Pangasinan Province:Contraceptive Self-Reliance

ExperiencePhilippines

&Excellence

Innovation InfluencePATHWAYS TO

RESULTS

Author

Luzviminda N. Muego

33rd Annual International Conference on Global Health

May 30-June 2, 2006Omni Shoreham Hotel, Washington D.C., U.S.A.

Local Enhancement and Development (LEAD) for Health Project

Management Sciences for Health

October 2003 – September 2006

Funded by USAID

p a n g a s i n a n

Population – 2.5 Million

Land Area – 5,300 sq. km.

Census 2000 PGR – 1.90 (2.36 Phil)

p a n g a s i n a n

Family Planning Program

1991 Local Government Code

Under Local Autonomy: Re-instituted

Population and Family Planning Program

The province’s population program built its capacity for a Management Information System (MIS)

Since the 1970’s, relied on USAID assistance (providing 80% of nation’s contraceptives)

p a n g a s i n a n

Census & DemographicHealth Surveys:1995 and 2001

0.0

0.5

1.0

1.5

2.0

2.5

1970 1980 1990 2000

Census Year

Po

p G

row

th R

ate

Source: NSO, NTSCB

Population Growth Rate

p a n g a s i n a n

35.0

36.0

37.0

38.0

1995 2001

DHS Survey Year

Rat

e o

f C

urr

ent

Use

rs

Source: Pangasinan DHS

Current Users, 38.00%

Non Users, 37.00%

With Unmet Need, 25.00%

Source: Pangasinan DHS

Current FP Users

Census & DemographicHealth Surveys:1995 and 2001

p a n g a s i n a n

The Context of CSR

25% 100%100%

70%

85%

30%

65%

0

30%

0 0

0

10

20

30

40

50

60

70

80

90

100

Per

cen

t Red

uct

ion

o

f Co

mm

od

ity A

ssis

tan

ce

2004 2005 2006 2007 2008Commodity Assistance Year

Pills

Injectable

Source: DOH-AO: 158, 2004

High Unmet Need for 

Family Planning  Services   

USAID Phase

Down Plan

for donated

commodities

in place

p a n g a s i n a n

Contraceptive Self-Reliance

“The ability to forecast, finance, procure and deliver good-quality and reliable     

contraceptives to          

all men and women          

who need them…        

when they need them.”      

CSRProcesses

p a n g a s i n a n

Major Challenges to CSR:Political & Socio-cultural

National & local governments’ weak policy and political will to sustain population & family planning program.

Local governments have limited resources and no policy & budget for contraceptives procurement.

Political sensitivity of FP targeted service. Distribution system gives free access to poor

(62%) and non-poor (38%).

p a n g a s i n a n

Major Challenges to CSR:Operational Barriers

Highly dependent on the public sector for FP Services (86%)

As program front-liners, LGUs capacity,competence and preparedness for CSR

is low

Minimal participation byprivate sector in

FP service delivery (14%)

p a n g a s i n a n

Pangasinan CSR VISION

“Sustainable and Quality Family Planning Program in Pangasinan”

p a n g a s i n a n

CSR “Road Map”

Policies & systems for transition in-place at the LGUs

2004

Participation of the private sector in FP market

2005

FP services operational at facility level

2006

Funding & processes institutionalized

2007

Pangasinan: CSR PROVINCE

2008

Goal: To promote LGU’s ability to sustain the provision of good quality and affordable FP services and commodities

Expected Outcomes

p a n g a s i n a n

Initiating the CSR Strategy

Political Will & Leadership by the Governor Issued legal basis for CSR Set policy agenda for

reforms Allocated funds for CSR

implementation Institutionalize all the reforms

Achieve CommoditySelf Reliance

Encourage PrivateSector Participation

Segment FPMarket

StrengthenNatural FP

Reduce UnmetNeed for FP

p a n g a s i n a n

Phases of CSR Implementation

Organizing the CSR

Implementation Structures

Social Preparation of

Implementers & Stakeholders

CSR Performance

Capacity Building,

formulation & adoption of policy

p a n g a s i n a n

CSR Performance: Results

Policy approval and adoption by LGUs

Commodity supply ensured during the Transition Period 2004 - 2008.

Provincial Logistics Management Information System in place.

29 out of 47 LGUs with contraceptives budget and procurement system in-place.

p a n g a s i n a n

CSR Performance:Results

731,760

750,000 2,405,397

1,600,000

2,685,500

3,000,000

0

1,000,000

2,000,000

3,000,000

4,000,000

5,000,000

6,000,000

Am

ou

nt

Ap

pro

pri

atet

d

2004 2005 2006

Budget Year

Province

LGUs

Increasing budgetary allocations for commodities by the province and LGUs

p a n g a s i n a n

CSR Performance: Results

Increasing contraceptives procurement

0

0.5

1

1.5

2

2.5

3

Am

oun

t A

ppr

opri

ated

(m

illio

ns)

2004 2005 2006

Budget Year

Province

Towns

p a n g a s i n a n

CSR Performance: Results

Mobilizing Private Sector Participation

Commercial Sector - Increasing volume of contraceptive sales

Capability building for private providers -

More midwives being trained as providers and entrepreneurs

2456,699

35,556

0

5000

10000

15000

20000

25000

30000

35000

40000

2003 2004 2005

132,502106,874

81,806

0

20000

40000

60000

80000

100000

120000

140000

2003 2004 2005

Injectables Sales (vials)

Pills Sales (cycles)

p a n g a s i n a n

CSR Performance: Results

Market Segmentation for FP targeted services

Client ClassificationAt the Public Sector Health

Facility

Living Standard Survey For ranking households

Groundwork forClient segmentation

Towards FPMarket

Transformation

• Enhanced Information Generation

- Willingness to pay- Facility Mapping- Private Sector

Mapping

p a n g a s i n a n

CSR Performance: Results

Service delivery strategies in place to reduce FP Unmet Need

Tool to identify married women with unmet need for FP in-place and functional

Client referral system in public & private facilities and providers

Outreach support for client generation intensified

p a n g a s i n a n

CSR Performance Results:Moving Forward

Replication of CSR Strategies Province-wide

20032003 9 LGUs 9 LGUs

20042004 24 LGUs24 LGUs20052005 45 LGUs45 LGUs

20062006 47 LGUs 47 LGUs

p a n g a s i n a n

Partnership Works for CSR Initiative

“…we commend you in looking at the issue of reduced donor contraceptive commodity support in the broader perspective by working towards CONTRACEPTIVE SELF-RELIANCE.”

From a letter to Gov. Victor E. Agbayani, USAID-Philippines

Dec 2002

p a n g a s i n a n

Partnership Works for CSR

Champions for Self-Reliance in Local Governance for the LGUs

Corporate Social Responsibility in Private Sector

The general population, Contraceptive Social Responsibility

p a n g a s i n a n

THANK YOU!

For more information…

Provincial Population Office2/F Kalantiao Bldg., Capitol ComplexLingayen, PangasinanPhilippines

Tel/Fax: (+6375) 542.6349Email: ppo_pang@yahoo.com