Training participants reflect on lessons learned in empowering CHWs for basic family planning service delivery.
A quiet revolution is taking place in the busy streets of Mandaluyong City, and it has the potential to change the landscape of reproductive health in the Philippines for years to come. Mandaluyong has already made significant progress toward empowering women’s reproductive health through its collaboration with The Challenge Initiative (TCI). Now, city-led training on informed choice and voluntarism (ICV) has resulted in a series of long-term, significant improvements in family planning programming and its residents’ well-being.
ICV – outlined in an Administrative Order (AO) from the Philippines’ Department of Health (DOH) several years ago – emphasized four guiding principles for family planning: respect for life, consideration of human rights, support for freedom of choice, and a commitment to enable clients’ rights to choose family size. The AO also outlined steps to support ICV, including enacting corrective actions, monitoring compliance, and reporting measures in the Philippines. Mandaluyong aims to localize the AO by fostering an environment where residents can feel empowered to make informed health decisions.
While high contraceptive discontinuation rates (58% of new acceptors) have posed a challenge in recent years, net contraceptive use could increase and contribute to better health outcomes if current users continue to use contraceptives. Equipping local healthcare professionals with ICV principles enables them to address these issues effectively.
With TCI support, the city has adopted a proactive approach, using past issues and complaints as opportunities for improvement. Capacity-strengthening programs are designed to dispel decades-old misconceptions about contraception and promote informed decision-making. Healthcare workers have also gained a deeper understanding of how family planning is integral to service delivery, prioritizing individual needs over compliance targets. New metrics – like Demand Satisfied and Unmet Need – are shifting the focus to women’s preferences, aligning with ICV principles and promoting a client-centered approach to reproductive healthcare in the city.
Seeding Change through Collaboration
Mandaluyong embarked on a journey to improve its public health system through a collaboration with the DOH’s Metro Manila Center for Health Development and the Quezon City Health Department, with support from TCI. Local midwives and nurses worked together with the DOH’s guidance to propose an ICV team structure. The recommended framework will be led by the City Health Officer, and co-led by the Family Planning Medical Coordinator, Adolescent Health and Development Medical Coordinator, Maternal and Child Health Medical Coordinator, and Mandaluyong’s City Medical Center Family Planning Medical Coordinator. The structure will also have regular monitoring every quarter.
Sustaining Momentum for Progress
Looking ahead, Mandaluyong recognizes the relevance of continuous monitoring and evaluation to assess the impact of its initiatives. Establishing an ICV monitoring team and implementing a reporting system will allow for systematic tracking of progress and informed decision-making. Moreover, the city has asked its Health Councilor to create a resolution to ensure quality standards in family planning programs and service delivery through ICV monitoring.
The collaboration between Mandaluyong and TCI, alongside other key stakeholders, transcends immediate outcomes to establish a lasting legacy of progress. As the city perseveres in its ICV efforts, Mandaluyong is not just initiating change, it is nurturing a culture of empowerment – one informed decision at a time.
