiatives.
• Ordinance 20-032 supports young mothers and helps prevent repeat pregnancies.
• In 2023, the city allocated PHP 1.6 million for adolescent health programs.
• In 2024, the budget nearly tripled to PHP 4.6 million – with 92% already spent on training, service expansion, and facility improvements.

Building a Future for Young People

San Jose continues to expand its programs in partnership with the City Population Office and the Department of Education – rolling out comprehensive sexuality education in schools. The City Health Office is also strengthening partnerships with private birthing centers and clinics to further improve family planning service delivery. Other key initiatives include:

• Kalalakihang Tapat sa Responsibilidad at Obligasyon sa Pamilya (KATROPA): Engaging men in family planning
• Batang Ina at Batang Ama (BIBA): Supporting teenage parents
• Information and Service Delivery Network (ISDN): Combating myths and misinformation about contraception

San Jose’s experience offers a blueprint for other cities – especially those with transient populations facing similar challenges.

A New Dawn for San Jose’s Youth

Jaira, now part of the Usapang BIBA program, is turning her story into one of hope:

I am thankful to the rural health unit for always checking in on me and my family. When I miss a check-up, they send a barangay health worker to remind me, bring vitamins, and share information so I can prevent another unplanned pregnancy. I want young people like me to know that we can turn our lives around after a mistake.”

San Jose City Mayor Kokoy Salvador speaks about the city’s partnership with TCI.

San Jose City’s partnership with TCI has sparked transformative change. With strong leadership, meaningful partnerships, and sustained investment, the city is proving that supporting young people is key to a healthier, more prosperous future. As Mayor Salvador said:

We are proud of what we’ve achieved, but there’s still more to do. With the help of TCI, our community, and our partners, we’re confident that we can build a better future for the youth of San Jose City.”