When the Young’s Problem is an Old Problem: Problem Dimensions and Policy Options to Curb Adolescent Pregnancy in the Philippines

Adolescent pregnancy is a longstanding and multi-dimensional problem engendering negative socioeconomic and humanitarian impacts in the Philippines. In 2020, 10.3 percent of live births in the country were by mothers aged 19 and below, rising from 7.13 percent in 2000. Most alarmingly, in 2020, the PSA recorded that girls aged 14 and below accounted for 2,113 live births in the country, marking an 11.0 percent increase from the 1,903 cases reported in 2016.

Despite continuing government efforts, the problem of adolescent pregnancy is threatening the country’s demographic window of opportunity, as well as the well-being and rights-enjoyment of adolescents and their babies.

Given this, this study presents multiple dimensions of analyses of adolescent pregnancy and accompanying healthcare reforms in the Philippines. It also highlights the contrast between the promise of decentralized healthcare and on-ground health outcomes for complex issues such as adolescent pregnancy. It discusses the economic and humanitarian impacts of adolescent pregnancy in the Philippines and the complexity of social policy design therein. Policy options as an alternative are presented, considering four problem dimensions (substantive, behavioral, operational, and political) vis-à-vis the rules of the game: incomplete information, information asymmetry, high transaction costs, and low credible commitment.

The decentralized nature of public healthcare in the Philippines mandates that local governments to deliver healthcare services, despite inadequate capacities at the local government level. However, the previous government approach to adolescent pregnancy has been top-heavy. Furthermore, the stigma surrounding reproductive health makes data gathering and implementation of policy interventions difficult. In response to these challenges, the Philippines has moved towards capacitating local government units to deliver services that comply with national standards, and to collaborate with national government agencies and civil society organizations. Two new policies are relevant in pursuing this strategy: (1) the 2019 Universal Health Care (UHC) Law, which enhances the decision-making power of local governments over healthcare service delivery, and (2) the Mandanas-Garcia Ruling, rolled out in 2022, which provides more financial autonomy to local governments over healthcare.

This case covers a number of policy areas such as (1) reproductive health, (2) universal healthcare, (3) gender equality, (4) administrative decentralization, (5) fiscal decentralization, (6) local governance, (7) a whole-of-society approach, (8) policy implementation, (9) program delivery, and (10) policy evaluation.