Participatory Children's Health and Nutrition Program (PH0064)

What is the commitment?

The emerging concerns (malnutrition and child pregnancy) within the context of the Pantawid Program have not been fully explored by researchers, and need further study. To do so, however, we need to have a better understanding of the context of the target families’ lived experiences.
● The commitment of the agency is the conduct of two Participatory Action Researches (PAR). PAR is an approach to research that emphasizes participation of community members in defining the problem, gathering and analyzing data, and arriving at solutions to the problem collectively. It is best for planning to emanate from the families themselves as only they know the situations they actually face and the options readily available to them. As they express how they choose from among available and potential options, solutions can be tailored to their specific needs and the capacities of the community to act on or absorb a program. The process of engaging the community and stakeholders through all the phases of PAR will be documented.
● Through the PAR, the community will be able to look deeply at the issues and address some of the identified factors impacting nutrition, in particular socio-cultural beliefs and perceptions which contribute to the problem of nutrition not being perceived as ‘urgent’ and issues related to accessing quality health facilities, such as transportation costs and unavailability of free medicines. While Municipal Nutrition Action Plans exist and are described as ‘comprehensive’, the participation and inputs of the community, especially of families who are in most need of assistance, in its crafting must be central and their involvement in the plans’ impact assessment and evaluation made more visible. Results of the research are also expected to be considered in the crafting of local policies on the focus areas.
● The first PAR will focus on the nutritional status of children in 4Ps families and will be led by 4Ps parent leaders and volunteers. The second PAR on the problem of teen-age pregnancies will be led by leaders and volunteers of 4Ps youth groups. In both researches, the program component of 4Ps—the Family Development Session and Youth Development Session—will be utilized to promote open conversation with beneficiaries, both adults and youth.
● In spearheading this conversation, DSWD will leverage its access to the families and children in 4Ps and other programs, as well as its role as head of the Cabinet Cluster on Human Development and Poverty Reduction and its network of NGO/CSO partners. The design and implementation of programs, projects, and activities (PPAs) are expected to be grounded on what its target beneficiaries want and need and delivered in a manner that responds holistically to the articulated needs. The approval and support of the local government units on the process and outputs will be solicited to facilitate integration in local development plans and sustainability of initiatives.
● Finally, the commitment hopes to ensure that the objectives and processes involved in the PPAs are understandable to the recipients themselves such that they become interested, undertake the required training, and enthusiastically participate in the accountability process that will be put in place to monitor and evaluate the value and impact of the PPAs.
 The inclusion of those who will be directly affected by policy initiatives should help refine the context within which problems are understood and approached to reveal issues that are otherwise overlooked, such as ‘invisible’ barriers that impede or limit demand and access to government services by those who most need them. Likewise, by allowing local and marginalized voices to be heard, people are empowered and hopefully encouraged to engage in the political process so that they are less isolated and able to share their public policy successes with other communities to become part of a virtuous cycle of active citizen engagement.
 The highest objective is to bring the results of these conversations to policy-makers and program managers at the highest levels so that they hear what the people for whom policies, programs, and projects are intended have to say. By enabling them to examine and articulate their own needs, the people that government say they serve will be able to influence how programs are designed and delivered so that these are contextualized and behavioral barriers normally not apparent to policy-makers are addressed.
 The weight and might of the whole of government is brought to bear on the protection of children and the corollary need to support their families. This is the convergence approach referred to in the Philippine Development Plan 2017-2022 that requires the implementation of a multi-sectoral roadmap for children to “build an enabling environment that respects, protects, and fulfils the rights of all children in the country . . . [in order for them to] attain their full potentials as enshrined in the United Nations Convention on the Rights of the Child (UNCRC).”

See Action Plan for additional information

8. Nutrition and Reproductive Health Participatory Action Research

"The commitment of the agency (DSWD) is the conduct of two Participatory Action Researches (PAR). PAR is an approach to research that emphasizes participation of community members in defining the problem, gathering and analyzing data, and arriving at solutions to the problem collectively.

Through the PAR, the community will be able to look deeply at the issues and address some of the identified factors impacting nutrition, in particular socio-cultural beliefs and perceptions which contribute to the problem of nutrition not being perceived as ‘urgent’ and issues related to accessing quality health facilities, such as transportation costs and unavailability of free medicines."

Main Objective

1. "The inclusion of those who will be directly affected by policy initiatives should help refine the context within which problems are understood and approached to reveal issues that are otherwise overlooked, such as ‘invisible’ barriers that impede or limit demand and access to government services by those who most need them. Likewise, by allowing local and marginalized voices to be heard, people are empowered and hopefully encouraged to engage in the political process so that they are less isolated and able to share their public policy successes with other communities to become part of a virtuous cycle of active citizen engagement;
2. The highest objective is to bring the results of these conversations to policymakers and program managers at the highest levels so that they hear what the people for whom policies, programs, and projects are intended have to say. By enabling them to examine and articulate their own needs, the people that government say they serve will be able to influence how programs are designed and delivered so that these are contextualized and behavioral barriers normally not apparent to policymakers are addressed; and
3. The weight and might of the whole of government is brought to bear on the protection of children and the corollary need to support their families. This is the convergence approach referred to in the Philippine Development Plan 2017-2022 that requires the implementation of a multi-sectoral roadmap for children to “build an enabling environment that respects, protects, and fulfils the rights of all children in the country [in order for them to] attain their full potentials as enshrined in the United Nations Convention on the Rights of the Child (UNCRC)."

Milestones

1. Policy Issuance on the conduct of PAR.
2. Choose pilot areas based on high incidence of malnutrition and teenage pregnancy (target areas: Camarines Sur, Negros Oriental, Negros Occidental, Zamboangao del Norte, Bukidnon, South Cotabato, Manila {Welfareville, Baseco, Bagbag}, Maguindanao, and Lanao del Sur, Regions II, VIII).
3. Mapping of CSO partners.
4. Strengthen partnership building through signing of MOU between DSWD, DBM, DILG, CSOs, LGUs.
5. Development of research design and workplace.
6. Development and pre-test of module on PAR.
7. Formation of PAR teams.
8. Trainings for parent-leaders/volunteers of the PAR group (to include Gender Sensitivity Training).
9. Conduct of participatory action research: Implementation of the community action plan; Tasking and assignment of roles; Reporting and evaluation mechanism in place.
10. Submission of research results with recommendations on Pantawid program enhancements.
11. Development of a communication plan towards addressing issues identified on malnutrition and teenage pregnancies based on the research findings.

Editorial Note: For the complete text of this commitment, along with the updated version submitted in the revised action plan, please see the Philippine action plan at https://www.opengovpartnership.org/documents/philippines-action-plan-2019-2022/.

Commitment analysis

This commitment introduces participatory action research (PAR) to create a holistic and integrated approach to address child malnutrition and early pregnancy in the Philippines. Families part of the Pantawid Pamilyang Pilipino Program (4Ps), the Philippine Conditional Cash Transfer program of the Department of Social Welfare and Development, will use PAR and engage their local government units (LGUs) to implement solutions in collaboration with civil society partners. Through PAR, families can identify and implement solutions for the nutrition and reproductive health concerns of children in the identified communities.

The 4Ps program is the biggest social protection program in the Philippines. The government provides cash transfers to poor households in exchange for compliance to health and education conditions to help break intergenerational poverty. It was introduced in 2008 during the term of then-president Gloria Macapagal-Arroyo and has grown exponentially in terms of coverage—from 376,000 households in 2010 ^[100] to 5,066,892 households in December 2019, making it the cornerstone of the government’s social protection policies. Beneficiary households are found in 144 cities and 1,483 municipalities across 80 provinces. ^[101] This commitment empowers families to shape the conditions to receive payments so that they address the underlying drivers of malnutrition and teen pregnancy. Therefore, this commitment has the potential to expand the program’s benefits beyond financial, education, and health support to include the benefits of civic participation.

While PAR has been applied to the childrens’ sector, this commitment represents a novel effort to apply PAR to a formal government program. Through this commitment, DSWD will partner with CSOs to train community members for PAR on malnutrition and teenage pregnancy. Citizens proposed this approach to DSWD, who realized there were concerns of high malnutrition and teenage pregnancy among 4Ps households. ^[102] DSWD notes that malnutrition and teenage pregnancy are national concerns not particular to 4Ps households. However, 4Ps is well placed to implement this commitment as preventing child malnutrition and early pregnancy requires improvements in parenting skills and behavior change, which has always been the ultimate goal of Family/Youth Development Sessions conducted within the program. [103] Through the PAR, communities will be involved in identifying and analyzing problems and developing action plans to respond to their own problems. This is important as communities may suffer from similar problems but require different solutions depending on the root causes and underlying factors. Priority sites will be chosen based on high incidences of teenage pregnancy, hunger, and malnutrition as well as where CSOs are located. ^[104] However, the COVID-19 pandemic required the program to reduce its scope to around seven research sites in four regions (NCR, Region 5, Region 6, and Region 9). ^[105] Results of the PAR will then be used to advocate for action from the relevant LGUs and other members of the community. The PAR will be timed with LGUs’ budget process to facilitate LGUs’ response to citizens’ recommendations. Each location’s efforts will be analyzed and documented to determine best practices. ^[106]

This commitment is relevant to the OGP of civic participation. Involving the 4Ps beneficiaries and community members in the research will not only help the government identify wider and deeper causes of teenage pregnancy and malnutrition, but also educate beneficiaries about their roles and responsibilities relating to these issues. ^[107] It is also important to note that the commitment’s design includes gender-sensitive programming such as ensuring women’s representation in the PAR process and developing gender-sensitive advocacy tools based on the PAR results.

This commitment has a moderate potential to improve civic participation in strengthening the Pantawid Pamilyang Pilipino Program. This reform can establish the policies, process, capacity, and relationships between the civil society, relevant government agencies, and LGUs needed for PAR. However, the commitment’s impact will largely depend on two factors. First, it will depend on the number of communities covered by this reform, as COVID-19 has caused DSWD to lower the number of communities involved. Second, vital to this reform is whether PAR findings are reflected in LGU budgets. Memorandum of understanding between DSWD, DBM, DILG, civil society, and LGUs will hopefully provide a basis to ensure LGUs act on PAR recommendations. If PAR efforts are successful and expanded across the program, this commitment can achieve transformational long-term results, as the Pantawid Pamilyang Pilipino Program is one of the largest cash transfer programs in the world.

Next Steps

The most critical aspect of this reform is whether PAR findings are incorporated into 4Ps and LGU budgets. Potential activities to ensure that the government responds to citizen feedback include:

• Training community and CSO volunteers to advocate to their LGU and government agencies based on their PAR findings;
• Seeking guarantees that LGUs will hold public consultations to consider PAR findings from the outset;
• Establishing incentives for LGUs to incorporate PAR findings into their budgets;
• Capturing and sharing success stories in which program and budget changes in response to PAR findings led to improved health in a community; and
• Following up with a report on where PAR findings resulted in program and budget changes with recommendations for other areas.