Commission on Population and Development (POPCOM) logo

 is a symbolic form of all types of people. The adjoined loops connote

interrelationship or togetherness, whether in connection with a family or with
individuals in a community. Completing the logo is a circle enveloping the
symbolic family or community, signifying that the family and the individual in
the community are the main focus of all POPCOM’s efforts.

Organizational structure

The Commission on Population (POPCOM) is governed by a Board of Commissioners

composed of 14 members: 11 from the government sector and three (3) members
representing the private sector.

These are as follows:

Chairperson:

The Socioeconomic Planning Secretary

Members:

Secretary of Health
Secretary of Interior & Local Government
Secretary of Labor & Employment
Secretary of Agriculture
Secretary of Agrarian Reform
Secretary of Education
Secretary of Trade and Industry
Secretary of Social Welfare and Development
Secretary of Public Works and Highways
Director of the University of the Philippines Population Institute (UPPI)

Three (3) Private Sector Representatives are appointed by, and serve at the pleasure,
of the President of the Philippines.

The POPCOM Board is tasked to set policies and directions for the country’s
population management program.

POPCOM Secretariat

The POPCOM Secretariat is headed by an Executive Director III. He is supported by a

Deputy Executive Director, five (5) Division Chiefs, and 16 Regional Directors.

The Central Office

At the central office, national coordination, policy formulation, planning, advocacy and
monitoring and evaluation of the population program are led by the Office of the
Executive Director, and the following divisions:

A. Technical Divisions

1. Policy Development and Data Management Division (PDDMD)

2. Planning, Monitoring and Evaluation Division (PMED)
3. Knowledge Management and Communications Division (KMCD)
4. Capacity Development and Field Operations Division (CDFOD)

B. Support Services Divisions

1. Administrative Division (AD), and

2. Financial and Management Division (FMD)

Internal Audit Unit is an independent body that audits the internal operations of the
Agency and directly reporting to the Board of Commissioners.

The POPCOM Central Office is located at Acacia Lane Ext., Welfareville Compound,
Brgy. Addition Hills, Mandaluyong City.

Regional Operations

For regional operations, 16 POPCOM regional offices nationwide are as follows:

POPCOM Region I (Ilocos Region) – San Fernando, La Union

POPCOM Region II (Cagayan Valley) – Tuguegarao City, Cagayan
POPCOM Region III (Central Luzon) – San Fernando City, Pampanga
POPCOM Region IV-A (CALABARZON) – Welfareville Compound, Mandaluyong City
POPCOM Region IV-B (MIMAROPA) – Welfareville Compound, Mandaluyong City
POPCOM Region V (Bicol Region) – Legaspi City
POPCOM Region VI ( Western Visayas) – Pavia, Iloilo
POPCOM Region VII (Central Visayas) – Banilad, Cebu City
POPCOM Region VIII (Eastern Visayas) – Palo, Leyte
POPCOM Region IX (Zamboanga Peninsula) – Zamboanga City
POPCOM Region X (Northern Mindanao) – Carmen, Cagayan de Oro City
POPCOM Region XI (Davao Region) – Bajada, Davao City
POPCOM Region XII (SOCCSKSARGEN) – BARMM Complex, Cotabato City
POPCOM Caraga Region – Butuan City
POPCOM Cordillera Administrative Region (CAR) – Baguio City
POPCOM National Capital Region (NCR) – Welfareville Compound, Mandaluyong City

NEW POPCOM CHIEF: Dr. Lisa Grace S. Bersales, Ph.D

 was sworn into office as the new executive director of the Commission on
Population and Development (POPCOM) on Friday, January 13, 2023 by
Socioeconomic Planning Secretary Arsenio M. Balisacan at the National
Economic and Development Authority head office. The former will now
concurrently serve as the undersecretary for population and development or
POPDEV, banking on her expertise as a statistics development-partner of the
country’s public and private sectors. Bersales brings into POPCOM her deep
 expertise from almost four decades of academic practice as a researcher and
professor at the University of the Philippines, where she was dean and director
of its Graduate Studies for the School of Statistics. As the first national
statistician, she led the implementation of the Philippine Statistics Act of 2013
by setting up the Philippine Statistics Authority in 2014. Bersales actualized the
Public-Private Partnership for the Civil Registration System Information
Technology Project-Phase 2 of the Philippines in 2016, and chaired Philippine
Identification System working group that provided inputs to the Philippine
Identification System Act enacted in 2018, where she formalized its
Implementing Rules and Regulation in the same year. Her most recent
significant engagement in the international arena includes being co-chair of the
United Nations-Statistical Commission’s Inter-Agency and Expert Group on the
Sustainable Development Goals’ indicators from 2015 to 2017, which developed
its global framework. Bersales has also written and co-authored numerous
publications on demography and economic growth

5th ANNUAL REPORT 2018

RPRH Report on the implementation of Republic Act No. 10354, otherwise known
as the Responsible Parenthood and Reproductive Health Act of 2012 (RPRH Law).
 The details of the 2018 program performance, as well as the challenges on the
five elements or key result areas of Reproductive Health (RH), are highlighted in
this Report.
 The Key Result Areas (KRAs) are
1) maternal, neonatal, child health and nutrition;
2) family planning;
3) adolescent sexuality and reproductive health;
4) sexually-transmitted infections and HIV and AIDS;
5) gender-based violence; and other related concerns in reproductive health and
rights.

EXECUTIVE SUMMARY
Policy and Governance

The unequivocal support of the Duterte Administration to reproductive health enabled

the swifter implementation of the RPRH law. This support was shown by:
• Including the strengthening of the implementation of the Responsible Parenthood
and Reproductive Law in this administration’s 10-Point Socio-Economic Agenda;
• Strengthening of the integration of population and development through
Executive Order No. 71 changing the name Commission on Population (POPCOM)
into the Commission of Population and Development (CPD); and
• Reverting POPCOM’s attachment from the Department of Health (DOH) to the
National Economic and Development Authority (NEDA) for policy and program
coordination.
The DOH also issued Administrative Order 2018-0014, “Strategic Framework and
Implementing Guidelines for FOURmula One Plus for Health (F1+).” It aligned health
initiatives into four (4) strategic pillars: Financing, Regulation, Service Delivery, and
Governance. It also added a cross cutting initiative for Performance Accountability.
The National Objectives for Health 2017-2022, a roadmap for the F1+ towards the
achievement of Universal Health Care, was formulated and issued. It specifies the
objectives, strategies and targets of DOH F1+ for Health. Important laws relevant to
the RPRH implementation were also passed during the 17th Congress. These are:
• The “Universal Health Care Act.” This law reorganizes the way health services
and commodities (including reproductive health) are financed, procured, delivered,
and accessed;
• The “Kalusugan at Nutrisyon ng Mag-Nanay Act” which scales up the national and
local health nutrition programs for pregnant and lactating women, adolescent girls,
infants, and young children in the first 1,000 days
• The “Philippine HIV and AIDS Policy Act” which strengthens the country’s policy
on HIV/AIDS prevention, treatment, care, and support. It also lowered the minimum
age requirement (from 18 to 15 years old) for the availment of HIV testing and
counseling without parental or guardian’s consent; and
• The “105-Day Expanded Maternity Leave Law” which increases the maternity
leave period to 105 days for all female workers; with an option to extend for an
additional 30 days without pay; and an additional 15 days for solo mothers.

The DOH has also issued several policies that specifically enables the implementation
of the RPRH law, but challenges remain. The passage of measures that will help
eliminate violence against women and children still needs to be lobbied. As in the
previous years, there is still a lack of overall strategic direction for the implementation
of RPRH. Specific activities and the corresponding agencies and units that should be
held accountable for the fulfillment of the RPRH goals and objectives should be clearly
stated in its proposed Strategic Plan. In terms of monitoring and evaluation, it is
imperative to review all the indicators used to get a clearer status of implementation
at the local level. This way, implementation issues can be determined, and the national
policies and specific supporting interventions could be accurately provided.

Budget and Financing

The indicative national government budget for RPRH increased by 10% from Php37.4
billion in 2017 to Php41.88 billion in 2018, based on adjusted allotments of concerned
government agencies. The DOH remains to be the main source of funds with its total
budget allocation of PhP41.35 billion in 2018, comprising 39% of RPRH’s total budget in
the 2018. This represents the following items: Family Health and Responsible
Parenting (FHRP), Expanded Program on Immunization (EPI), and Health Facilities
Enhancement Program (HFEP).

POPCOM allocated 60% of its Php516.88 million budget. This covered reproductive
health/family planning and adolescent health development/population and development
(POPDEV) integration, among others. The National Health Insurance Program
(PhilHealth) reimbursed a total of Php121.04 billion. Of this amount, 26% (Php31.12
billion) was paid for the government-sponsored members and at least 17% (Php21.41
billion) was paid for RPRH-related benefits. In 2018, there were 811 accredited
facilities with trained and certified FP providers which are mostly from Central
Visayas, NCR, and MIMAROPA regions.

The Local Government Units (LGUs) allocated around Php406.4 million for FP training,
FPrelated workshops, and procurement of FP commodities, among others. This FP
budget represents only1.04% of the total budget of LGUs. Various development
partners (Php2.11 billion) and CSOs (Php74.43 million) also allocated huge budgetary
support for the implementation of the RPRH Law.

Maternal, Newborn, Infant Health, and Nutrition

The DOH Field Health Service Information System (FHSIS) showed that maternal health
outcomes improved for the past five years, with a maternal mortality ratio (MMR) of
58/100,000 livebirths in 2018. However, the Maternal Mortality Estimation Inter-Agency
Groupi in 2015 demonstrated a maternal mortality ratio of 114 per 100,000 live births.
It would be difficult to assess status of maternal health outcomes using only the FHSIS
since MMR can only be accurately calculated from considerably large sample sizes.
Meanwhile, perinatal mortality rate increased over the years. In 2018, a total of 8,574
perinatal deaths were accounted for which translates to 5.06/1,000 live births. In
contrast, infant mortality rates declined from 8.15/1000 live births in 2016 to 7.48 in
2017 but showed a marginal increase for the current reporting year of 7.78/1,000 live
births. The biggest challenge the DOH faced in 2018 was the weak national
immunization coverage. Only 66% of children less than one year old were fully
immunized, a decrease of 9 percentage points from 2014.

Major interventions to improve Maternal, Neonatal, Child Health and Nutrition (MNCHN)
services include: • Provision of pre-pregnancy services and commodities which
includes iron and folate supplementation, counseling and provision of family planning
(FP) methods, and prevention and management of infection and lifestyle-related
diseases; Strengthening of antenatal care through development of new policies and
continued demand generation activities;
• Sustained training of health professionals for Basic Emergency Obstetric and
Newborn Care (BEmONC) and provision of safe delivery kits nationwide;
• Development of strategies to eliminate preventable causes of pregnancy-related
deaths exemplified by the Maternal Sepsis Elimination Campaign;
• Passage of the First 1000 Days Law;
• Capacity building of health staff in the Philippine Integrated Management of Acute
Malnutrition; and
• Communication and social mobilization through intensified and sustained community
awareness of the risk of measles and the benefits of vaccination through various
channels and local champions.

Improvements in maternal health outcomes were evident in this reporting year.

However, a number of mothers are still dying due to preventable causes of pregnancy-
related deaths. While quantitative measures of skilled birth attendance (SBA) and
facility-based delivery (FBD) show progress, antenatal and post-partum care lag
behind.

Challenges in the delivery of child health interventions particularly in the

implementation of the immunization program has been an immense problem in 2018.
This resulted to measles outbreaks and increase in measles-related mortalities for the
current reporting year. Recommendations on MNCHN include, but are not limited to:
• Evaluate BEmONC and Comprehensive Emergency Obstetric and Newborn Care
(CEmONC) implementation in the entire country and the barriers of Emergency
Obstetric and Newborn Care (EmONC) delivery;
• Align the 2008 MNCHN policy to the Sustainable Development Goals, Philippine
Development Plan, and the Universal Health Care Law;
• Address results of the maternal death surveillance and response;
• Intensify and sustain community awareness of the risk of measles and other
vaccinepreventable diseases and the benefits of vaccination through various channels
and local champions; and
• Identify and address effectively the barriers to breastfeeding, and the whole infant
and young child feeding.

Family Planning
In 2018, 7.4 million women of reproductive age (WRA) were provided with modern
family planning (MFP) methods in both public and private facilities and clinics. This is
equivalent to about 2.6 million unintended pregnancies prevented, 1.6 million probable
abortions avoided, and 1,410 maternal deaths averted. Based from the FHSIS, modern
Contraceptive Prevalence Rate (mCPR) increased from 53% to 57% in 2018. However,
this only represents service utilization in the public sector and does not reflect
performance of the private sector. The target mCPR under the Philippine Development
Plan (PDP) is 65% for married women of reproductive age (MWRA). The NDHS 2017
reports mCPR at 40% which covered both public and private sector performance.

A comparison of Executive Order 12 Zero Unmet Need for Modern Family Planning (EO
12) performance in 2017 and 2018 showed that in 2018, 1 3.9 million WRA were
reached and identified with unmet modern family planning (MFP). This figure already
exceeded the estimated number in 2017.2 Of the 3.9 million WRA reached, 1.2 million
(31%) women were served3 and newly accepted a modern family planning method in
2018 based on FHSIS data. However, while the number of WRA reached already
exceeded the estimated number of women with unmet need for MFP, there remains
2.3 million WRA who have not yet been served and remains to have unmet need for
modern family planning. This implies that 2.3 million WRA were not provided with MFP,
which translates to 835,000 unintended pregnancies that could have been avoided,
492,000 possible abortions prevented, and 440 maternal deaths that could have been
averted. The challenge of reducing the gaps in linking demand generation to service
delivery remains.

Key interventions that supported 2018 Family Planning program performance were:
• Demand generation activities that were able to reach 252,184 WRA identified with
Unmet Need for Modern Family Planning and where a total of 214,971 (85%) were
referred and served with MFP methods;
• Social marketing strategies that includes quad-media campaigns that were able to
reach 104,594,768 viewers nationwide;
• Service delivery to a total of 1.2 million WRA who were served and accepted a new
method: 54% from the regular public health facilities and 33% through post-partum FP
service, while 13% of WRA accepted MFP through the conduct of outreach FP
services.
In 2018, Php162,642,000.00 was spent to procure family planning commodities at the
national level. Based from the logistics monitoring reports, a total of 2,360 out of
2,450 (96%) facilities reported having no stock outs of FP commodities in 2018. A
number of challenges still needs to be addressed. This includes:
• Setting of the national goal, strategic directions and multi-year costing of the
National Program on Family Planning under a co-management arrangement between
the DOH and the POPCOM under NEDA;
• Resolving bottlenecks in the implementation of the collaborative framework of the
national program on Family Planning under the co-management arrangement between
the DOH and POPCOM at the national and regional levels
• Addressing the shift in the distribution mechanisms of FP commodities from direct to
service delivery point mode to regional distribution scheme.
• The need to review and revise the M&E RPRH Framework following the directional
plan of the national FP program;
• Unresolved bottlenecks in operations such as service delivery structure, in
particular, the implementation of the service delivery network; timely provision of
critical inputs to service delivery, namely family planning supplies and trained
workforce; and information, behavior change and communication; and
• Challenges related to DOH budget utilization and PhilHealth benefit utilization
Adolescent Sexual and Reproductive Health
A slight decline was observed in the following: adolescent fertility rate, the proportion
of women who have had a birth or are pregnant with the first child, the number of
babies born to adolescent parents, and the number of newly diagnosed HIV positive
cases among the 15-24-year age group.

The number of teens who began childbearing in 2018 remains high at 425,000. The
Philippines still has one of the highest adolescent fertility rates, ranking closely with
countries with the worst performance. Unmet need is still highest among the youngest
age group and the proportion of HIV positive cases among the 15-24 age group more
than doubled in the past ten years.

Major policies in 2018 include the issuance of the Department of Education (DepEd)
Guidelines on the Implementation of Comprehensive Sexuality Education, the
development of Adolescent Health and Development Program Directions 2018-2022,
and the signing of the ‘Philippine HIV and AIDS Policy Act’ expanding access of
adolescents to HIV services and the ‘Nutrisyon ng Mag-Nanay Act’. Training and
information dissemination activities related to Adolescent Sexual and Reproductive
Health/ Adolescent Health and Development Program (ASRH/AHDP) were also
continued in 2018.

There are still several measures that need to be done. Training of K-12 teachers in
schools need to be fast tracked to scale up the Comprehensive Sexual Education
(CSE) program. There is also a need to streamline structures and arrangements on
ASRH and Adolescent and Youth Health and Development (AYHD) to avoid duplication
of adolescent health-related initiatives and confusion in roles and responsibilities of
concerned agencies. The disaggregation of relevant health data by age and build on
adolescent database need to be pushed, too since it should guide the design of ASRH
service delivery, training, and IEC interventions. Adolescent-friendly health service
packages should be developed to address unique needs of adolescents and youth in
terms of correct information and access to RH services especially among 18-19 years
age group where pregnancy rate is the highest and compliance to parental consent is
not required by Law.

Sexually Transmitted Infections and HIV AIDS

The Philippines remains as a low HIV prevalence country. However, current estimates
show that the number of HIV cases in the country will triple in the next ten years—
from 80,000 in 2018 to 266,000 by 2028. In 2018 alone, there were 11,427 new HIV
confirmed positive individuals. From 13 cases per day in 2013, the number of daily
new diagnosed cases increased to 32 in 2018.

HIV infection among 15 to 24 years old doubled from 13% in 1999-2008 to 29% in 2009-
2018. More males (95%; 10,828) were diagnosed with HIV in 2018 compared to
females (5%; 599). The number of diagnosed women in 2018 was a two-fold increase
from the same period in 2013 (299).

HIV in the Philippines is primarily transmitted through sexual contact and this has not
changed since 1984. Currently 83% (49,078) of infections transmitted through sexual
contact were among males and transgender women who have sex with males
(M/TSM). More than half of all diagnosed HIV cases in 2018 came from three regions
alone, the National Capital Region (31%; 3,596), Region 4A (16%; 1,817), and Region 3
(11%: 1,230).

Deaths among people living with HIV (PLHIV) in 2018 were primarily in males (67%;
567), and mostly among the 25 to 34 years old age group. These reported deaths were
due to any cause, not necessarily due to their HIV status. The World Health
Organization (WHO) however, reports that among PLHIVs, the number one killer
remains to be tuberculosis (TB). In January to December 2018, 98% of the 36,838
PLHIV were screened for TB, up by 14% from 2016 DOH data. Among those screened,
14% (5,094) were positive for TB coinfection, subsequently referred for TB-Directly
Observed Treatment Short Course (TB-DOTS) facilities.

To reduce new HIV infections and improve health outcomes and wellness of PLHIV,4
National AIDS/STD Prevention and Control Program (NASPCP) adopted the 90-90-90
global target for HIV: 90% of all PLHIV should know their status, 90% of all PLHIV will
receive antiretroviral therapy (ART), 90% of all receiving ART are virally suppressed.
Tried and tested advocacy events such as International AIDS Candlelight Memorial
and World AIDS Day were conducted. New events were launched to encourage key
populations at risk for HIV to get tested early and seek treatment if they have HIV.
Through various training sessions, NASPCP ensured that the quality of health care
services was in accordance with the existing DOH policies and guidelines. To install
Social Hygiene Clinics, Primary HIV Care Facilities, and Sundown Clinics, the
Integrated Services for HIV Care (iSHC) was expanded in various locations, increasing
access to HIV testing and treatment. A demonstration project on HIV Pre-Exposure
Prophylaxis (PrEP) continued in 2018 with results expected in 2019.

There are still hurdles that are yet to be overcome to control the HIV/AIDS epidemic in
the country. There is still a low level of knowledge on HIV, especially on the mode of
transmission and ways of prevention, even among those who already engage in risky
sexual behavior. The use of condoms among those who engage in anal sex is only
50%. The implementation of a comprehensive sexuality education through DepEd is
recommended. The DOH may also reclassify condoms as an infection prevention
commodity, not as a family planning commodity to increase accessibility to minors.

Stigma and discrimination are ongoing challenges that need to be addressed because
they delay access to screening and testing. The DOH needs to test more at a faster
rate, given the increasing trend in diagnosed cases per day from 22 in 2015 to 32 in
2018. Currently, testing for HIV is limited to HIV-proficient medical technologists who
are authorized by the DOH to perform the tests. Provisions of RA 111665 on lowered
age of HIV testing coupled with the use of a Rapid HIV Diagnostic Algorithm may be
implemented soonest coupled with mobilization of non-medical technologists for a
step zero in HIV screening.

Access to ART is limited to 15 to 24-year-old PLHIV, with only 14% initiated on

treatment.6 Near stock-out and near expiration of anti-retroviral drugs were also
reported across regions. The limited availability of treatment for other HIV co-
infections remain a burden for many PLHIVs. It is recommended that time from
diagnosis to initiation of ART be routinely reported by age group. This will allow
program adjustments where necessary, more targeted messaging, and better logistics
management to avoid stock outs. Finally, out-of-pocket expenses of PLHIVs,
especially for management of co-infections, need to be measured as part of program
implementation and to inform enhancement of PhilHealth's HIV package.

Elimination of Violence Against Women and Children

The Philippines continues to narrow the gender gap between men and women in the
country. It ranked 8th among 149 countries in the 2018 Global Gender Gap reported by
the World Economic Forum. To date, the country has closed 80% of its overall gender
gap. Despite this, violence against women continues to be a serious problem in the
country.

Data from the Philippine National Police (PNP) Women and Children Protection Center
(WCPC) and DOH Violence Against Women and Children (VAWC) Registry System show
a declining trend in the reported cases of violence against women and children over
the past three years. PNP reported a 19.5% decrease in VAW cases from 2016 (32,073)
to 2017 (25,805); and another 26% decrease from 2017 to 2018 (18,947). A similar
decline in the trend of cases on violence against children (VAC) was reported by the
PNP over the last three years. There was a 9% reduction of cases from 2016 (28,686)
to 2017 (26,143) and a decrease of 21% (20, 728) in 2018.

The DOH VAWC Registry System also reports a substantial decreasing trend in
reported cases from the hospitals. A 50% decrease in the VAWC cases was noted from
2016 (3,167 cases) to 2017 (1,574 cases). This further went down by 49% in 2018 (800
cases). The decline may be due to unreported cases especially from far-flung and
isolated areas and less reporting compliance from participating hospitals.
Interventions to help eliminate violence against women and children in 2018 are as
follows:
• Statement of commitment of funding to operationalize Strategic Plan 2017-2022 by
issuing IACVAWC Resolution No.2, s. 2018;
• Issuance of the National Advocacy and Communication Plan 2017-2022 and conduct
of specified activities; • Issuance of DILG Memo Circular 2018-144 for the retention/re-
appointment of current VAW desk persons in the barangays;
• Conduct of training on the 4Rs (recognizing, recording, reporting, referring) of 9,311
public providers and 6,273 private providers in 1,270 LGUs;
• Establishment of women and children protection program in 577 LGUs with a
dedicated coordinator and a trained provider;
• Training of 7,646 PNP officers on Women and Children Protection;
• Establishment of VAW desk in 37,723 barangays;
• Assistance provided to VAWC victims by the Department of Social Work and
Development (DSWD), DOH-Women and Children Protection Unit (DOH-WCPU), and the
National Bureau of Investigation (NBI).

Several measures need to be done to effectively reduce VAWC. Since there is no

common recording and reporting of cases, there is a need to unify the registry of
cases. Accurate data is important in determining the need for appropriate service
providers, in the establishment and enhancement of facilities, and drafting/revision of
policies for the program. It is imperative that the concerned agencies work together
to marry their systems.

Other recommendations are as follows:

• Review of existing protocols and guidelines and standardize services across the
country;
• Conduct of inventory of all available services that should be disseminated as
reference for referrals. It will also serve as basis for establishment of additional
facilities;
• Establishment of VAW desk in remaining barangays and ensure their functionality
and the re-appointment or retainment of current VAW desk officers;
• Harmonization of capacity building activities for service providers;
• Advocacy of policies and legislations that reduces/eliminates discrimination of
women;
• Ensuring the provision of a comprehensive package of services for VAW victims
(psychosocial care & evaluation; rescue & protection; legal assistance; reintegration);
and
• Facilitation of quick resolution of VAWC cases.