TCI in the Philippines aims to reduce teenage pregnancy through enabling cities to become youth friendly. Various factors inhibit city governments in the Philippines from addressing adolescent and youth issues in accessing reproductive health programs despite operational policies encouraging city governments to prioritize adolescent and youth health. With the COVID-19 pandemic, these challenges are further aggravated with quarantines and lockdowns restricting actual movement of health workers to provide reproductive health services and for young people to access these services. City leadership and governance becomes critical because of disruptions in reproductive health services, and reallocation of financing to pandemic response. Improved leadership and governance are core to sustain interventions in implementing effective and sustainable family planning and adolescent and youth sexual reproductive health (AYSRH) programs.