Labro, M. N. L. (2018). Multisectoral collaboration: Raising awareness towards the reduction of teenage pregnancy in Balangkayan, Eastern Samar (Unpublished master's thesis). Graduate School of Public and Development Management, Development Academy of the Philippines.

Graduate School of Public and Development Management Health Systems and Development Batch 1 - Regular Thesis (MPM-HSD)--Development Academy of the Philippines.

Background: In common with most municipalities in the Philippines, teenage pregnancy is a persistent problem in the Municipality of Balangkayan, Eastern Samar. From 2012 to 2017, the Teenage Pregnancy Rate in the municipality ranged from 13.61% to 23.97%. These figures are much higher than the national target of less than 4%. Interventions have already been developed on a national scale yet them seem ineffective. This study was conducted in a local setting and was aimed to know and understand the current status of implementation of the Adolescent Health and Development Program in the Municipality of Balangkayan, Eastern Samar, to find out what are the factors the contribute to the high number of teenage pregnancy in the locality, and let the different sectors in the community come up with strategies and interventions for its reduction through collaboration. Methods: The project used descriptive, participatory, conclusive research methods. Documentary analysis through records review of FHSIS reports of the RHU and BHSs, and BHW reports through the NDPs were done. A Program Implementation Review of the AHDP program was conducted and existing policies and laws: national, provincial, and local were reviewed. Surveys through questionnaires based on WHO's Illustrative Questionnaire for Interview-Surveys with Young People (Cleland, 2001) were conducted with the following subjects: teenagers who gave birth from 2014- 2016 and the Grades 9 and 10 students of Balangkayan National High School. Interviews with subject matter experts: PHO AHDP Coordinator and City Population Officer were done. Meetings, discussion, and FGD were conducted with barangay leadrs, parent leaders, and teachers. Stakeholders were convened through meetings and forum. Results: The study yielded the following major results: the Adolescent Health and Development Program in the Municipality was not institutionalized, the teenage mothers didn't do anything to avoid pregnancy, the teenage mothers and their families were financially disadvantaged, most of the teenage mothers graduated from high school, a little more than half of them were not in school when they got first pregnant while the rest were in school, 32.1% were co-habiting with their partner prior to pregnancy, and 91% were with partners at the time of the survey. The study also showed that the major source of information on reproduction health was the school while the source preference of such information for the teenage mothers was the health worker and school teacher for the students. Sex-related matters were almost never discussed with parents. Most of the students didn't know or were not sure about facts on pregnancy and HIV and only 36% knew about contraceptive methods, 45.1% were in a boy/girlfriend relationship, 8.3% of whom had sexual intercourse, and 5.9% said they were forced to have sexual intercourse. Parenting issues and family dynamics were stressed by the teenage mothers, parents, teachers, and other stakeholders as a significant factor contributing to teenage pregnancy. Cellphone user emerged as a risk contributor. Strategies and activities for teenage pregnancy prevention and reduction were identified by the different sectors in the community. Conclusions: The non-institutionalization of the AHDP in the Municipality of Balangkayan makes its implementation weak. The fragmented status of its implementation from the national to the local level makes the transfer of responsibility and accountability challenging. The APP further concludes that the teenage pregnancy phenomenon in the Municipality of Balangkayan is not only a health issue but a social issue. Factors that were strongly associated with teenage pregnancy were poverty, poor knowledge on sexual and reproductive health and contraception, early co-habitation with partner, and poor parenting. Being out of school may be a contributing factor to teenage pregnancy but being in school is not a significant protective or hindering factor. Advancement in communication technology and sexual abuse are potential risk factors. The APP also concludes that collaborative effort by all sectors in the community will have a strong impact on teenage pregnancy reduction. Recommendations: It is recommended that the AHDP in the Municipality of Balangkayan, E. Samar be institutionalize through creation of local policies that will establish accountability, budgetary assurance, and sustainability. The DOH should make a comprehensive review of the program and make policy recommendations that are realistic and applicable at the grassroots level. Strengthening of sexual and reproductive health awareness and education campaign at home, in schools, and the community in a more proactive manner must be done by the health workers, teachers and other local agencies concerned. The SK should be actively involved. Parenting effectiveness learning activities and tools must be enhanced. Values formation activities and spiritual advocacy should be regularly conducted in schools and the community. It is further recommended that the collaboration of the stakeholders be institutionalized and sustained through local legislation, establish a functional stakeholders' network, and develop a comprehensive Multisectoral Plan for Teenage Pregnancy and ASRH which will be integrated into the Municipal Development Plan.