Population Policy and Program Monitoring and Evaluation

1. Population Policy and Program Monitoring and Evaluation Alejandro N. Herrin and Aniceto C. Orbeta, Jr. Baguio City June 26, 2003

2. POPCOM and PIDS Project Reports • Herrin, A. N., 2002, “Population Policy in the Philippines, 1969-2002”. • Orbeta, A. C., Jr. et al., 2002, “Review of the Population Program: 1986-2002”. • Racelis, R. H. and A. N. Herrin, 2003, “Philippine Population Management Program (PPMP) Expenditures, 1998 and 2000”. • Herrin, A. N., A. C. Orbeta, Jr., F. del Prado, I. Acejo, and J. Cuenca, 2003, “An Evaluation of the Philippine Population Management Program” (in progress).

3. Outline • Part I: Population policy and program review, with attention to population growth and family planning, 1969-2002 • Part II: Monitoring and evaluating the PPMP: a strategy, some results, and information gaps • Part III: Some conclusions regarding future directions

4. Part I: Population policy and program review, with attention to population growth and family planning, 1969-2002

5. Population Policy and Program, 1969-2002 • Marcos administration (1967-1986) • emphasis on negative consequences of rapid population growth • adopted FP that provided both information and services plus advocacy of a small family size norm • Aquino administration (1986-1992) • emphasis on rights of couples to determine number of children • FP program emphasized maternal and child health

6. Population Policy and Program, 1969-2002 • Ramos administration (1992-1998) • recognized role of rapid population growth in constraining socioeconomic progress • adopted FP in the context of reproductive health • Estrada administration (1998-2001) • FP to assist couples achieve desired fertility and promote health • contraceptive mix - scenarios to achieve faster reduction in fertility

7. Population Policy and Program, 1969-2002 • Arroyo administration (2001- ) • FP emphasizes objective of assisting couples to achieve desired fertility and promote health • FP program emphasis on promoting modern Natural Family Planning • Will not fund purchase of contraceptives for distribution to public health facilities in the event bilateral and multilateral donors stop providing supplies.

8. Factors Influencing Population Policy • International commitments e.g., International Conference on Population and Development (ICPD) • Opposition of the Catholic Church hierarchy (especially on the promotion of artificial contraceptives) • Views of the general public (national demographic surveys and opinion polls)? • Views of partner GOs and NGOs?

9. Some conclusions from the policy and program review • Broaden population concerns but address the issue of rapid population growth and fertility reduction once and for all. • Need for clear and consistent statements of national policy to guide national and LGU programs – need to forge a stable consensus. • In formulating policy, consider also the views of partner GOs and NGOs, and the larger, albeit unorganized and silent constituency – the married couples with unmet needs for contraception.

10. Some conclusions from the policy and program review • There are opportunities for working closely with the Catholic Church and other groups in some areas of population policy and family planning.

11. Part II: Monitoring and evaluating the PPMP: a strategy, some results, and information gaps

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

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

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

15. 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

16. Outputs

17. Outputs Sources of supply of modern methods

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

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

20. 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)

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

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

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

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

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

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

27. Outcomes High Risk Fertility Behavior* *The risk of children dying is higher if, at time of birth, the mother was <17 years or > 35 years old, her latest birth was less than 24 months, and she had already more than 3 childrenthan if the mother was not in any of these categories. Sources: 1993 NDS and 1998 NDHS

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

29. 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

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

31. Outputs

32. Utilization Prenatal care, 1999-2002

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

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

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

36. Utilization Postnatal care, 1999-2002

37. 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)

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

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

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

41. Adolescent Health and Youth Development (AHYD)

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

43. Outputs

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

45. Outcomes

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

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

48. Population and Development Integration (POPDEV)

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

50. Outputs