 Good morning, good evening, everyone na sa manpo kayo sa parten ng mundo. Maraming-maraming salamat po sa pagdalo at pag-attend po ng ating stop COVID-19 webinar series. We are now on our 65th installment or 65th episode po and we are glad that you're able to join us today as we continue to spread the word about our credible online community and bring you timely and informative topics in our COVID-19 learning journey together. Aside from the crisis brought about by the COVID-19 pandemic, teenage pregnancy is yet another emergency in the Philippines that started way before the pandemic. As of the year 2019, the Population Commission or the Commission on Population and Development reported 178,000 births to teenage mothers. So medyo malaki po yun and if we put it another way that is nearly 500 limangda ang mga bata giving birth sa mga bata din po each and every day and that's something that we wanted to shine a light on and a focus in today's topic po. And we have today invited several different experts po in their fields to talk about this very important topic. I'm Dr. Raymond Francis Sarmiento, Director of the National Telehealth Center, National Institutes of Health University in the Philippines, Manila. Always a pleasure to be with all of you during our regular Friday lunch date and always looking forward po. Very happy that my partner was able to join us. She is our Adjunct Research Faculty at the National Telehealth Center and also the Special Envoy of the President for Global Health Initiatives. Dr. Susie Pineda Mercado. Dr. Susie? Hi, good afternoon Raymond. Magandang hapon po sa inan lahat wherever you are. I was able to come on time and just happy to be with you also Raymond this afternoon. On the news nabi ni Raymond na pa-isip ako. If we stop and think about 500 young girls giving birth every day during this pandemic, it's really something that as you said we should shine a light on. Magandang naman sa ating credible online community is that even with all our own personal hardships and trials, we still have the energy to think about those who really, really, really, really need extra help. And I would think of course today we're going to talk about teenage pregnancy and COVID-19. We're going to think, we're going to talk about sabing at children giving birth to children. And I think we want to talk about prevention, but we also want to talk about what is the extra care we need to give to all these young girls who are going through a very difficult time. So welcome to the webinar everyone. I can see yung mga usual regular viewers natin and dito Raymond. And we will open our webinar with our person on the street, our interviews done by TVUP. TVUP over to you. I did this whole in a very diverse group. I'm going to see it at home for once or twice. And really, hindi ko nag-agadam na may pandemic in some communities. The people I still going out, so interacting, business is mutual. And these interactions include pa siya po yung kailangan d-end, d-lead. I was talking to someone who was casually mentioned na parang nag-talag-leg siya before because to that segment, during the time of COVID. Meron po dito sa community namin. Parang 19 years old po na nangan ako yung during pandemic. Dito po kasi sa community, medyo common ako yung ganyan. Maraming mga case ng teenage pregnancy. Sa kanyan po kasi talaga, dahil nang anak na po siya din sa public hospital, doon sa hospital ng Maynila, doon na rin po niya pinile. Tapos humagad siya nga niya lang na pumila doon for the prenatal check-up. Tapos ano pa po siya, sasarian pa po yung kanyang delivery. The story is that I've heard and seen with my own two eyes, it's yung kaka lang na actual education. Most of the girls have gotten pregnant that I know of. Really seen from communities where have both of them have had sex and sex ed. Sa line din po ng work ko, kasama rin po yan sa gender and development. One major reason po yan yung pagtigil doon sa access to reproductive health services ng mga kababaikan. At siyang parin mga kalalakihan din. So yung pagbibigay po natin ang mga tinatawang na commodities, yung contraceptives, yung family planning method, yung counseling na tigil po talaga siya. So, well, I definitely want to be optimistic and say that, first thing should get better. But it really has to start with course needs. So, there are so a lot of conservative teachers now. The way they teach sex education is very pragmatic. Malaking pag-ask sa yung pagmakikita mo yung mga healthcare workers and yung mga concern citizen, yung mga CSO, yung mga NGO. Chepro din sa colleagues mo na kaya pa lang harapin ito kung papakinggan or magiging mas-participative yung mga policy-making sa government natin at yung mga policy implementers there. Thank you very much, TVUP. It's always good to start with what's happening on the ground. And I think we heard some very real live stories about teenage pregnancies and we have a very exciting group of speakers. So, magbukay yung alias kasi star-studied na naman tayo ngayon. Pero Raymond, did you want to talk about the certificates of attendance and some other announcements? Go ahead, Raymond. Thank you, Dr. Suzie. Before we go on to the certificates po, we have it on flash on the screen. We have already sent out all the certificates for those who are eligible to receive them for the previous 64 webinars that we have hosted. Again, we would like to ask for those who still do not have, at least have not yet received any certificates po, in any from 1 to 64, please let us know. And by emailing stopcovidets at pup.edu.ph and our team will reach out to you with regards to your question. For today's webinar, we also would like to extend our gratitude po and greet all the members of the Philippine Obstetrical and Gynecological Society, or POGs. Watching us from all over the country, POGs is the premier organization composed of highly competent obstetrician gynecologists providing excellent reproductive healthcare. And we are grateful that they have partnered with us on this very important topic. And for those who are asking also, since we are going back to sort of our mainstream structure po, for those who are joining us for the very first time, either you are watching us in the live streaming in Facebook of the Stopcovidets page, the TV UP page, or whether you're logged in in the YouTube channel po of TV UP. We always start with a set of presentations from our two speakers and then followed with reactions from our esteemed panelists. Very, very short reactions po followed by a set of question and answers during the panel discussion. And then we will usually invite someone from the audience to ask their questions live to our panelists. So please, anayahan nyo po, encourage and tell all of your family, friends and relatives po. And those who you are working with, if they, well, at least if they are interested and are free to join us, please let them know we are able to accommodate in the Zoom webinar up to 3,000 attendees. So please let us know and we will be more than happy to accommodate them. Over to you, Dr. Susi. Thank you very much, Raymond. And I just like to welcome all our other panelists who are here. As I said, we've got a very exciting group of speakers, but we're going to start with the president of the Philippine Obstetrics and Gynecological Society. This is Dr. Benjamin Cuenca, who will be giving us our opening remarks and binabati natin lahat ng mga tagapogs na nakikimig ngayon. I understand that we have representatives from all over the country. Dr. Cuenca, please go ahead and you might want to show your face first before you go to the slides. Anayahan, we can see you, sir. Good afternoon, Dr. Susi and Dr. Raymond. Yes, how are you, sir? How are you, Dr. Cuenca? And I wish everyone is all just the same and I welcome everyone to TV UP and on my capacity as president of the Philippine Obstetical and Gynecological Society, I am very happy to be here with you this afternoon to give these welcome remarks. Go ahead, Dr. Cuenca. Okay. Listed among the flagship programs of the POGs in 2021, is the society's plan to launch the advocacy to prevent teenage pregnancy? Sorry, sir. I think we have to go to slide show view. Mukang nakaanot tayo. We are seeing your notes. Sana para po medyo malaki din po ang ana, sir. Is it the icon that looks like a screen? Yung ba yan, Raymond? No, it's that if you log out and then click on the bottom part of the pop-up. Yan, nakikita po kayong ngayon. So now let's see how you'll... okay, let's see. Yes, okay. Thank you so much. Ganda naman, sir. Ganda ng opening slide nyo. Okay, go ahead, pa. Go ahead, Dr. BJ. Thank you, sir. Good afternoon again to everyone. Alampuni nyo, since 2021, it has been our advocacy to really work into the issue of teenage pregnancy. In fact, in our town hall meeting in April, this was one of our items in the agenda that the 4,890 members of the POGs agreed on to delve this year at least. So that the POGs, being the primary society that takes care of and promotes women's health care, has already put under one subgroup all the pre-existing advocacy programs which are related to teenage pregnancy. These are the adolescent health issues and perspective, which was founded in 2004. The PREPARE, or the Preparatory Reproductive Health Education Priming Young Adults for Responsible Engagement, which was institutionalized in 2017. The POGs Task Force on Family Planning. And of course, the Gender Waste Violence Project, which was founded in 2003. Being the primary society that promotes and ensures the highest quality of women's health care, we want to put an end on teenage pregnancy. And we cannot do that as a private institution or a pandemic institution responsible only for, as a non-government society. Now to hinge, we have to work with government institutions like the PAPCOM, which we have been doing since last year and of course with the Department of Health. So that the POGs with its PREPARE project last year has already dealt and started working with PAPCOM in training counselors and teachers in Samuanga City, where intensive education for health education and sex education has been discussed with counselors and teachers. This year, we are working with the teachers and guidance counselors in the secondary schools in Mimaropa. Indeed, we are endorsing comprehensive sexuality education. So that with this ang unang laban po ninyane ay mangyayare sa August 20 at ito po ay tinatawag naming bahay-bahayan kararasan ninyane, kung saan inibitahan natin ang undersecretary Just Dado M. San Antonio of the Department of Health and of course, the Executive Director of Likaan Center for Women's Health, Dr. Tunis Lirsa Melgar. Hindi po namin ito lulu ba yan ito po ang ating programa na ipag-i-invita rin namin sa inyo. Pag atapos po nito, ang pangalawang laban para kay ninyane ay mangyayari sa katapusan ang Augusto. Ito po ay sa August 31 kung saan bukod sa papcom at sa Department of Health, nag-invita rin po kami ang ating legal counselors at hopefully si Senatorisa Ontiveros para madiskas ang mga batas para mapangalagaan ang ating mga batang kababaihan against teenage pregnancy. The POGS is now working hand-in-hand with all the other related health societies, like yung Panawagan ng PPS President, Dr. Josephine Yusebio, where we are now calling on the Philippine Congress to immediately pass a law that increases the age of statutory rape to below 16 years of age. And with that, as I have said, hindi po lulu ba yan ang POGS ang labang ito para kay ninyane. Atulip po namin gagawin and strong collaboration will be always ready to work with government as well as non-government agencies to be able to put an end sa sinasabi natin violence being committed to young female children of our country. Paraming salamat po. It's very heartening to see this huge effort that POGS is making to address the issue of teenage pregnancy. But we're going to hear a little bit more about teenage pregnancy in the country and what happens when we have all of these pregnant girls during COVID because we know that even before COVID, it's very difficult for them to access healthcare services. Ano pa kaya ngayon na may COVID? So itong concern natin talaga na in terms of prevention, in terms of taking care of our girls, it's become more difficult during the pandemic. So I think we'd all like to know what the situation is and what we can collectively do. What we can collectively do. So I'm very honored to introduce our main presenter who I've also known for the longest time. We were together in the core group or the lead team of then Secretary Juan Flavir. And so we worked together with Manong Johnny. And I'm very happy to see that he has continued in an area that was very dear to the heart of Secretary Flavir which is population and family planning. So may I welcome the Undersecretary and Executive Director of the Commission on Population and Development or PAPCOM, Dr. Juan Perez III or GP? GP, welcome to the webinar. Thank you very much, Topsusi. It's been 30 years since BOH. Oh no, no, no, no, no! It's been 30 years since BOH. I'm so happy that I'm going to be with Raymond because I haven't met Raymond yet. Yes, it's been a while. In a while, I think it's really great to see you continue that vision of Manong Johnny Flavir. And I think it'd be very sad to hear about what's happening in terms of teenage pregnancy. So please go ahead and tell us what's going on and what do we need to do. Go ahead, GP. Yes, thank you. Thank you, Raymond. And of course for the nice words of Dr. Penta. We're really going to collaborate with the private sector, particularly POGs. As we move forward in this work. Allow me now to share my screen. Let me move to the top of my presentation. Sorry, it appears to be a long presentation, but I hope it will be informative and it will set the ground for our discussion this no time. So thank you, everyone, the panelists for being here and everyone in this webinar. I'd like to talk about how we can address teen pregnancy in the Philippines, not only pre-COVID, but also in the time of COVID. And some findings that we have found, we have seen in the last 15 months. So I will cover what we know about teen pregnancy in the Philippines. In a way also, my second portion will be to explain what factors are contributing to and what are consequences of teen pregnancy in this country. Factors that have led to PAPCOM and NEDA calling for the government to consider teen pregnancy and national emergency even before COVID. And what interventions are going on right now in the time of COVID, but also even before COVID and way forward. What should we, what are we doing now that we should continue and what are new ideas to move forward in this issue? So what do we know about teen pregnancy in this country? We have been benefited by looking at the young adult fertility sexuality standard by the population institute with the BRDF. There have been three major studies in the last 20 years that have shown that young Filipinos have continued to be more active more engaged in risky sexual activity with no significant protection. And we have seen that in the past, it was particularly in 2002, it was the males who were quite more active and females less so, but by 2013, there was among the 15 to 19 years old, there were almost in an equal place that as many young women and girls who are already engaged in premarital sex as males up to 25% among the 15 to 19 years old. Now, we are concerned about unintended pregnancies, particularly among young people, but because of their association with adverse consequences in terms of health and social outcomes for the mother and for the child. And even more so when the mother is a child herself. And we consider in this country up to 18 years old as children, in the pediatric population. Now, the number of mothers age 15 to 19 who are giving birth, we have seen a decline since 2016, gradually declining to 178. And this happened during a period when there was greater awareness about teen pregnancy as a problem. However, during the same period, we have seen an increase in 10 to 14 year old pregnancies, live birds. It's now up to seven live birds per day among 10 to 14 year old girls in this country. And secretary Cabral has said it's good news that there's a decline, but still one pregnant in Asia is one pregnant in Asia too many and we need to look at those younger than 15 who have become pregnant because of their individual stories that collectively should pickle our conscience. Now, where is birth happening in this country? 2019 showed that five cities in the NCR Kezon City, Manila, Kaloakan, Pasig and Antipolo which is outside NCR were among the highest number of showed the highest number of teen births because the sheer number of the population one third of the population is in NCR and surrounding regions. But Cebu City ranked relatively high and it was the sole city representing Visayas and Mindanao had four other slots. Now, the Vau City registering the highest and it's considered the place where percentage wise we have the highest number of teen pregnancies in the country. As well, we know Sambanga City and it's good that folks is doing something there. So, this four cities in Mindanao are where we are seeing outside of NCR the large number of teen births. We're also concerned about repeat pregnancy and among the 10 to 70 year old girls these are the minors who are giving birth who have given birth and around 60,000 of them every year 5,000 of them at its height in 2015 gave birth to a second pregnancy and this has remained relatively stable and going up again to 4,600 from 4,500 the previous year up to 2018. So, there's a significant number of repeat pregnancies among minors in this country who are giving birth. We also noted based on PSA data on birth certificates that up to two thirds around those who reported their ages were older than the mother 20 years or older some going up to 70 years old these were the partners of these young mothers when you look at just the minors below 18 and only 16,000 or a third of the same age of the mother and which is why it's not surprising that a good number of adolescent women 15 to 19 report violence during their pregnancy and they are the largest group of women among all women who are pregnant at any given time they are the ones who are reporting the most numbers of violence and it may be linked to the fact that many of their partners they have an equal relationship with the partners most of the time. When it comes to health we have noted in 2019 among the 1,458 maternal mortalities reported 177 of them were among 10 to 19-year-old 10 to 14 44 at 15 to 17 so 47 of them were among minors and 70 were among 18 to 19 years old what we are seeing at community level is that the mothers are starting families at the rate of around 166,000 now this year we are projecting that 166,000 plus families will be led by minors throughout the country this will include 60,000 plus who will give birth in 2021 and about 100,000 minors who continue to be heads of their families from previous years so this is a growing number and we think it will be among the highest numbers ever since we started tracking this group another dimension of adolescent pregnancy we are looking at is how much can a teen mother who is earned compared to other teenagers who did not become pregnant now the child bearing has been shown to reduce the earnings particularly because they are not able to complete high school and four piece of the SWD is reporting one of the most common reasons why children drop out of the four piece program is because of the pregnancy so that the losses that these young teenage women bear every year is around 33 billion pesos every year which is about 1% of the GDP so this is lost income or teenage girls who need them the most this is coming from a study by Alex Zeril for UNFBA and another study that came out early in the pandemic was a study made by the UP Population Institute and they were projecting that the health crisis can create another crisis particularly among adolescents predicting that there could be up to 102,000 unintended pregnancies among adolescents if there were the worst case scenario and they were saying that community quarantines would have impact particularly due to lower services or non-availability of services to teenagers and the increase would be at around 21.4 period assuming nine and a half months of quarantine so it was the context that the UPPI said was that with economic slowdowns travel restrictions, physical distancing all of this would lead to lowered provision and access to essential sexual reproductive services at the community level now another study that was done by the Commission on Population and Health Futures showed that women in general and our study areas here where Queson City, Cebu, Zambuanga were refraining from visiting health facilities due to fear of exposure to COVID-19 or due to movement restrictions at two ways and we surveyed with the general population and 41% were saying that the COVID pandemic had effects in terms of their access to services because of too many processes no available health workers long Ques, particularly the long Ques were reported in NCR as among the reasons why Filipinos were feeling difficult to access family planning services so we added up all the 41% from this list of reasons why they were having difficulty to get family planning services or products and if you look at the geographic location of these women having difficulty in attaining or getting family planning services a large number of them 29% were reporting this difficulty in Mindanao and of course the balance of Luzon outside Metro Manila 18% and Visayas 14% so these were the problems that they were saying but just note that in Metro Manila 13% were saying there was a long Ques this is around November last year and we can predict that with this new lockdowns with the current surges this year the same situations probably prevailed now a team pregnancy when women were asked what is the most important problem of women today in November 59% noted early team pregnancy and related to pregnancy 11% also were worried about unexpected pregnancy so you can see that together 70% of women were concerned about pregnancy in one form or another another concern was other concerns were physical violence, sexual violence and emotional violence so these issues of pregnancy and violence were at the top of mind of women and men at the time the survey was done in November now what are the factors that are contributing to and to this team pregnancy again study by Health Futures with DOSD and PCHRD showed that currently young women adolescents look at the family as an institution that plays an important role in molding their behavior and also those adolescents living in non-traditional families solo parents, living with relatives families in difficult circumstances poor dysfunctional incidents of abuse and malprement where they feel they are more vulnerable to early pregnancy and gender and power dynamics were also cited by these girls gender norms, power relations play a significant role in sexual activity and teen pregnancy and we have noted that from the numbers from the partners being reported in birth certificates of minors in this country and again this kind of relationship leads to a sense of a lack of power to refuse sexual favors exacerbated by a culture of silence which places the adolescent girl in greater difficulty and this is during COVID and they also cited no knowledge on sexual reproductive health and rights and limited access to services as contributing to their situation where sex or sexuality remains a taboo topic in most Philippine homes. One of the YAF surveys in 2000 showed that only 10% of parents roughly were willing to talk about sexuality or sex with their children and so 90% of households probably are still not talking about it at this time and the existing services for reproductive health they feel not designed with them in mind although I know DOH has been pushing adolescent friendly health services now they feel that at this time it's not yet now there is also poor knowledge on contraceptives and formal or informal sources are not enough for them to feel empowered to be able to avoid particularly repeat pregnancies and other consequences that they were citing are early maturation and roles here Adolescent mothers still immense pressure to perform at role as mothers they are juggling domestic world workload and child reading and they have difficulty coping with current responsibilities of being a wife and mother at that age these adolescent mothers also felt isolated socially being at a feeling of being stigmatized and frowned upon by the community then common to these teenagers and embarrassment ending them from visiting healthcare facilities and fear of gossip and criticism and another consequence that they were reporting early pregnancy is a compelling reason to stop schooling and some do not go back to school anymore again being reported by DSWD in their four piece program often they also become financially dependent on parents or the partner's parents also there is this lack of empowerment among these young mothers as they are financially strapped or limited in their situation so what can we do about their situation particularly in this time of COVID and technically speaking government has several plans which cover sexual reproductive health from Filipino adolescents included in the Philippine Development Plan in the Philippine Youth Development Plan of NYC and in the Philippine Population Development Program of the Commission on Population which is usually included in the Philippine Development Plan what we are trying to do with the Department of Health in particular is that in terms of service delivery DOH is working very hard to set standards and to identify adolescent friendly health facilities and really recognize them for the work they do and they are working to enhance the capacities of healthcare providers and support the establishment of teen centers to compliment the services provided by public and private facilities on the demand generation side Babcom usually works on we are working with the PED which is a member of Babcom to implement comprehensive sexuality education both in and out of schools particularly out of school when it comes to alternative learning systems we would like to also mainstream information education communication demand generation strategies address particularly to adolescents and parents as a key populations that we work with and continuing our policy advocacy including the submission to the office of the President of a draft executive order to address teen pregnancy in this country something that we sent out a year ago more than a year ago in February this was endorsed by Secretary Perna who was chair of the time of Babcom and later re-endorsed by Secretary Carl Chua when he assured leadership of NETA at Babcom we have also set up health lines who supplies family planning on teen health and sexuality and the health line has been in place since May to July and the queries coming up from adolescent include inquiries on pregnancy check up implant insertion how to use appeal administration questions in general we also have set up a program Facebook live program who supplies family planning which I said 10 episodes since August so a year ago now and we have many different guests full service family talking about population and development at family planning and we have of course online videos that we are posted from our previous engagements with schools where they produce indigenous films on issues that affect children also we go online at different levels regional at the provincial level with population offices talking to adolescents and we feel that that is not adequate we need to add some more and as I said we submitted to the president at draft executive order and it was issued last June 25 and the title is to as a national priority the implementation of measures to address the root causes of the rising number of teenage pregnancies and mobilizing government agencies for the purpose and really the ones who are asked to take the lead here are to get the youth and communities to be mobilized to address the pregnancy the national youth commission is asked to become a forum between government and youth and PAPCOM will work with the entire community to come up with a comprehensive action plan towards the prevention of adolescent pregnancy and we are supposed to submit this plan to the human development poverty reduction cluster headed by secretary Bautista of the SWB in Amandstein and then this will initiate the implementation of activities submitted to the executive order and our general plan is based on this framework that are at the end what we want to see as a country are well informed empowered healthy responsible adolescents and that will be achieved by helping them attain improved health and nutrition improve the education employment and increase youth participation in development this is the ideal that we are aiming for and the outcome that will help us achieve that that we are working for is to reduce the incidence of pregnancies among adolescents and this is particularly by reducing first and repeat pregnancies among adolescents and that will take the following guide of behaviors outcomes delayed sexual activities we should work on reducing incidence of unprotected sexual activities reduce the incidence of sexual abuse reduce other non sexual risk behaviors that impact on pregnancy increase utilization of sexual reproductive health services by adolescents and increase participation in community development by adolescents in general the strategies we will employ are both preventive and protective one pillar will be comprehensive sexuality education which is already a mandate under the RPRH law and with depth end as the lead and the community is also participating access to reproductive health services which include amily planning maternal newborn child adolescent health and nutrition services so this will be particularly led by local governments and civil society that are providing services to adolescents we will also look at measures to combat sexual abuse and coercion that we have mentioned including among very young adolescents pregnancies at 10 to 12 years old as well as instances of abuse wherever it is reported and to mobilize agencies like DOJ Philippine Commission on Women Commission on Human Rights to work in this area socioeconomic development interventions will also be focused on the 166,000 minors who are leading families and social protection program is being developed by POPCOM and DSWB to address the services needed by those mothers who are already contending with their situation and to provide support for their children as well and youth participation and development in this area we hope National Youth Commission the SKS Nationwide take the lead with the support of different government agencies including POPCOM, DOH, DSWB so across cutting issues in terms of leadership and governance particularly at local government we need to develop good information and manage that knowledge so that it's used by different agencies and to monitor and evaluate the program as it progresses on a year-to-year basis and we lead the support of all stakeholders at community level in particular Among the early activities that we have conducted is that November last year we started a program with local government units to prevent adolescent pregnancies at the challenge initiative and we started with three cities Kagayan De Oro with Mayor Moreno Dipolo City with Mayor Daral Uy and Puerto Princesa City with Mayor Bayron to focus on establishing adolescent and youth-friendly cities and take the lead in reducing teen-age pregnancies this year so that we have one city in every region participating in this initiative and both DSWD and PAPCOM are working to develop a social protection program for teen mothers who are minors and their children yung 166,000 and we hope there will be funding for that in the coming general appropriations act so these are initiatives that we hope people can add to people can participate in and all for for a better and empowered adolescent population Maraming salamat po, magandang tanghalian po sa ating lahat thank you very much thank you so much Yusek GP very very comprehensive presentation and a lot of new numbers as it relates to teen pregnancy mga repeat teen pregnancies teen maternal mortality thank you so much Dr. GP will call on you again sir during the panel discussion and hopefully you'll be able to join us next up we will have the chief of the division of adolescent medicine in the department of pediatrics at UPPGH is also the co-founder of the PGH teen mom program and also the president of the Philippine society of adolescent medicine specialist please welcome to the webinar Dr. Emma Lianto yes thank you may share my slides yes ma'am go ahead po do you see it sir? yes po go ahead ma'am again thank you for the invitation and Dr. JP for such an extensive presentation I know some of the numbers but they still continue to upset me so I hope that we will be able to do something about it and this does not end just another webinar so my presentation will be mostly focused on how we can respond to the different abilities and needs of our teen pregnant girls so just as a summary these are the unique vulnerabilities of our young girls especially for those who are younger than 15 years old the bodies are not well developed so they're short we also have a very high standing rate among our adolescents that's about 26% so they're short and small so that's why they are more prone to obstructed labor also 37% are nutritionally at risk so they have anemia they're underweight and so they tend to have low birth weight babies and when they have a repeat pregnancy which happens in 15% of all our pregnancies you set up an intergenerational cycle of malnutrition you know the impact of malnutrition not only in terms of physical physical impact but also on the mental and IQs of our children and adolescents and adults so those are the things that are really important the interval between births for young girls it's very short 17 months the advice right now is to have 3 years in between pregnancy so you see how compromised they are in terms of nutrition now this was also emphasized by doctor JP but again I would like to emphasize that coercion is in the picture especially if you have very young girls automatic if they're younger than 14 you have to ask about relationships and the age of the guy who is pregnant because the PSA statistics itself shows that 17% 2 out of 3 infants born of teen moms were actually fathered by much older men and also mentioned was ITV that's intimate partner violence we also need to screen for this because this is quite common and it's no wonder that the postpartum depression can be high in this age group in this particular segment of adolescents this is data from abroad but I think we need to make our own studies here in the Philippines and what is also difficult is that they have pre-pandemic access is always very late so usually we get them when they're in the second trimester sometimes in their third trimester because of course they try to hide the pregnancy so they try to hide it because of the fear of reprimands and stigma and they don't think well so that the families don't become bigger so really it sets them up for all these disadvantages now this is in the next few slides I'll talk about our teen mom program which we set up in 2000 and this is basically remember the levels of prevention are two primary level which there's a lot of plans that Dr. J.P. mentioned that's preventing the first pregnancy our program in PGH actually is more on preventing the subsequent pregnancy because they are prone to rapid repeat pregnancies about 20-40% of them can have another pregnancy in the next two years so this is actually mainly a partnership between perinatology, OB pediatrics and adolescent medicine but you see that we involved a lot of a lot of the subspecialties and services in the hospital so because the needs of pregnant adolescent are multiple so it's perinatology for obstetric care, contraceptive services very important, nutrition and medical subspecialties like cardiology because we do have a population of RHD patients or those with chronic kidney disease or SLE lupos who get pregnant and we have been seeing also an increase in the number of those in multiple congenital anomalies so we call in genetics also for counseling and other services but what sets this program apart from any obstetric program for teen pregnancy for pregnancy is the psychosocial support which is mainly the work of adolescent medicine we do the psychosocial assessment we do the health education together with OB social workers play a very important role child protection also comes in because usually if we ask the age of the partner if it's a gap of four or more years we actually do a referral to child protection and if we detect depression or suicidal thoughts we also have a referral to child and adolescent psychiatry so it's an interprofessional service now the thing here is that approach is also unique to use the adolescent friendly approach which is basically strengths-based non-judgmental, respectful focus on the adolescent's confidentiality and supportive of the emerging capacities for instance you see this picture we interview them alone so that is respectful for confidentiality privacy and also this teaches them to deal with health workers on their own now what is important is that we screen for both the strengths and the risks so we do the heads interview and we ask about relationships at home education have they dropped out their activities much time on the internet where they are meeting their partners use of drugs alcohol, tobacco and other drugs violence in the relationships depression and suicide and with this information we are able to do counseling and referrals to MSS social services and child protection unit and we also engage the adolescent in these major decisions so decisions like will you raise the child on your own with your family do you involve your boyfriend or your partner are you thinking about adoption and if they do think about adoption we also involve MSS because there is a lot of preparations here but most of our adolescents actually opt to raise the baby with their families stay with your parents or cohabit with the partner we discourage cohabiting because that sets them up for another pregnancy and they are unable to go back to school resume or quit school so it's so important to get them back to school we tell them that the school does not have any right to kick them out and we can contest that and of course we talk about decisions about having another baby is that something in their agenda would you like to prevent that what are your thoughts here and we give them options about the use of contraceptives and the emphasis here is really for them to understand long acting reversible contraceptives like Implanon and IUD we give them the space they can prevent pregnancy for three years that's enough time for them to finish school to breastfeed for their bodies to recover so this is very important to understand how important it is to prevent a rapid repeat pregnancy now we also empower them with information as well as skills so we do health classes that cover these topics and this picture shows a class on infant care we demonstrate to ask them to do the actual diaper changing et cetera and also we emphasize breastfeeding because breastfeeding rates among adolescent women mothers are quite low there's a lot of challenges for them so we really support them in terms of information and skills now we also supplement the lessons with brochures we go through a birth plan because they have to plan where they're going to give birth are they prepared with the money is the fill health ready they have the bag with the clothes et cetera and the provisions because remember they can't plan as well as adults and so we need to help them in planning and decision making so in 2014 in gender health with USA funding actually set up similar clinics they call it program for young parents PYP so this is les stigmatizing the teen mom and by the end of 2018 they actually had 33 clinics across the Visayas I think there are two in Leite Ibaranci and Abuyog and there's a big one in Iloilo so this was recognized by DOH and actually given an award by NEDA so although I don't know what's happened here because the funding ended but we really are hoping that we can really pick it up and DOH should pick it up and enable the other hospitals to have this program so it can be replicated okay so I'm almost done just a few more slides now this is Dr. J.B. mentioned problems with access but this is really data from the NCR households by UNICEF a survey done in December 2020 and it shows that pregnant women were receiving fewer antenatal care so this is pre-COVID dark blue 99% were able to get four visits now in the COVID times pandemic 61% so if you don't go toward checkups you are less likely to take iron and polyacid tablets this is also a little bit alarming especially for teen pregnancies women are less likely to give birth at hospitals where they need to be for adolescents and more likely to give birth at other health facilities although at this time own births had not increased but remember this is NCR data we don't know what's happening in the provinces mentioned already was the access to sexual reproductive health services like FB very low to start with now lower and this is for all women so it's much lower for young girls and remember the restrictive laws and provisions of the RPRH that you need consent to be able to access contraceptives so that's something also that we need to think about so in our experience in PGH mark decrease in the number of teen pregnancies that we girls with teen pregnancies seen in our teen mom clinic so in 2019 we were able to serve 228 young mothers but in 2020 just 43 of them showed up and this is understandable because we had to close and the services shifted to COVID efforts my fellows mentioned we were starting to come in again so this month we had I think nine referrals instead of the usual two or three so what happens is that they are admitted in the wards very few of them though have had COVID my fellows were able to see them with precautions of course and they noted that the isolation is very tough and especially because they don't have gadgets they don't have cell phones to keep infaturing their family so it's very isolating it's very difficult for these young girls who just gave birth and they're in an isolation ward now we also noted that there's an increase of sick babies left at the ICU of course our statistics are skewed because we are a referral center but for instance we saw six mothers last month four of them had premature babies and then we had one who had congenital malformations so that's just an observation so no big data yet it's just coming in now what happened is that we shifted remember we have health classes we shifted to online so we also shifted our postpartum follow ups online so the thing is that it's very difficult to gather them number one it's difficult to gather them they don't have the gadgets they don't have the connectivity and even though we start the calls and if our fellows are giving them load they don't show up for instance this is a screenshot the ones these are the patients too and then the rest are doctors so in this particular call you would go but only two appeared so you can see and there's a lot of effort that goes into setting up an online consultation now this is a postpartum visit just to follow up on how the baby is doing the breastfeeding, how she's feeling et cetera so we try to do that although we see this as an opportunity also because we're able to follow them up which is very difficult pre-pandemic because they would not come back to us so those are the limitations also of the program now the challenges I think I mentioned it's the physical access to the services and of course access to online services because we've shifted key points basically just to summarize the unique vulnerabilities of our adolescents it's both medical and psychosocial we do have comprehensive existing comprehensive pregnancy program which is open for people DOH to pick up it has been picked up our challenges are obvious access to prenatal contraceptive services and online services it's a big big challenge although it is also an opportunity for them to access our services and for us to reach them so what can we do um a lot of plans and um it is very concrete and I really say good luck and please let's really move this forward so for us it's improving the connectivity both inpatient if they're isolated, outpatient of course family planning services should really be strengthened also have the COVID vaccine available for our teen pregnancy when they're admitted in the hospital and other vaccines also should be available of course comprehensive sexuality education um we should take care of the restrictive loss of the RPRH remember even though they are they've already given birth but they're below 18 they cannot give consent so it's really ridiculous and of course expanding adolescent friendly services which the DOH has been really trying hard but we need to try harder thank you so much for the opportunity to share my insights thank you so much Doctor Lianto we learned a lot about the teen mom clinic but I really like your last slide on expanding adolescent friendly services ma'am stay on for our panel discussion later on thank you Doctor Lianto next up we will have another expert she is the former director of the UP Population Institute please welcome to the webinar Doctor Josefina Nativedad Doctor Rajoy hello doctor thank you very much for the very informative slides both from DocGP and Doc Emma we learned a lot especially from Doc Emma and my reactions are really a reaction to DocGP's presentation and it's coming from academia and not being a physician this is really a reaction that will be about centered on three things my reactions will be one is my suggestions how to further maybe enhance or rethink what analysis of available data on teen pregnancy and how to get more out of it in order to draw lessons that can be used for better interventions and then I will talk a little about what are the drivers of teen pregnancy in the Philippines and then in the third is a very short section on the teen pregnancy in times of COVID-19 so for the data analysis issues I wrote down my comments so I'll just read them. I don't have slides I think it is important to break down the prevalence rates of teen pregnancy by single age for purposes of better targeting of intervention policies and programs because there is an age gradient in teen childbearing by this I mean that for example more than half of all teen pregnancies are actually accounted for by women aged 18-19 and the risk both health and non health related will be different for the older teens 18-19 compared to the younger ones those who are 17 and below the same goes for access to services because the 18-19 year olds are already adults so for better targeting it may be better to frame the issue of teen pregnancy not as a lump of 15-19 year olds or 10-19 years old but may be alternative to break it up into early pregnancy meaning pregnancy below 18 and then 18-19 year olds so you have young adolescents and for young teens and older teens and in that way you can get a better picture of who is really at risk because I think that much of the attention should be focused on the 17 and below ok apart from age this aggregation of teen pregnancy prevalence I also suggest analysis of the school living status of teens to get pregnant the popular notion is that a girl is not schooling implying that living school is the consequence of the pregnancy this is quite contrary to what has been found from the young adult fertility and sexuality study 2013 data set which doctor GP also quoted and this is one thesis from a student of mine the last one I advised before I retired in the thesis 20-24 year olds in the who got pregnant in their teens and were also school dropouts that is they left school without completing a high school education 95% has already dropped out of school before the pregnancy 4% had the dropping out and pregnancy happening at about the same time and 1% reported that the pregnancy happened to or prior the mean age of dropping out was 14 years while the mean age at birth of the first child was 18 years for this cohort so as Maniego concluded within this age group of teen moms so are also school dropouts almost all had already left school before they bore their first child this indicates that for most of these women majority are who are former from poor households early child bearing did not cost them to drop out of school but leaving school early may have left them with fewer life options one of which was evidently to find a partner and start a family early okay what this finding implies is that school based interventions for teen pregnancy prevention may have to start at earlier grades to catch those who drop out really early before they finish junior high school it further implies that there should probably be an entirely different set of programs designed to address school dropouts I think Dr. GP already pointed this out but this could be flashed out more that there should be a special program for those who have dropped out of school and that these programs will not just provide training and opportunities for better human capital formation or persuade them to go back to school but really about pregnancy prevention as well so which brings us to a third point to consider in the disaggregation of the data and that is may I suggest that since most teenage pregnancies happen in the lowest socioeconomic brackets may provide the population into quintiles right from lowest to poorest most teen pregnancies occur in the two lowest quintiles the lowest 40% of the population in terms of socioeconomic status so these are teen moms who are unlikely to access the services of private practitioners or may even be hesitant to access the public facilities I think PCH is doing a very interesting this cohort of young women and maybe this is a program that can be adopted in other public hospitals as well to really cater to the needs of teen pregnant of teen women who are in the lower socioeconomic status because they may be prone to stigmatizing if they go to the public facilities where everyone else goes and then they will be talk about ang baka-bata muna, so things like that so maybe there's a special program that can give them better attention okay next are what are the drivers of teen pregnancy okay as doctor Emma pointed out adolescence is really a special time for growing up and in general it is developmentally adolescence is characterized in terms of behavior by high risk taking and generally poor judgment by adult standards and that is really just the nature of the adolescent brain so sexual activity is one example of this high risk taking that adolescence take and the drivers of teen pregnancy this time we can look at for example number one this came from the YAPS 2013 but likely will also be more magnified we are now in the preparation for the next round of YAPS we are going to go on field within 2021 and this is an area that is explored much more detail and one driver of teen pregnancy that we found in 2013 and likely to be higher now is the higher prevalence sexual activity joo are driven in part by the early exposure to sexual content through various sources that are more readily available with the internet and the ease with which the internet can be accessed especially now through the mobile phone so sexual activity among teens are enabled by these new technologies they can meet up, they can take videos of themselves, they can exchange videos and so it's this whole world of the young sexual world of the young adolescence that is now one of the drivers for a higher teen pregnancy there's also the changing norms about sexual behavior admittedly sex outside of marriage is no longer as tabu as it used to be and it is normally depicted in everywhere in media in the teleceria and all of these other popular media forms that it's not so different I mean having sex without being married is not as tabu as it used to be and so if you have sex and you're unprotected you're more likely to get pregnant probably also another driver is the earlier age at Menarch compared to maybe two or three generations ago when women are able to conceive much earlier now and there's sexual activity then there's a higher risk of getting pregnant also there are changes to the social acceptability or tolerance for teen pregnancy because I mean compared to my generation certainly it is no longer as stigmatized and more importantly there is no more compulsion to get the teen formally married when a teen nature gets pregnant although we were talking about during the pre preparations for this webinar there's really a rise in pohabitation and that is not just among young people but among all age groups in the Philippines the number of formal marriages are decreasing but there are more people who are living together in a marital union that is not formal more acceptable ang sexual behavior and then it's not so teen pregnancy is no longer at such a horrible experience at least need to be socially at least and all of these exacerbated by the lack of appropriate knowledge I mean this has already been pointed out and the lack of enabling behaviors to prevent the pregnancy like the use of contraception for example a condom as simple as a condom the lack of also an enabling mindset I mean a mindset that when I engage in sex pregnancy is likely to happen and therefore I should do this thing so that I will not get pregnant it's not there is not that kind of a mindset in our adolescence yet maybe a lot of this is also attributed to the fact that there is a lack of male involvement in the teen pregnancy issue the potential fathers the lack of the sense of responsibility that they are just as responsible for bringing a child into this world as a woman so what happens is that teens have sexual activity and then they get pregnant and when the woman gets pregnant it's not the boy is so all of these are when you put all of these together then you have a higher that you have the drivers for higher teen pregnancy and so what is the effect of the pandemic on the prevalence of teen pregnancy we do not yet have the data to ascertain if the prevalence of teen pregnancy increased or decreased since March 2020 but according to the PSA I think there is some data just with that the number of registered births in 2020 actually sharply decreased compared to 2019 from 1,673,923 births in 2019 to 1,403,336 births in 2020 so births have pretty much declined in general although of course there can be issues about low registration because of lack of access but even then even if we discount that possibility I think there is a real decline in the number of births in 2020 so my personal projection is that teen child buried among those who are never married may have decreased mainly because of the limited mobility of the population the closure of schools and many people staying home so for the same reason that they cannot access services there is also a decrease in the interaction among potential partners because we are all locked down so maybe we can see decrease in overall first time pregnancies among teens who are in a marital union but among teens who are in a marital union and by marital union I mean both formal and cohabiting there is a higher likelihood of repeat pregnancy as already been pointed out if there is interruption in the provision of family planning services in general so in all there may be a decrease in first pregnancies among teens during the pandemic but an increase in repeat pregnancy among teens who are married either formally or informally thank you very much that's my reaction thank you very much thank you very much that's Dr. Joy Nativedad formerly of the UP Population Institute and for those insights I think more penetrating analysis of what's actually going on okay, next speaker is one of your favorites and I'm sure maraming babati sa chat she's been with us before and again this time kami naman makasamani Ophiel in the time of time of Secretary Albert Romaldes who also pushed for family planning and she's been in reproductive health for the longest time but she's now Mayor Mayor of Tulosa late Dr. Ophiel Alcantara who actually we want to hear from you Ophiel on the ground in the community in a rural area like Tulosa, Leyte marami bang teenage pregnancy Jan, ano bang nangyayari so welcome Dr. Ophiel Alcantara your ma Mayor Ophiel parang frozen e Ophiel I think she's trying to open her video pero Ophiel I think it's our internet pa Dr. Suzy internet? it might be her internet connection okay let's see yun ay oh your ma how are you your ma kina mahan ako pagsabi mo yung your ma nagkat ang connectivity ko of course thank you Suzy and Dr. Raymond I'm happy to be back napaka importante din ito sa akin as mayor as a person itong topic na ito kasi matagal na natin ito bago pa mag health sector health sector reform agenda in 2019 pinag-uusapan na natin itong family planning kasama itong reproductive health. So damong asalamat maupay nga oddo, kulop mga namamati magandang hapon sa ating lahat let me share my slide okay ako si ako yung mayor ngayon ng tulosa asa na itong okay and okay and nakikita okay okay thank you gusto kayo pa alam nagaral ako ng medicina matagal di ba so may boyfriend pwede mag boyfriend anaka 31 years old so hindi ako 10 age pregnancy siguro noon ang family yung family support yung values isang bagay na nakatulong which actually as presented di Dr. JP at sa kanila Doc Emma and Doc Josie na may effect ang lalo na ang environment where our adolescents are so I will make as a panel reactor I will look at ano yung presented Doc JP and also nagdag-dagan ako yung learning from Doc Emma which definitely I will also adapt the 10 months in the locality in Tulosa and also the sharing na Doc Josie na ito yung realities ano yung kailangan natin especially on the data that would move forward our policy at saka program ngayon yung with this presentation and really thank you stop COVID-19 webinars kasi kami din sa local government kami used to be a program nagpobili develop ng program and as a person nagadag-dagan na aming continuous learning so every Friday we look forward to this webinar series and for today I am here to be your panel and if you look at yung presentation highlight and observation na Doc JP at status of children and its effect problema talaga very alarming matagal ng wake up call but still it happened yung factors continue to persist and more so hindi pinag-usapan at maraming effect ngayon kagaya ng social media and the pandemic has really affected itong aten teenage pregnancy especially sa bahay lang sila and ang mas ang minsan itong third bonlit ko on poverty and security na when I went around the barang guys and pick up bakit nabuntis itong 13 years old karirigla lang and then nabuntis agad ang sinasabi ng family parang kasi poverty kadagdagan na konte ang pagkain so dini divide divide sa family malaki so mas maganda magasawa ka na para mawala ka na sa amin that's really and then is a security issue parang yung bata nakakapil secured lalo na kung ang kanyang aasawahin o magiging partner or relationship is older pwede niyang patuloy suportaran at matiyong pamilya ang mayroon naman kami na yang ang young then ang nakabuntis kasi itong mga nagaaral naglalaro pa lang nagluberoan dino lubasada nawawala sa picture nagsiseks na pala at itong nagsayari na bubuntis pero most of our children or itong mga teenage na nabuntis na na interview ko ay iniwan talaga hindi silang pinakasalan or hindi yung pagsama o suportahan yung pabuntis to siyino naga alaga yung nana ay mayroon din kami history dito na most of this teenage pregnancy happen not just poverty malaki ang pamilya but mayroon din history na early pregnant yung nana ay parang naging kultura sa kanilang pamilya nabagan ok lang pala mabuntis nang mas maaga so may very alarming din yan kumia sa babay at sa head ng family at the same time aarugaan yung akong community na mas mapaganda at mapaunlad yung ating bayan and now with this information na siniyard ni doc jp at saka ngayon nadagdagang pa ko from my panel reactors co-panel reactors anong gagawin ko as a chief executive at also isang family planning advocate na pwede natin magawa ano yung service package na pwede natin direct yung ibigay sa teenage pregnant or maprevent itong pregnancy at to at saka ano naman yung sistema para mapabilis mapadali may ibigay yung services yung information lalo na ngayong pandemic na hindi na pwede tayong mag-dialog at saka ano yung performance tracking ano yung ichi-check natin top ten indicators sa ating programa para mapigyan natin ng attention itong mga teenage na nagpre-pregnancy at saka yung adolescent or youth program itself okay and I would announce doc jp yung important discussion national at kami sa local government ma-involved itong increasing pregnancy sa ages 10 to 14 as I mentioned itong 13 years old na karegla na buntis 12 na regla na buntis sabi ko pa ano anong mangyayare hindi nga niya maintindihan kung bakit may baby siya na siya mismo yung anato minya at ano basta na buntis ako so hindi niya ma-explain or sa sarili niya na so we really have to have this discussion and also itong mga ano natin papag-asawahin para kasi na buntis yung ating pagbuntis pinag-uusapan but the likelihood na much repeat ang pregnancy meron kami ito wala pang one year pag pinagsama itong young ones very 14 na bubuntis akad wala pang hindi pa nago one year after yung last delivery buntis so yung space niya para mabuntis which is already risky baka na siya magbaanak pa wala sa tamang space hindi pa ano ang kanyang anato mi yung kanyang mattress so magiging problema and I think we need also to discuss further itong violence against women especially ngayon marami ang solo parent of course marami din wala yung parent nalo niyang nana na sa labas sa iban lugar at na iiwan sa father so meron tayong itong incest that also happened and perpetrator mismo within the family so kailangan yan very ano ako dyan kasi kasali ako lagi sa bao di pa ko naga asawa din i-discuss na topuntahan na ako nito and of course yung last ano yung programa na pwede namin magawa kasi as presented ang ganda ng latag ng programa but sa akin ay paano natin mau operate makostumize sa local especially kami parang sinasabi ko yung aking adolescent babantayan namin so paano yung approach kasi we need also to look at the entire population at sa kayong other programs Karin realities family values but if you look at ngayon itong mga kabataan din nga sumasali sa pagrorosari o pag cisimba o ano yung values na meron o kultura sa pamilya kasi basis sa cell phone sa God gets or na sa bahay nga pero hindi nagi interact ang family about discussing di issue but paano maging progreso ang family yung noticing environment malaki din sabi ko na pamilya yung una peers paglabas ng kung mga kapayut and then the community where they are ito yung crucial ano natin tingnan and then the social media effect wala na conservative ito ano sabi nga natin napakarreligious dito sa amin din napakarreligious pero itong young ones ginawa nilang sex ang lugar yung likod ng groto mayroong kaming bukid na dasalan misan nakikita pa pero parang wala lang happy pa so these are the values na tingnan natin at ano yung knowledge practice ng kabataan ngayong mas malalim sabi ng doc jossy mas malalim na pagaanalyze at anong data ang kukuni natin para mas tumbuk natin kung ano ang intervention na gagawin natin among the youth sa local government because of the pandemic budget shift almost all 90% of our budget nakapokos sa COVID kasi yung sabi kung hundi na kayong magpokovid mag minimum health standard tayo mayroong patayong budget to continue education continue local economic development and the provider so yung tao hindi lang yung health even yung aming MDR yung aming other sector sa local government and partners nakapokos sigay ng services sa COVID kasi hindi lang ko about treatment but also about informing the public and also paka-inin yung nakakwarantiyin at among others and ngayon dahil pandemic na less na yung face-to-face so hindi na napapag-usapan with the youth ang mga talakaya na dapat pinag-uusapan parang naging bahala may mga kongting discussions pero wala ng in-depth na so and then ang mention ko about poverty and security challenging and difficult times and compounded mental health and dami namin mga yung ones na nakakaroon talaga ng mental health and wala silang matanungan ng tabang information especially about their bodies sa modular ang class so wala ng interaction para tingnan ano nangyaring changes sa ating katawan itong mga young ones and ang isa ang current realities that's an opportunity mayroong project ang dole mga junior interns ito na ako yunobog ko bago mag-start sila to work in the local government we start with body, mind and spirit dito ang para values sa kanakahubog ng aking first agenda na balik tayo diprootedness domesticated mapagmahal sa sarili sa pamily at sa bayan di ka magkatamalin para if itong value inculcation then next is the four piece alam mo ang four piece is not a welfare or poverty anong welfare program to me it's more of an education program pag may nakatapos dyan sa pamilyang mahirap siguradong aangat at maaahon sa kahirapan kapagtrabaho itong nakatapos pag-aaral but anong reality as presented ngayon hindi drop out ang laki ng drop out sa mcct may mayro na silang incentive para maging party ng program at makatapos but yet na da drop out kasi nabubuntis malakarang nandon na yung opportunity na wala pa at then ako naman dito sa local ang ginawako ito mga programa kinonsolidate ko ito ginawa namin munisipyo sa barangay so yung service ang program ginawa namin services together with the barangay council or officials para mapadala yung services sa barangay ginawa namin ito regularly and yesterday nga yung isang culmination napakaganda kasi mga yut ang empowered sila nagturo sa amin ng council ng barangay at munisipyo at saca department heads na nan dito kami and sila mismo sabi nila nga lagaan namin magi-start kami sa limang barangay at pati yung yut na involved na sa development at ang isa nila din tinatalakay na hindi maguntis at delay ang pang puwede mag boyfriend pero wala yung sexuality can be pagusapan para maging responsible okay so yun yung isang current realities natin okay and so with this information ako been working with family planning and 10-H yut and development bago pa in 80s pa pero ang frutante ay anong gagawin natin sa mga bagong information ako I look forward to this weekly webinar kasi na dadagdagan yung aking continuous learning to improve father more personal mastery for myself for my family, community and bilang mayor so like now crucial sa aking yung learning paano when I ask our M.H.O bakit ganito yung programa natin talang palawakin na so ngayon meron tayong mga data at information as presented at J.P. para sa ating local policy development na ako ang 10-H pregnancy begin ng focus at nakakontek siya sa maternal nutrition child health and nutrition program hindi siya hiwala'y but focus tayo dito sa young ones na para maprevent yung pregnancy o ma early malate ang paging impregnant and then part of the responsible pregnancy program in universal health care and eventually yung aking ambition do local translation or customization ng ating ambition 2040 program ng government second ay yung youth as part of our economic development and human development and then yung third I think yung yung maganda yung learning sa PG-8 sa 10 months itong sharing nidok Josie and of course itong programa ng PAPCOM with different agencies that sits in the PAPCOM ay pababain sa amin ganun naman ang gagawin namin sa munisipyo pababain pa natin para mas makarating tayo sa ating mga constituents na naghuhubog ng ating mga teenagers at mga youth and farther enhance ako i-review ko agad itong actually ni-review ko ano sinabiyan when I look at the program na binigay ko directions where are we now so this information could further enhance at nang aming strategic direction and program on teenage pregnancy and third is may mga partners na pwede natin as presented kanina yung pogs ako yung transmit ko na pog member palagi akong call apprentice telehealth kasi iba ang needs ng teenager so if we can institutionalize this coordinating mechanism na mapababasa amin sa munisipyo una of course Amelia, Barangay, munisipyo at ganun din ang support ng munisipyo from the province at national agency especially with PAPCOM and National Youth Commission and the other agencies especially like DOHs this WD Dolly TESDA, DEPED, GED among others and of course the other private sector ang tiditing ng po ang dami palang ideas na na mayor na 42 years mayor namin ng mga nangyari sa national na hindi ako na involved kasi nan dito ako sa local kasi ni implement ko sa local na nakita ko ang dami iniisip yung thinkers natin sa mga NGAs private sector ang daming magaganda ngayon ng ating is how do we connect the national programs may be PAPCOM to work with DILG and an integrated framework to localize action para claro ito ang nakakabit-kabit siya nakahulistic systema para pag-implement namin dito ako customize nalang namin at localize and one is ang opportunity na papainazati na program may budget for youth may budget for God so there is a a budget or a resource that we could use to fund intervention that is direct to 10-H pregnancy prevention of 10-H pregnancy or pag napregnant ano ang programang meron tayo and ang kabataan is part of the policy making body na sa municipio may sangunian kabataan na nakaupo at sa lahat ng barangay council napakaganda mga youth nagagawa ng batas para sa kanila at isangan nito is how to prevent 10-H pregnancy and ito very quickly ginama ko yung 2014 kasi Yolanda area kami a reality after a pandemic na raming nabubuntis maraming nabuntis 2014 2013 yung Yolanda and then when I sabi ko tingnan natin yung 5-year data na reduce siya but ito na naman pandemic nag-start to increase and ganun pa rin yung picture yung mas rural ng barangay doon mas maraming 10-H pregnancy yung population zero nang asya eba at ang malapit sa population I think it's more ang mga bata naka-interact pa rin and they can naka-access ng mga information kasi mas malapit baka yun ng theory ko kasi yung partner barangay baka ito din yung mga development na kailangan din natin in place mo ok aso anong paharap natin anong gusto natin mangyare ako with this as mayor is Ayut and development programs ako I think let's go back to values ang ating culture na family as a unit of the society anorising environment pataposen pag-education at help na at anatomy ang nago umpisa but also look at body, mind and spirit at psychological preparedness sa ating mga Ayut para kasabi sila hindi pa ako handa jang kasi ako pwede magbuntis and then itong welfare program gawin natin carot na pataposen mag-aral para hindi magbuntis at makatulong umahon sa kairapan at itong sinasabi ko na maging dahil kairapan mag-asawa ka na or baka potential na bow itong bata kung older maging partner ang reality kung yang naman iniiwanan naman talaga at baka masundan pa kung ituloy ang pagsama ng mga yan so we need to look at holistic framework for youth development then second yung family ma-empowered ito na nga yung mga nandyan sa teen moms nandyan sa dog JP paano natin gagawin sa kumunidad at sa families makakaabot especially ngayong pandemic but there's an opportunity e-government na or digital nakakarating na tayo lahat halos dito 85% my cell phone so pwede gamitin natin as much magandang paggamit itong mga technology at hand no and of course itong community mobilization kagain sa nabig itong ginawa namin municip sa barangay na ang youth mismo ang naging mayingay sa pagpunta namin sila ang nag-lead ka-asama yung kanilang council of course patuloy na stakeholders partners special sa community at itong mga learnings coming from the NGO mga models na ginawa ng in-development partner mabuo natin to and third is a community support group for the peers hindi yan sila pupunta sa RHU para magpagamot o magtanong kasi una pagagalitan agad ay nagbuntish ka bala ka barang ganun it's a reality they don't come right away ang una nilang pupunta han yung kapwa nilang peer youth na hindi rin alam and that's why itong peer support team so doc JP itong ating teen centers na mas mapalawa maraming ano ito with UNEP nangyaring maganda ang best practices that we can do sa local and itong call a friend dahil nga ngayon ay pandemic magamit natin and ang last is involved natin ang youth sa development program youth in congress youth in tourism youth as advocates for COVID magprevent magpabakuna minimum public health standards and also in local economic development ito yung inaano ko with national youth commission ito yung inaadvocate nila with pubcom na paano ito din implement na holistic dito sa amin either directly to the teenager or to the youth then directly to the teenage pregnant woman or child and also them participating in development and progress ito ang programas ay may mga dinagdag ako kasi ito yung inaano ko sa aking MHO and during the local health board magkaroon tayo as part of universal health care ng adolescent youth program na dyan yung services to include health education welfare and protection yung ano yung dapat na mayroong sila information, bakuna dibidual at saka yung health education especially population services and ipasok din yung mental health kasi ito ngayon ang malaking programa and a tailored fit teenage pregnancy services maglagay tayo ng a private sector baka lying in a private sector which the youth can go kasi mas kung baka ano nakapocus kasi private hindi masyadong maramiang tatrabaho at nakakabigay kasi private nga at saka silang nagdidiskas lang walang masyadong maramiang clients so nabibigyan nang focus and teen centers referral centers yung hindi naman siyong kanina ni Bok Thora Emma yung Visaya Self-USA nag-implement we discussed din ito sa PHO lahat inadap sa lahat ng district hospital in Leyte pero ang tanong na sustain that's the one na pwede natin balikan kasi kami sa rural health unit with the lying in ng private provider ay yung next referral namin ng special care ay itong teen center na buu-buu-buu ang pag buntis na titing nansya hindi lang prenatal but the others as mentioned din ni Dr. Emma and part of the reproductive health that 10 components is palawakin yung mail involvement kasi sila ang silang nakakabuntis they are part mas kasama ang babaay at lalaki pero kung makakasabi sila sa babaay na hindi pwede kasi ngayon sa aking random tanong babaay ang mas sexually active at sa kanang ngalabit sorry sa term yung nga na na ito nag-estimulate ng a-relationship at a-mail partner kaya kung ma-empowered ng kababaihan ito mga tabataan ganun din yung mail involved na tin sa let-empowered na okay ang relationship but alam mo mabubuntis ka kung wala kang family planning or wala kang responsive na pananaw no so kailangan natin ma-involved and of course the policies and system at data na paka-importante as mentioned parter profiling of this mga kabataan and also kababaihan and the digital approach of informing and the getting information and second is the IEC health promotion and capacity building and ang third bolit ko is coordination mechanism at the community at outside to LOSA maybe we can institutionalize yung program ng folks at PPS dito sa province para masama sa our healthcare providers networks ang NGOs and other CEOs that could help us para mabigyan ang importance at yung teenage pregnancy and of course resource mobilization especially financing ting na natin LGO financing may also look at real health financing as a major source of financing and as I mentioned kanina a very important sensitive indicators for our performance tracking atin from the teenage pregnant ang top 10 ang top 10 ang top 10 na titing na ang service provider ang top 10 teenage pregnancy ang top 10 ang top 10 ang managers at local government para ma-empower ito mga youth ma-involved at mabigyan services directly at ang top 10 teenage pregnancy of course our continuing organizational at institutional capacity in municipio at barangay of course for leadership and governance kasi ito lang ang pangarap ko ambition doc a-depruted and domesticated to losanos malik tayo organized and orderly to losa makakatulong itong mga youth sa pag-unlad at pag-organisa ng ating anong puwede natin mga gawa for our youth the convenient comprehensive convenient tailored fit especially for them convenient services for to losanos especially for this teenage pregnancy and together may mga executive orders may morando may mga policies sa national work up up J.P. with DILG and NYC kasi DILG ng ang a-ming ang a-ming secretary siya ang a-ming mga mayors no of course ang B.O.H. and to look at technical and also developing partners among others to look right technical assistance and technical information as well as kami ang atong administrative orority that we have we are mandated itong mga information mga gawa namin para itong mga gawa itong facility. So moving forward doc J.P. is of course pop com help us inhabitants and migrant survey may para magamit namin pag-analyze kasi kailangan natin niyang for policy at sa program enhancement. Nagstart ako mag skills ang talent mapping itong mga youth kasi part of our municipio sa barangay services is also to map them para kung sinong pwede kung malagay sa junior junior intern program mamatch din sila yung skills nila to a-productive ito like kahapon nakita ko ang ganda size cheater and arts atong mga bata isang barangay yan wala silang tourism pero sabi ko kayo mismo ang tourism at makakatulong pagaahon ng barangay at saka ng ating mga pamilya and then with the ICT then meron kaming local livelihood program digital online so ito mga bata tinuturuan inaayos yung CV nila at skill so international national at local hina hire na sila dalawang course na ako and then hindi pa yan online business may mga produkto kami lalo ngayon mahirap ang marketing nago online business nila okay and yung policy ang parliament congress as I mentioned SK sa municipio sa council at sa kabarangay council now i-discuss ito mga kabataan yung paano yung care of pregnant and ages or youth development para nga maprevent yung pregnancy may funds nyan sila say let's lagyan natin bagyan naman information itong mga kabataan para mahabudin nila sila mismo youth to youth ang paggawa ng program pang tailored fit kasi sila mismo and direct services from the teen centers may sports clinic ako before before covid but ngayon may hindi po hindi ang ball games but this could be also an opportunity para may engage into something good itong ating mga mga youth and of course their services and last is a continuing collaboration and organizational capacity ng local government municipio at barangay at sa kaito nga ang council sa youth and again as sensitive indicators gamitin natin pag analyze quarterly annual para maslalong maparating natin yung programa and last but not the least the youth ito yung principle of leadership and governance kagay nito ako nga matanda ay palaging thirst for knowledge the continuous learning to improve our personal mastery and ito ang mayiwan natin sa mga youth ang wisdom na natutuna natin so continuous mastery and then paano nila systematize at gagamitin yung information ito magunilang learnings and tayo naman a shared vision sa kanilang mga youth at tayo naman mga wisdom group na mga senior na ay makatulong in that shared vision ng para team continuous ang ating team learning at sa systemic organization of this program sa akin ay punting kaalaman malaking kaalaman gamitin for action at eventually maging habit and pag tayo mag stop maging part ito yung character ng ating mga youth na no kung kalangan mag-no ito continuing or yes to development yes to congress sa local to participate in the discussion organized tayo and this is a lifelong process of continuous learning so with this say with slide with popcom thank you J.P. hopefully NYC DOH Will Health and other engines stop COVID death webinar session poit tulosa ay say halika na prevent teenage pregnancy mag youth in development in the next normal magandang umhapon and thank you very much Thank you very much that's Dr. Ophel Alcantara Mayor of Tulosa Leite baka dapat governor na o kaya President President Alcantara napakayaman napakayaman ng kanyang presentation at napakalina in terms of yung comprehensive development so parang ko parang ang take away ko sa mga sinabi niya ay yung teenage pregnancy parang siyan ay hindi yung problema it's a symptom of something else okay we're going to ask all our panelists to open their their videos right now and while they're doing that we have a public service announcement from stop from TVUP TVUP go ahead paed po gamat po Mama bayad po na po, anak tabi mo na yan para masukliyan ko ang mga sacrificio na sa na taong bayan makagbigay po kayo na ikita ko ang mahal na mahal ninyo ang inyong pamilya kama ka kaya nag-alala na ako parang mamatapos ang pandemiyang to? para matapos umpisahan na ninyo magpabakuna na kayo man ko kayo magpapabakuna ko thank you so much thank you the covid communication PSA is one of the many outputs of the up research entitled communicating covid-19 in post quarantine Philippines it is headed by none other than our vice president for public affairs at up doctor elena pernia and it's funded by the DO STP CHRD and the DOH under the ahead HSPR project over to you dr. susie thank you very much Raymond for that now I think we're almost at the top of the hour so we're going to we have actually two members of the Philippine obstetrics and gynaecological society who are going to ask some questions or make some very brief comments so Raymond let's call on them now okay let's start with dr. Socorro Bernardino she is the former president of the pediatric adolescent gynaecology society of the Philippines during the years 2018 to 2019 dr. Sox okay thank you Raymond na na for the introduction I'd like to congratulate all the speakers in corollary with the objectives also of the society na pediatric gynaecology as well as nang aming mother society ang Philippine obstetrics and gynaecological society nang thrust natin is to really prevent teenage pregnancy manami po tayong natutunan manami po tayong natutunan na information at the same time we have also learned a lot of tips and the proponents na lang para mapreventang ating teenage pregnancy so with this I'd like just to share what would be the effect ng pandemic na ito sa atin we have data in one hospital government hospital we're in we have the section of pediatric gynaecology kung saan we cater for teenage pregnant patients kasi high risk pregnancy unit po kami napansin po nalaga namin that the prevalence of teenage pregnancy from 2011 to 2019 has really increased both as inpatient when you say inpatient can delivery stamina at the same time ang aming opd for prenatal check up however during the 2020 na start ng pandemic it has decreased siguro kasi meron tayong lockdown at the same time mobility was also limited to these teenagers di sila pumapaso but then napansin namin na pag ating ng january to june 2021 from 4% na opd sensors namin na sa 20% na siya so I don't know if this is a significant thing this is a one unit data but I guess siguro the the reasons na sinabi po niyusek Paris kanina nagsaset in na yung limited RH services for these teens so yan po ang aking masishare sana po hindi ganito ang trend but nevertheless we are seeing it ang aming prenatal check ups and teens mas nag increase na po ngayon 2021 okay thank you for that very very quick reaction po na Doctora Socks and now we'll like to hear from the Pogs Regional Director for Region 10 Doctor Emelda Pascar-Bahal Doctora Kar-Bahal Yes, good afternoon Marami ko salamat sa pag-ibita dito sa webinar na to and I am very glad to be here now in terms of teenage pregnancy in our region and as mentioned repeatedly by yusek parents outside the NCR is one of the highest has one of the highest incidents of teenage pregnancy and particularly Region 10 is the second in the statistics now the thing po dito sa pandemic I still don't have the concrete data or the concrete statistics with regards to the teenage pregnancy but the information the information I gathered from the different area coordinators in our region there is already a referral center which has a 12.07% rate of teenage pregnancy from January to June so that is still an alarming figure now because one in kagayante ora city because our referral our hospital is a COVID referral center maybe the decrease in the teenage pregnancy delivery is because of fear of having the COVID and they have only 1.2% although our advocacy programs are being implemented during before the pandemic before the pandemic but during the pandemic the programs are really put on hold however there are really challenges that we were we encountered in the region because most of these teenage pregnancies are they come in labor already very late and they don't have even the counseling in the primary health centers if they are being asked if they were being counseled they don't even they are not being aware that they should be receiving counseling with teenage pregnancy pregnancy and they are not also they don't even realize the impact and outcome of their behavior majority are also in days because of the sudden shift from teenager to motherhood and they cannot even grasp the severity of their situations so I think just like what Dr. Bernadito have said we have received teenage pregnancy consultation tumaspo yung consultation namin din but although we don't have yet the exact figures but we expect that now in terms of we have our brothers and sisters in the Muslim areas teenage pregnancy is still expected because of their culture of the and the practice of what they call this is yung parang arrange marriages and sometimes it is being in the being to settle dispute among families so parang expected parin ang teenage pregnancy among them but in our region just like the other sectors we also want to decrease the teenage pregnancy in our region because teenage pregnancy by decreasing it we also decrease the maternal morbidity and mortality in our region and that is contributing to the economy of our country also that's all that I can share thank you very much Dr. Carbajal and to the Philippine obstetrics and obstetrical and gynecological society for your participation today and you know we're really out of time but everything starts with a discussion and I think raising awareness of the problems, the issues is enough for us today to be able to go back think about what we need to do and I think right now we're going to ask for closing remarks first it's very brief so a minute or less anong message nyo sa mga nanunood no we have frontliners, nurses, doctors from all over the country who are watching so what are your parting words for our audience today we're going to start with Mayor Ophell Ophell okay thank you so much Dr. Susie Susie and that team called ang masasabi ko as ang ating lalo na yung gumagawa ng programa ay mas palawakin pero may tutok sa ating team okay na pre-siata si Ophell okay did you want to finish your state-year sentence kasi medyo na puton palamin natin alamin natin ya ah ganun ba ngayon how is it how is it okay, better palawakin palawakin palawakin ang kalaman at tutok para sa ating magil ako as member ng pamilya so makumpisa tayo sa ating pamilya mabantayan kasi kakaibat talaga ang teen age itong group na ito bigyan sila ng special attention at hindi lang siyang pagsasalita but alamin basi sa kilos ng ating mga kababaihan at kalalakihan din ng mga youth kasi ito ang kailangan matutukan sa family level palam and palamin agad sa amin na sa position na sa ako as mayor at sa aming local government ating tugunan agad para hindi mas maging problema so ay thank you for this opportunity again to share and patuloy saludo ako sa inyo Dr. Susie and Raymond and to all the team in this step COVID-19 COVID na marami pang crisis tutukan at ating subpoe marahing salamat po Thank you very much it's near of L. Alcantara let's go to a few closing remarks from Dr. Joy Dr. Joy Raymond na wala basi Dr. Joy na time today though yes please your partner my parking words is an appeal young adult fertility and sexuality study is going on field despite the pandemic and they are going to the regions so ang aking paki-usap sa inyo kung paki-paki-paki ang aming mga hindi hindi hindi hindi maon ang video ko if you can help in any way to facilitate the entry of our interviewers into your areas if you encounter them mahirap ko mag-serving ngayon pero kailangan natin gawin yun po nga yaps ang isa sa mga pinaka-importanting source ng data natin kung pulta sa teenage pregnancy at kung ano ang nag-the-drive ng trend na ito so sana po kung mak-encounter nga sila ay please especially si Mayor baka masampul po si Mayor ang inyong municipality or your friend mayors yung mga teams namin na pupunta sa lady I hope you can mapanggit nyo sa kanila para mapapasok yung aning mga interviewers for Yaps 5 Thank you Thank you very much Let's have Dr. Emma Lianto Yes, na yes Dr. Emma Lianto you're closing remarks We have Dr. Emma I'm not seeing her I'm still she might have fallen off disconnected but Let's go to GP Paris GP you're closing remarks you're on mute Dr. GP we can't hear you sir That's it Hindi na go work anyway Thank you to the other reactors and I also learned from the reactions and from all the insights of the audience but my closing message here is that team pregnancy is not just a health problem very often we think this is a health problem but it's beyond health it must be addressed by other social sectors and different sectors in government so let us look at it as a problem that needs community and our individual actions magtulung-tulung tayo paraming salamat Thank you very much that's Dr. GP Paris the executive director of POPCOM and last but not the least Dr. Benjamin Quenta please see your closing remarks Thank you Dr. Susie we now appreciate that the problem is really multi-sectoral and therefore rather the approach must be multi-sectoral because the problem is going to linger it will cross and generations from now if we don't do something about it and we have to start from somewhere I can see here that the approach must be as I've said must be consolidated on a national level and each stakeholder must be engaged with identified roles to play so yun lamang pa and as as the head of the Philippine obstetrical and gynecological society I will reiterate again that the doors of POGs are always open for collaboration not only to help societies like us but more importantly to government agencies who would like to tap us tap our members members numbering to about 4,890 across the country we are very willing to work with you let's make a dent in this lifetime and not in the next let's see the difference that we can do all together during this lifetime thank you thank you very much Dr. Cuenca the president of the POGs and Raymond we'll launch our evaluation now yes we're seeing 630 plus of our remaining attendees for those who are still in the zoom please feel free to input your answers po I'll just read off the questions number one the panelists demonstrated thorough knowledge of the topic number two the panelists were well prepared and organized number three the panelists spoke clearly and audibly number four the panelists used appropriate language with technical medical jargons adequately explained and number five contributed to new perspectives and knowledge on managing various key COVID-19 health issues over to you Dr. Susie for the introduction of our closing remarks speaker thank you very much Raymond and it's my honor to introduce our closing remarks speaker again this takes me back to the time of Secretary Flavillier when the most successful family planning campaign was actively done under the wing of our next speaker Mike Delarosa who was working with the Johns Hopkins University on a campaign called kung silay mahalin nyo mag-plano and he's now NEDA Undersecretary for Corporate Affairs and takes this topic very dearly to close to his heart he's very close to this issue and has really been championing the issue on family planning as a development issue so like to welcome Undersecretary Mike Delarosa Mike your closing remarks please yes, good afternoon to everybody hello to my colleagues to my UP colleagues actually I wanted to wear my new UP T-shirt but this is our evidence and I am representing NEDA NEDA is the primary agency that's heading the population program now as chair of the PAC Con board and to my colleague Yuseka D.P. Perez to our reactors mayor, idol mayor Ovel Alcantara doctor mayor parang ikaw na yung aking model ng pro-servant no, government servant and to doctor Natividad doctor Lianto and of course Raymond and of course my favorite doc Susi and doc Nanny Pernia B.P. of UP now a pleasant afternoon all of us witness how the COVID-19 havoc on the lives of the people this pandemic affected every facet of our lives but the most affected are the vulnerable population the poor, the older persons and even our young population our young population are affected by the pandemic not in the way older persons and persons with comorbidities are affected but in other aspects such as in education and health particularly on their access to reproductive health services from the presentation we learned that unintended pregnancy in itself is a great concern having wide range of consequences for both the mother and her child but it is far more worrying when the mother is still a child herself although the number of births have been declining for ages 15-19 births from younger children are slowly increasing the pandemic may exacerbate the issues as access to reproductive health information services have been a challenge among the youth with further inaccessibility for essential sexual and reproductive health services because of mobility restrictions this was estimated to produce 102,000 unintended pregnancies last year alone we are still unsure how this new quarantine measures will also impact these young people to address these challenges we at NEDA updated the Philippine Development 2017-2022 plan to ensure that the government strategies will be responsive to the new normal specifically Chapter 13 reaching for the demographic dividend across all regions highlights the use of innovative mechanisms to deliver reproductive health information and services especially among the youth this include the provision of health lines to provide information as well as referral services on family planning and the prevention of both adolescent pregnancy and gender based violence it also calls for the use of technology like online platforms and cell phone applications or apps to generate demand for services and for advocacy we are glad that from the presentation of our use at GP most of these strategies are already being implemented in addition the national and local government units and its partners the civil society organizations and international development organizations are working together for the full implementation of the responsible parenthood and reproductive health law and executive order number 12 attaining and sustaining zero unmet need for modern family planning the implementation of this policies are vital during the time of pandemic to ensure that individual reproductive health rights are being fulfilled we also included projects and initiatives that further improve the delivery of reproductive health services in the updated public investment program 2017 to 2022 such as the national program on population and family planning which addresses teenage pregnancy although we are currently facing enormous challenges as we are competing with other pressing priorities brought by COVID-19 pandemic we managed to pursue the reproductive health agenda for young people designing of the executive order 141 adapting as a national priority the implementation of measures to address the root causes of the rising number of teenage pregnancies and mobilizing government agencies for their purpose indicates the government's commitment to strengthen its interventions to ensure the development of our adolescent population we thank PAPCOM and the other members of the Board of Commissioners for their relentless efforts to ensure the signing of this EO by the president now that the policies and programs are in place we hope that these are appropriately implemented and further strengthen especially during this time of pandemic I would like to thank the UP NIH for spearheading the conduct of this webinar series I also extend appreciation to our reactors who gave valuable insights on the issue at hand activities such as these as a venue for the RH and youth advocates as well as the general public to learn about current government initiatives and know how they can participate and advocate for it we encourage everyone especially the adolescents to support the implementation of the identified reproductive health policies and programs these are key elements towards the attainment of the sustainable development goals as well as the realization of the Commission 2040 of having a matatag pag-inhawa at panatag na buhay in closing, thank you to all I have been in the program for a long time and I am really glad that we still have the champions around Mabuhay tayong lahat Mabuhay ang pag-rana Barami, salamat Thank you very much it's under Secretary Mike de la Rosa economic and development authority NEDA for that closing and that reassurance that this is really seen by the government as an integral part of our development so I think we are going to okay so next week don't miss it balik tayo sa bakuna we will talk next week about bakunado and we will have I believe we are going to have the Department of Health we are trying to get some of the local governments to talk about this and continue to persevere and getting more people vaccinated so don't miss it next week we will see you on Friday Ray, mad over to you Thank you Dr. Susie we are seeing very consistent results as regards the evaluation poll for attendees who were able to key in their answers for our evaluation of our panelists and thank you from the bottom of our heart thank you po for the extensive and comprehensive findings and also updates from each and every one of our resource speakers when we were trying to plan this we did not anticipate that this will be a hot topic but just seeing all of the reactions from the chat it was really very well received so thank you po sa inyong lahat before we conclude our program let's first acknowledge the following these are the individuals po or the groups who are making a difference in making sure that our learning series is possible and together with each and every one of you who constitute our credible online community thank you po and then finally our webinar from number 1 to number 64 and then after this webinar po number 65 will be archived and can be viewed po at any time at the YouTube channel of TVUP if you are having any trouble po just go to www.youtube.com and then look for the TVUP page and you'll be able to see it I just want to give a quick shout out to those who have registered and are attending po all the way from San Marcelino District Hospital in Zambales, Santa Rosa Community Hospital in Laguna, Dr. Gomersindo Garcia Senior Memorial Hospital in Caban Calan, Negros Occidental from Mindana State University College of Medicine in Ilegan, Lano, Dill Norte and Kotabato Regional Medical Center in Kotabato from BARM Internationally also National Center for Global Health and Medicine from Tokyo, Japan, Mexico, in Taipei, Taiwan VISM Hospital while you're India, Bangkok, Thailand Abu Dhabi and Dubai Inhat po kayo ating mga kababayan OFWs from Al-Ostra Medical Center Saudi Arabia Lunichi Ali University of Bleeda to Algeria Bagopuyon University of Fiji in Lautokofiji, St. Catherine's from Canada and from Johannesburg in South Africa So this brings our webinar to a close Makita kita po tayo ulit Next week, same time, same channel Every Friday from 12 noon to 2 pm It's a date! Together we can stop COVID deaths So keep safe, keep healthy and see you online! We'll stay with you until the coast of spirit The other Spain before my fears The other lives before my tears But right behind the mask I look into myself and ask Do I have strength to carry on Oh God, how long will this go on And leave you here to keep me strong I'm here to hold the line Oh keep my hand Until my hands His name to realize It's fine to be Just hold on to the word he gave This time we'll come to pass Cause this salvation makes a last You'll carry you to see the break of day The other Spain before my fears The other lives before my tears But right behind the mask I look into myself and ask Do I have strength to carry on Oh God, how long will this go on And leave you here to hold the line Oh keep my hand Until my hands die For my fears The other lives before my tears But right behind the mask I look into myself and ask Do I have strength to carry on Oh God, leave you here to keep me strong The other Spain before my tears These things through another day