Sustaining Access to Critical Health Services in the Philippines

USAID ReachHealth was a six-year (December 2018–September 2024) activity, implemented by RTI that aimed to strengthen and improve access to critical health services for Filipino families. It focused on enhancing access to family planning (FP) and decreasing teen pregnancy and newborn morbidity and mortality, particularly for disadvantaged women, adolescents, and underserved communities.  

USAID ReachHealth integrated gender equality and inclusive development across all its activities, including inclusive messaging to prevent gender-based violence, and discrimination among LGBTQI+ communities. USAID ReachHealth built upon the success of previous USAID investments in the Philippines. In addition to its FP-related activities, from April 2020 through September 2023, USAID ReachHealth expanded its focus to address the COVID-19 pandemic by accelerating the widespread and equitable access to and delivery of COVID-19 vaccinations.  

USAID ReachHealth’s Core Activities  

• Increase access to comprehensive services and strengthen the capacity of healthcare workers to deliver evidence-based quality care.
• Strengthen health systems and functionality across governance, budgeting and finance, human resources, supply chain, and data.
• Improve individual, household and community knowledge of family planning and maternal and neonatal health (FP/MNH).
• Increase demand for FP/MNH services, transforming gender norms and promoting gender equality
• Implement messaging and interventions to prevent gender-based violence (GBV) and discrimination against LGBTQI+ communities. 
• Strengthen FP availability and commodity security.
• Assist the government's response to the COVID-19 pandemic.  

Increasing healthy behaviors among underserved populations in the Philippines

In partnership with the Department of Health (DOH), Commission on Population and Development, local government units, and other stakeholders, USAID ReachHealth used a comprehensive, gender sensitive, and inclusive development strategy to promote healthy behaviors among marginalized groups. The project focused on enhancing and scaling up quality, client-centered, and respectful FP and MNH care and services in areas with low access while also strengthening capacities and systems at the national, regional, and local levels to manage, implement, and sustain FP/MNH programs and policies.  

To promote sexual and reproductive health and to encourage FP use, USAID ReachHealth shared information through traditional and online media, engaged with underserved populations via social media, and supported local health workers in hosting discussions on the importance of FP. These efforts were designed to be inclusive and to address gender-specific needs and barriers.

Key Outputs and Impact  

• Usap Tayo sa Family Planning [“Let’s Talk About Family Planning”]: Reached over 57 million people through a multi-channel family planning campaign for Filipino couples with at least one child. Messages were shared over social media platforms like Facebook, traditional media such as TV and radio, a custom website, and in-person activities at related events.  
• I CHOOSE #MalayaAkongMaging campaign: Launched a gender-sensitive and inclusive campaign for Filipino teens focusing on adolescent health and development. The campaign reached over 65 million Facebook views, including 20 million teenagers, promoting inclusive messages that addressed the unique needs of all adolescents, including those from LGBTQI+ communities.  
• Enhanced Usapan: Built on a previously developed USAID activity, Enhanced Usapan (meaning Discussion) integrated FP service delivery with social behavior change materials to ensure effective and inclusive dialogue between providers and clients, fostering a more comprehensive approach to family planning discussions.
• It’s OK to Delay: Created for young adults who plan to have children in the future, this campaign positions family planning as a way for young people to achieve personal and relationship goals.  
• Konektado Tayo [“Let’s Connect!”] Campaign: In partnership with the Commission on Population and Development and DOH, USAID ReachHealth launched a social media platform for parents, teachers, and guardians of teenagers to promote adolescent reproductive health by empowering trusted adults and equipping them with the knowledge and skills to discuss “sensitive” topics such as love, sex, and relationships.  
• Family Planning in the Workplace Program: In collaboration with the Department of Labor and Employment (DOLE), the Commission on Population and Development (CPD), and the DOH, this program connects private companies with accredited providers to offer essential family planning services onsite, with costs covered through PhilHealth (Philippine Health Insurance Corporation).  In General Santos City, 400,000 workers have already benefited from this program, which is helping reduce absenteeism and empowered employees, especially women, to manage their health effectively. The program is also active in Boho. 

Improved family planning service delivery and quality of care in the Philippines

USAID ReachHealth developed and implemented a broad array of training, job aids, and tools to improve access to and quality of FP/MNH care throughout the project regions. The project trained healthcare service providers on FP-related skills and services, supported quality improvement initiatives in health facilities, and created mechanisms for expanding FP provision beyond health facilities. In addition to general improvements to FP/MNH care, the project focused particularly on improving adolescent sexual and reproductive health.

Key Outputs and Impact  

In partnership with national and local government agencies and local government units, USAID ReachHealth achieved the following:  

• Health Worker Training: trained 2,957 health workers in FP services, significantly contributing to improved quality and availability of FP services.  This included 1,626 health workers who completed the Basic Course in FP through a Blended Learning Program developed in collaboration with the DOH.  This approach combines online modules and in-person training to equip health workers with essential FP service provision skills. Trained participants expanded FP outreach in their respective cities/provinces, conducting 407 FP outreach activities that reached 12,602 people, particularly in hard-to-reach areas.
• FP Training Institutions: Supported 13 hospitals and 1 community service organization to obtain official recognition from the DOH as FP training institutions. This contributed to the sustainability of FP training systems and services, increasing access to FP and adolescent reproductive health (ARH) training for health professionals.  
• Adolescent-Friendly Facilities: Assisted 281 health facilities to become functional adolescent-friendly health facilities, contributing to an enabling environment for adolescents to seek reliable information and services.
• Comprehensive Sexuality Education and Adolescent Reproductive Health (ARH) Convergence: Supported Philippine health and education agencies to implement the Comprehensive Sexuality Education and Adolescent Reproductive Health (CSE-ARH) Convergence at 122 schools and 119 health facilities, fostering a more integrated approach to adolescent health education and services.
• Logistics and Supply Monitoring: Worked with the DOH to improve logistics and supply monitoring systems across project sites, ensuring availability of FP commodities. This included support to the roll out the USAID supported-DOH electronic Logistics Management Information System (eLMIS). 

Strengthening health policies and systems in the Philippines

A robust FP/MNH service delivery network requires the underpinning of a comprehensive, resilient system of policies and programs. To this end, USAID ReachHealth supported DOH and PhilHealth in developing and implementing policies specific to FP/MNH as well as the general policies related to Universal Health Care (UHC) and to insurance reimbursements. In addition, the project worked to reduce the number of and mitigate the effects of stockouts for crucial FP supplies.

Key Outputs and Impact

• Local Health Planning: Assisted local government units (LGUs) translate national priorities into local plans such as the Local Investment Plans for Health and Annual Operation Plans in 32 U.S. Government-supported sites, and Disaster Risk Reduction and Management Plan for Health in 14 LGUs. This enabled LGUs to efficiently and effectively achieve their health reform objectives.
• Support for UHC Law Implementation: Provided crucial support to the implementation of the UHC Law, which was signed in March 2019. USAID ReachHealth aided in developing Local Health Investment Plans (LIPH) and Annual Operating Plans (AOPs) across 32 provinces and cities, including developing Devolution Transition Plans (DRPs) for Health and the formation of Provider Networks.
• UHC Integration Sites: As a partner to 15 UHC Integration sites, the Project supported local health systems integration through policy development, capacity-building for local governance boards, technical guidance on fund pooling mechanisms, and collaboration with public and private health care facilities to create strategically aligned networks.  
• Social Health Insurance Policies: Supported the development of 18 key Social Health Insurance Policies contributing to an estimated Php 42B (USD720M) increase in social insurance payments for 2024. These policies also expanded primary care capitation to include family planning counseling, and set quality standards for adolescent care, maternal and child nutrition, comprehensive breast cancer screening, and family planning.
• Facility Accreditation: In coordination with LGUs, facilitated the accreditation of public health facilities to the National Health Insurance Program. By 2024, 282 rural health units and 202 public hospitals were accredited as primary care and family planning providers. As of April 2024, USAID supported sites accessed almost USD 2M in social insurance payments for primary care services.

Reduced gender-based violence (GBV) and increased gender equality in the Philippines

In the Philippines, 1 in 20 women and girls aged 15-49 have experienced sexual violence. COVID-19 lockdowns and quarantines exacerbated this issue, leading to — an unprecedented increase in GBV due to extended periods of restricted movement and home confinement.

Key Outputs and impact:

• Training Health Providers: USAID ReachHealth trained 2,918 health service providers to reinforce gender equality and women’s empowerment, through gender sensitivity training and by equipping them to respond to GBV effectively.  
• GBV Prevention Messaging Campaign:  
  • During the COVID-19 pandemic, USAID ReachHealth launched a “No to GBV” social media campaign via the FamiLigtas (Safe Families) activity to prevent GBV and to let people know about available services. The campaign generated a media value of at least  USD $200,000 with various celebrities participating in the FamiLigtas launch in October 2020.  
  • Reached more than 15.9 million people online and via radio through the FamiLigtas (Safe Families)  
  • The FamiLigtas campaign also regularly promoted LGBTQIA+ inclusion and equality, often running shorter campaigns focused on issues relevant to specific identities, such as encouraging parents of transgender, nonbinary, or gender nonconforming children to provide safe environments for their children to thrive authentically or increasing awareness of aromantic and asexual identities.
• Strengthening referrals for GBV: Partnered with the City Government of Caloocan to create the GBV Responder’s Directory, providing contact information and referral details for GBV cases. It also offered guidance on survivor-centered care. USAID trained health providers and responders, strengthening local systems during COVID-19 to foster a safer, just environment.
• Improving GBV Services: GBV services provided by USAID-supported organizations such as the Lunas Collective, a University of the Philippine- based organization, included psychological first aid, messages of sex- and body-positivity, promotion of self-care options, referral to appropriate authorities, professionals, and protection centers and shelters. For Women and Children Protection Units, this includes comprehensive medical and psychosocial services. In one year along, USAID ReachHealth reached 11,558 individuals with various interventions providing GBV services. This accomplishment resulted from the project’s continuing implementation of two key interventions: the FamiLigtas national campaign on GBV, and support to GAD events of local LGU partners. Both interventions contributed to improving 1) GBV awareness among the population; and 2) closer monitoring of GBV services provided to clients which likewise improved the recording and reporting mechanism for GBV-related services.  

COVID-19 emergency response in the Philippines

In 2020, as COVID-19 became a global crisis, the Philippines emerged as one of Southeast Asia’s most affected countries.  USAID ReachHEalth, in collaboration with the DOH, PhilHealth, the Department of Interior and Local Government, United Nations agencies, the private sector, civil society and community-based people’s organizations, played a crucial role in strengthening the government’s emergency response at all levels.

As part of its initial support, USAID ReachHealth enhanced national, sub-national, and community level capacities to support the government’s implementation of the Prevent, Detect, Isolate, Treat, and Re-Integrate (PDITR) Strategy. This included bolstering local capacities for contingency planning and, later, response to COVID-19. Activities included establishing Temporary Treatment Monitoring Facilities (TTMF)/ Community Isolation Units (CIU), conducting rapid evaluations of Infection Prevention and Control (IPC) and Healthcare Waste Management (HCWM) in hospitals, and providing training in Contact Tracing and Microplanning training for Barangay Health Emergency Response Teams (BHERTs).

USAID ReachHealth also assisted the national and local health offices in integrating COVID-19 risk communication and community engagement and vaccination with other programs, to ensure sustainability as well as readiness for the next global health emergency.  

Key Outputs and Impact:

Vaccine administration and distribution:

• Supported the DOH and LGUs in administering more than 9 million doses of COVID-19 vaccine, including primary and booster doses.
• Provided Bakuna (vaccine) Jeepneys to support mobile vaccination teams and transported senior citizens to their assigned vaccine sites.
• Distributed personal protective equipment (PPE): Facilitated delivery of 53,704 hygiene kits and provided 1 million face masks to 150,000 beneficiaries in high-burden COVID-19 response areas.

Risk communication and community engagement:

• Collaborated with the DOH to reach over 8.6 million people through mass media and social media communications on COVID-19 risk communication, community engagement, contact tracing, and home care practices.  Additionally, 4.4 million people were reached through media related specifically to COVID-19 vaccinations.
• Supported the DOH and the Department of Education to facilitate safe reopening of schools, as the country slowly shifted back to face-to-face learning.  

Capacity building and health system strengthening:

• In collaboration with the DOH, trained over 20,000 health care providers about infection, prevention, and control; risk communication and community engagement; contact tracing; COVID-19 vaccine-related topics; and surveillance and rapid response.  
• Provided more than 200,000 diagnostic tests and auxiliary diagnostic supplies to health facilities in selected project sites and installed more than 300 handwashing stations  
• Worked closely with the DOH and the Department of Education to facilitate safe reopening of schools, as the country slowly shifted back to face-to-face learning.  
• In support of the DOH’s continuous service provision, makeshift teleconsultation equipment and mechanisms were installed at 46 health facilities providing 29,470 consultations.