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Philippine Population Management Program (PPMP) Monitoring and Evaluation

Philippine Population Management Program (PPMP) Monitoring and Evaluation. Alejandro N. Herrin and Aniceto C. Orbeta, Jr. August 28, 2003. Outline. Monitoring and evaluation framework Some findings Information gaps Future directions. Framework for PPMP Monitoring and Evaluation. Outputs

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Philippine Population Management Program (PPMP) Monitoring and Evaluation

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  1. Philippine Population Management Program (PPMP) Monitoring and Evaluation Alejandro N. Herrin and Aniceto C. Orbeta, Jr. August 28, 2003

  2. Outline • Monitoring and evaluation framework • Some findings • Information gaps • Future directions

  3. Framework for PPMP Monitoring and Evaluation Outputs (services, capacity- building, advocacy, organizational support) Basic inputs Objective Strategy Utilization (intermediate outcomes Outcomes (achievement of policy objectives) Other factors Other factors

  4. Responsible Parenthood and Family Planning (RP/FP)

  5. Outputs PPMP Expenditures by Use, 1998 and 2000 Source: Racelis and Herrin (2003)

  6. Outputs

  7. Outputs Sources of supply of modern methods

  8. Utilization Sources: NDS 1968 to 1993 and NDHS 1998

  9. Utilization Fertility and CPR, Selected Countries 2002 Source: UNESCAP (2003)

  10. Utilization Fertility and contraceptive use: 1998 NDHS TFR=total fertility rate ASFR (15-19)= age-specific fertility rate among women 15-19 years old. Source: Gwatkin, et al. (2000)

  11. Utilization Percent of Currently Married Women by Method, Poor and Non-Poor, 2000 and 2002

  12. Utilization Percentage of currently married women with unmet need for family planning

  13. Outcomes Sources: NDS 1968 to 1993 and NDHS 1998

  14. Outcomes Fertility and contraceptive use: 1998 NDHS Source: Gwatkin, et al. (2000)

  15. Outcomes Total and Wanted Fertility Rates, 1993 and 1998

  16. Outcomes Percent of Married Women Who Want No More Children

  17. Summary: Family planning • Outcomes: Slow fertility decline, high unwanted fertility among the poor • Utilization: Low contraceptive use of modern methods. More likely due to lack of access to high quality and preferred methods than lack of demand, especially among the poor. • Outputs: Lack of consistency in policy to reduce fertility and promote FP, especially with the promotion of modern and effective “artificial” methods, which affect total effort as reflected in government allocation of resources to contraceptive supplies. Households finance close to half of total expenditures for direct FP services.

  18. Reproductive Health /Family Planning (RH/FP)

  19. Outputs 10 elements of reproductive health (DOH AO 1-A, January 15, 1998) • Family planning • Maternal and child health and nutrition • Prevention and management of abortion complications • Prevention and treatment of reproductive tract infections including STDs and HIV/AIDS • Breast and reproductive tract cancers and other gynecological conditions • Adolescent reproductive health • Education and counseling on sexuality and sexual health • Men’s reproductive health • Violence against women and children • Prevention and treatment of infertility and sexual disorders

  20. Outputs PPMP Expenditures by Use, 1998 and 2000 Source: Racelis and Herrin (2003)

  21. Outputs

  22. Utilization Prenatal care, 1999-2002

  23. Utilization Pre-natal care visits (%): 1998 NDHS Source: Gwatkin, et al. (2000)

  24. Utilization Percent of children 0-59 months by type of delivery attendant Percentage for “Others” not shown.

  25. Utilization Delivery attendance (%): 1998 NDHS Source: Gwatkin, et al. (2000)

  26. Utilization Postnatal care, 1999-2002

  27. Outcomes High risk fertility behavior, 1993 and 1998 Risk defined in terms of early (<18) and late (>34) childbearing, short birth intervals (<24 months), and high birth order (>3)

  28. Outcomes Sources: Flieger 1982; Flieger and Cabigon 1984; NSCB 1992; UNESCAP 2002

  29. Outcomes Philippines Thailand South Korea Sources: Flieger 1982; Flieger and Cabigon 1984; NSCB 1992; UNESCAP 2002

  30. Outcomes Infant and child mortality by income class: 1998 NDHS Source: Gwatkin, et al. (2000)

  31. Outcomes Maternal mortality ratio estimates • Estimates for other countries for 1990-98: • South Korea: 20 • Malaysia: 39 • China: 65 • Thailand: 44 • Singapore: 6 • Indonesia: 450 • Philippines: 170 • Source: World Bank (2001)

  32. Summary: Reproductive health • Outcomes: slow decline in infant and child mortality; high infant and child mortality among the poor; high maternal mortality; high risk births; little information on other aspects of RH. • Utilization: Low utilization of MCH services provided by trained medical providers among the poor. Subsidized public sector services captured by the better off. • Outputs: Traditional services in place but public delivery now the main responsibility of LGUs probably not highly efficient nor of high quality. Households finance close to half of direct RH expenditures.

  33. Adolescent Health and Youth Development (AHYD)

  34. Outputs PPMP Expenditures by Use, 1998 and 2000 Source: Racelis and Herrin (2003)

  35. Outputs

  36. Outcomes Age-specific birth rates (per 1,000 women)

  37. Outcomes

  38. Outcomes Fertility and contraceptive use: 1998 NDHS Source: Gwatkin, et al. (2000)

  39. Outcomes Teenagers who have begun childbearing, 1993 and 1998

  40. Summary: Adolescent health and youth development • Outcomes: Early childbearing and high fertility, especially among the poor. • Utilization:Lack of information on services and their utilization. • Outputs: Very little expenditures on AHYD. Current expenditures mainly coming from NGOs, suggesting that there is little public sector programs for AHYD.

  41. Population and Development Integration (POPDEV)

  42. Outputs PPMP Expenditures by Use, 1998 and 2000 Source: Racelis and Herrin (2003)

  43. Outputs

  44. Summary: POPDEV • Outcomes: Not much expected if little activities are in place. • Utilization: Not much expected if little activities are in place. • Outputs: Not much activities during the period covered – 1998 to 2000 as reflected in the small expenditures for the POPDEV program.

  45. Information gaps • Reasonably updated data on FP use, source of supplies of modern methods, and fertility, but not so with infant, child and maternal mortality, and outcomes data on youth. • Very limited utilization (intermediate outcomes) and outcomes data on the other components of RH. • Limited disaggregation of utilization and outcomes indicators by major social groups, e.g., poor vs. non-poor. • Limited disaggregation of expenditure data by major public/private and modern/traditional providers of RH/FP services. • Limited indicators of utilization and outcomes for AHYD and POPDEV.

  46. Future directions • Greater effort at systematic development and application of POPDEV “tools” (data and analysis of interrelationships) to inform policy at both national and LGU levels. • Monitoring of population welfare through a rights-based, gender and life cycle approach to ensure that gains in one stage of the life cycle are not lost in the next, or that disadvantages in one stage are adequately compensated in the subsequent stages.

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