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Evaluation of the Sixth UNFPA Country Programme to the Philippines 2005-2010

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Evaluation of the Sixth UNFPA Country Programme to the Philippines 2005-2010 Prepared for: UNFPA Country Office, Manila, the Philippines Prepared by: Dr Godfrey JA Walker M.D. - Team Leader Dr. Magdalena C. Cabaraban, Ph.D. - Mindanao/ARMM Consultant Dr. Ernesto M Pernia, Ph.D. - PDS Consultant Dr. Pilar Ramos-Jimenez, Ph.D. - Gender and RH Consultant November 2010 Evaluation of the UNFPA Sixth Country Programme, Philippines 2005-2010 Table of Contents Page Map of the Philippines iv Acronyms v Executive Summary vii Background and Situation Analysis vii Evaluation Purpose, Audience and Methodology vii Main Conclusions vii Sustainability x Relevance x Impact – Effectiveness xi Factors Facilitating CP Success xi Efficiency xii Main Recommendations for the 2012-2016 Country Programme xii 1. UNFPA and Evaluation 1 2 Scope and Objectives of the Evaluation of the Sixth UNFPA Philippines Country Programme 1 3 Methods Used in the Evaluation 2 4 Country Background and Context 3 5 The Sixth UNFPA Philippines Country Programme 5 6 Review of Implementation of the PDS Component of the Country Programme 9 7 Review of Implementation of the RH Component of the Country Programme 21 7.1 Maternal Health 23 7.2 Family Planning 40 7.3 Adolescent Reproductive Health 47 7.4 HIV and AIDS 55 7.5 UNFPA’s Humanitarian Response Strategy for RH and SGBV 62 8 Review of Implementation of the Gender & Culture Component of the Country Programme 64 9 Review of Implementation of the Sixth Country Programme in Mindanao 75 10 UNFPA and Implementation of UNDAF, Joint UN Programmes and South to South Co-operation 89 11 Monitoring Implementation of the CP and Assessment of Overall Achievement ii Evaluation of the UNFPA Sixth Country Programme, Philippines 2005-2010 of the Targets Set in the CPD and CPAP 2005-2009 93 12 Management of the Country Programme: Complementarity, Coordination and Integration of RH, PDS, Gender and Culture. Humanitarian Response Programme Implementation. Additional Resources Mobilized 99 13 Sustainability 102 14 Conclusions 103 15 Recommendations and Possible Strategies for the Next Programme Cycle 2012-2016 111 Appendices 1. Tables from PDS section 2. Evaluation ToRs including the evaluation matrix 3. The evaluation team 4. People seen 5. Places visited 6. Documents consulted: a) Programme documents; b) Gender and Culture Documents c) Journal articles 7. Summary of Key Activities by Component and Project Supported under Implementation of Sixth UNFPA Philippines Country Programme 8. a UNFPA Sixth Country Programme Budget by Component b UNFPA Sixth Country Programme Expenditure by Activity (2005-June 2010) 9. List of Studies and Publications supported by UNFPA 6th CP iii Evaluation of the UNFPA Sixth Country Programme, Philippines 2005-2010 Map 1: The Philippines iv Evaluation of the UNFPA Sixth Country Programme, Philippines 2005-2010 Acronyms 3RG Reproductive Rights Resource Group AECID Agencia Española de Cooperación Internacional para el Desarrollo ARH Adolescent Reproductive Health ARMM Autonomous Region of Muslim Mindanao AUSAID Australian Agency for International Development BCIC Bohol Crisis Intervention Centre CCA Common Country Analysis CEDAW Convention on the Elimination of All Forms of Discrimination against Women CERF Central Emergency Response Fund CHD Centre for Health Development CO Country Office CP Country Programme CPAP Country Program Action Plan CPD Country Program Document CPR Contraceptive Prevalence Rate CSR Contraceptive Self-Reliance DILG Department of Interior and Local Government DKT International NGO promoting family planning DMPA Depot Medroxyprogestrone Acetate DOH Department of Health DOJ Department of Justice DSWD Department of Social Welfare EC European Commission FPS Family Planning Survey GAD Gender and Development GBV Gender-based violence HAPPI Harmonized Approaches for Population and Poverty Integration HAPPIER Harmonizing Approaches in Population Management, Poverty Reduction, Integrating Environmental Resources HAPPIEST Harmonizing Approaches in Population Management, Poverty Reduction, Environmental Sustainability and Innovations in Science and Technology HB 3773 Responsible Parenthood and Population Management Act Of 2005 HB 5043 Reproductive Health and Population Development Act of 2008 IACAT-VAWC Inter-Agency Committees on Anti-Trafficking and Violence against ICPD International Conference on Population and Development IEC Information Educational and Communication Materials JICA Japan International Cooperation Agency LGU Local Government Unit v Evaluation of the UNFPA Sixth Country Programme, Philippines 2005-2010 LMIS Logistics Management Information System MDG Millennium Development Goals MNCHN Maternal Newborn Child Health and Nutrition MOVE Men Oppose to Violence against Women Everywhere MRL Muslim Religious Leaders MTPDP Medium Term Philippine Development Plan NDHS National Demographic and Health Survey NEDA National Economic and Development Authority NFP Natural Family Planning NGA National Government Agency NGO Non-government Organization PCW Philippine Commission for Women PDS Population Development and Strategies PhilHealth Philippine Health Insurance Corporation PIPH Province-wide Investment Plan for Health PNP Philippine National Police POPCOM Commission on Population POPDEV Population and Development PPMP SOP Philippine Population Management Program Strategic Operational Plan RBM Results-Based Management RDP Regional Development Plan RH Reproductive Health RHU Rural Health Unit RP Responsible Parenthood RRF Results and Resource Framework RR Reproductive Rights STI/HIV Sexually Transmitted Infection/Human Immunodeficiency Virus TCPR Triennial Comprehensive Policy Review TFR Total Fertility Rate UNCT United Nations Coordination Team UNDAF United Nations Development Assistance Framework UNDG United Nations Development Group UNEG United Nations Evaluation Group UNFPA SPO UNFPA Southern Philippine Office UNICEF United Nations Children’s Fund USAID United States Agency for International Development VAW Violence against women (VAW) Women and Children (provincial crisis intervention centre (the PCIC) vi Evaluation of the UNFPA Sixth Country Programme, Philippines 2005-2010 Executive Summary Background and Situational Analysis In the Philippines, over the last 40 years or so, concerns about the population issue and, more recently, reproductive health have received varying levels of attention depending on the specific Government at the time and opposition from the Catholic Church hierarchy and other influential groups in the country. In 1970, the National Population Program was launched following the creation in 1969 of the Commission on Population (POPCOM). The programme’s principal thrust was the reduction of fertility and its core strategy was the provision of family planning (FP) services using a clinic-based and contraceptive-oriented approach. The population of the country in 2007 was recorded at 88.6 million. While there has been a steady decline in the total fertility rate from 6.0 children per woman in 1970 to 3.3 children per woman in 2006, absolute increases in population have been substantial (from 27.0 million in 1960), impacting adversely on the achievement of Millennium Development Goals (MDGs). Demand for contraception is high even among the poor but access is inadequate and, hence, unmet need remains substantial. Since 1969 UNFPA has provided assistance to the Philippines. Initially this focused on family planning, population education, and advocacy for population and development. From 1995 there was a major paradigm shift from family planning to reproductive health. The Sixth Country Programme (CP) covering 2005 to 2009 (and extended to 2011) has two major concentrations – one at a central level focusing on policy issues and the second at field level supporting efforts principally to improve the reproductive health situation in three municipalities in each of 10 provinces. The overall intention of the CP was “to improve the reproductive health (RH) status of the Filipino people through better population management and sustainable human development”. The efforts at a provincial level were intended to demonstrate successful arrangements for the implementation of RH care which would be appropriate for more widespread replication throughout the programme and in non-programme provinces. Evaluation Purpose, Audience and Methodology This is an end-of-programme evaluation and aims to provide information principally for key stakeholders, particularly the Country Office, including the UNFPA Regional programme managers, regarding the design, strategies and operations likely to improve the performance of the Seventh CP in the Philippines. The evaluation team made considerable efforts to gather relevant information including: review of a large number of programme reports and other documents; extensive field visits to programme sites; discussions with a wide range of partners, beneficiaries and other stakeholders involved and associated with the programme; limited focus group discussions with stakeholders; and review of the 2006 baseline and the 2010 end line surveys. Main Conclusions UNFPA has been successful in implementing the Sixth Country Programme. This is vii Evaluation of the UNFPA Sixth Country Programme, Philippines 2005-2010 impressive because it happened despite the ambivalent and often unfavourable policy environment in the country with respect to population policy and reproductive health. In addition, the UNFPA CP has had relatively limited resources available. Partly due
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