Pangasinan Province : Contraceptive Self-Reliance Experience Philippines p a n g a s i n a n & Excellence Innovation Influence PATHWAYS TO RESULTS Author Luzviminda N. Muego 33rd Annual International Conference on Global Health May 30-June 2, 2006 Omni 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 & Demographic Health Surveys:1995 and 2001 Source: NSO, NTSCB Population Growth Rate

p a n g a s i n a n Source: Pangasinan DHS Current FP Users Census & Demographic Health Surveys:1995 and 2001

p a n g a s i n a n The Context of CSR 25% 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.” CSR Processes

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 by private 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 Commodity Self Reliance Encourage Private Sector Participation Segment FP Market Strengthen Natural FP Reduce Unmet Need 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 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 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

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 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 Classification At the Public Sector Health Facility Living Standard Survey For ranking households Groundwork for Client segmentation Towards FP Market 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 LGUs LGUs LGUs 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 Office 2/F Kalantiao Bldg., Capitol Complex Lingayen, Pangasinan Philippines Tel/Fax: (+6375)