Philippine Population Management Program PPMP Monitoring and Evaluation

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Philippine Population Management Program (PPMP)
Monitoring and Evaluation

• Alejandro N. Herrin and Aniceto C. Orbeta, Jr.
• August 28, 2003

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Outline

• Monitoring and evaluation framework
• Some findings
• Information gaps
• Future directions

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Framework for PPMP Monitoring and Evaluation
Outputs (services, capacity- building, advocacy, o
rganizational support) Basic inputs
Objective Strategy
Utilization (intermediate outcomes
Outcomes (achievement of policy objectives)
Other factors
Other factors
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Responsible Parenthood and Family Planning (RP/FP)
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Outputs
PPMP Expenditures by Use, 1998 and 2000
Source Racelis and Herrin (2003)
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Outputs
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Outputs
Sources of supply of modern methods
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Utilization
Sources NDS 1968 to 1993 and NDHS 1998
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Fertility and CPR, Selected Countries 2002
Utilization
Source UNESCAP (2003)
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Utilization
Fertility and contraceptive use 1998 NDHS
TFRtotal fertility rate ASFR (15-19)
age-specific fertility rate among women 15-19
years old.
Source Gwatkin, et al. (2000)
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Utilization
Percent of Currently Married Women by Method,
Poor and Non-Poor, 2000 and 2002
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Utilization
Percentage of currently married women with unmet
need for family planning
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Outcomes
Sources NDS 1968 to 1993 and NDHS 1998
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Outcomes
Fertility and contraceptive use 1998 NDHS
Source Gwatkin, et al. (2000)
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Outcomes
Total and Wanted Fertility Rates, 1993 and 1998
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Outcomes
Percent of Married Women Who Want No More
Children
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Summary Family planning

• Outcomes Slow fertility decline, high unwanted
  fertility among the poor
• Utilization Low contraceptive use of modern
  methods. More likely due to lack of access to
  high quality and preferred methods than lack of
  demand, especially among the poor.
• Outputs Lack of consistency in policy to reduce
  fertility and promote FP, especially with the
  promotion of modern and effective artificial
  methods, which affect total effort as reflected
  in government allocation of resources to
  contraceptive supplies. Households finance close
  to half of total expenditures for direct FP
  services.

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Reproductive Health /Family Planning (RH/FP)
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10 elements of reproductive health (DOH AO 1-A,
January 15, 1998)
Outputs

• Family planning
• Maternal and child health and nutrition
• Prevention and management of abortion
  complications
• Prevention and treatment of reproductive tract
  infections including STDs and HIV/AIDS
• Breast and reproductive tract cancers and other
  gynecological conditions
• Adolescent reproductive health
• Education and counseling on sexuality and sexual
  health
• Mens reproductive health
• Violence against women and children
• Prevention and treatment of infertility and
  sexual disorders

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Outputs
PPMP Expenditures by Use, 1998 and 2000
Source Racelis and Herrin (2003)
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Outputs
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Utilization
Prenatal care, 1999-2002
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Utilization
Pre-natal care visits () 1998 NDHS
Source Gwatkin, et al. (2000)
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Utilization
Percent of children 0-59 months by type of
delivery attendant
Percentage for Others not shown.
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Utilization
Delivery attendance () 1998 NDHS
Source Gwatkin, et al. (2000)
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Utilization
Postnatal care, 1999-2002
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Outcomes
High risk fertility behavior, 1993 and 1998
Risk defined in terms of early (lt18) and late
(gt34) childbearing, short birth intervals (lt24
months), and high birth order (gt3)
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Outcomes
Sources Flieger 1982 Flieger and Cabigon 1984
NSCB 1992 UNESCAP 2002
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Outcomes
Philippines
Thailand
South Korea
Sources Flieger 1982 Flieger and Cabigon 1984
NSCB 1992 UNESCAP 2002
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Outcomes
Infant and child mortality by income class 1998
NDHS
Source Gwatkin, et al. (2000)
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Maternal mortality ratio estimates
Outcomes

• Estimates for other countries for 1990-98
• South Korea 20
• Malaysia 39
• China 65
• Thailand 44
• Singapore 6
• Indonesia 450
• Philippines 170
• Source World Bank (2001)

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Summary Reproductive health

• Outcomes slow decline in infant and child
  mortality high infant and child mortality among
  the poor high maternal mortality high risk
  births little information on other aspects of
  RH.
• Utilization Low utilization of MCH services
  provided by trained medical providers among the
  poor. Subsidized public sector services captured
  by the better off.
• Outputs Traditional services in place but public
  delivery now the main responsibility of LGUs
  probably not highly efficient nor of high
  quality. Households finance close to half of
  direct RH expenditures.

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Adolescent Health and Youth Development (AHYD)
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Outputs
PPMP Expenditures by Use, 1998 and 2000
Source Racelis and Herrin (2003)
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Outputs
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Outcomes
Age-specific birth rates (per 1,000 women)
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Outcomes
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Outcomes
Fertility and contraceptive use 1998 NDHS
Source Gwatkin, et al. (2000)
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Outcomes
Teenagers who have begun childbearing, 1993 and
1998
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Summary Adolescent health and youth development

• Outcomes Early childbearing and high fertility,
  especially among the poor.
• Utilization Lack of information on services and
  their utilization.
• Outputs Very little expenditures on AHYD.
  Current expenditures mainly coming from NGOs,
  suggesting that there is little public sector
  programs for AHYD.

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Population and Development Integration (POPDEV)
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Outputs
PPMP Expenditures by Use, 1998 and 2000
Source Racelis and Herrin (2003)
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Outputs
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Summary POPDEV

• Outcomes Not much expected if little activities
  are in place.
• Utilization Not much expected if little
  activities are in place.
• Outputs Not much activities during the period
  covered 1998 to 2000 as reflected in the small
  expenditures for the POPDEV program.

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Information gaps

• Reasonably updated data on FP use, source of
  supplies of modern methods, and fertility, but
  not so with infant, child and maternal mortality,
  and outcomes data on youth.
• Very limited utilization (intermediate outcomes)
  and outcomes data on the other components of RH.
• Limited disaggregation of utilization and
  outcomes indicators by major social groups, e.g.,
  poor vs. non-poor.
• Limited disaggregation of expenditure data by
  major public/private and modern/traditional
  providers of RH/FP services.
• Limited indicators of utilization and outcomes
  for AHYD and POPDEV.

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Future directions

• Greater effort at systematic development and
  application of POPDEV tools (data and analysis
  of interrelationships) to inform policy at both
  national and LGU levels.
• Monitoring of population welfare through a
  rights-based, gender and life cycle approach to
  ensure that gains in one stage of the life cycle
  are not lost in the next, or that disadvantages
  in one stage are adequately compensated in the
  subsequent stages.