Margarita Romina Barrion, also known as Maita, is a registered nurse currently working at the City Health Office (CHO) in Naga City, Philippines. Maita handles the safe motherhood and newborn hearing screening program, which includes family planning. She has worked in government for almost six years. Before The Challenge Initiative (TCI) engaged Naga City in November 2021, she found her work uninspiring. She accomplished the tasks assigned to her as the Safe Motherhood Program Coordinator and the CHO Family Planning point person, but she was unable to see how those tasks contributed to any bigger health goals. She recalls:

We were all randomly doing and implementing our program assignments. We have limited capacities and understanding, groping from thin air of what must be done every day. We work in silos. The City Health Office staff knew that teenage pregnancy is a looming problem. Personally, I have had doubts of whether we are on the right direction. I lacked confidence where to start. We did some advocacies regarding teenage pregnancy prevention from school to school and have lessened our bias towards teenage mothers, but I feel that it was not enough. We have to do more.”

Once Maita was invited to become a member of the City Leadership Team (CLT) for its adolescent and youth sexual and reproductive health (AYSRH) program in partnership with TCI, POPCOM and the Department of Health, everything changed. Maita began to receive leadership and governance training alongside fellow CLT members, who are representatives from various offices tasked to work together towards establishing Naga as an adolescent and youth-friendly city. To ensure sustainable impact, TCI recommends that a committee or working group, like the CLT, coordinate and collaborate to address the underlying challenges that lead to high rates of teenage pregnancy in Naga. The CLT works to operationalize the city mayor’s vision to reduce teenage pregnancies and become an adolescent and youth-friendly city. Maita shares what it has meant to her to be part of TCI and the CLT:

I came to see the real situation and why teenage pregnancy is considered a national social concern in our country. I am very grateful to know TCI and its high-impact approaches, which we have adopted in Naga City. This time, I have teammates that revived my enthusiasm in my work and inspired me to keep going and achieve our common goals in our respective line of duties. We became bridging leaders, fully cognizant of the community’s problems especially related to health inequities and looking at health as a system. The process we underwent in the past few months was very organized as we prepared the AYSRH Program Design for Naga City.”

TCI’s Program Design Workshops effectively guided Maita and the CLT in preparing a more responsive adolescent-friendly program. Maita saw the importance of each stakeholder’s role in the development, implementation and monitoring of AYSRH in the city:

The program design helped us to identify the gaps of the city and select which high-impact approaches would be most effective in addressing those gaps.”

Maita shared her appreciation for the tools and approaches readily available at the TCI University, which will help her implement TCI’s high-impact interventions.

We will maintain what we have started as a leadership team. What is important now is the recognition that we cannot do this alone. Good teamwork will always produce the best results. With strong hope and desire, I can say, it’s not just a mandate of our office to deliver the health services to all Naguenos. We will do our work with passion because we are all inspired in the team to make a change in our city, making it an adolescent and youth-friendly city.”

Naga City ‘s Leadership Team has contributed 2.5 million pesos (about $48,000 USD) to implement the high-impact interventions. To support leaders and city implementers who will develop, implement and champion local strategies, policies and programs for AYSRH, the city adapted TCI’s Leadership for Adolescent and Youth-Friendly City and Meaningful Youth Engagement interventions. The reluctance of adolescents to access family planning services from health facilities will be addressed by strengthening and adopting the adolescent and youth-friendly health services and post-partum family planning interventions. The city will also implement comprehensive sexuality education through the Department of Education, while the CLT implements intergenerational dialogues and engages parents to ensure community support.