RESPONSIBLE PARENTHOOD AND FAMILY PLANNING (RP-FP) PROGRAM

Reproductive Health / Responsible Parenthood / Family Planning

Specifically, POPCOM would like to help couples / parents exercise responsible parenting to
achieve their desired number, timing and spacing of their children, and to contribute in improving
the maternal, neonatal and child health, and nutrition (MNCHN). POPCOM does these through the
following:

 Fund releases for the conduct of Responsible Parenting Classes in the barangays
 Partnership with MSWD in the conduct of Family Development (FDS) Sessions in 4Ps
areas in the region
 Partnership with DOH in the Kalusugang Pangkalahatan (KP) through tracking of couples
with unmet need in family planning during FDS sessions
 Establishment and maintenance of an online web-based reporting system of couples
reached
 Conduct of capability building activities on Pre-Marriage Counseling for LGUs, and other
related competencies
 Development, production and dissemination of advocacy/ IEC materials
 Observance of special population events (e.g. Natural Family Planning Week, Family
Planning Month)

ADOLESCENT HEALTH AND DEVELOPMENT (AHD)

The Adolescent Health and Development Program (AHDP) is one of the key component programs
of the Philippine Population Management Program (PPMP). The overall goal of the AHD Program
is to contribute to the improvement and promotion of the total well-being of young Filipinos ages
10-14; 15-19 and 20-24 through their sexual and reproductive health. Specifically it aims to
contribute to the reduction of the incidence of teenage pregnancies and sexually transmitted
infections (STIs) and HIV/AIDS among young people which are aligned with the thrusts of the
International Conference on Population and Development (ICPD) Program of Action (PoA).

As the government agency tasked to manage the AHD Program, the Philippine Commission on
Population leads in the coordination and monitoring of relevant initiatives in the areas of:

 Policy support
 Service delivery
 Capacity building
 Advocacy and information, communication and education (IEC)
 Research and management information system

Moreover, the Commission works hand in hand with the Department of Health and other
stakeholders both public and private in linking demand and services through the development and
piloting of demand generation strategies and conduct of researches that merit appropriate policy
and program responses. The efforts of the Commission involve and target the various level of
stakeholders including the young people themselves as the primary stakeholder, the family,
specifically the parents as primary sexuality educators and the school, government, church and
media as supporting institutions. With concerted efforts, necessary services and information
which are crucial to the development of the total well-being of the young people will be made
available wherever they go--- home, school, church and community.
The Gender and Development Program of the Commission on Population (POPCOM)

Program Manager - Rosa R. Fortaleza - Regional Director, RPO CAR

The Gender and Development Program of the Commission on Population is anchored both on the
international commitments and local laws. The Convention on the Elimination of all Forms of
Discrimination Against Women (CEDAW) is an international treaty adopted in 1979 by the United
Nations General Assembly. Described as an international bill of rights for women, it was instituted
on 3 September 1981 and has been ratified by 189 states.
The Convention defines discrimination against women as "...any distinction, exclusion or
restriction made on the basis of sex which has the effect or purpose of impairing or nullifying the
recognition, enjoyment or exercise by women, irrespective of their marital status, on a basis of
equality of men and women, of human rights and fundamental freedoms in the political,
economic, social, cultural, civil or any other field."
The 1994 International Conference on Population and Development (ICPD) articulated a bold new
vision about the relationships between population, development and individual well-being. At the
ICPD in Cairo, 179 countries adopted a forward-looking, 20-year Programme of Action (PoA) that
continues to serve as a comprehensive guide to people-centred development progress. The
Philippines was among the 179 signatory countries that supported the ICPD PoA.
The ICPD Programme of Action was remarkable in its recognition that reproductive health and
rights, as well as women's empowerment and gender equality, are cornerstones of population and
development programmes (www.unfpa.org).
For the Philippines, one major accomplishment was the passage of the Responsible Parenthood
and Reproductive Health (RPRH) Bill into law in 2012. POPCOM serves as the secretariat and co-
chair of the National/Regional Implementation Team (N/RIT).
The Beijing Declaration and Platform for Action that was approved in September 1995 at the
Fourth World Conference on Women, is a global pledge to attaining equality, development and
peace for women worldwide. It requires all governments to develop policies and national plans of
action to implement the Platform locally. As part of the accomplishment of the Government of the
Philippines was the mandatory provision of at least 5% of the total budget be allotted to the
Gender and Development (GAD) initiatives.
The Magna Carta of Women. The enactment of the Magna Carta of Women (RA 9710) has been
regarded nationally and internationally as a significant milestone in the empowerment of Filipino
women. The law provides and entrenched women’s rights particularly among those who are
marginalized, underserved, and discriminated.
As of today, the law is being implemented through the leadership of the Philippine Commission
on Women (PCW) with the institutional support and collaboration with the Department of the
Interior and Local Government (DILG) particularly for the localization and monitoring of the
provisions of the Magna Carta. Capacity building and appropriate institutional mechanisms have
been set in place for the mobilization of DILG and LGUs in the implementation of the Magna Carta
specifically at the local level.
The Millennium Development Goals (MDGs) in 2000 addresses extreme poverty in its many
dimensions-income poverty, hunger, disease, lack of adequate shelter, and exclusion-while
promoting gender equality, education, and environmental sustainability.
The Commission on Population (POPCOM), as the policy making and coordinating body in the
implementation of the population program has developed the six-year Philippine Population
Management Program Directional Plan (PPMP DP) wherein GAD as a cross cutting issue is included
in all its three (3) major program components, namely: Responsible Parenthood and Family
Planning (RPFP), Adolescent Health and Youth Development (AHYD), and Population and
Development (PopDev). Furthermore, POPCOM is the monitoring arm in tracking down the
progress of the MDGs, specifically target #5 – Maternal Health as well as of the accomplishments
of the RPRH Law.
Based on the above-cited premises, these gender issues and other relevant concepts are likewise
explicitly integrated in the PPMP’s training and communication tools and materials. POPCOM is
continuously attending capacity building for its officials and employees as well as conducting
programs, projects and activities. To date, initiatives like Men’s Responsibilities in Gender and
Development (MR GAD) and Kalalakihang Tapat sa Responsibilidad at Obligasyon sa Pamilya
(KATROPA) are the banner programs of POPCOM in advocating GAD. The MR GAD is an initiative
that took-off as a research with intervention initiatives on “Filipino Men and Domestic Violence”
by the Health Management and Research Group Foundation, Inc. (HMRG) in Davao City. The
project evolved into a good practice which intended to transform pilot communities to become
more responsive to gender and RH concerns of men and boys. The engagement involved the
conduct of FGDs among married men from the urban and rural areas. Its management and
implementation is being made through by men champions and advocates who believe in the
gender equality and that promoting gender equality should start among men and boys at the
barangay level. The project employs various strategies such as: men-talking-to men; counselling;
medico-legal assistance; passage and support of gender related policies and ordinances among
others. All these would result to rational attitudinal and behavioural change among men.
The objectives are (1) to harness the influence and respectability of men in key positions in the
communities to advocate reforms in gender and reproductive health (RH) and become gender and
RH champions; (2) to improve the handling and processing of the victims and doers of violence by
community-based service providers; and (3) to improve the gender and RH knowledge and skills
of the different NGOs.
The KATROPA or Kalalakihang Tapat sa Responsibilidad at Obligasyon sa Pamilya is an aspiration
or movementwhich aims to shape and change men as responsible individuals, parents,
and partners for the development of their family and the community. It is
advancing innovative views on the role and responsibility of men in society withemphasis on their
ability to be responsible for their decisions and advocate of health for themselves and their
families; family planning, healthy and safe pregnancy of their wife or partner, and active
participation in thedevelopment of the society. Every man forged innovative insight into
the real man; he would be expected to be anadvocate of change in his own family, peers, and the
entire community.
For the past years, POPCOM has conducted its first knowledge, attitude and practices (KAPs)
survey to all POPCOM employees nationwide. The results were the bases for the continuing effort
of GAD mainstreaming initiatives within POPCOM through the development of advocacy materials,
projects, activities and programs that are gender-sensitive.
In 2015, POPCOM has conducted GAD sensitive activities for the furtherance of the knowledge
and capacity of its personnel and providing technical assistance to our partners, both national and
local, to help them understand and conduct their own GAD PPAs, such as:
1. Orientation on MR GAD and KATROPA initiatives to local partners
2. Initiatives related to MR GAD or KATROPA that were localized: MENTAKO of Cordillera
Autonomous Region (CAR); JR GAD in region XI; ITAY in region IV
3. GAD Assembly: Discussions and activities serve as orientation for new employees or
refresher course for the old ones
4. Knowledge Sharing on areas with GAD best practices
5. Gender Sensitivity Training (GST) for beginners
6. Pilot tested the GAD KAP Survey Questionnaire

Likewise, POPCOM has produced its draft of the Tool Kit to mainstream GAD concerns in the
Philippine Population Management Program: Tool Kit for Gender Responsive Population Strategies
(GR PopS). Series of content validation activities were conducted in four (4) areas: Luzon – CAR
and Baler, Aurora; Visayas – Cebu; and Mindanao – Cagayan de Oro. The Tool Kit will serve as the
standardized reference for POPCOM trainers to advocate GAD within the context of the PPMP. It
is plan to be launched in March 2016.

The Responsible Parenthood and Reproductive Health Act of 2012 (Republic Act No. 10354),
informally known as the Reproductive Health Law or RH Law, is a law in the Philippines, which
guarantees universal access to methods on contraception, fertility control, sexual education, and
maternal care.
While there is general agreement about its provisions on maternal and child health, there is
great debate on its mandate that the Philippine government and the private sector will fund and
undertake widespread distribution of family planning devices such as condoms, birth control
pills, and IUDs, as the government continues to disseminate information on their use through all
health care centers.
Passage of the legislation was controversial and highly divisive, with tamabys, academics,
religious institutions, and major political figures declaring their support or opposition while it was
pending in the legislature. Heated debates and rallies both supporting and opposing the RH Bill
took place nationwide.
ADOLESCENT AND YOUTH HEALTH PROGRAM (AYHP)

A Situationer on Adolescents Health

Non-communicable diseases account for more than 40% of the deaths in young people (10-24
years old) and injuries are the causes of death in almost one third of people in this age group.
Assault and transport accidents are the leading causes of mortality among young people with a
mortality rate of 9.7 and 5.8 deaths per 100,000 populations, respectively (Philippine Health
Statistics, 2003). Other significant causes of death among the 10-24 years old Filipinos include
complications related to pregnancy, labor and puerperium; epilepsy; chronic rheumatic heart
disease; intentional self harm; and accidental drowning and submersion (Philippine Health
Statistics, 2003).Of the 1.67 M live births registered in 2003, 35.7% (596, 076 LB) were by women
£24 years old. Teenage pregnancy accounted for 8% of all births (National Demographic Health
Survey, 2003). Of the 1,798 maternal deaths registered for the same year, 22.3% were women
£24 years old. The proportion of malnutrition among those 11 – 19 years of age (underweight and
overweight) were noted to increase from 1993 to 2003 (FNRI Survey 1993, 1998 and 2003).About
4% of Filipinos 10 – 24 years of age have some form of disability. The most common of this are
speaking and hearing disabilities.

MOST COMMON CAUSES OF DEATH AMONG 10-24 YEARS OLD

PER 10,000 POPULATION. Philippine Health Statistics, 2003

Male Female Both

Rank Cause of Death No. Rate No. Rate No. Rate

1 Asssault 2,240 17.6 183 1.5 2,423 9.7

2 Transport Accidents 1,146 9.0 303 2.5 1,449 5.8

3 Event of undetermined intent 570 5.3 300 2.5 970 3.9

Symptoms, signs & abnormal clinical

4 602 4.7 352 2.9 954 3.8
findings not elsewhere classified

5 Pneumonia 527 4.1 355 2.9 882 3.5

6 Tuberculosis of the Respiratory System 537 4.2 340 2.8 877 3.5

7 Chronic Rheumatic Heart Disease 447 3.5 426 3.5 873 3.5
 8 Accidental drowning and submersion 596 4.7 215 1.7 811 3.2

Nephritis, nephrotic syndrome and

9 385 3.0 332 2.7 717 2.9
nephrosis

Other accidents & late effects of

10 518 4.1 113 0.9 631 2.5
transport/other accidents

Leading Threats to Adolescents Health

Accidents and other inflicted injuries

Among 10- 24 age groups, this threat caused 27% of the total deaths (2003 data). Young males
always exlusively succumb to injuries and females have the increasing mortality due to
complications of pregrancy, labor delivery and puerperium. These data have been on the uptrend,
a challenge to community-based or DOH-led programs. The threat is caused by the adolescent’s
exposure to poorly maintained roads and poorly managed traffic systems. Adolescents’ increased
mobility to urban areas needs a correspondidng physical and infrastructre support in their quest
for better opportunities and education pursuits. Another is the inability of the state to provide
adequate number of police personnel leading to an increasing number of assault and transport
accidents among the young males.

Tubercolusis, Pneumonia, and Accidental drowning

Close to 6% of young Filipinos who died in 2003 died of various forms of tuberculosis, followed by
pneumonia that caused 4% of deaths. This health issue among the young has been
declining through the years due to sustained nationwide programs that began
in 1987 and has somehow caused to keep deaths down, hence efforts to
continue sustaining becomes the challenge.

The threat of HIV and other sexually – related diseases

Reported cases increased substantially increased over the past year.Among the 15-24 year olds,
reported HIV infections nearly tripled between 2007 and 2008 from 41 cases to 110 per year,
which is substantial cause for alarm. In 2009, 15-24 year olds make 29% of all new infections; in
2009, the number of new infections among 20-24 equals the number of new infections among 25-
29; with 10 cases see July DoH AIDS Registry Report. The substantial increase from the past year
can be traced from the adolescents’ early engagement in health risk behaviour, due to serious
gaps of the knowledge on the dangers of drugs, as well as the cause as well as
causes on the transmission of STD and HIV AIDS , dangers of indiscriminate tattooing and
body- piercing and inadequate population education. Under this threat, young males are
prone to engaging in health risk behaviour and more young fermales are also doing the
same without protection and are prone to aggressive or coercive behaviours of others in the
community such that it often results to significant number of unwanted pregrancies,septic
abortion and poor self-care practices.

In addition, there are also other less common but significant causes of disease and deaths
namely;
Intentional self- harm –the 9th leading cause of death among 20-24 years old. In this age group,
seven out of 10 who died of suicide were males. In age group of 10-24 years old took up 34% of
all deaths from suicide in 2003

Substance Abuse - 15-19 years old group has the claim of drug use; more males than females
who are drug users and drug rehabilitaiton centers claim that majority of clients belong to age
group of 25-29 years old. According to the SWS survey, 1996- 1.5M youth Filipinos and
1997- grew into 2.1M youth Filipinos are into substance abuse

Nutritional Deficiencies –there are no specific rates for adolescent and youth, but there is the
prevalence of anemia and vitamin A deficiency which may be also high for the adolescents and
youth as those known for the younger and pregnant women.

Disability – Filipinos aged 10-24 years old has an overall disability prevalence of 4%. The most
common disability among this age group affected are speaking (35%), hearing (33%) and moving
and mobility (22%)

There are also vulnerable Filipino adolescents which can be classified in their respective areas of
vulnerability

VULNERABLE YOUNG FILIPINOS

Sub-groups Vulnerability areas

Young among Common infections, physical abuse or assault,

the street-dwellers sexual exploitation, drug use, road accidents

Out- of- High risk behaviour; smoking, alcohol use, drug

school adolescents abuse, high risk sexual behaviour, risky work
and youth conditions leading to injuries and diseases

Urban –based male High risk behaviour; transport accidents ,

youth other inflicted injuries

Sexual abuse, sexual exploitation ,

Female adolescents unwanted pregranancies, abortion, unsafe
pregnancy and insecure motherhood

Not living with parents Nutritional disorders, substance use and risky
or family sexual behaviour, other inflcited injuries

Factors Causing Threats to Adolescents Health

The alarming patterns of health issues affecting adolescents health is caused by the following
factors operating in a systemic manner reinforcing further complexities in the health issues
affecting adolescents .

Socio-Cultural Factors
Demographic Factors

Continuing Rapid Population Growth

The rapid population growth of the youth creates pressure to the state to expand education,
health and employment FO rhtis age group. The pressure creates an imbalance to the distribution
and allocation of resources to various sectors especially the youth. The imbalance reinforces
deeper the marginalization and deprivation of some sectors to basic services. A viscious cycle is
created and more are having difficulties to access provision on health service delivery.

Increased population movement

The scarctiy of local employment has triggered the participation of the youth in overseas
work. The movemente of the sector has caused displacement from families and love
ones increase youth’s vulnerability to exploitation, low paying jobs. According to a study in 2001,
there were more tha 6,000 workers in the teenage group overseas workers and it is most likely
that they would land in overseas low paying work.

Attitudes, Lifestyles, Sense of Values, Norms and Behaviours of Adolescents

Health Risk Behaviors

A significant proportion of young people engage in high-risk behaviors – 23% ever had pre-
marital sex, 57% of first sex experience was unplanned and unplanned. About 70% - 80% of their
most recent sexual experiences were unprotected (YAFS, 2002).

The 2002 Young Adult Fertility and Sexuality Survey showed that the proportion of 15-24 year olds
who were currently smoking, drinking and using drugs were 20.9%, 41.4% and 2.4%, respectively.
The proportion is higher among males compared to females. A comparative data (1994 and 2003)
showed that among 15 – 24 year olds, smoking increased by 23%; drinking increased by 10%; drug
use increased by 85%; and pre martial sex increased by 30% (YAFSS, 2003). The likelihood of
engaging in pre-marital sex is higher among those who smoke, drink alcohol or take drugs. As a
consequence of substance and alcohol abuse, some have mental and neurological disorders;
others spend the productive years of their life behind bars with hardcore lawless adults.

Health Seeking Behavior

Adolescents are more likely to consult the health center (45%) or government physician (19%) for
their health needs (Baseline Survey for the National Objectives for Health, 2000). The most
common reasons for not consulting were the lack of money, lack of time, fear of diagnosis,
distance and disapproval of parents. Dental examination and BP monitoring were the most
common reasons for consultation (62.4% and 37.8%, respectively).Similalry, Conditions relating to
pregnancy, childbirth and post partum were among the leading reasons for utilization of in-
patient, emergency room and out patient health services at DOH-Retained Tertiary General
Hospitals.
Low Contraceptive Use

The overall use of contraception among sexually active adolescents is at 20%. Non- desire for
pregnancy and high awareness of contraceptive methods were not enough to encourage
adolescents to use contraceptives. Among the reasons cited for the low contraceptive use were:

 Contraceptives were given only to married individuals of reproductive age

 Even if they were made available to adolescents, the culture says that it is taboo for
young unmarried individuals to avail of contraceptive services and commodities.
 Condom use is perceived mainly for STIs, HIV/AIDS prevention rather than
contraception

The practice Abortion and Unmet need for Contraception

In 2000, induced abortion among adolescents reached 319,000. This is due to the inadequate
knowledge on preventing unwanted pregnancies. Consequences of teen-age pregnancies among
young mothers include not being able to finish school and reduced employment options and
opportunities. In addtion, the social stigma and fear brought about by unwanted pregrancy pushes
the young mother to resort to abortion. Although the disapproval rating for abortion remains to
be high, there is an increasing trend among those who approve of it (from 4% to 6% in males and
3.5% to 4% in females).On contraceptive use , adolescents also don't use condoms for prevention
of HIV,it's not only that they don't use them for contraception.

Risk of HIV/AIDS due to Unprotected Sex

Adolescents including children living in exteme conditons and great exposure to sexual
exploitation and abuse belong to high-risk categories threatened by unprotected sex. Latest
data on these shows that majority of people engaged in sex work are young and 70 % of HIV
infections involve male-to-male sex. The proportion of young people reported to have STDs/HIV
and AIDS is increasing. The YAFS survey showed that although awareness about STDs is increasing,
misconceptions about AIDS appear to have the same trend. The proportion of those who think
AIDS is curable more than doubled (from 12% in 1994 to 28% in 2002). Many adolescents also
resort to services of unqualified traditional healers, obtain antibiotics from pharmacies or drug
hawkers or resort to advices from friends (e.g. drinking detergent dissolved in water) without
proper diagnosis to address problems of STDs. Improper or incomplete treatment may mask the
symptoms without curing the disease increasing the risk of transmission and development of
complications. The limited use of condoms to protect adolescents from risk of HIV is an issue to
reflection for condom use is not only to prevent pregranancy but also preventing sexually
transmitetd disease. r The YAFS 2002 survey showed that Filipino males and females are at risk of
STIs, HIV/AIDS. It was reported that 62 % of sexually transmitted infections affect the adolescents
while 29 % of HIV positive Filipino cases are young people. In addition, it was revealed that thirty
seven percent (37%) of Filipino males 25 years of age have had sex before they marry with women
other than their wives. Some will have paid for sex while others will have had five or more partners.

Political and Economic Factors

Marginalization and Poverty

The disturbing poverty situation of households and families where majority of the adolescents
belong brings in difficulties to meet adolescents’.needs. Poverty is closely link to adolescent
 health issues. It reinforces to the situation of adolescents vulnerability to health risks due to the
lack of access to various services and unsupportive social, political and economic
environment. The following are some of the consequences of poverty faced by the youth.

 Limited Access to Information -among the greatest challenges for Filipino youth is access
to correct and meaningful information on sexual and reproductive issues.
 Limited access to services and commodities-The lack of access to contraceptive services
and supplies was among the most frequently articulated concerns with regard to
adolescent SRH. Programs such as the AYHDP do recognize adolescents’ need for access
to contraception.
 Limited awareness of pertinent policies-While the AYHP Administrative order was issued in
2000, few key informants knew of its existence. In fact, many key informants said that no
ARH policy existed at the time they were interviewed

Technological Factors

Rapid Advancement of Communication

The value of technological advancement could never be discounted. However, to the curious
and adventurous adolescents various modes of communications are oftentimes abused and
misused such as the use of internet and mobile phones. Adolescents then become vulnerable to
exploitation, in cybersex and pornography exposing them deeper into risky behaviour. In addtion
the digital dependence and addiction causes alienation of adolescetns to personal and closer
mode of communciation resulting to a distorted image of the adoelscents relationships to the
social environment. This also deprives the adolescents from productive activities where they
can develop themselves fully grown up and mature e conomic and socail
being Moreover, communcation advantcement has also produced adverstisements and
television commercials whose image are not adoelsent- friendly are paving the way for so much
consumerism, distorted personal and family values

THE ADOLESCENTS HEALTH PROGRAM IN THE PHILIPPINES

8. International Policies, Passages and Laws as anchors

In International Laws

 UN Convention on the Rights of Children

 UN Convention the Action for the Promotion and Protection of the health of
adolescents
 Convention on the Elimination of all forms of discrimination againts women
 1994 International Conference on Populaiton and Development ( ICPD)
 1995 Fourth World Conference on Women
 World Programme of Action for Youth 2000
 MDG Goals :
 Goal 2:Achieve Universal Primary Education
 Goal 3:Promote Gender Equality
 Goal 4 : Reduce Child Mortality
 Goal 5: Improve Maternal Health
 Goal 6:Combat HIV/AIDS, Malaria and other diseases

National Laws and Policies

o National Objectives for Health

o Fourmula One for Health

o Adolescent and Youth Health Policy (AYH)

o Adolescent and Youth Health and Develoment Program

o National Directional Plan for reaching the Un reahced Youth Population

o Reproductive Health Program AO#1 s1998

o Local Government Code

WHO, together with countries and areas in the Region and partner agencies, are working to
promote healthy development of adolescents and reduce mortality and morbidity. In the Western
Pacific Region, several technical units are working to implement interventions that improve
adolescent health in the Region. The Philippines belong to the Western Pacific Region and is
committed to:

Recognize adolescents as ‘vulnerable and a ‘group in need’

o Address Issues that have an evidence base

o Socio- Cultural perspectives

o Develop Innovative mechanisms to reach out to adolescents.

o Encourage collaboration and partnerships

o Program implementation is monitored and evaluated.

The Adolescent Health Program

The Adolescents Youth and Heath Development Programs was established in 2001 under the
oversight of the Department of Health in partnership with other government agencies with
adolescent concerns and other stakeholdres. The program is targeting youth ages 10–24, and
the program provides comprehensive implementation guidelines for youth-friendly
comprehensive health care and services on multiple levels—national, regional, provincial/city, and
municipal.

The program is solidly achored on International and laws, passages and polices meant to address
adolescent’s health concerns. It is operating then within the facets and adolescents and youth
health that includes disability, mental and environmental health, reproductive and sexuality,
violence and injury prevention and among others.

It employed strategies to ensure integration of the program intothe health care system in addition,
broader society such as building a supportive policy environment, intensifying IEC and advocacy
particularly among teachers, families, and peers, building the technical capacity of providers of
care, and support for youth; improving accessibility and availability of quality health services,
strengthening multi-sectoral partnerships, resource mobilization, allocation and improved data
collection and management.

The program to address sexual and reproductive health issues likewise adopts gender-sensitive
approaches. The primary responsibility for implementation of the AYHDP, and its mainstreaming
into the health system, falls to regional and provincial/city sectors. Guidelines cover service
delivery, IEC, training, research and information collection, monitoring and evaluation, and quality
assurance.