THE DEVELOPMENT CONTEXT - s3.amazonaws.com · 4 Table 2. Caraga Socio-Economic Targets, 2004-2010 SOCIO-ECONOMIC INDICATORS ANNUAL TARGETS GRDP annual growth rate 4.40 % Service sector

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THE DEVELOPMENT CONTEXT

Introduction

In September 2000, the United Nations General Assembly concluded the Millennium Summit with the adoption of a Millennium Declaration renewing global commitment to peace, respect for human rights and setting specific goals and targets towards reducing poverty and the worst forms of human deprivation. The Philippines was among the 47 member states which signed the Declaration and has vowed to achieve the targets set by 2015.

The MDG is a specific and time-bounded goal comprised of 8 related goals, 18 targets and 48 indicators. The development goals as enshrined in the declaration are to:

1. eradicate extreme poverty and hunger; 2. achieve universal primary education; 3. promote gender equality; 4. reduce child mortality; 5. improve maternal health; 6. combat HIV/AIDS, malaria and other diseases; 7. ensure environmental sustainability; and 8. develop global partnership for development

The goals and targets are not mutually exclusive but are integrative and are premised on the basic human rights of every individual. It is not a new set of commitments but a reinforcement of the previous international commitments made by the member states with the intent of uplifting the quality of life of every individual regardless of sex, age, race and nationality.

In February 2005, the Regional Development Council Caraga has also reaffirmed its commitment to bring about quality life to its constituents and adopted the MDGs as a development framework. The integration of other international human rights instruments and national development agenda in the local development processes is a vital concern of the Council along with bringing development to every individual in Caraga Region.

ECONOMIC SITUATION

Caraga is a relatively young region created in 1995 by virtue of Republic Act (RA) 7901. As of 2000, Caraga has a total population of 2,095,367. Around 51 percent of the total population in the region is male. By year 2042 the population of Caraga Region is estimated to double. It has a total land area of 20,710.9 sq. km. divided into seven geo-political subdivisions, with four provinces and three cities namely: Agusan Del Norte, Agusan Del Sur, Surigao Del Norte, Surigao Del Sur, Bislig City, Butuan City and Surigao City. Caraga Region is one of the less populated regions in the country with 101 persons per square kilometer. Surigao City is the most densely populated with 483 persons per square kilometers followed by Butuan City with 327 population density. Agusan Del Sur has the largest population size accounting for 27 percent of the total population in the region.

Table 1 shows selective socio-economic indicators for Caraga. Its economic performance showed a better picture in 2004. It surpassed the Gross Regional Domestic Product (GRDP) growth rate of 0.9 percent in CYs 2002-2003, posting a 5.8 percent growth rate in 2004. This raised Caraga to the 9th place in GRDP growth rate among the 19 regions of the country. Among the Mindanao regions, Caraga placed 4th, besting Region IX and the Autonomous Region of Muslim Mindanao (ARMM). This is a remarkable improvement from the region’s previous performance in 2003, when it had the second lowest GRDP growth rate across the country and the lowest GRDP growth rate among Mindanao regions. However, in terms of percentage distribution, Caraga had the second lowest percentage contribution to the GDP across the country and in Mindanao, beating only the ARMM. For 2003 and 2004, the region contributed only 1.16 percent to the country’s Gross Domestic Product.

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Exports reached US $ 49.756 million while a total of PhP 1,991.556 million of investments poured into the region in 2004. Agusan del Norte got the highest share of investments in the region, comprising 36 percent of the total investments in Caraga. Surigao del Sur has 646.480 million pesos worth of investments in 2004, for a 32 percent share. Agusan del Sur has the lowest investment share, with its total investments reaching 157.837 million pesos. The employment rate of the region managed to increase by 1 percent, from 89 percent in 2003 to 90 percent in 2004. The unemployment rate decreased to 10 percent in 2004, from its 2003 level of 11 percent.

Table 1. Key Development Indicators, Caraga Region, 2003-2004

Indicator 2003 2004 Population Size 2,095,367 (2000) Male 1,071,249 (2000) Female 1,024,118 (2000) Population Growth Rate 1.63 (2000) Land Area 20,710.9 sq.km. Gross Regional Domestic Product (@ constant 1985 prices, in thousand) 12,455,017 13,172,232 Percentage Share of Sectors to the GRDP

• Agriculture, Fishery and Forestry 28.63 30.14

• Industry Sector 28.92 27.97

• Service Sector 42.44 41.89 Share to GDP 1.34 1.30 Caraga’s share to Mindanao GDP 7.49 7.29 Foreign trade and industry 466,261,000,000

Caraga’s Export (in million US $’) 49.756 Caraga’s Investment (in million PhP) 1,991.556 Employment Rate 89% 90% Unemployment Rate 11% 10% Underemployment rate 18.6 % Poverty Incidence of population 54.2 % Functional Literacy Rate 81% Male 73.3 % Female 84.6 % Elementary participation rate 74.80 percent (SY 2005-2006) Male 74.48 percent (SY 2005-2006) Female 75.12 percent (SY 2005-2006) Maternal Mortality Rate (per 100,000 livebirths)

143 per 100,000 livebirths

100 per 100,000 livebirths

Infant Morality Rate (per 1,000 livebirths) 9.6 per 1,000 LB 9.7 per 1,000 LB Sources of data: NSCB, NSO, Dep-Ed Caraga, DOH-CHD Caraga

The region remains hopeful in attaining its targets and goals indicated in the Caraga Regional Development Plan 2004-2010. Anchored in the ten point agenda espoused in the Medium Term Philippine Development Plan, the region aims to pursue the targets as listed in Table 2:

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Table 2. Caraga Socio-Economic Targets, 2004-2010

SOCIO-ECONOMIC INDICATORS ANNUAL TARGETS GRDP annual growth rate 4.40 % Service sector growth rate 5.66 (5.3% – 6 %) AFF 4.13 % (3.9 %– 4.5 %) Industry 2.86 % (2% - 3 %) Job creation 64,848 jobs per annum (2005-2010) Creation of MSME’s 2,085 annually Poverty reduction 2.7 % annual reduction Maternal Mortality Rate reduction 10% decline annually Infant Mortality Rate Reduction 5 % annual reduction

Participation Rate 2 % annual increase

ECCD Gross Enrolment 2 % annual increase

As part of Caraga’s initiatives to spur economic development, the Regional Development Council (RDC) founded the Industry Clustering (IC) in the region. By virtue of RDC Resolution Number 6, series of 2005, the IC was adopted to enhance region’s competitive advantage in economic growth. It was developed to address the problem on lack of market opportunities, which depend largely on production quantities, homogenous standards and regular supply of raw materials and finished products. IC promotes networking among local enterprises, buyers, input providers, local policy makers, the academe, research institutions, transport and hauling providers and other stockholders in the industry. Moreover, it also answers the problem on markets that require large production by pooling all raw materials and finished products. Thus, small-scale producers have the chance to compete globally with the large-scale producers in the other parts of the country. Primarily, Industry Clustering facilitates investments for the ten clusters. These are: wood, oil palm, tourism, banana, abaca, high value vegetables, seaweed and arts and crafts, processed foods and the information and communication technology clusters. The investment potential from the industry clusters in Caraga is estimated to amount to more than PhP40billion. Aside from the IC, the Caraga RDC also created the Regional Investment Exports Promotion Committee on February 23, 2005 through RDC Resolution Number 14, series 2005. The RIPC was created to establish the framework and define the mechanisms for the integration, coordination, planning and monitoring investments in the region. Infrastructure projects also play a vital role in the economic development of Caraga. In Butuan City, 2nd Magsaysay Bridge, the longest Bridge in Mindanao costingPhP2.15Billion was recently inaugurated. The bridge grants easy and convenient access to people, goods and services in the northeastern part of Mindanao. A bustling economy, fast transport of agricultural products as well as the influx and multi-exchange of goods and services is expected. REPORT PREPARATION PROCESS The Caraga Regional Progress Report on the MDG CY 1990-2005 is a product of a collaborative and participatory process. Key stakeholders were involved and consulted from the conceptualization, drafting and finalization of the report. Series of activities were undertaken to ensure a socially inclusive process in coming-up with a comprehensive progress report.

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The Regional Development Council through the Social Development Committee convened a Regional Technical Working Group for the Millennium Development Goals (TWG for the MDG) to spearhead the conduct of assessment. Members of the TWG came from various regional line agencies and local government units. As an initial step, an internal agency assessment was conducted by the members of the TWG. The output of the assessment were presented and discussed to the body during one of its meetings. While the regional line agencies were undertaking an internal assessment, the local government units also convened and conducted their own assessment in preparation for the visit of the RTWG. Through the focus group discussion cum field visit, the four provinces and three cities presented to the RTWG the result of their initial assessment. Representatives coming from the various local offices participated in the discussion with the Regional Team. Data validation was also done during the Focus Group Discussion (FGD). The LGU good practices were also visited and documented by the RTWG. The field visit allowed close interaction between the project/program implementers, beneficiaries and the member of the RTWG. After conducting the FGD-cum field visits, issues and concerns raised during the FGDs were deliberated and addressed by the concerned agencies. The first draft of the report was prepared in close consultation with the local government units and the partner agencies. Comments coming from the NEDA Central Office were also considered and integrated in the draft. The final draft came out after integrating the comments and suggestions generated during the RDC-Social Development Committee Meeting where the findings of the RTWG assessment on the performance of the region in relation to the goals and targets were presented. The progress report was then presented to the Regional Development Council. The final legitimization of the report was in the Regional Development Council where it was presented, approved and endorsed by the body.

Figure 1. Report Preparation Process

SDC-TWG(convened)

Agency Assessment LGU FGD cum Field Visit

Drafting

SDC Presentation and Adoption

RDC Presentation and Endorsement

Integration of TWG and NEDA CO comments

Draft finalization

SDC-TWG(convened)

Agency Assessment LGU FGD cum Field Visit

Drafting

SDC Presentation and Adoption

RDC Presentation and Endorsement

Integration of TWG and NEDA CO comments

Draft finalization

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EXECUTIVE SUMMARY

Goal 1 : Eradicate Extreme Poverty

The poverty incidence of population of Caraga in 2003 was posted at 50.4 percent which is the highest rate all over the country. Around 31 percent if the population were considered core or food poor in the same year. Wide disparity between the national and regional figures has even aggravated the situation. The Region still struggles to attain the needed poverty reduction rate. Based on the current rate of progress, the fighting target of reducing poverty incidence by half in 2015 is difficult for the region. Prevalence of malnutrition is relatively higher in the region compared to the national average which was posted at 26.32 percent in 2005 (International Reference Standards). A more positive trend can be expected in the succeeding years with the implementation of effective nutrition programs. Attaining the target of 13.6 percent prevalence of underweight 0-5 years old children by 2015 is most likely to be achieved. Goal 2 : Achieve Universal Primary Education

The declining education performance of the region for the past 11 years in terms of access to education has painted a gloomier picture of the education sector. More development interventions should be implemented in order to increase the participation, cohort and completion rates at the elementary level and secondary levels. The participation rate in SY 2005-2006 was 74.8 percent, cohort survival rate was 63.14 percent and completion rate was 60.06 percent in the same school year. These figures are lower than the national average. With the current performance, the attainment of the 2015 target seemed elusive. Figures indicate low chances of attaining goal 2. Goal 3 : Promote Gender Equality

At all levels of education (elementary, secondary and tertiary), females are more dominant than males. Female participation rate in elementary in SY 2005-2006 was 75.12 percent which is a little bit higher than the participation rate of male posted at 74.48 percent. The gender disparity is more pronounced at the secondary level where male participation rate was 44.2 percent while its female counterpart was 55.1 percent in SY 2005-2006. Around 53 percent of the enrollees and 55 percent of the graduates in Academic Year 2005-2006 in tertiary education were females. Positive reinforcement should be implemented to increase participation and retention rates of males to address gender disparity. Goal 4: Reduce Child Mortality

Child health has improved through the years as shown in the under-five and infant mortality rates. Under-five mortality rate declined from 3 per 1,000 livebirths in 2000 to 1.98 per 1,000 livebirths in 2005 and infant mortality rate declined from 17.4 per 1,000 livebirths in 1991 to 7 per 1,000 livebirths in 2005. There is a high probability that the 2015 targets under goal 4 will be attained. Goal 5: Improve Maternal Health

Maternal deaths in the region showed a decline from 1991 to 2005. Caraga’s MMR was 167 per 100,000 livebirths in 2005. However, the current rate of progress is not enough to ensure that the 2015 target of reducing maternal deaths by two-thirds will be attained. On the other hand access to reproductive health services is constrained primarily due to the lack of supplies for contraceptives. The total fertility rate of 4.1 is higher than the desired fertility rate of 2.8.

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Goal 6 : Combat HIV/AIDS, malaria and other diseases

The Sexually Transmitted Infection (STI) prevalence rate has been erratic in the last five years while no HIV/AIDS case was reported in Caraga. Efforts to combat malaria and Tuberculosis in the region showed positive results with the declining morbidity and mortality rates. There is also an observable shift from filth diseases to lifestyle-related diseases. Goal 7: Ensure environmental sustainability

Caraga’s forest cover showed a noticeable decrease of 45 percent in 2003 compared to 1987. Reforestation efforts covered 7,433 hectares per year with the private sector as the major player. About 1.2 million hectares or 62 percent of the region’s land area is within watershed and around 8,165.18 hectares were rehabilitated at the end of 2005. Mangrove rehabilitation covered 3,447 hectares from 1997 to 2005. As of 2005, 81.93 percent of the households have access to safe drinking water and 47.23 percent of the total households have complete sanitation facilities. Water borne diseases continue to be among the top ten leading causes of morbidity. Security of tenure remained to be a major issue of the housing sector. Informal settlers are proliferating in the region especially among urban areas. In 2003, a total of 48,138 informal settlers were recorded. Housing programs and projects were implemented in the region to address the housing needs of the informal settlers, particularly those implemented by the National Housing Authority together with the LGUs. Non-government organizations are also involved and actively participating in the provision of housing. Goal 8:Partnership Development

Through the availability of the Botika ng Barangay (BnB), the access to essential affordable drugs has been improved. While the initiative started with the national government through the Department of Health, the Local Government Units have expanded the currently operating BnBs. Thus despite the closure of some DOH supported BnB, the LGU-supported BnB continues to respond to the needs at the barangay level.

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Table 3. MDG Rate of Progress, 1990-2005 Caraga Region

Millennium Development Goals Baseline Current Level 2005

Target by 2015

Average Rate of

Progress

Required Rate of

Progress

Ratio of Required Rate to

Average Rate

Probability of

Attaining the

Targets

Eradicate extreme poverty

Proportion of population below

subsistence threshold 33.7 c 31

g 15.85 -0.45 -1.18 2.62 Low

poverty threshold 51 c 54.2 g 25.5 0.53 -2.39 -4.48 Very Low

Proportion of families below

subsistence threshold 27.3 c 24.5 g 13.65 -0.47 -0.90 1.94 Low

poverty threshold 59.5 a 47.3 g 29.75 1.02 1.46 1.44 Low

Prevalence of malnutrition among 0-5 years old (% underweight) – Based on IRS 34.1g 31.5 17.05 -0.52 -1.20 2.32 High

Achievement of universal primary education

Elementary participation rate 93.01 i 74.8 l 100 -1.82 2.52 -1.38 Very Low

Elementary cohort survival rate 68.43 i 63.14

l 82.25

m -0.53 1.91 -3.61 Very Low

Elementary completion rate 66.79 i 60.06

k 81.27 m -0.67 1.93 -2.87 Very Low

Promote gender equality and women empowerment

Elementary Participation Rate

Male 86.78 j 74.48 l 100 -2.46 2.55 -1.04 Very Low

Female 93.27 j 75.12 l 100 -3.63 2.49 -0.69 Very Low

Secondary Participation Rate

Male 50.54 j 44.2 l 100 -1.27 5.58 -4.40 Very Low

Female 57.23 j 55.1 l 100 -0.43 4.49 -10.54 Very Low

Reduce child mortality

Under-five mortality rate (per 1,000 -five population.) 3.83

e 2.17 1.28 -0.33 -0.09 0.27 High

Infant mortality rate (per 1,000 livebirths) 17.4 a 7.5 5.8 -0.71 -0.17 0.25 High

Improve maternal health

Maternal mortality rate (per 1,000 livebirths) 161

a 167 54 .43 -11.30 -26.37 Very Low

Increase access to reproductive health services

Contraceptive prevalence rate 37.96 d 43.82 75.92 0.98 3.21 3.29 Low

Halt and begin to reverse the incidence of malaria and other diseases

Malaria morbidity rate (per 100,000 population) 155

b 90.4 31 -6.46 -5.94 0.92 High

TB Morbidity Rate 231.1 b 174.03 46.22 -5.71 -12.78 2.24 Low

Provide basic amenities

Proportion of families with access to safe drinking water 70.61

f 81.93

g 87 3.77 0.46 0.12 High

a - 1991 h - 2004 Probability of attaining the target

b - 1995 i - SY 1995-1996 < 0 Very Low

c - 1997 j - SY 2000-2001 < 1.5 - 0 High

d - 1999 k - SY 2004-2005 1.5 - 2.0 Medium

e - 2000 l - SY 2005-2006 > 2 Low

f - 2001 m - based on Dep-Ed Caraga Medium Term Educational Development Plan

g - 2003

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Goal 1: Eradicate Extreme Poverty and Hunger Target 1: Halve the proportion of people in extreme poverty between 1990 and 2015

STATUS and TRENDS

Poverty remains to be pronounced in the lives of many Caragans. Despite the interventions of the government, more than half of the population in the region cannot afford basic food and non-food requirements in a sustained manner. From 1991 to 2003, Caraga’s progress in fighting poverty remained slow compared with other regions. Caraga has the highest number of poor population. Based on the new set of poverty estimates released by the National Statistical Coordination Board (NSCB), Caraga’s poverty incidence of population in 2003 was posted at 54.2 percent which is almost twice the national figure of 33 percent. The top three regions with the highest number of poor population are all in Mindanao namely: Caraga Region, ARMM and Western Mindanao (Region IX). Ironic to the national trend which showed a decline in the poverty incidence, Regions IX, X, XI and Caraga exhibited an increasing poverty incidence of population from 2000 to 2003. Poverty incidence of population in Caraga increased by 3.3 percent compared to the 2000 figure of 50.95 percent.

Figure 2. Poverty Incidence of Population, Philippines and Mindanao Regions,

2000 and 2003 (In percent)

Source: National Statistical Coordination Board

Looking at the available poverty incidence data at the provincial level, wide spatial disparity can be observed. Agusan Del Sur has the biggest size of population below the poverty threshold. In 2003, 60.3 percent of the population in the province was considered poor, which was 5.7 percent higher than the regional figure. The Province ranks 4th among the provinces in the country with the highest poverty incidence. On the other hand, the poverty incidence of population in Surigao Del Sur showed a dramatic increase of 11.2 percent, from 45.8 percent in 2000 to 57.1 percent in 2003. Surigao Del Norte exhibited the same increasing trend. While the other three provinces in the region

P R O G R E S S P E R G O A L

34.438.4

44.3

49.453.1

30.4

54.2

33.13

46.8343.84

44.84

59.85

50.95

33.03

0

10

20

30

40

50

60

70

Philippines Caraga

Region

ARMM Region IX Region X Region XII Region XI

2003 2000

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showed an increase in the poverty incidence, Agusan Del Norte was able to lower its rate by 6.3 percent from 2000 to 2003 and remained to have the least magnitude of poor population.

The proportion of population who are considered food poor are those people who have income less than the food threshold (or the subsistence incidence) remained high. This means that thirty one percent of the total population in Caraga in the year 2003 experienced extreme poverty or thirty one (31) out of one hundred (100) persons did not earn enough to satisfy the minimum cost of basic food requirements. This is 45 percent higher compared to the national figure of fourteen (14) in every one hundred Filipinos in 2003. The reduction of extreme poverty in Mindanao areas is slower compared to most of its counterparts in Luzon and Visayas. Caraga particularly, exhibited a slight increase from 2000 to 2003 and ranks 2nd with the highest subsistence incidence of population or number of population below the food threshold next to Region IX.

Figure 3. Subsistence Incidence of Population, Philippines and Mindanao Regions, 2000 & 2003

(In Percent) Source: National Statistical Coordination Board

Table 4. Poverty Incidence of Population, By Province, Caraga Region, 2000 & 2003

(In Percent)

Poverty Incidence of Population Province 2000 2003

Agusan Del Norte 46.3 40.0 Agusan Del Sur 60.1 60.3 Surigao Del Norte 51.3 59.8 Surigao Del Sur 45.8 57.1 Caraga 50.95r 54.2 r Philippines 33.03 r 30.4 r Source: National Statistical Coordination Board

13.8

32.8

25.4

17.6 18.4

31

24.1

15.8

25.8

23.8

16.7

22.6

30.7

28.5

0

5

10

15

20

25

30

35

Philippines Region IX Region X Region XI Region XII Caraga

Region

ARMM

2003 2000

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High poverty incidence in the region is due to the unequal distribution of wealth. The 2003 NSCB estimates revealed that income distribution in the region has been largely unequal. Its gini coefficient in 2003 was posted at 0.4294 from 0.4118 in 2000. This means that the region is experiencing a growing inequality of income distribution. But comparing its income distribution to the rest of the country, it ranks 6th among the regions with the lowest unequal income distribution and is below the national average of 0.4660 although it is one of the eight (8) regions which exhibited an increase for a period of three years.

Based on target one, the Philippines has to reduce poverty incidence of population to 22.65 percent and subsistence incidence of population to 12.15 percent by 2015. While at the national level the target is likely to be attained, wide disparity across regions entails that other areas must double their current rate of progress to ensure that they can reach the regional targets and address wide disparity.

Attaining the MDG target of halving the proportion of people in extreme poverty between 1990 and 2015 is a difficult task for the region. This would mean that Caraga has to reduce its poverty incidence of population to 25.5 percent (based on the 1997 available data) in the remaining 12 years. This translates to an annual reduction of 2.39 percent poverty incidence of population. The increasing trend in poverty incidence of population and the required rate to reach the target suggest that the region has a very low probability of attaining the target.

Figure 4. Reduction of Poverty Incidence of Population, Philippines and Caraga Region, 1997-2015

(In Percent)

Table 5. Subsistence Incidence of Population, By Province,

Caraga Region, 2000 & 2003 (In Percent)

Subsistence Incidence of Population Province

2000 2003 Agusan Del Norte 26.4 23.1 Agusan Del Sur 40.7 34.9 Surigao Del Norte 12.4 27.1 Surigao Del Sur 8.2 26.7 Caraga 30.7

r 31.0

r

Philippines 15.8 r 13.8

r

Source: National Statistical Coordination Board

Poverty incidence of families

2015 target

Current rate of progress

Rate of progress needed to attain the target

Source of basic data : NSCB

Poverty incidence of families

2015 target




22.62

33 33.0330.4

25.52

51 50.9554.2

0

10

20

30

40

50

60

1997 2000 2003 2010 2015

Philippines Caraga

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The region has to peg its subsistence incidence of population to 16.85 percent by 2015 with an annual required rate of reduction of 1.18 percent. On the other hand, addressing the needs of the population in extreme poverty or food poor has shown a positive result. From 1997 to 2003 the average rate of reduction of subsistence incidence of population is .45 percent. However, this decline is not enough compared to the required rate of progress making the 2015 target hard to attain. Unless it is able to surpass its current performance by more than half, the region will not attain the 2015 target of 12.15 percent.

Figure 5. Reduction of Subsistence Incidence of Population, Philippines and Caraga Region, 1997-2015

(In percent) PRIORITY POLICIES and PROGRAMS

From 2000 the region has adopted the integrated and convergence approach in addressing poverty and protecting the vulnerable groups. Different stakeholders including program implementers converge their efforts and initiatives in addressing the plight of the poor. The region has implemented the Kapit-Bisig Laban sa Kahirapan (KALAHI) as the overarching program for a focused, accelerated, convergent and integrated approach to maximize the impact of programs and projects in reducing poverty incidence and attaining social development. There are several modes of KALAHI implemented in the regions. KALAHI Rural prioritizes the indigenous people groups in poor communities while KALAHI in Conflict Areas (CA) and the National Internal Security Program (NISP) prioritize those barangays which are internally threatened but cleared by the Armed Forces of the Philippines (AFP). In the region, twelve (12) projects for five (5) barangays under the KALAHI Rural have already been launched since 2001 while the Regional KALAHI Convergence Group (RKCG) was only organized in January 2002. In early 2003, project proposals and areas were generated from Agusan del Sur and Surigao del Sur for KALAHI in Conflict Areas (CA) implementation. It was only in the 1st Quarter of 2004 that funds were released and implementation of a total of eight (8) projects for nine (9) barangays were started by the LGUs. Projects under both modes were funded by the National Anti-Poverty Commission (NAPC) – the lead convenor for KALAHI implementation. Unique to the region, some amount has been accessed by the Office of the RKCG Chairperson for projects in the four (4) provinces and three (3) cities. Memoranda of Agreement (MOAs) were signed with respective LGUs during the second quarter of 2004 for the implementation of projects in areas prioritized by the LGUs themselves. Moreover, the Office of the Presidential Adviser for the







17 15.8

12.15

16.85

30.7

33.7

0

5

10

15

20

25

30

35

40

1997 2000 2010 2015

Philippines Caraga

13

Peace Process (OPAPP) in close coordination with NAPC and the Armed Forces of the Philippines (AFP) identified sixty-five (65) AFP survey operation team (SOT) SOTized or cleared areas under the KALAHI Para sa Kalayaan for Caraga. Barangay consultation for the Kalayaan barangays have already been done and priority community needs have already been gathered. All these areas are now the KALAHI convergence areas in Caraga. The DSWD is also implementing the KALAHI Comprehensive and Integrated Delivery of Social Services (CIDSS) in selected municipalities. In addition, the Department of Agrarian Reform (DAR) has its KALAHI Agrarian Reform Zones (KARZones) in selected agrarian reform communities. Several direct anti-poverty programs in the region were implemented. In 2005, the total cost of the programs and projects of the different agencies which address poverty amounted to PhP 3,757813821.99. The Table 6 shows the specific programs and projects geared towards fighting poverty and protecting the vulnerable groups.

Fighting Against Poverty: The Barangay Duangan Experience

Barangay Duangan of Esperanza, Agusan Del Sur is largely an agricultural area with a total population of 1,331and an average family size of 5. Around 262 are indigenous peoples belonging to the Manobo tribe. The households’ major source of livelihood is farming with rice and banana as the major crops. While farming is seasonal and there is no other better means of livelihood in the barangay, most of the families have to make ends meet and struggle for a decent living. Upon the introduction of the Convergence Development Approach of the Provincial Government, the residents found new hope and better prospects for development. More services and better support facilities are available. Through the collaboration and pro-active stance of the Municipality of Esperanza and the Provincial Government, agricultural productivity is enhanced. Farmers with an income of less than PhP 2,000.00 per month were selected and became beneficiaries of the Techno Demo on Banana Production and Techno Demo on Fruit Tree Production. Assistance extended to them included the provision of seedlings and fertilizers. They were also given skills training to enhance their farming skills and equip them with the necessary farming techniques and technology to ensure better harvest. A marketing plan has also been developed to ensure that local produce will have captured market when harvesting time comes. Income situation of farmers improved from their previous income of PhP 2,000.00 to PhP3,500.00. Empowerment and strong cohesion among the members of the community are also evident. Under the leadership of Barangay Captain Elvie M. Batoy, residents and project beneficiaries are given the opportunity to participate in decision-making and to provide feedback for better program implementation and management and even to stabilize net income of farmers in the community. This also promotes ownership among the members of the community. The indigenous peoples are also actively involved in the community affairs. Elders of the Indigenous Peoples are consulted and actively involved in the matters affecting the barangay. Women are empowered to take on their role in the development process. Through the women’s association in the barangay, their Botika ng Barangay continues to provide the residents with access to more affordable essentials drugs. Systems are also in placed at the barangay level to ensure the sustainability of the projects.

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Table 6. Direct Anti-Poverty Interventions Caraga Region, 2005

Area of Concern

Program/Project/Activity

(PPA) Total Cost

(PhP) No. of Beneficiaries

Agency

Asset Reform Cluster Distribution of Public Land 5,246,904.00 7434 individuals DENR

Public Land Survey 13,321,800.00 2487 individuals DENR

Southern Phil Irrigation Special Project-

Watershed Mgmt. Subcomponent 13,000,000.00 21 POs DENR

Reforestation of Denuded Areas within

Protected Areas 1,120,000.00 20 PO members DENR

Reforestation within 1st District of

Surigao del Sur 1,400,100.00 146 PO members DENR

Livelihood and Community Livelihood Assistance 2,192,348.50 544 beneficiaries DENR, Fund 101

Employment Secretary's Fund

Agro-Forestry Livelihood Projects 500,000.00 391 individuals DENR-Presidential

Fund

Distribution of Seeds, Planting Materials 7,430,370.00 2,448 individuals DA

and Animals

Goat Raising & Plant Production 4,422,280.00 1,001 individuals DA

Livelihood Projects 2,813,336,077.00 219 HH DAR-ARISP,

12,157 individuals SPOTS

964 ARBs

Fishery Resource Management 11,339,000.00 913 fishpond operators CBRMP 62 fisherfolk associations

Community-Based Resource Mgmt. 131,595,000.00 3175 beneficiaries MDFO-DOF

Project

Abaca Production/Expansion & Mktg. 2,700,920.00 1,592 households FIDA

Various Small and Medium Enterprises 1,270,267.00 682 beneficiaries DOLE-PRESEED,

and other livelihood projects WEED

PAYAPAG MAMANWA SETTLEMENT Payapag Mamanwas – once a tribe of hunters and gatherers and were once subjected to constant eviction from their temporary residences – are now living in a secured, productive and self-sufficient community. In 2001, the Surigao del Norte NGO Coalition for Development (SUNGCOD) with the implementation of the Integrated Community Health Service Program (ICHSP), an AusAID-Assisted Project, initiated the settlement project for the Mamanwas. In collaboration with the Provincial Government of Surigao del Norte and its local offices, and the Peace Equity Foundation (PEF), the settlement for the Mamanwas was established and benefited twenty four households with 141 members. This was supported with basic social services, basic infrastructures and packaged with livelihood programs. Sustainability mechanisms such as intensive trainings on improving economic capabilities and enhancing environmental sanitation were also initiated. In compliance with RA 9003, a Material Recovery Facility (MRF) was established in the area. Organic fertilizers were manufactured utilizing the waste accumulated from the households. Mamanwas were also taught to utilize alternative materials to produce other farm inputs, as well as supplementary feeds and medicines. To date, the settlement project has effectively resolved the basic shelter problem of the Payapag Mamanwas. With the collaborative efforts of the Provincial LGU, government agencies and non-government organizations, the Payapag Mamanwa settlement has just presented a successful endeavor worthy to be recognized and replicated to other minority groups in the region.

15

Table 6. Direct Anti-Poverty Interventions Caraga Region, 2005

SEA-K 10,307,850.00 692 families DSWD

Human Development Scholarships, Skills and Vocational 11,263,500.00 42,524 beneficiaries TESDA

Services and Social Development

Protection Scholarship Grants 13,670,108.96 3,939 beneficiaries CHED

Water Supply for Waterless 5,688,500.00 7 barangays DPWH

Communities Health & Nutrition Services 100,828,694.34 15 LGUs, 6 barangays, DOH, UNICEF, region-wide coverage USAID, Red Cross, Culion Foundation and JBIC

Farm to Market Road (INFRES) 38,194,067.00 DA-INFRES

Potable Water Supply Project 121,231,078.29 2,923 HH

12 barangays DAR-ARISP,

2,000 individuals SPOTS

Power Supply Project 110 ARBs

82,870,525.90 104 HH DAR-SPOTS

3,190 individuals

Infrastructure Projects 18,536 HH

362,757,653.00 875 ARBs DAR-ARISP

234,224 individuals

Health Interventions 2,126,778.00 4,365 individuals DAR-MinSSAD

KALAHI-CIDSS 95,400,000.00 8 municipalities DSWD, WB

159 barangays

TOTAL 3,853,213,821.99

Sources: Regional Line Agencies and Project Management Offices

CHALLENGES and PRIORITIES for ACTION

Considering the work that is yet to be done and the magnitude of poor people that needs help, national line agencies must closely coordinate with the regions in strategizing efforts to maximize impact. It is therefore a continuing challenge for national, regional, local government stakeholders and the private sector to strengthen their working relations to achieve utmost results of convergence efforts. Intensify convergence approach to poverty reduction National KALAHI Convergence Group through the National Anti-Poverty Commission (NAPC) should strengthen its support to the Regional KALAHI Convergence Group (RKCG) by securing budget support to agencies for interventions to priority areas. Budget allotment and releases should be ensured at the Central level so that commitments are delivered. Also, national mechanism must be strengthened so that RKCGs are clarified with the anti-poverty direction of the government. On the other hand, for the RKCG to be able to consolidate all anti-poverty programs, projects and activities for maximum impact, a regular staff/secretariat in the region has to be set-up.

Private sector participation in anti-poverty initiatives

Advocacy activities and coordination work will have to be intensified to be able to gather more private sector partners and the civil society in the fold of poverty alleviation initiatives.

Increase allocation for social protection and services LGUs will be continuously encouraged to spend more for social services and social protection like health, housing, education and others. Addressing the unequal distribution of wealth The unequal distribution of wealth in the region is a stumbling block in addressing poverty. Programs and projects should be directed towards improving access of the poor to human

16

development services and social protection, increasing livelihood opportunities through community-based interventions, making credit more accessible to micro, small and medium enterprises (MSMEs) to create more and better job opportunities. Priority should be given to the marginalized sector in the provision of technical vocational education and trainings to develop and improve their competence and productivity. Increasing the productivity of employees should also be considered by the Regional Tripartite Wage and Productivity Board (RTWPB) aside from setting the minimum wage in the region. At the national level, refinement of taxation policies to progressively raise the taxes of the richer citizens should be implemented so that more funds can be redistributed to the poor. Updating of the Minimum Basic Needs (MBN) through the Community-Based Monitoring System (CBMS) and Harmonization with the Dev Info 4.0 The LGUs will be encouraged to use the CBMS for a more accurate definition of the needs of the poor. Poverty mapping is an important tool for planning. For LGUs using the CBMS already, data generated from the system will become the basis for determining needs of the poorest of the poor and the appropriate interventions to alleviate their situation. While the CBMS is a repository of primary data related to poverty and maintained by the LGUs, the DevInfo shall contain data not only on poverty but overall socio-economic development indicator coming from the LGUs disaggregated up to the barangay level. It will also include data coming from the CBMS and regional line agencies. These shall be merged and consolidated as the Caraga Regional Database managed and maintained by the RDC Target 2: Halve the proportion of the population below the minimum level of dietary energy consumption and halve the proportion of underweight children (under five years old) STATUS and TRENDS

The capacity of every household to provide the basic requirements of every member of the family is largely determined by its income level. Poverty has a considerable bearing on the health and well being of the children. The high poverty incidence of the region directly relates to the magnitude or prevalence of malnutrition among 0-5 years old children. Based on the 2003 National Nutrition Survey, Caraga Region’s Proportion of Households with Per Capita Intake Below 100 Percent Dietary Energy Consumption was posted at 53.2 percent which is 3.7 percent lower than the national figure of 56.9 percent. The region has to curb it into 26.6 percent come 2015 in order to attain target 2.

17

Figure 6. Proportion of Households with Per Capita Intake Below 100 Percent

Dietary Energy Consumption, Caraga Region Source of basic data: Food and Nutrition Research Institute

The mean one-day per capita energy intake and percent adequacy for Caraga Region was 1,898 kilocalories and 100.0 percent compared to the 2001 figure of 1,689 kilocalories and 89.4 percent, respectively. There is an increase of approximately 10.6 per cent adequacy intake from 2001 to 2003.

Table 7. Mean One-Day Per Capita Energy Intake and Percent Adequacy, Philippines and Caraga, 2001 & 2003

2001 2003

Philippines Caraga Philippines Caraga Mean one-day per capita energy intake (grams per day)

1,884 1,689 1,905 1,898

Energy Adequacy (In Percent) 87.8 89.4 98.3 100 Source: Food and Nutrition Research Institute

Comparing the mean one-day food consumption by major food group/sub-groups for 2001 to 2003, generally there was an increase for the following: from 371 to 381 grams for cereals and cereal products; 12 to 21 grams for sugars and syrups; 10 to 14 grams for fats and oils; 121 to 155 grams for fish, meat and poultry; 9 to 10 grams for eggs; 18 to 37 grams for milk and milk products; 57 to 142 grams for other fruits and vegetables; 17 to 48 grams for miscellaneous foods. On one hand, there was an even consumption of 9 grams for dried beans, nuts and seeds and a slight decrease by 1 gram for starchy roots and tubers (from 26 grams in 2001 to 25 grams in 2003). On the other hand, there was significant decrease in consumption for vegetables from 92 to 36 grams for the same period. On the percentage of households with 100 percent energy adequacy for the year 2003, Caraga region posted approximately 52.3 percent.

26.6

52.3

0

10

20

30

40

50

60

2003 2015

18

Table 8. Mean One Day Per Capita Food Consumption Philippines, Caraga Region, 2001 & 2003

(In Grams Per Day)

2001 2003 Food Group/ Subgroup Philippines Caraga Philippines Caraga

Cereals and Cereal Products

340 371 316 381

Starchy Roots and Tubers

17 26 19 25

Sugar and Syrups 19 12 28 21 Fats and Oils 12 10 29 14 Vegetable 106 92 22 Green Leafy and Yellow Vegetables

- - 22 36

Vitamin C Rich Foods - - 21 14 Other Fruits and Vegetables

- - 104 128

Fruits 77 57 Fish, Meat and Poultry 147 121 222 155 Eggs 12 9 18 10 Mild and Milk Products 44 18 79 37 Dried Beans, Nuts and Seeds

10 9 13 9

Miscellaneous (Beverage, condiments, & others)

19 17 55 48

Total 803 742 926 878 Source: Food and Nutrition Research Institute

Caraga’s malnutrition rate of children 0-5 years old was posted at 31.5 percent in 2005. This is 2.6 percent decline from the 1998 figure of 34.1 percent. A slow but gradual decline was exhibited by the region in the past six years. Compared to the national performance, the malnutrition rate in 2003 is higher by 3.9 percent and the rate of decline at the national level is faster than that of the region.

Table 9. Prevalence of Malnutrition Among Children 0-5 Years Old, Philippines and Caraga, 1998, 2001 & 2003

1998 2001 2003

Caraga 34.1 33.5 31.5 Philippines 32 30.6 27.6

Source: Food and Nutrition Research Institute

At the regional level, the number of malnourished children is also closely monitored through the conduct of operation timbang ever year. The prevalence of underweight children 0-5 years old was posted at 7.49 percent in 1999. This exhibited a continuous decline until it reached to 6.97 percent in 2002. In the succeeding year, the prevalence of malnourished children soared to 28.65 percent. This is primarily attributed to the change in the reference standard from the Philippine Reference Standard (PRS) to International Reference Standard (IRS). The latter has higher standards compared to the former thus, making some of the children who were considered with normal weight to be underweight. From 2003 it declined to 24.41 percent in 2004 and went lower to 22.45 in 2005. Malnutrition was very pronounced in Surigao Del Sur in 2003 with 33.15 percent malnutrition rate but was reduced to 25.9 percent in 2005. Surigao Del Norte also has high malnutrition rate from 27.28 percent in 2003 to 23.89 percent in 2005. Agusan Del Norte had the sharpest decline in malnutrition from 27.22 percent in 2003 to 21.63 percent in 2005. Children in the three cities have

19

better nutritional status compared to their provincial counterparts. Butuan City has only 13.94 percent malnourished children in 2003 which declined further to 10.42 percent in 2005.

Table 10. Prevalence of Malnourished Children 0-5 Years Old, By Province and City, Caraga Region, 1999-2005

(In Percent) * International Reference Standard

Source: Department of Health – Center for Health Development Caraga

For the computation of the probability of attaining the target in nutrition, the result of the National Nutrition Surveys conducted by the Food and Nutrition Research Institute (FNRI) shall be used. Caraga’s prevalence of underweight 0-5 years old children was posted at 31.5 percent which is 3.9 percent higher compared to the national figure of 27.6 percent in 2003. Using the 1998 as baseline data, the region’s target by 2015 is to curb the prevalence of malnutrition to 17.05 percent. At the rate the region is going, there is a low probability that it will attain the 2015 target given that the average rate of progress from 1998-2003 was posted at -0.52 percent and the required rate for the next ten years is 1.20 percent decline per annum.

Figure 7. Reduction of Malnutrition, Philippines and Caraga Region, 1998-2015

Sources of basic data: 2

nd Philippine MDG Progress Report and DOH-CHD Caraga

34.1 33.5 30.2

17.05

32 30.3 27.6 17.25

0

10

20

30

40

50

1998 2001 2003 2015Caraga Philippines

Province/City 1999 2000 2001 2002 2003* 2004* 2005*

Agusan Del Norte 7.27 7.99 6.58 5.32 29.06 21.82 19.76

Agusan Del Sur 9.05 6.54 7.51 6.38 27.22 27.71 21.63

Surigao Del Norte 10.25 8.91 8.5 7.29 27.28 23.53 23.89

Surigao Del Sur 9.44 8.76 9.62 9.05 33.15 25.88 25.9

Bislig City 6.93 5.58 6.67 21.52 15.07 14.72

Butuan City 3.38 3.04 2.86 2.75 13.94 11.64 10.42

Surigao City 5.54 4.28 4.57 4.38 19.73 20.81 18.35

Caraga 7.49 7.74 7.54 6.97 28.65 24.41 22.45

20

PRIORITY POLICIES and PROGRAMS

The Philippine Plan of Action for Nutrition directed towards the improvement of nutritional status of the nutritional at risk groups is being mainstreamed at the local levels through the implementation of various programs and projects aimed at improving the nutritional status of children. The Bright Child Program has also been launched region-wide in 2003, which calls for the integration of various health and nutrition programs for children. Full implementation of Executive Order 51 Series of 1986 or the Milk Code is an area of concern of the health sector. Local health workers conduct advocacy and information dissemination on the benefits of breast-feeding. Health personnel closely monitor compliance of mothers admitted to hospital facilities on breastfeeding. Despite these efforts, exclusive breastfeeding has shown an erratic trend over the last seven years (1999-2005). Eight (8) out of ten (10) children in 2005 were exclusively breastfed up to 4th month. However, comparing the figure in 1999 to 2005, a dramatic decline is observable as exclusive breastfeeding plunged from 90.13 percent in 1999 to 79.62 percent in 2005. At an average, 87.57 percent of the children in Caraga were exclusively breastfeed up to 4 months. Agusan del Norte has the highest number of children exclusively breastfed up to 4th month in the last seven years. Surigao City continuously has the lowest breastfeeding rate with only 65.27 percent in 2005. The other two cities namely Butuan and Bislig City slightly higher rates compared to the regional figure. Increasing preference for infant formula especially among working mothers in the urban areas is a contributory factor. Agusan Del Sur exhibited the highest decline in breastfeeding rate. From 97.45 percent in 2004 it went down drastically to 58.49 percent in 2005. It is ironic that while the incidence of poverty remains high in the region, more and more money are being spent on infant formula.

Table 11. Percentage of Infants Exclusively Breastfed up to 4th month By Province and City, Caraga Region, 1999-2005

* www.doh.gov.ph


Through intensified advocacy, regular monitoring and household salt testing, the implementation of the ASIN Law in the region has gained momentum. In 2005, 99.6 percent accomplishment on the “Patak sa Asin” for commercial establishments and 98 percent household utilization of iodized salt was recorded. Mothers are also educated on the need for iodized salt. The local government units as mandated under the LGC Code of 1991 facilitate the delivery of quality services. The region created an ASIN Task Force to monitor the compliance of the law. LGUs have also institutionalized

Province/City 1999 2000 2001 2002 2003 2004 2005 Average

Agusan del Norte 96.9 98.31 96.28 96.67 95 95.23 95.88 96.32

Agusan del Sur 96.44 97.5 94.3 75.28 96.83 97.45 58.49 88.04

Surigao del Norte 96.14 89.66 92.08 83.86 89.6 93.09 93.77 91.17

Surigao del Sur 88.2 90.72 88.17 88.17 85.69 87.11 86.01 87.72

Bislig City - 84.14 87.29 87.29 71.56 78.77 80.89 69.99

Butuan City 82.2 87.66 87.75 90.1 85.52 89.17 83.63 86.58

Surigao City 82.2 54.35 54.81 59.26 64.86 64.02 65.27 63.54

Caraga 90.35 86.05 85.81 82.95 84.15 86.41 80.56 85.18

Philippines (2003)* 70

21

the use of iodized salt as Indicated in their Local Code for Children (LCC) have adopted the ASIN Law). Asin Task Forces were also organized at the local levels which act at the frontline in ensuring the full implementation of the law.

Garantisadong Pambata (GP) is program of the DOH to reduce the prevalence of malnutrition. It is conducted twice a year (April and October). Health practitioners from various sectors are involved in this program. Activities under the GP include giving of Vitamin A supplementation, deworming, household salt testing, health teaching, IEC, breastfeeding advocacy, ferrous sulphate (FeSO4) supplementation to malnourished children and health education on personal hygiene. Last 2005 Agusan del Sur got the highest percentage of children given vitamin A with a 98 percent and 99.9 percent accomplishment in the 1st and 2nd round of Vitamin A supplementation respectively. for (60-71 mos.) and 95 percent for (6-11 mos.) while Surigao City got the highest of 104 percent for (12-59 mos.)

Figure 8. Percentage of 6-71 Months Old Children Given Vitamin A Supplementation, Caraga Region, 2005


The LGUs also conduct supplemental feeding programs benefiting pre-school and school children especially the malnourished. The Culion Foundation, Inc. and the World Vision also provide micronutrient supplementation, mass feeding and IEC activities on proper nutrition to complement with the programs of the LGUs and DOH. Private and religious organizations at the LGU level also provide assistance in the conduct of supplemental feeding programs. The nutritional needs of children during calamities are given premium attention. Thus, the family packs given to families affected during calamities would include nutri-pack. In its effort to reduce hunger and poverty among the poorest of the poor, the government has launched the “Tindahan Natin” project that hopes to benefit about 100 impoverished barangays that have high malnutrition rate. Tindahan Natin project provides low-priced but good quality rice and noodles through a store jointly identified and endorsed by the DSWD, Barangay Council, the National Food Authority (NFA) and the City/Municipal Social Welfare and Development Offices. The Tindahan Natin outlets are operated by entrepreneurs, community-based organizations, NGOs, LGUs, barangay councils and existing retail/sari-sari stores registered and accredited by regulating agencies. A family beneficiary can only purchase the quantity of rice equivalent to their weekly allocation which is 14 kg. for a family of six (6) in which the price is lower than the prevailing market price.

0

20

40

60

80

100

1st Round 99 98 90.6 81.3 77.1 96 96 92.7

2nd Round 96.6 99.9 90.5 86.8 84 97 97 94

Agusan

Del Norte

Agusan

Del Sur

Surigao

Del Norte

Surigao

Del Sur

Bislig

City

Butuan

City

Surigao

CityCaraga

22

The Regional Nutrition Council (RNC) conducted quarterly meetings to ensure the implementation of nutrition-related programs and projects at the LGU level. The Regional Evaluation Team (RET) composed of representatives from the various member agencies of the RNC also conduct Monitoring and Evaluation of Local Level Plan Implementation (MELLPI) and search for Outstanding Barangay Nutrition Scholars (OBNS) on an annual basis. It also pursued programs and projects identified at the national level such as the egg-based recipe contests in December 2005 to serve as venue for selection of low-cost egg-based recipes that can be used in feeding the pre-school child. The Department of Education through its health and nutrition unit effectively implemented the integrated school health and nutrition programs which include food production in the school, supplementary feeding among identified underweight pupils and also those of normal nutritional status, establishment of school canteens free from junk foods. Responsible Parenthood teaches parents of the nutritive-value foods their children need instead of junk foods. Dental treatment, fluoridization and deworming are activities conducted to help reduce malnutrition prevalence rate.

The Department of Social Welfare and Development has been implementing the Food for School (Day Care) Program. Dubbed “Dunong ng Bata, Yaman ng Bansa,” the Program is designed to improve nutrition, attendance rates and learning achievement of pre-school / day care children and increase farm and off-farm incomes and contribute to job generation. The target beneficiaries are children in the day care centers by providing them 1 kilo of rice per child per day based on the attendance of the child in the day care center. Other food complimentary interventions shall be undertaken by parents to supplement the food assistance. Reproduction and distribution of IEC materials is a regular support coming from the DOH to promote proper nutrition and address malnutrition. Conduct of the “Pabasa sa Nutrisyon sa Barangay” attended by mothers is being conducted regularly in various LGUs. For Surigao City this is done with assistance of the Surigao City Medical Society and Philippine Nurses Association. Focus Group Discussions (FGD) on nutrition programs in the barangays are also undertaken. Integration of nutrition concepts in the education curriculum has also helped in promoting proper nutrition among children. Barangay Nutrition Scholars (BNS) are also capacitated in the implementation of nutrition programs and in monitoring the progress of malnourished children. The region has a total of 445 BNS who are at the forefront of providing nutrition interventions at the barangay level. There are also other local initiatives in addressing food shortage namely the Sapat na Pagkain Para sa Lahat (SAPAGKAT), Project Kalusugan, Sustainable Health Through Nutrition Education (Project SHINE) and the Comprehensive School Health and Nutrition Services Package (CSHNSP)


Enhanced coordination and collaboration with NGOs and private sector

With the limited resources of the LGUs, there is a need to strengthen current linkages with private and non-government organizations which implement nutrition-related programs. Complementation of services between the government and the civil society can be achieved through proper coordination and pro-active approach of the LGUs in tapping the civil society for possible partnership. Proper coordination of program curbing malnutrition is also necessary to attain greater impact and avoid duplication of efforts. Areas which are severely affected should be targeted to receive comprehensive interventions and not only limited to dole-outs.

Increased budget for nutrition related programs

Considering the high malnutrition rate in the region and since nutrition is a devolved function, the LGUs need to increase budgetary allocation for nutrition related programs to improve the nutritional

23

status of children. This shall address the limited supplies of micronutrients and feeding commodities which are necessary interventions in addressing malnutrition. Addressing malnutrition during emergencies

Needs of children during natural and man-made calamities should be properly addressed to make them less susceptible to the outbreak of water and air borne diseases which usually occur due to poor sanitation and congestion in relocation areas. Moreover, special nutritious food and supplements such as milk and fortified foods should be made available. Making LGU-Based Institutions functional Local institutions such as the Local Health Board and barangay-based institutions such as the Barangay Nutritional Committee and Barangay Council for the Protection of Children, should be made functional so that nutrition-related concerns can be addressed at the lowest level possible and the needed interventions will be given priority. Increased education and empowerment of parents

The government can only do so much in ensuring the nourishment of children. Parents being the primary duty-bearers in the provision of health and nutrition related needs of children should be well educated on the value of proper nutrition and should be equipped with the essential knowledge on how to prepare balanced diet, preserve the nutritional value of food and proper nutrition. Programs at the barangay levels such as “Pabasa sa Nutrisyon” should be strengthened to improve the basic knowledge of mothers or parents on nutrition. Dole-out programs should be replaced with more sustainable programs such as backyard gardening, Sapat na Pagkain Para Lahat, provision of seedlings in support for the food sufficiency program among others. This is to enhance the capacity of the family to provide the basic needs on nutritious food and transcend beyond the usual dole-out system which perpetuates more dependence. Transfer of Nutrition Program Management from DA to DOH

Per Executive Order No. 472 dated November 30, 2005 , the National Nutrition Council has been transferred to the Department of Health by President Gloria Macapagal-Arroyo from the Department of Agriculture. To date, program management is still lodged with the Department of Agriculture. At the regional level, the Regional Nutrition Council has no approved plantilla positions. It is merely an add-on function to existing staff of the Department of Agriculture, thus, not much focus is given to nutrition related activities.

Goal 2: Achieve universal primary education

Target 3: Achieve universal access to primary education by 2015 STATUS and TRENDS

The region’s Elementary Participation Rate (public and private) has been notably decreasing in the last eleven (11) school years. Regional performance in SY 1995-1996 was 93.01 percent, 89.46 percent in SY 2000-2001 and 74.80 percent in SY 2005-2006. Its 2005 performance is way behind compared to SY 2003-2004 national figure of 90.05 percent. Only the Division of Butuan City showed a significant increase from 93.83 percent in SY 1995-1996 to 102.82 percent in SY 2000-2001 while the Divisions of Siargao and Surigao del Norte had slight increases. However, the following school years showed a decreasing trend across Divisions. For SY 2005-2006, highest performing Division was Siargao with 88.56 percent. The newest Division of Bislig City, on the other hand, was lowest with 67.54 percent.

24

Figure 9. Elementary Participation Rate (Public and Private), By Division, Caraga Region, SY 1995-1996, SY 2000-2001 & SY 2005-2006

(In Percent) Source: Department of Education Caraga

The Cohort Survival Rate showed a fluctuating trend and somewhat low performance. For SY 1995-1996, the Region registered a 68.43 percent performance with Surigao del Norte having the highest performance of 82.20 percent. In 2000-2001, performance went down with 58.39 percent. This time, Surigao City was the highest performing Division with 79.42 percent. For SY 2005-2006, performance slightly went up with 63.14 percent. Still, Surigao City performed highest with 75.68 percent. Agusan del Sur remained to be the lowest performing Division in the respective school years with 50.33 percent, 50.14 percent and 57.17 percent. Comparing the region’s latest cohort survival rate to the national figure in SY 2003-2004, Caraga needs to increase its rate by 6.7 percent to at least level with the national performance of 69.8 percent. Figure 10. Elementary Cohort Survival Rate (Public and Private), By Division, Caraga Region,

SY 1995-1996, SY 2000-2001 and SY 2005-2006 (In Percent)

Source: Department of Education Caraga

0

20

40

60

80

100

120

Agusan

Del Norte

Agusan

Del Sur

Surigao

Del Norte

Surigao

Del Sur

Bislig City Butuan

City

Surigao

City

Siargao Caraga

1995-1996 2000-2001 2005-2006

0

20

40

60

80

100

Agusan

Del Norte

Agusan

Del Sur

Surigao

Del Norte

Surigao

Del Sur

Bislig City Butuan

City

Surigao

City

Siargao Caraga

SY 1995-1996 SY 2000-2001 SY 2005-2006

25

Completion Rate has been showing almost the same scenario of declining performance. In SY 1996-1997, regional performance was only 66.79 percent, very low at 56.33 percent for SY 2000-2001 and gained back a little with 60.06 percent in SY 2004-2005. Surigao City occupies the highest performance in the same school years with 74.64 percent, 76.87 percent and 77.12 percent. Agusan del Sur was the lowest performing Division with 50.33 percent in SY 1996-1997 and decreased its performance further in SY 2000-2001 with 48.09 percent. It was, however, the Division of Bislig City which was the lowest in SY 2004-2005 with 51.96 percent.

Figure 11. Elementary Completion Rate (Public and Private), By Division,

Caraga Region, SY 1995-1996, SY 2000-2001 & SY 2005-2006 (In Percent)


The decline in access to education has been largely attributed by the Department of Education to the increasing poverty incidence in the region. Parents cannot afford to send their children to school despite the minimum enrolment fees and even sustain miscellaneous expenses including their transportation fare and school supplies. Some parents are also inclined to let their children work in the farm to augment their income. Moreover, children from remote barangays find it hard to access education due to the distance of their homes from school. The 2003 Functional Literacy, Education and Mass Media Survey (FLEMMS) is the latest national survey that gathers information on basic and functional literacy status of the population. According to the survey, Basic Literacy Rate of population 10 years old and over for the region is 92.1 percent. The Functional Literacy Rate of population of 10-64 years old is 81.0 percent. The declining education performance over the last 11 school years has a negative implication in attaining the 2015 target of universal access to primary education. Based on the sharp decline in the participation rate from 1995 to 2005, there is a very low probability that the region will attain the 100 percent participation rate in elementary education. In order for Caraga to reach the target, it needs an annual increase of at least 2.52 percent to recover from the past years’ negative performance. Unless more effective measures to increase enrolment and retention of children in school will be implemented the trend will most likely to continue.

0

20

40

60

80

100

Agusan

Del Norte

Agusan

Del Sur

Surigao

Del Norte

Surigao

Del Sur

Bislig City Butuan

City

Surigao

City

Siargao Caraga

1995-1996 2000-2001 2005-2006

26

Figure 12. Elementary Participation Rate (Public and Private), Caraga Region, 1995-2015

Looking at the cohort-survival rate over the past years, the same conclusion can be generated. The region needs an annual increase of 1.91 percent in order to attain the 2015 target of 82.25 percent. Caraga’s average rate of progress has decline at an average of .53 percent (using the SY 1995-1996 and SY 2005-2006 data). Given the rate needed and the region’s average rate of performance, there is a very low probability of attaining the target. Thus, the education sector must double its efforts to attain the 2 percent annual increase as targeted in the Caraga Medium Term Education Development Plan which is consistent with the MDG.

Figure 13. Elementary Cohort Survival Rate (Public and Private), Caraga Region, 1995-2015

Source of data: Dep-Ed Caraga

Elementary Cohort Survival Rate

2015 target



Elementary Cohort Survival Rate

2015 target




2015 target




2015 target



100

74.8

89.4693.01

0

20

40

60

80

100

1995 2000 2005 2010 2015

Source of basic data: Dep-Ed Caraga

82.25

63.1458.39

68.43

0

20

40

60

80

100

1995 2000 2005 2010 2015

Source of basic data: Dep-Ed Caraga

27

PRIORITY POLICIES and PROGRAMS Republic Act 9155 or the Governance of Basic Education Act of 2001 mandated the Department of Education (DepEd) to continue the implementation of policies, programs and projects to provide access to quality basic education in partnership with other stakeholders of education. A total of 165 public elementary schools and 124 public secondary schools were established in the region from 1996 to 2005.The region has only 1,310 barangays and the current number of elementary public schools is 1,600. The data imply that 290 public elementary schools are opened even in sitios to provide access to elementary education. The number of completed schools from CY 1996-2005 reached 732. Primary schools reached 230, elementary 427 and secondary 75. The Multigrade Program is implemented to contribute in improving access to basic education for children residing in remote and isolated areas. A combination or multigrade class is handled by one teacher. This program also addresses the lack of teachers. In SY 2005-2006, the region has organized 1,516 multigrade classes in 778 public elementary schools with 1,516 teachers. Out of the 356,608 enrolment in public elementary, 57,027 or 16 percent pupils are enrolled in multigrade classes. In SY 2005-2006, the region organized seven types of Special Education (SPED) classes namely: Hearing Impaired (HI), Visually Impaired (VI), Mentally Handicapped, Learning Challenge, Autistic, Behavioral Problem and Fast Learners. There are 269 SPED classes organized in 53 elementary schools with 266 teachers handling the 6,898 special pupils.

School mapping of elementary schools with considerable Muslim population was done in the eight divisions for the Arabic Language and Islamic Values Education (ALIVE). The survey revealed that there are only seven divisions with considerable number of Muslim enrollees for Madrasah classes. Among the eight School Divisions of Caraga, only Siargao School Division has not started its Madrasah class. The region has a total of 741 Muslim enrollees with 16 Madrasah Instructional Managers as of CY 2006. The Alternative Learning System (ALS) in its efforts to provide educational opportunities to out-of-school youth and adults, continue to pursue its goal of promoting literacy in the region providing its clientele trainings both in literacy and other beneficial skills. The region has 366 Alternative Learning System Workers broken down as follows: 100 ALS District Coordinators, 8 District Supervisors, 31 Mobile Teachers, 222 Literacy Facilitators, 8 ALS Division Supervisor and 5 ALS Division Chief and Regional Supervisors. Literacy and Service Contracting Schemes (LSCS) and Basic Literacy Mobile Programs (BLMP) are being implemented in the region. A total of 1,526 adults and youth were enrolled in the LSCS and 1,152 adults and out of school youth were enrolled in SY 2005-2006. The BLMP primarily aims at providing access to basic education for the out-of-school youth (OSY) and adults in the disadvantaged, depressed, and underserved (DDU) areas in the region. There are 31 Mobile Teachers who organize several classes. They also gave priority to indigenous peoples in the region. The ALS Accreditation & Equivalency (A&E) Program aims at providing more access to secondary and tertiary education. The program enabled the beneficiaries not only to be educated but to gain more opportunities for better jobs. Under the program, there were eight (8) classes organized with a total of 218 enrolment. Ninety-one (91) or 41.74% were male and 127 or 58.26% were female. The Basic Literacy Program-Parents Literacy & Livelihood Education Program in School (PLEPS) is implemented in the six (6) Divisions of the region. Out of the total 2,302 enrollees, females comprised 65.25 percent. Only 63.47 percent of total enrollees completed the program, of which 977 were females and 484 were makes. Several region-initiated projects were currently being implemented. These include the Project LIFE (Literacy & Livelihood For Everyone), Parent Literacy and Livelihood Program in School (PLEPS), COBDEP (Comprehensive Barangay Development Program), Capability Building Program for ALS implementers, Values Formation Program for Basic Literacy and Monitoring & Evaluation Program for ALS programs & projects. There are also region coordinated projects which include the following:

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1) Caraga Literacy Implementing Council; 2) Female Functional Literacy; 3) Army Literacy Patrol System; 4) Paaral Program of Philippine Army; 5) Philippine Educational Placement Test and 6) LGU/NGO Funded Basic Literacy & Literacy Cum Livelihood classes Classrooms were constructed and rehabilitated, sets/units of table and chairs were delivered to schools regionwide while a number of schools were provided with funds for the repair and maintenance of school buildings. Specifically, the Secondary Education Development and Improvement Project (SEDIP) has constructed and turned over 225 classrooms to respective school buildings in Agusan del Sur. Through SEDIP, 13 science laboratories, 10 faculty rooms, 3 guidance centers, 3 rooms for home economics and 5 for industrial arts rooms were established. A number of schools were also recipients of libraries while 146 toilets were completed and turned-over to respective offices/schools. The SEDIP is currently working on the construction of 40 classrooms, 8 science laboratories, 4 guidance centers, 8 faculty rooms, 3 rooms for home economics, 6 for industrial arts rooms, 5 libraries and 24 toilets. The Third Elementary Education Project includes in its component the trainings for teachers, school managers and district supervisors. The TEEP also provided instructional materials and textbooks. For Bislig City alone, a total of 19 classrooms were constructed in 2003-2004.

THE BASIC LITERACY MOBILE PROGRAM OF THE BADJAOS IN SURIGAO CITY The Badjaos in Surigao City originally came from Leyte and Zamboanga. With their dependence on marine life, the group settled at Barangay Canlanipa, Surigao City where their source of livelihood is readily accessible. However, absence of education made them an outclass in the society they have inhabited. Some tried to expose themselves and enrolled in formal schools but were not able to continue because of insecurity and inferiority. Recognizing the necessity to educate them, the Department of Education, Division of Surigao City with its Alternative Learning System, reached out to the Badjaos through a Mobile Teacher with the assistance of a Badjao Facilitator. A total of thirty two learners responded positively and enrolled Basic Literacy Mobile Program (BLMP) scheduled every Wednesday, two to four in the afternoon. The Badjaos were taught to speak, read and write in their own dialect, Filipino and English languages. In support to BLMP, the Local Government of Surigao City extended its support to the Badjaos by providing honorarium for the Badjao Facilitator, school supplies and other learning materials as well as the on-going repair and construction of the bridge going to the Badjao community. Once known to be remote in manner, the Badjaos were able to put their trust with the people whom they think would cause them no harm but wellness and progress. This endeavor was able to demonstrate a successful partnership between the implementers and Badjaos.

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Improving school-retention capacity The school administrators and teachers need find ways and means to hold pupils/ students in school in order to reduce the drop-out rate and also to increase participation rate especially to children and their families in conflict-affected areas, in extreme poverty, those belonging to indigenous communities and those in the hinterlands. Alongside improving quality of education, Intensified health and nutrition services, livelihood support system, and other social protection program activities should be continually strengthened to keep the children in school and to raise their level of achievement.

Improving governance, resource allocation and utilization All school heads are now authorized to initiate and engage in educational innovations to improve actual delivery of basic education to the children based on their own needs. Regions and central offices always provide all the systems support. Partnerships between the schools and the communities shall be strengthened to improve performance of both teachers and pupils or students.

Improving performance through research and study

The Schools Division in close coordination with the Commission on Higher Education (CHED) and existing institutions in their respective areas should work hand-in-hand in the conduct of researches or study involving the education sector. Researches and studies are especially critical in determining the declining performance in the different areas of education so that appropriate interventions will be employed.

Fund sourcing to address school facilities and equipment requirements

The Dep-Ed Regional Office must continually initiate fund sourcing from other sources outside the regular budget to be able to augment available resources. The Special Education Fund of LGUs should be tapped creatively to fund more of the most pressing requirements of the sector.

Private sector partnership

The Schools Division should intensify efforts in generating the support of private companies and private individuals to sponsor scholarships for pupils and students and adopt more schools.

Closing resource gaps The eight divisions have inadequate resources that need to be addressed to provide quality education. Among these resources are teachers, school buildings, desk and armchairs, computers, laboratory equipments and instructional materials such as textbooks. Raising Learning Outcomes The challenge for the education sector does not only stop in ensuring universal access to primary education but more so in providing quality education. For the past years the deteriorating quality of education has alarmed the Department of Education. Although compared to its other regional counterparts, Caraga’s performance in national achievement test is relatively higher and has shown an upward trend in the areas of English, Mathematics and Science. However, it falls short of the 75 percent ideal mean percentage score.

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Goal 3. Promote Gender Equality

Target 4: Eliminate gender disparity in primary and secondary education preferably by 2005, and in all levels of education not later than 2015.

STATUS and TRENDS

As shown in Figure 14, enrolment data of elementary school children showed that there were slightly more male pupils enrolled in Grade 1 in five (5) consecutive school years from SY 2001-2002 to SY 2005-2006 at 51.46 percent, 51.62 percent, 51.77 percent, 51.59 percent and 51.64 percent, respectively. While Participation Rate in the same period has been declining in general, more female pupils are staying in school than the male population. Cohort Survival Rate and Completion Rate likewise showed wide disparities in performance and with the female population taking the lead.

Figure 14. Elementary Participation Rate (Public and Private), By Division, By Sex

Caraga Region, SY 2005-2006 (In Percent)


73 73 74

69

80 78

88

7474 74 74 74

66

79 79

90

7574

0

20

40

60

80

100

Agusan

Del Norte

Agusan

Del Sur

Surigao

Del Norte

Surigao

Del Sur

Bislig City Butuan

City

Surigao

City

Siargao Caraga

Male Female

31

Figure 15. Elementary Completion Rate (Public and Private), By Division, By Sex, Caraga Region, SY 2004-2005

Source: Department of Education Caraga The 2003 FLEMMS likewise showed that there are more female with basic literacy than the male with 94.6 percent to 89.5 percent. The same trend is seen with 84.6 percent of the female population in the region with functional literacy as against 77.3 percent of the male.

Technical Vocational Education and Training Courses (TVET) whether school-based, center-based, enterprise-based, community-based or extension or outreach, show a constantly fluctuating trend as to male and female ratio in terms of the population enrolling in TVET courses and its graduates. From 2000 to 2005, there seem to be no definite trend in the enrolment pattern. However, higher percentages of the female population than the male graduated from their respective courses except in 2004. As to TVET completers by getting the number of male and female graduates against the number of same gender enrollees, it was very evident that the female population achieve a higher rate of course completion than the male population.

Table 12. Distribution in TVET Enrolment, Graduates and Completers,

By Sex, Caraga Region, 2000-2005 (In Percent)

Source: Technical Education and Skills Development Caraga

59.3

46.3

60.2

50.754.3

58.8 58.4

71.6

60.5

72.266.4

49.9

72.8

82.6

71.272.4

54.1

66.9

0

20

40

60

80

100

Agusan

Del Norte

Agusan

Del Sur

Surigao

Del Norte

Surigao

Del Sur

Bislig City Butuan

City

Surigao

City

Siargao Caraga

Male Female

2000 2001 2002 2003 2004 2005

Enrolment

Male 50.75 53.07 47.64 48.14 52.95 44.96

Female 49.52 46.93 52.36 51.86 47.05 55.04

Graduation

Male 43.24 47.43 45.29 44.42 50.65 41.14

Female 56.76 52.57 54.71 55.58 49.35 58.86

Completion

Male 60.44 54.93 84.65 71.25 75.23 74.34

Female 81.75 68.86 93.04 82.77 82.50 86.88

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Female dominates region’s higher education but despite this, participation of male has significantly improved, thereby narrowing gender disparity. Across major disciplines, from 44 percent enrolment in SY 2003-2004, it went up to 45 percent in SY 2004-2005. The male graduates comprised 38 percent in SY 2002-2003, and 41 percent in SY 2003-2004. Source: Commission on Higher Education Caraga

Source: CHED Caraga

Figure 18. Graduates in Higher Education By Sex, Caraga Region, AY 2003-2004 Source: Commission on Higher Education Caraga higher number of graduates in teacher education and business related programs. Butuan City, which accounted for 41 percent of the total enrolment in SY 2004-2005, has four (4) of the region’s seven (7) nursing schools. The significant increase in the enrolment of males in the city is mainly caused by the growth of enrolment in BS Nursing. The increase in the number of offerings of BS Criminology and various engineering programs outside of Butuan City has also contributed the decrease in the disparity. Looking at the employment statistics in the region, Table 13 shows the employment trend for the past 10 years. It posted high figures on number of persons employed with an average of 880,000 out of 1,381,400 household population 15 years and above. It can also be noted that there are more male employed persons than female.

21,437

55%

17,586

45%

Male Female

Figure 16. Enrollment in Higher Education, By Sex, Caraga Region, AY 2003-2004

19,512

47%

22,368

53%

Male Female

Figure 17. Enrolment in Higher Education By Sex, Caraga Region, AY 2004-2005

The biggest narrowing factor in enrolment disparity between males and females is the very high increase in male enrolment in the nursing program. Traditionally male discipline, engineering and technology, posted also an additional increase in the total males enrolment. While there was a decreasing trend in the total number of graduates, the number of male graduates has showed an increase brought about by the increase in traditionally male disciplines namely engineering, technology and maritime. Moreover, there was also an increase in the number of female graduates in the abovementioned disciplines. Female continue to have

2,872

41%

4,140

59%

Male Female

33

Employment rate has also been increasing from 2002-2005. However, compared to 2001 levels, Caraga experienced massive displacement of workers not only in the wood-based industry but also in agricultural sector in 2002. Some of the most notable retrenchments reported to DOLE were attributed to establishments which were either closing for good or having to retrench workers due to economic reasons.

Table 13. Key Labor and Employment Statistics (In thousands),

Caraga Region, 1996-2005 (October Rounds)

Source: Department of Labor and Employment Caraga Note: Details may not add up to totals due to rounding. Of the total 5,923,000 working population, 64 percent of whom are working in the rural areas which is strengthening the analysis that Caraga is more of an agricultural area. Looking at the sharing of women and men participation in the workforce at the rural or urban areas, there are much lesser women in both areas with about 41 percent of them against men in the urban areas and about 36 percent in the rural areas.

Table 14. Employment Status (In Thousands) By Sex, Urban-Rural, Caraga Region, 1996-2002 (October Rounds)

Indicator 1996 1997 1998 1999 2000 2001 2002

Total Employed Urban Male Female Rural Male Female

875

328

189

139

548

361

187

851

315

186

130

536

350

186

770

285

167

118

486

316

170

826

311

187

124

516

331

185

837

297

175

122

540

352

188

919

327

191

137

592

361

231

882

327

191

135

555

359

196

Source: Department of Labor and Employment Caraga Note: Details may not add up to totals due to rounding.

Indicator 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 Household population 15 yrs old & above

1,323

1,361

1,246

1,288

1,337

1,362

1,429

1,455

1,504

1,509

Employed persons Male Female

875

549 326

851

536 316

770

483 288

826

517 309

837

527 310

919

551 368

882

550 332

931

574 358

934

582 352

976

- -

34

Shown in Table 15 is a sex disaggregated data of Employed Persons by Major Occupation Group and Sex from 2001-2004. Among occupational groups, the farmer, forestry workers and fishermen and the laborers and unskilled workers posted the two highest number of employment. These data reinforced previous assessment of Caraga as an agriculture region where majority of the economic activities are in the agriculture and informal sectors.

Table 15. Employed Persons by Major Occupation Group and Sex(In Thousands) Caraga Region, 2001-2004 (October Rounds)

2001 2002 2003 2004

Male Female Male Female Male Female Male Female Major Occupation Group

Officials of Government and Special Interest Organizations, Corporate Executives, MANAGERS, managing Proprietors and Supervisors

17 37 19 38 25 67 28 62

Professional 9 32 7 26 11 27 11 29

Technical and Associate Professionals 13 12 12 12 10 13 10 15

Clerks 14 35 13 29 10 20 10 25

Service Workers, Shop and Market Sales Workers 24 47 21 48 35 37 32 44

Farmer, Forestry Workers and Fishermen 230 65 225 46 203 38 203 35

Traders and Related Workers 56 20 47 10 49 12 45 11

Plan Machine Operators and Assemblers 49 2 54 1 62 2 57 1

Laborers and Unskilled Workers 136 118 148 122 164 140 182 130

Special Occupations 2 3 4 3

Total 551 368 550 332 574 358 582 352 Source: Department of Labor and Employment Caraga

On local governance, advocacy on increasing the participation of women is seen to be increasing from only about 10 percent or less in the previous elections. Of the total elected officials for 2007 to 2010, 18 percent of whom are women. Among provinces and cities, Surigao del Norte shows the highest percentage of women in the elective positions with 22 percent.

Table 16. Elected Local Officials, 2007-2010

Source: Department of Interior and Local Government, Caraga

Province/City TOTAL

M F TOTAL

Agusan del Norte 99 20 119

Agusan del Sur 119 24 143

Surigao del Norte 168 46 214

Surigao del Sur 151 33 184

Dinagat Islands 70 13 83

Bayugan City 8 2 10

Bislig City 10 2 12

Butuan City 11 1 12

Cabadbaran City 10 - 10

Surigao City 10 2 12

Tandag City 8 2 10

GRAND TOTAL 664 145 809

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Agencies, local government units, as well as the private sector are joining hands in advancing gender and development efforts to mainstream the goals and purposes of gender advocacy and to bridge the gender disparity in all fields of development.

In the region, with the Regional Development Council Gender and Development Coordinating Committee (RDC GADCC) in the helm, continuing advocacy and trainings have been done since its creation in December 1998 through the RDC Resolution No. 48, series of 1998. All these efforts were capped with a Most Gender Responsive Local Government Unit (LGU) and Most Gender Responsive Regional Line Agency (RLA) ‘competition’ in 2003. As a result, the LGU of Butuan City came out as winner with an edge over the others on a special fund sourced out from the Office of the Sangguniang Panlungsod Chairperson for Women for their economic empowerment activities for women in the barangays. The Department of Environment and Natural Office Regional Office came out winner in the RLA category. DENR-Caraga has successfully allotted a considerable amount of their agency budget for GAD activities, not only in the regional office but as well their Provincial and City ENROs. DENR-Caraga likewise organized a strong GAD Focal system in the agency.

At the time of evaluation, the following were observed to be the prevailing situation in the provinces, cities and RLAs :

• Existence of GAD Teams and permanent GAD Focal Persons,

• GAD Budget allocation and expenditure is less than 5%,

• Total GAD Budget indicated is a consolidation of budget spent for regular programs,

projects and activities (PPAs) which are women- related,

• If GAD PPAs outside of the regular PPAs are initiated, allocation usually comes from the SP Chairperson on Women budget, in the case of the LGUs,

• The need to strengthen the involvement of stakeholders in the preparation of plans where gender gaps and issues become the bases for GAD interventions with corresponding budget request,

• There is a need to closely look at the rising incidence of violence against women and children cases and that appropriate structures and mechanisms be installed or strengthened,

• The need to activate or encourage women and women’s groups representation in

Local Development Councils, and

• The need to strengthen the databases and the sex disaggregation of data.

The competition was seen as a challenge for all. As a result, structures have been strengthened and systems much improved after that round of evaluation. LGUs and agencies are again up for the same competition for 2006. Preparatory activities are currently being undertaken by the RDC GADCC for the Search for Most Gender Responsive LGU and RLA .


The DepEd continuously promotes gender sensitivity in learning content and approaches. In the implementation of Restructured Basic Education Curriculum, the gender issue was taken into consideration in the five learning areas of English, Filipino, Science, Math and Makabayan (Social Studies, History, Arts Technology and Home Economics).

36

All divisions and the region have crafted their own Gender and Development (GAD) vision and mission and every year a GAD Plan is formulated with the corresponding budgetary requirements. This serves as the road map on the activities to be undertaken in that particular year on gender mainstreaming.

These are the priority programs/ projects/ activities implemented to attain the MDG target under this area:

* Integrate GAD concepts and skills in all subject areas in grade year levels including in the Alternative Learning System,

* Provide all divisions copies of GAD Exemplars, * Reproduce and distribute GAD Exemplars to school administrators and teachers, * Advocacy on GAD Program to pupils/students parents (during PTA meetings) and

communities, * Coordinate with other line agencies for the implementation of GAD program, * Develop prototype Lesson Plans with GAD integration, * Conduct orientation/training (regional and divisional levels) on GAD Program to

DepEd Officials, support personnel, supervisors, school heads and teachers, * Attend national GAD trainings/workshops * Conduct Monitoring and Evaluation of GAD Activities (actual accomplishments vs.

targets) * GAD trainings/workshops, orientation and awareness seminars * Search for Most Gender Responsive Regional Line Agency and Most Gender

Responsive Local Government Unit * Scholarship Programs The Regional Development Council also monitors agency compliance on the 5 percent GAD budget. The Council only endorses budget proposals with GAD budgets. This is being done to ensure that the necessary interventions to promote gender equality will have the needed budgetary allocation to support its implementation.

37


Improving the gender content of education There is a need to review and improve the Basic Education Curriculum content to eliminate division of labor/roles of women and men (such as joint parenting and non-traditional skills and livelihood). Moreover, providing funding support for the conduct of training and orientation on gender-sensitive approaches to education to reach wider audience of teachers and school administrators shall facilitate gender mainstreaming in the education sector.

Strengthening the Alternative Learning System (ALS)

By strengthening the Alternative Learning System, those who are deterred from entering or staying within the existing formal education system because of gender considerations are provided with viable option in accessing education. Meeting the learning needs of marginalized learners especially

The Experience of the Puting Bato Women’s Organization: A Success Story Barangay Puting Bato is located 8 kilometers away from the town center of the municipality of Cabadbaran and 40 kilometers from the provincial capital of Agusan del Norte. It can be reached by a jeepney plying to the barangay once a day for a fare of P20 or by a single motorcycle (habal-habal) at a fare of P25 or P80 when one passenger rides alone (pakyaw). The average level of education among women is elementary. Moreover, 10 percent of the womenfolk are illiterates. The people in the barangay are small farmers producing corn and root crops. Those living at the barangay center are engaged in small business such as fish vending and sari-sari stores. To uplift the socio-economic status of the barangay, the municipality of Cabadbaran as well as some Non-Government Organizations (NGOs) has sponsored development projects which provide degree of awareness in terms of women’s social participation and involvement. In January 2001, the women organization, Nagkahiusang Pundok sa Kababayen-an sa Puting Bato, has officially registered its cooperative in the Cooperative Development Authority under the name: Kooperatiba sa Kababayen-an sa Puting Bato (KKPB). The KKPB which started a capital of P22,000.00 was able to release P139,198.07 interest on share capital and P137,384.59 for patronage refund in 2004. The KKPB assets also continuously increased from P312,447.94 in 2004 to P409,849.59 in 2005. The remarkable performance of KKPB has garnered recognition from the Nagkahiusang Pundok sa Kababayen-an sa Cabadbaran (NPKC) when KKPB was declared for three (3) consecutive years (2004, 2005 and 2006) as grand slam prize winner in the NPKC Search for the Best Livelihood Project. Furthermore, the President of KKPB Ms. Cherly Oyo-a was unanimously elected President by the Agusanong Kahugpungan sa Kababayen-an (AGUKAKABA), a provincial federation of women organizations in Agusan del Norte which have been recipient of the Women’s Health and Safe Motherhood Project – Partnership Component (WHSMP-PC), a European Union (EU)grant aid project. The Ambassador of the EU and party visited Barangay Puting Bato and commended the KKPB for its sound and sustainable management of health and livelihood projects among others. The experience of the Puting Bato women organization has inspired its partner women organizations in Agusan del Norte to persevere and to fully commit themselves for the sustainable implementation of health programs and livelihood projects for women empowerment and family well-being. The Puting Bato experience not only contributes to MDG 3- Promote Gender Equality but also address MDG 1: Eradicate Extreme Poverty and Hunger.

38

women, outside the school system are reached through a more flexible approach. Additional Mobile Teachers who are gender-sensitive for ALS will be helpful in improving access to education. Additionally, gender issues shall be adequately integrated with the concerns in improving the DepEd’s service-delivery capacity in partnership with the private sector.

Understanding the socio-cultural nuances of gender issues

Generally, the current education indicators show that females hold an advantage over males when it comes to education. The low completion and retention among males in the school system are issues to be considered in planning and implementation with interventions. All stakeholders of education shall move toward a deeper understanding of the socio-cultural nuances of gender disparity to be able to make educational programs more responsive to specific situation.

Strengthening partnership with the media and appropriate bodies

Gender sensitive education shall be pursued with the media as a strong partner especially in any print, audio and video materials disseminated. Moreover, area specific gender issues will be addressed and continuing education activities shall be undertaken in close coordination with the local government units concerned, the Divisions and other line agencies.

Increasing scholarship slots for the region

The number of scholarship slots coming from CHED is very limited. Considering the magnitude of poor population in the region, more slots should be given to Caraga to support more students interested to pursue college education. The available scholarship will surely augment the chances of getting higher education for better job opportunities. More slots should also be made available especially to indigenous peoples. Strengthening the GAD Advocacy and other Mainstreaming Activities GAD mainstreaming initiatives will be continuously undertaken at the different levels to ensure gender equality, not only in the access but in the control of resources and opportunities.

Goal 4: REDUCE CHILD MORTALITY Target 5: Reduce under-five mortality rate by two-thirds by 2015 STATUS and TRENDS

Putting every child at the center of development and ensuring that their right to survival is respected, and fulfilled is a vital element of the Millennium Development Goals. In Caraga, efforts to make headway in reducing the Infant Mortality Rate (IMR) have shown positive results. Over the last 15 years (1991-2005), IMR has been reduced from 17 per 1,000 livebirths in 1991 to 7.5 per 1,000 livebirths in 2005. At an average, the IMR of Caraga was posted at 11.97 per 1,000 livebirths. Compared to the national figure of 10.2 per 1,000 livebirths, the region has a slightly lower figure in 2003 with 9.6 per 1,000 livebirths.

In the last 15 years, Butuan City consistently had the highest infant deaths but with a decreasing trend since 2000. Infant mortality rate was 24 per 1,000 livebirths in 1991 to 11 per 1,000 livebirths in 2005. Agusan Del Norte on the other has managed to sustain its efforts in reducing infant morality from 9.8 per 1,000 livebirths in 1991 to 3.4 per 1,000 livebirths in 2005. From 1991 up to 2005, it remained to be at the bottom in terms of infant deaths and has considerably lowered its IMR by 65 percent. Next to Butuan City is Surigao City with an average rate of 12.62 per 1,000 livebirths from 1995 to 2005. One reason of the high recorded IMR in the two cities are the instances where deaths occurred in the hospital or health facilities located in these cities despite the fact that they are originally from the neighboring municipalities. In this case, under reporting in the other provinces can be inferred. Across the region, Surigao City is the best performing in terms of reducing IMR. From 25 per 1,000 livebirths in 1991, which was the highest in that year it went down to 7.5

39

livebirths in 2005. This means a reduction of 72 percent from the year 1991 to 2005. However, the increasing trend in IMR in Bislig City is alarming thus, preventive measures to remedy the increasing infant deaths should be instituted. The remarkable reduction of IMR in the province of Agusan Del Sur can be attributed to the presence of several foreign funded projects which ensures improved facilities and more supply of medicines and vaccines.

Table 17. Infant Mortality Rate, By Province and City, Caraga Region, 1991-2005

(Per 1,000 Livebirths)


Based on the 1991 data in IMR, the region has to curb infant deaths to 5.8 per 1,000 livebirths by 2015. The average reduction in IMR from 1991-2005 is .71 per 1,000 livebirths. In order to lower the IMR to 5.8 per 1,000 livebirths by 2015, the required annual reduction is 0.17 per 1,000 livebirths. Given Caraga’s performance over the last 14 years, it is likely that the region will be able to reduce by two thirds the number of infant deaths if current gains will be sustained. Since all the ten leading causes of infant deaths such as pneumonia and diarrhea are preventable, implementation of measures that will effectively reduce and/or prevent these infants from dying of any of these causes should be strengthened and be made affordable and accessible to the people especially the poor.

Figure 19. Reduction of Infant Morality Rate, Caraga Region, 1991-2015

Province/City 1991 1995 2000 2001 2003 2005

Agusan del Norte 9.8 14 9.5 5.8 3.2 3.4

Agusan del Sur 15 13 9.9 10 9.1 5.8

Surigao del Norte 22 18 8 9.4 8.7 9.8

Surigao del Sur 21 12 10 15 13 9.2

Bislig City 5.5 3.4 6.8 9.3

Butuan City 24 19 23 19 16 11

Surigao City 25 18 15 13 10 7.1

Caraga 17 16 11 12 9.6 7.5

Infant mortality rate (per 1,000 livebirths)

2015 target



Infant mortality rate (per 1,000 livebirths)

2015 target



17.416

11

5.8

7.5

0

5

10

15

20

1991 1995 2000 2005 2010 2015

Source of basic data: DOH-CHD Caraga

40

The Under–Five Mortality Rate (U5MR) in six years is generally erratic. For the last 5 years, the decline in U5MR in the region is significant, from 4 deaths per 1,000 under-five population in 2000 to 2.79 per 1,000 under five population in 2003 and rose sharply to 4.03 per 1,000 under five population and reached its lowest rate in 2005 with 2.17 per 1,000 under five population. On the average rate, Butuan City has the highest U5MR at 4.14 per 1,000 under five population that may be attributed to some deaths from other areas who died within the health facilities in Butuan City. The Province of Agusan Del Sur posted the sharpest reduction from the 2000 rate of 3 per 1,000 under five population to 1.49 per 1,000 under five population which is 51 percent lower than the figure in 2000.

Table 18. Under-Five Mortality Rate, By Province and City, Caraga Region, 2000-2005

(Per 1,000 under five population)


There is a high probability that the region will be able to peg its U5MR to 1 per 1,000 under five population in 2015 given the current rate of progress. On the average, it has reduced its U5MR by .22 per 1,000 under five population in the last five years while the required reduction annually is 0.09 per 1,000 under five population. As long as the region continues to implement programs on ensuring child health effectively, the region will meet the 2015 target.

Province/City 2000 2001 2002 2003 2004 2005 Average

Agusan del Norte 3 1.47 1.71 1.6 2 1.82 1.93

Agusan del Sur 3 2.85 2.72 2.9 3.5 1.49 2.74

Surigao del Norte 3 2.43 2.79 2.7 2.3 2.47 2.62

Surigao del Sur 3 2.79 2.76 3.4 4.8 1.81 3.09

Bislig City - 2.22 2.37 2.3 7.3 2.54 3.35

Butuan City 6 3.57 3.81 2.8 4.8 3.89 4.14

Surigao City 5 3.86 2.4 3.8 3.5 2.64 3.53

Caraga 3.83 2.74 2.65 2.79 4.03 2.17 3.06

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Figure 20. Reduction of Under-Five Morality Rate, Caraga Region, 2000-2015



Under the Expanded Program on Immunization (EPI), trainings and orientations were conducted to different health personnel on both the EPI Mid Level Course and EPI Cold Chain Management Course. The DOH continues to provide vaccines, syringes and needles to the four provinces and three cities as an augmentation to local resources. Production and distribution of EPI charts were also done. The health sector undertakes a pro-active approach in ensuring wide coverage of immunization. Barangay Health Workers (BHWs) are deployed even to remote barangays when the immunization period takes place.

Table 15 shows the region’s performance on the EPI. A sustained gain in the coverage of immunization is evident in 1999 with 79.43 percent coverage which steadily rose, reaching 84.97 percent in 2003. This is relatively higher than the national figure of 60 percent in 2003. Although the accomplishment region-wide is much higher than the national in 2003, it declined steadily in the next two years and went down to 80.26 percent despite the capable trained health personnel, available standard management protocol, availability of vaccines and other logistics. Some contributory factors resulting to the declining performance includes fast turn-over of program coordinators, un-updated master listing of targets, no regular immunization session plan showing how to reach every community, no follow up of defaulters and some LGUs has inadequate funds to purchase sufficient drugs & supplies especially syringes and needles.

Butuan City is the consistent highest performing LGU in terms of immunization coverage throughout the years. About 94 percent of the total number of children was immunized in 2005 which is much higher than the regional and national figures. Bislig City on the other hand, remained to be the slowest performer with only 52.33 percent coverage in 2005. The discrepancy in the projected and actual number of children caused the difference in the city’s accomplishment. Out-migration is currently observable in the city.

3.83

2.79

2.17

1.28

0

1

2

3

4

2000 2003 2005 2010 2015

Under five mortality rate (per 1,000 under five population)

2015 target



Under five mortality rate (per 1,000 under five population)

2015 target



42

Table 19. Percentage of Fully Immunized Children, By Province and City, Caraga Region, 1999, 2003 & 2005

* NDHS2003 Source: Department of Health – Center for Health Development Caraga

Massive information dissemination and advocacy is being spearheaded by the Department of Health in implementing the New Born Screening Program. Under the Program, newborns are screened for congenital diseases to prevent abnormal development and to determine the needed medical intervention to arrest the situation. It has conducted orientation to public and private hospital staff and Rural Health Units (RHUs) personnel. From 2004-2006 newborn screened in Caraga totaled to 305 babies. Currently, there are 12 newborn screening facilities in the region. The Integrated Management of Childhood Illnesses (IMCI) is a strategy to reduce under-five mortality rate. Under the IMCI, basic training courses to further capacitate doctors, nurses and midwives on managing child illnesses and in assessing the present nutritional status of a sick child seeking services at the health centers was conducted. Considering that diarrhea is among the causes of infant and under-five mortality, the DOH and the LGUs continue to provide ORS to diarrhea cases (0-59 months) to avert dehydration or complications leading to death. Among the LGUs, only the province of Agusan Del Sur has 100 percent accomplishment on IMCI training of health personnel. The presence of ECCD Project has also provided support on the conduct of IMCI trainings. Several capability building activities such as: Psychosocial Care Seminar and consultative conference with Mother Baby Friendly Hospital Initiative (MBFHI) coordinators were conducted to further capacitate health workers on child health. CHALLENGES and PRIORITIES for ACTION

Inadequate drugs and supplies The major constraint in the immunization program and micronutrient supplementation is the lack of funds to purchase the needed vaccines, drugs, syringes and needles. Most of the LGUs are dependent on the supplies provided by the DOH which can only cover part of the target population. There is a need for the LGUs to allocate more funds to support program implementation to ensure child health and to find innovative and creative ways to augment their meager funds. Increasing budgetary allocation for health and nutrition at the local level Budgetary priority should be given to maternal and child care to augment the supplies of syringes, medicines, micronutrient supplementation and upgrade equipment to ensure the survival and well-being of children and mothers alike. Pro-active stance can also be taken by barangay-based health workers with the support of the LGUs through the provision of financial assistance during the

Province/City 1999 2003 2005 Agusan del Norte 84.40 89.41 86.98 Agusan del Sur 70.87 94.53 86.99 Surigao del Norte 78.47 82.80 82.50 Surigao del Sur 79.20 73.55 74.14 Bislig City - 71.78 52.33 Butuan City 87.30 96.49 93.71 Surigao City 76.32 86.24 85.17 Caraga 79.43 84.97 80.26 National (2003)* 60

43

conduct of out-reach or house to house campaign on the different child health related programs in order to reach those who are located in the far flung areas. The Local Health Boards endowed with the power to propose to the local legislative bodies budgetary allocation for the operation and maintenance of health facilities should also give budgetary priorities to the upgrading of the health facilities and in the acquisition of needed supplies and equipments for effective delivery of health services. The Boards should also take a pro-active stance in the identification of policy and program intervention to address existing health-related needs of the locality.

Lack of human resources The region suffers from the limited plantilla positions in the health sector. This has resulted to the limited field work or the irregular outreach programs to the community which provide better avenue to reach the children in far flung areas. The current staffing pattern of the DOH has also limited its pro-active role in health delivery. Increased participation of civil society in the health programs of the LGUs and in monitoring existing gaps or inadequacies in health services The civil society should be tapped in providing alternative health care to meet the increasing demand for services and supplement the limited capacity of the government to provide the basic health services due to competing demands and priorities at all levels. Moreover, the civil society should remain vigilant in monitoring the quality of health services provided by the government to facilitate identification of gaps and areas where they can come in. NGO’s participation in the Local Health Boards at various levels should also be maximized to promote complementation of services and in raising standards for health service delivery. Full enforcement of the provisions of the Food Fortification Law and Milk Code

The proliferation of infant formula in the market encourages mothers to go for instant milk solution rather than breast milk. The low breastfeeding rate is very apparent and needs to be addressed with the necessary program intervention. Among which is to intensify advocacy, education and information dissemination especially among mothers. Tapping the Milk Code Task Force in monitoring strict compliance to the law will also address the declining breastfeeding rate. Hospitals and RHU personnel should be used as agents in ensure breastfeeding upon birth. The establishment of Child Minding Centers among public and private institutions will also provide opportunities for working mothers to breastfeed their infants even during office hours. Breast-feeding should be complemented with the enforcement of the Food Fortification Law. Information and education campaign on the consumption of fortified foods with iron and other vitamins will also help in addressing malnutrition and promote child health especially with the growing number of children deficient in iron and vitamin A. Strengthening the delivery of child health services of public health personnel and community volunteer health workers. By increasing the capacity of the public health personnel and community volunteer health workers to deliver child health-related services, child survival and well being will be guaranteed. Part of the capability building intervention needed is the Cold Chain Management Training which some RHUs have not undergone. Moreover, facilities of the RHUs and district hospitals should be upgraded to be more responsive to the needed health care of children within the catchment population.

44

Goal 5: IMPROVE MATERNAL HEALTH Target 6: Reduce Maternal Mortality Rate (MMR) by two-thirds by 2015 (half by 2000, half by 2015)

STATUS and TRENDS

Maternal health is a pressing concern across the region. Caraga Region’s Maternal Mortality Rate (MMR) is one of the highest in the Philippines, second to ARMM in 2003 with 131.43 per 100,000 livebirths. Over the period of 15 years, maternal deaths remained alarming with no sustained reduction despite the interventions to ensure safe delivery of mothers. In 1991, the MMR was 143.75 per 100,000 livebirths, which went down to 93.5 per 100,000 livebirths in 1995 but peaked to 165.71 per 100,000 livebirths in 2000 instead of curbing it into half. By 2005 the MMR was 170 per 100,000 livebirths which is a little higher than in 1991. In the last 15 years, maternal deaths was high in Butuan City with an average MMR of 197 per 100,000 livebirths followed by Agusan Del Sur with 173 per 100,000 livebirths. In 2005, Surigao Del Sur had the highest MMR with 340 per 100,000 livebirths which is almost twice the regional figure. Agusan Del Norte was able to sustain its performance on low maternal deaths from 175 per 100,000 livebirths in 1991, 83 per 100,000 livebirths in 1997 then it registered 0 deaths in 2003 and 60 per 100,000 livebirths in 2005.

Table 20. Maternal Mortality Rate By Province and City, Caraga Region, 1991, 2000 & 2005

(Per 100,000 live births)

Province/City 1991 1995 2000 2003 2005 Agusan del Norte 175 58 70 0 60 Agusan del Sur 151 196 210 270 140 Surigao del Norte 69 94 130 40 120 Surigao del Sur 180 64 190 140 340 Bislig City - - 40 170 160 Butuan City - 69 370 180 220 Surigao City - 80 0 120 150 Caraga 143.75 93.50 144.29 131.43 170.00 Philippines (2006)* 162

*2006 Family Planning Survey Source: Department of Health – Center for Health Development Caraga Annual Report 2006

Deliveries attended by skilled health personnel that include doctors, nurses and midwives ensure that the needed obstetric care is given to delivering mothers thus preventing maternal deaths. Looking at the data on births attended by skilled health personnel, in a span of 10 years from 1995 to 2005, the average rate registered only to 46.36 percent. This means that traditional birth attendants whether trained or untrained attended more than half of the deliveries in Caraga. The ratio of Rural Health Midwives to the population in 2004 was posted at 1:3,320. This is a good indicator since the region has better figure compared to the standard of 1:5,000. This also tells us that there are available midwives who can assist the delivery of pregnant women. However, despite the availability of the Rural Health Midwives, there is still strong preference for TBAs. This preference towards the TBAs is more apparent in rural or remote barangays where TBAs are more accessible to the populace over the skilled health personnel. Although training of hilots has started in 2001, this has not significantly reduced the number of maternal deaths in the region. On the other hand, the region is still way above the standard ratio of doctors and nurses to population which were

posted at 1:24,973 and 1:19,210, respectively as against the standard of 1:20,000 and 1:15,000. Compared to the national figure in 2003 posted at 67.8 percent, Caraga has a rate lower by 18

45

percent. The high percentage of deliveries not attended by skilled health personnel is a contributing factor why maternal mortality in the region is among the highest in the country.

Agusan Del Norte had the highest average in births attended by skilled health personnel that supports the low maternal deaths in the province. On the other hand, Surigao Del Norte had the lowest average rate for the last 10 years. Surigao City had shown the highest increase from 36.9 percent in 2004 it increased dramatically to 76.54 percent in 2005.

Table 21. Percentage of Births Attended by Skilled Health Personnel By Province and City, Caraga Region, 1995-2005

* NDHS 2003 Source: Department of Health – Center for Health Development Caraga

Considering that there was no sustained positive gain in ensuring maternal health, the region is unlikely to reduce maternal deaths by three quarters in 2015. The required rate in the remaining 12 years is higher than its current performance. Contributing factors to high maternal deaths include high percentage of home deliveries attended by traditional health attendants or hilots, high percentage of high risk pregnancy, low percentage of women provided with postpartum care within the first 72 hours after delivery, late referral and inaccessibility of health care service attributable to geography and economic reasons. Leading causes of maternal deaths can be prevented with measures like proper pregnancy risk assessment, early referral of cases, provision of postnatal care especially 72 hours critical period, provision of vitamin and mineral supplements to pregnant women, facility-based delivery, close monitoring of traditional birth attendants (TBAs). For the past years, the region’s health sector which include not only the government but private and the community, are trying to enhance and intensify implementation of these measures to address the problem on high MMR.

Province/City 1995 1999 2003 2004 2005

Agusan del Norte 45.1 55.9 57.7 53.3 53.28

Agusan del Sur 24.1 51.6 50.6 51.6 73.82

Surigao del Norte 26.4 45.2 48.5 52.4 46.88

Surigao del Sur 37.2 52.4 46.5 47.7 47.47

Bislig City 65.9 61 59.71

Butuan City 42.8 48.5 41.4 42 35.2

Surigao City 34 36.1 43 46.9 76.54

Caraga 34.93 48.28 50.51 50.70 56.13 Philippines (2003) ) 60

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Figure 21. Reduction of Maternal Morality Rate, Caraga Region, 1991-2015

Caraga’s prenatal care coverage is considerably lower than the national figure and has declined in 2003. At the national level prenatal care covered 67.8 percent of pregnant women in 2003 while Caraga’s coverage was only 62 percent which went down to 57.35 percent in 2005. Only 6 out of 10 pregnant women were able to visit the Rural Health Units/clinics for 3 or more times for prenatal care leaving the other four (4) pregnant women more susceptible to infection thereby increasing the risk to complications of both the mother and the child inside her womb.

Within Caraga, the top performing LGUs include Agusan Del Norte, Butuan City and Surigao Del Norte with coverage higher than the regional level. Bislig City had the lowest coverage and experienced the highest decline from 58.16 percent in 2004 to 39.45 percent in 2005. It is very hard to determine the improvement of implementation of prenatal care activities in as much as the trend had been very erratic for the past years.

161 172 167

54

0

50

100

150

200

1991 2000 2005 2010 2015


Maternal Mortality Rate (per 100,00 livebirths)

2015 target


2015 target


47

Table 22. Percentage of Prenatal Care Coverage By Province and City, Caraga Region, 1998, 2000, 2003-2005

Province/City 1998 2000 2003 2004 2005 Agusan del Norte 54.5 79.9 75.93 71.9 72.52 Agusan del Sur 39.8 43 58.81 59.02 51.23 Surigao del Norte 71.2 55.1 60.92 58.44 60.77 Surigao del Sur 53.1 64.8 46.87 41.54 41.31 Bislig City - 58.1 53.93 58.16 39.45 Butuan City 64.6 76.4 81.55 79.74 77.49 Surigao City 48 41.1 60.5 57.86 62.97 Caraga 55.20 59.77 62.64 60.95 57.96 Philippines (2003)* 88


Post-natal care coverage in the region is higher than its pre natal care coverage. However, it lagged behind compared to the national average of 69.5 percent in 2003. Caraga’s post-natal care was posted at 66.54 percent and increased slightly to 67.1 percent in 2005. Butuan City registered the widest coverage in the past eight years with 80.36 percent on the average. Bislig City’s post-natal care coverage has declined steadily from 95 percent in 2000 to 35.1 percent in 2005, the lowest among the seven LGUs.

Table 23. Percentage of Post Natal Care Coverage By Province and City, Caraga Region, 1998-2005


The low pre-and post-natal care coverage in the region has contributed to the high maternal deaths. Part of the maternal health program is the Vitamin A supplementation. A total of 33,057 lactating mothers were given Vitamin A supplements in 2005. Preventive dental services were given to a total of 3,785 pregnant women and preventive treatment to 8,523 pregnant women.

Province/City 1998 2000 2003 2005

Agusan del Norte 47.9 81.4 67.61 74.01

Agusan del Sur 63.2 77.9 66.18 68.37

Surigao del Norte 65.8 81.4 61.65 58.97

Surigao del Sur 57.3 69.3 58.11 59.15

Bislig City - 95 59.28 35.1

Butuan City 77.2 74 88.47 89.67

Surigao City 71.7 82.9 65.24 68.29

Caraga 63.85 80.27 66.65 64.79

Philippines (2003)* 55.7

48


Under the Maternal Health Program, an integrated package of services for women was provided to promote safe motherhood and ensure the well being of mothers. This includes the provision of prenatal and post natal care among mothers. Capability building through orientation and trainings of midwives on partograph are done annually. Training needs assessment of the provincial and municipal coordinators were also conducted as well as strategic planning workshop on Emergency Maternal Obstetric Care (EMOC). Maternal death review (MDR) is being undertaken by the regional, provincial and some organized municipal MDR Teams. Trainings are also given to the MDR Teams. Another strategy of the DOH to lower maternal deaths is the suspension of training for traditional birth attendants (TBA). It has been found-out that despite training of TBAs, more deaths occurred for deliveries they solely attended. However, considering the geographical configuration of Caraga, deliveries attended by TBA cannot be eliminated right away especially in remote areas. Under the Women’s Health and Safe Motherhood Project which covered the Province of Surigao Del Sur and Agusan Del Norte, upgrading of the Basic Emergency Obstetric Care (BEMOC) and Comprehensive Emergency Obstetric Care (CEMOC) were undertaken. To date, there are only a total of 10 BEMOC and 10 CEMOC established. This posted a shortage of 12 BEMOC. The inadequate number of functional BEMOC has also contributed to the high maternal deaths in the region. The lack of facility and capability of the health personnel to handle varying degree of complex delivery situations aggravated maternal deaths. Through the support of the United Nations Children’s Fund (UNICEF), augmentation for capability building interventions and monitoring and evaluation is made available. Capability-building for health personnel with funding support from UNICEF included trainings on partograph, EMOC, infant and young feeding, micronutrients and conduct of maternal death review. CHALLENGES and PRIORITIES for ACTION

Strengthen health care delivery system There is a need to strengthen the delivery of health care system through the provision of adequate resources including human resources, training facilities, capability building interventions, drugs, equipment and buildings. Most of the district hospitals and rural health units need upgrading and rehabilitation. Construction of new facilities that would satisfy the standards set by the DOH is also a pressing need. The Rural Health Units, District Hospitals and Provincial Hospitals in the region need to be upgraded because the facilities are too old and dilapidated. Not only the buildings are in dire need of rehabilitation and upgrading but also the equipment and laboratory facilities. Shortage of equipment and supplies of drugs are also apparent problems in the delivery of appropriate medical interventions. Inadequate and/or inappropriate training of health workers, with an emphasis on curative-oriented rather than community-oriented programs should also be addressed. Strengthening of the referral system and responsiveness of the area health zones will likewise avert maternal deaths. Further capacitate the new medical staff The exodus of the program coordinators poses a problem and needs to be addressed. In this regard, efforts should be geared towards retaining them. Moreover, the newly hired medical staff should be given intensive training on MCH so they can perform their task of improving maternal and child health.

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Provision of scholarships and better career paths to increase retention of medical workers The provision of scholarship grants for medical related courses among qualified college students is an option which the LGUs can adopt to encourage students to pursue career on the fields of medicine and health related occupation. The service obligation requirement shall help ensure that there will be available health workers in the locality. Trainings and brighter career path for the medical personnel should be made available to increase the retention rate of the staff and to motivate them to stay in the public sector despite the lucrative offers outside the country. Intensify IEC/Advocacy activities and program implementation in remote/hard to reach areas The core of every health related program is the advocacy and education aspect to influence behavioral preferences of mothers especially in far-flung areas. There is a need to intensify the campaign on the different components of the maternal health program to encourage pregnant women and mothers to avail of the services intended to the ensure safe motherhood. Enactment of Local Legislation to Discourage Deliveries Solely Attended by TBAs LGUs are encouraged to use its law making power by passing a local ordinance prohibiting the delivery of mothers to be solely attended by TBAs to ensure that proper obstetric care is provided and to prevent maternal deaths. The municipality of Tubay has passed Municipal Ordinance No. 2004-04 entitled “Imposing Penalties to Untrained Hilots Handling the Delivery of Babies”. The Department of Health is convinced that this is a necessary intervention to effectively address the problem. Other LGUs are likewise encouraged to pass their own legislative measure and implement the same. Strengthen collaboration with civil society organizations and linkages with local/foreign funding institutions to address budgetary constraints of the LGU The civil society has a big role in providing the needed health services given the limited capacity of the government to provide for such services. NGOs whose expertise is on the provision of health services should be encouraged to intervene and provide alternative access to services. Foreign donors should also be seen as an important player to address the unmeet need for health services especially in terms of facility upgrading or establishment and provision of hospital equipment. Target 7: Increase access to reproductive health (RH) services to 60% by 2005, 80% by 2010, and 100% by 2015 STATUS and TRENDS

Women who prefer to space or limit births but are not practicing family planning are considered to have an “unmet need”. In the 2004 Family Planning Survey (FPS) the total unmet need for family planning services in Caraga was 19.5 percent – 8.7 for spacing and 10.8 for limiting births while the Philippines has an unmet need of 20.6 percent – 10.8 percent for spacing and 9.7 percent for limiting and births. There is no significant disparity between the unmet need for family planning between Caraga and the Philippines in 2004. Several studies identified factors contributing to a large unmet need. Most of these are related to the monetary and non-monetary cost of contraception, fertility preference, perception of risk and health effects, attitudes on/acceptance of Family Planning (FP), and lack of access to FP information and services. Total Fertility Rate (TFR) is the number of births a woman would have on average at the end of her reproductive life. Caraga’s TFR is at 4.1 and the desired fertility rate is at 2.8 (NDHS 2003). This means that women in Caraga had one more child than they planned or desired. Compared to the

50

national TFR of 3.5 and desired fertility rate of 2.5, fertility preference in Caraga is higher by one more child both in the TRF and desired fertility rate. Fertility preference varies across regions. Since TFR in Caraga is higher than the desired fertility rate, interventions should be provided to help couples in meeting their desired number of children. Government efforts should target those couples with lower educational attainment and those with lower economic status as the national survey revealed that the less educated and those who belong to the lowest quintile wealth index have bigger fertility preference and higher unmet need for family planning. Generally, the less developed regions have higher fertility reference compared to the more developed ones. This has implications on the available and needed resources within the region to support the annual growth of population. There has been an observable decline in TFR. While the region’s TFR has fallen from 4.6 in 1998 to 4.1 in 2003 according to the NDHS, it remains higher than the national average. Current figures for the region show that the desired number of children is 2.8 and the TFR is 4.1 (NDHS 2003). This means that, while Caraga women are having fewer children over their lifetime, there remains a gap of more than one (1) child between their desired and their actual number of children. Many couples, particularly among the poor, were not able to achieve their fertility goals. There was a lack of access to high quality services of preferred contraceptive methods. Married women have fear of adverse health effects to contraceptives. The survey also cited that there was a lack of gender equity in the determination of fertility goals. Based on the NDHS 2003, 54.6 percent of currently married women in the region use any method of contraception. Thirty-four percent use modern method and 20.6 percent use traditional method. The contraceptive mix in 2003 was as follows: the pill is the leading family planning method (14.8) percent) followed by traditional methods including calendar, rhythm, periodic abstinence (13.2 percent); female sterilization and Intrauterine Device (IUD) (7 percent), withdrawal (4.7) and male condom (2.7 percent). Injectibles (1.4) and male sterilization (0.3) were the least preferred contraceptives. Generally, contraceptive use is higher in Mindanao regions except in ARMM. Looking at the actual contraceptive prevalence rate (as recorded by DOH) in the region, it can be gleaned in Table 24 that the Contraceptive Prevalence Rate (CPR) has been erratic in the last seven years. It exhibited an increasing-decreasing trend but generally, it went up from 37.96 per cent in 1999 to 43.82 in 2005. The highest CPR was in 2003 with 53.85 percent. Among the provinces, Surigao Del Norte had the highest CPR with 57.59 percent followed by Surigao Del Sur and Butuan City with 44 percent. The CPR in Butuan City doubled in a matter of seven years, from 1999 to 2005. Surigao Del Sur’s CPR on the other hand, was reduced by almost half, from 83.9 percent in 1999 to 44 percent in 2005.

Table 24. Contraceptive Prevalence Rate, By Province and City,

Caraga Region, 1999-2005 (In Percent)

Province/City 1999 2000 2001 2002 2003 2004 2005 Agusan del Norte 21.19 35.91 29.71 39.43 44.09 41.63 37.49 Agusan del Sur 61.56 54.91 51.61 51.59 65.43 44.14 49.91 Surigao del Norte 23.7 46.81 41.98 36.17 64.48 35.08 57.59 Surigao del Sur 83.9 48.96 48.16 51.79 46.63 51.38 44.39 Bislig City 60.74 83.71 89.36 61.42 55.55 41.8 Butuan City 19.65 23.38 23.28 43.49 36.68 41.06 44.41 Surigao City 39.96 40.03 36.54 42.27 45.93 44.45 40.73 Caraga 37.96 45.46 43.79 48.01 53.85 43.76 43.82 Philippines (2005)* 49.7*

* 2005 Family Planning Survey Source: Department of Health – Center for Health Development Caraga

With the target CPR of 75.92 percent, it requires that the region will have an increase of at least 3.21 percent in the remaining 10 years. However, given the slight increase from years 1999-2005

51

which averaged at .98 percent only, there is a low probability that the region will be able to attain the target. Moreover, the full withdrawal of contraceptives from foreign donors should be addressed effectively to mitigate its adverse effects especially to those who are not financially capable to purchase contraceptives and who have been highly dependent on the logistics and supplies coming from foreign donors.

Figure 22. Contraceptive Prevalence Rate, Caraga Region, 1999-2015

(In Percent)

Women are affected with a wide range of reproductive health problems. Based on the data released by DOH-Caraga pregnant mothers suffer from iron deficiency and are afflicted with goiter. Reproductive tract infections, due to sexually transmitted infection, unsafe birth, traditional health practices and poor environmental conditions are also common. These can lead to infertility, ectopic pregnancy, cervical cancer, pelvic inflammatory diseases, infant death and increased susceptibility to HIV infection. Fertility is a proximate determinant of the changes of population growth, size, and structure. The 2000 population (2.1 million) of Caraga Region increased by 153,000 over the 1995 NSO figure of 1.9 million and 331,000 over the 1990 figure of 1.8 million. The region’s population growth rate (PGR) decreased from 2.53 (1990) to 1.82 (1995) and, further, to 1.63 (2000). The latest regional PGR is lower than the country’s 2.36. If the average annual growth rate of the population continues at 1.63 percent, the population of this region is expected to double in 43 years.

NSO projected the population size of the region in 2005 at 2,445,620 which is relatively a young population. The age bracket 15-24 comprised above 18 percent of the total population. Slightly over 40 percent of the population is below age 15. Just over 55 percent of the population is in the economically productive age group (15 to 64) and those over 65 years of age constitute 3.5 percent. This young age structure has two primary effects, first on the population momentum. A young age structure means that regardless of the average number of children born to a woman in her lifetime (TFR), the population will continue to grow for a long time. Even after the TFR reaches replacement level of 2.1, the population will continue to grow for at least 65 years. This is due to the large number of women currently in their reproductive ages. Even if these women have only two children, there are so many more births than deaths that the population will continue to grow.

Contraceptive Prevalence Rate

2015 target



Contraceptive Prevalence Rate

2015 target



75.92

43.82

53.8545.46

37.96

0

20

40

60

80

100

1999 2000 2003 2005 2010 2015


52

Another is on the dependency ratio. In the region, the total dependency ratio is 82 which is considered high. A high dependency ratio means greater consumption and less savings. At a minimum, young people need food, health care, and education. Meeting these needs places a strain on the family’s ability to save – at the micro level – and on the government’s ability to provide resources for this dependent population. The average household size in Caraga Region decreased slightly to 5.32 persons in 2000 from 5.35 persons in 1995.This means that for every 100 households, the number of members decreased by three persons.

Among the four (4) provinces and one highly urbanized city in Caraga region, Agusan del Sur registered the largest population at 559,000 persons; followed by Surigao del Sur with 502,000 persons. Butuan City had the smallest population at 267,000 persons. Surigao del Norte was the fastest growing province in the region with an average annual growth rate of 1.84 percent, while Surigao del Sur was the slowest with 1.35 percent.


Population and development program is being spearheaded by the Commission on Population. The Philippine Population Management Program (PPMP) 2005-2010 has been advocated to the RDC and generated support among various stakeholders. Provision of family planning services is a major intervention in improving access of couples to family planning services. In 2005, beneficiaries of Family Planning services reached 56,821 while 49,231 were provided with counseling services. A total of 21,336 new acceptors for family planning were noted in the same year. These are the users of condoms, injectibles, IUD, LAM, NFP, pills, male and female sterilization. Lactating Amenorrhea Method (LAM) has the highest percentage of users among all methods mentioned. Several activities were conducted to promote Natural Family Planning (NFP) methods such as trainings among RHU personnel, orientation on fertility awareness and NFP among Dep-Ed personnel, tri media campaign, radio interviews, TV guesting, reproduction of IEC materials and coordination with academe and other religious sectors. Artificial family planning is also being mainstreamed and in fact has more acceptors than the NFP. A door-to-door strategy was used in giving orientation and updates on artificial family planning. Capability building interventions for health workers were conducted. Training on contraceptive self-reliance and artificial family planning among health workers were conducted. Fertility awareness is heightened among high school and college students and personnel of the Department of Education. Advocacy through radio interviews, distribution of IEC materials, and resource person to different government agencies. The LGUs also provide family planning supplies, services and build competency and efficiency of reproductive health care providers through trainings and orientations. CHALLENGES and PRIORITIES for ACTION

Increase budget allocation The gradual phasing out of contraceptive supplies and logistical support for family planning services from foreign donors implies that the responsibility will be borne by the LGU. While there is an increasing demand for family planning services, the budget allocation of LGUs is very limited. Provision of FP services should be among the priority of the local governments to meet the demand. Intensify IEC Campaign There is a need to generate public awareness and understanding on the impact of population factors on various development processes and aspects through IEC activities. Creating interests and demand among key public officials, planners and program managers on POPDEV integration and planning is equally necessary. There is also a need to mobilize local advocacy groups/teams/alliances at all sectors and levels for the integration of Population and Development

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(POPDEV) interrelationships in development plans, policies, programs and other development efforts Moreover, by educating and relaying the right information, couples can make informed decisions especially in determining their number of children. Misconceptions about the different family planning methods and its perceived side effects can be clarified. Eventual change in behavior towards the use of FP methods for reproductive health can only take place with proper education. Coverage of IEC campaign should reach remote areas. Younger generations of indigenous peoples are more receptive in the use of FP methods. This should encourage reproductive health workers to reach out to the IP communities considering that they have bigger family size. Strengthen advocacy for Natural Family Planning (NFP) Although Natural Family Planning is practiced by several couples, the acceptability is still too low compared to artificial family planning. With the limited supplies for artificial family planning especially at the onset of the withdrawal of support, couples should be encouraged to utilize NFP. In the FP orientation and sessions at the barangay level, RH workers should stress the utility of NFP. Need for the local chief executives and local councils to formulate and legislate specific policies on Family Planning and Adolescent Reproductive Health (ARH) The LGUs should take a pro-active stance in pursuing family planning and adolescent reproductive health programs. Initiatives on effective and innovative approaches in reproductive health should come from the local government units along with clearer policy options. Establishment of a comprehensive and reliable database on FP Generation of family planning related data has been limited. There is a need to establish a database on Family Planning to clearly assess the unmeet needs of the population. Data on total fertility rate is not available at the provincial and city levels which are appropriate indicators to measure how FP services influenced the reproductive functions of couples.

Capability Building To ensure that there will be a pool of experts in POPDEV-sensitive development planning, a cadre of trainers needs to be capacitated with planning skills and armed with correct understanding of population and development concepts and measures. Moreover, enhancing the capacity of local planners and data managers on the establishment, generation, management, monitoring, analysis and integration of POPDEV indicators system and other population database systems is equally necessary.

Adoption of POPDEV indicators in local and sectoral development planning and policy formulation

POPDEV planning and integration approach requires development of plans and policies with conscious consideration of population and development data, which are empirically gathered and accurately analyzed. As such, the POPDEV indicators form an integral part of POPDEV planning and integration. Although the adoption of these PODPEV indicators has been established by corresponding resolutions from appropriate agency, its utilization and integration in local development planning and policy formulation is much to be desired. To establish a favorable environment for the efficient integration and utilization of these indicators, the adoption and institution of POPDEV indicators in the information management systems and development planning processes should be vested with appropriate legal enactments and support at the sectoral and local levels. Local policies supportive of regular collection and updating of the POPDEV indicators should be pursued.

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Goal 6: COMBAT HIV/AIDS, MALARIA and other DISEASES Target 8: Halt and reverse the spread of HIV/AIDS by 2015 There has been no record of HIV/AIDS case in the region. Currently, there is no facility that has the capability to diagnose and treat HIV/AIDS patient in Caraga. Although there has been no record of HIV/AIDS case in the region, the evidence of high-risk situations and practices signal that the region may not be HIV/AIDS-free in the next years. Thus, intensified advocacy with enhanced IEC campaign are implemented and collaborative efforts were done with partner agencies and all sectors region-wide. The 2003 NDHS revealed that 99 percent of male and 98.2 percent female respondents from Caraga have heard of HIV/AIDS. It registered the highest percentage among all regions thus, it shows that more males and females in Caraga are knowledgeable on HIV/AIDS compared to its counterpart in other regions. Although they differ on the level of knowledge they have. Furthermore, there is little disparity on the knowledge about HIV/AIDS between the two sexes. Knowledge on ways to avoid HIV/AIDS transmission such as using condom and limiting sex to one uninfected partner among males is higher than the females with 56.2 percent and 64.2 percent, respectively. Females in Caraga registered the highest knowledge on avoiding AIDS across the country while the males registered the 4th highest rate. Table 24 shows the prevalence of Sexually Transmitted Infections (STI) is an indicator of a high risk situation. STI cases were higher in the three cities compared to the provinces. The presence of commercial sex workers in urban areas have contributed to the increasing STI cases in the region. From 2000 to 2005, the cities of Bislig, Butuan and Surigao City have interchangeably registered the most number of STI cases. In the years 2000-2003, Bislig City had the most number of cases followed by Surigao City. While Surigao City had shown continuous decline from 2001-2005, Bislig City exhibited an erratic trend. It had the sharpest decline in 2005 where the cases went down to 79.36 per 100,000 population from the previous year’s 208 per 100,000 population. Butuan City on the other hand, registered the highest number of cases in the years 2004-2005. Among the provinces, Agusan Del Sur had the highest registered cases compared to the other provinces.

Table 25. STI Prevalence Rate Per Province and City, Caraga Region, 2000-2005

(Per 100,000 Population)


Year Province/City 2000 2001 2002 2003 2004 2005

Agusan del Norte 22.8 25.4 8.1 19.2 15 1.6

Agusan del Sur 30.6 40 19.1 19.7 27.3 48.71

Surigao del Norte 6 4.9 0.8 0.6 0.4 4.44

Surigao del Sur 11.4 5.1 9.2 0.7 3.5 27.18

Bislig City 265.7 292 288.7 324.1 208.7 79.36

Butuan City 45.3 76.6 132.3 175.5 258.7 168.22

Surigao City 64.1 269.7 166.5 150.1 94 65.23

Caraga 34.7 51.8 45 50.6 54.5 48.17

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Through the Sexually Transmitted Infections (STI) Control Program several awareness campaign activities were done such as radio guesting, advocacy and information dissemination to private and public schools on STD / AIDS. The RHUs which have the capability to examine patients through syndromic approach and gram staining undertake the needed examination before referring them to the social hygiene clinics which conducts the appropriate examinations and the necessary referrals. The LGUs provide the needed drugs to patients with STIs depending on the available supplies. Contact tracing is also undertaken especially for sex workers found to be positive with STIs. At the LGU level, in 2002 Surigao City has established a Reproductive Tract Infection (RTI) Clinic, which was supported by the DOH-Women’s Health and Safe Motherhood Program. This facility has served cases of sexually transmitted diseases and reproductive tract infections. Surigao City also provides weekly consultations and vaginal smearing to commercial sex workers. CHALLENGES and PRIORITIES for ACTION

Establishment of functional hygiene clinic Currently, there are only seven (7) social hygiene clinics throughout the region. These can be found in the three cities, in the Municipalities of San Franciso and Bayugan in Agusan Del Sur, in Tandag, Surigao Del Sur and in Agusan Del Norte Provincial Hospital. Access to medical health facilities which can provide the necessary interventions should be improved. This is to address the prevailing situation of patients coming from other localities seeking medical treatment to established facility nearby. Early intervention will most likely prevent more complications. Further, counseling and support system shall be made available through the hygiene clinics which are necessary in the treatment and full recovery of patients. Increasing technical capability to diagnose STD cases Due to the lack of equipment and reagents to diagnose STI cases, the reported some reported cases are merely symptomatic. There is a need to acquire facilities and supply of reagents needed to diagnose patients. Some staff of RHUs have limited knowledge and capacity to handle STI cases thus, there is need to capacitate them. Establishing an effective monitoring system Effective monitoring system needs to be institutionalized at various levels to track the actual and suspected cases of STIs/HIV not only among commercial sex workers but among the general public. This will control the spread of STI/HIV in the region. Close monitoring also requires the cooperation of private health facilities in providing the necessary data and interventions to patients. Expanding collaboration with civil society organizations in terms of resource mobilization and advocacy The LGUs should work with the civil society organizations which provide interventions on STI cases for complementation of services and to facilitate coordination of efforts. Moreover, the LGUs should tap partner NGOs in resource mobilization to augment its resources intended for prevention, treatment, care and rehabilitation of STI/HIV/AIDS patients. They can also extend support in the advocacy aspect. Furthermore, they can be tapped to extend advocacy and IEC campaigns especially organizations which have access to tri media facilities and have the capability in introducing innovative IEC campaigns.

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Intensify Advocacy and IEC Campaign Advocacy and IEC activities should be strengthened to improve community’s awareness and knowledge on STIs and HIV/AIDS. Integration of topics related to STIs/HIV/AIDS in the education curriculum of high school students is an effective venue to raise the knowledge and understanding of the youth. Come-up with effective local responses The LGUs should expedite the implementation of local responses in addressing the number of STI cases and preventive measures on HIV/AIDS. Currently, there is no Local AIDS Council organized in the region. The Council is tasked to spearhead the conduct of interventions to prevent spread of HIV/AIDS and the coordination of the different program interventions. Target 9: Halt and begin to reverse the incidence of malaria and other major diseases STATUS and TRENDS

Malaria has been a recurrent problem in some parts of the region and has enormously affected people living in rural areas where the carriers of the deadly disease thrive. Despite efforts to eliminate the disease and provide better interventions to affected population, malaria cases are still prevalent although it is not among the top ten leading cause of morbidity in the region. In 2002, the malaria morbidity rate in the Philippines and Caraga were posted at 48 per 100,000 population and 150.17 per 100,000 population, respectively. Malaria morbidity rate in Caraga was higher by 200 percent compared to the national figure. It is most pronounced in Agusan Del Sur particularly in the years 1995 to 2002 where the morbidity rate registered to as high as 961.48 per 100,000 population in 1997 but declined steadily to 353.01 per 100,000 population in 2002. Improvement on malaria morbidity rate was also very apparent in 2003 and 2004. It went down to 76.03 per 100,000 population in 2003 and 51.79 per 100,000 population in 2004. In a span of ten years, malaria cases have been reduced significantly. The decline in the morbidity rate in Agusan Del Sur can be attributed to the presence of Malaria Control Project funded by AusAID. More active preventive measures should be instituted in Surigao Del Sur as high morbidity rate is recurring after it has been substantially reduced in the last six years (1995-2000). It increased gradually from 2001, increased drastically from 72 per 100,000 population in 2004 to 226.52 per 100,000 population in 2005. This was the highest rate within Caraga Region in 2005 and was more than twice the regional figure. On the other hand, Surigao Del Norte and Surigao City have malaria cases that are almost negligible in the last five years (2000-2005).

Table 26. Malaria Morbidity Rate Per Province and City, Caraga Region, 2000-2005

(Per 100,000 population)

Province/City 1995 2000 2001 2002 2003 2004 2005 Agusan del Norte 17.2 98.49 110.92 211.47 164.06 80.38 59.11 Agusan del Sur 280.5 539.15 420.12 353.01 134.31 43.41 113.56 Surigao del Norte 0 1.37 0.27 0.53 0.53 0.79 0.26 Surigao del Sur 388.5 67.74 28.43 37.26 56.47 72 226.52 Bislig City - 211.95 86.62 133.26 43.82 133.39 77.32 Butuan City 125.5 411.22 97.09 44.45 29.96 71.6 34.2 Surigao City 118.2 1.69 0 0.81 0 0.79 0 Caraga 154.98 240.92 157.34 150.17 76.03 51.79 90.4 Philippines (2002)* 48

*MTPDP 2004-2010 Sources: Department of Health – Center for Health Development Caraga

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Based on the Medium-Term Philippine Development Plan 2004-2010, morbidity rate should be reduced by 50 percent. In the case of Caraga, it should decline from 154.98 per 100,000 population to 77.5 per 100,000 population. With an average rate of progress of 6.46 per 100,000 population and with the required rate of 1.29 per 100,000 population, there is a high probability for Caraga Region to attain before 2015 target on the reduction of malaria cases.

Figure 23. Reduction of Malaria Morbidity Rate, Caraga Region, 1995-2015

The malaria morbidity is relatively higher in Caraga with wide disparity across the region. But these cases have been managed well and provided with the necessary interventions to avoid complications leading to death. The number of deaths due to malaria has been reduced from 3.1 per 100,000 population in 1995 to 0.52 per 100,000 in 2005. Agusan Del Sur which registered the highest mortality rate in 1995 was able to peg its mortality rate to .3 per 100,000 population starting 2002 to 2004 and with no deaths in 2005 despite the high number of malaria cases in the Province. Except for Surigao Del Sur which registered a mortality rate of 2.79 per 100,000 population in 2005, the rest of the LGUs did not report deaths due to malaria. Surigao Del Sur’s case management should be dealt with appropriately to reduce deaths due to malaria.

77.5

154.98

240.92

90.4

0

100

200

300

1995 2000 2005 2010 2015

Malaria Morbidity Rate (per 100,000 population)

2015 target



Malaria Morbidity Rate (per 100,000 population)

2015 target




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Table 27. Malaria Mortality Rate Per Province and City, Caraga Region, 2000-2005


Province/City 1995 2000 2005 Agusan del Norte 3.3 0.7 0 Agusan del Sur 5.1 1.5 0 Surigao del Norte 0.4 0.3 0 Surigao del Sur 3.9 1.9 2.79 Bislig City 0 Butuan City 4 1.5 0 Surigao City 1.9 0 0 Caraga 3.1 1.2 0.52


Tuberculosis remains to be one of the top ten leading causes of morbidity in the region. In 2005, it is the 6th leading cause of morbidity. About 52.4 percent of the registered cases belong to 15-49 years old age group, 27.61 percent from 50–64 age bracket, 10.93 percent 65 years old and above and the remaining 17 percent from 14 years old and below. Between the two sexes, majority of the cases were males which account 62.3 percent of the total number of TB cases. The morbidity rate across the region in 2003 posted at 157.80 per 1000,000 population is higher than the national figure. There was a huge increase in the number of registered TB cases as the shift from passive to active case findings was intensified in 2003. From 252.52 per 100,000 population in 2003 it went down to 174.03 per 100,000 population in 2005. TB cases are highest in Bislig City and Surigao City.

Table 28. TB Morbidity Rate Per Province and City, Caraga Region, 1995, 2000, 2003 & 2005


Province/City 1995 2000 2003 2005 Agusan Del Norte 250.70 95.80 157.77 115.98 Agusan Del Sur 219.60 115.89 205.74 128.14 Surigao Del Norte 196.70 213.51 196.64 241 Surigao Del Sur 892.90 210.22 355.52 196.55 Bislig City 484.10 291.99 Butuan City 187.80 57.00 266.41 134.02 Surigao City 490.90 189.06 374.08 270.25 Caraga 231.10 137.43 252.52 174.03 Philippines (2003) 157.80


By 2015, TB morbidity rate is targeted at 46.22 per 100,000 population from its 231.1 per 100,000 population in 1995. Recent developments in the interventions of the Department of Health and Local Health Offices in addressing TB cases have proved to be effective. The increased case findings in the latter years have vastly contributed to the number of reported cases. Such development should not be taken negatively as this has contributed to the reduction of morbidity rate as interventions are immediately provided even before the onset of complications. Even with the lower average rate of progress to the required rate, the health sector is very much confident that the 2015 target will be attained.

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Figure 24. Reduction of TB Morbidity Rate, Caraga Region, 1995-2015

Mortality due to TB is higher than the deaths due to malaria. In 1995, TB mortality rate was registered at 32.95 per 100,000 population and went down to 19.67 per 100,000 population in 2001 and rose slightly in 2002 to 21.54 per 100,000 population. It declined steadily until it registered to 17.84 per 100,000 population in 2005.

Surigao City had the highest TB mortality rate from 1999 to 2005. Over the years the morality rate in the City had not been reduced and more patients died due to TB. Surigao Del Norte has consistently ranked 2nd from 1999 with 47.4 per 100,000 population to 32.46 per 100,000 population in 2004. Despite its high mortality, deaths due to TB in Surigao Del Norte have been reduced significantly from 1995 to 2005. On the other hand, Butuan City had shown an erratic trend in TB mortality rate but comparing the 1995 figure of 32.95 per 100,000 population in 2005 with 17.84 per 100,00 population, TB has been reduced substantially in Butuan City.

Table 29. TB Mortality Rate Per Province and City, Caraga Region, 2000-2005


Province/City 1995 2000 2001 2003 2005 Agusan del Norte 24.3 13.68 21.17 20.22 No data Agusan del Sur 21 19.26 4.83 5.91 6.98 Surigao del Norte 48 37.23 33.65 34.68 28.72 Surigao del Sur 37.7 33.47 23.32 24.07 16.5 Bislig City - - 13.72 19.36 17.3 Butuan City 24.7 17.48 18.56 17.83 34.54 Surigao City 42 52.94 47.1 58.60 50.48 Caraga 32.95 24.72 19.67 21.28 17.84

Source: DOH-CHD Caraga

The decline of deaths due to TB can be attributed primarily to the increase in case findings and treatment in all areas and at all levels with the adoption of the TB-DOTS strategy. Caraga is one of the high performing regions in terms of active case findings and treatment under the TB-DOTS project.

TB Morbidity Rate (per 100,000 population)

2015 target



TB Morbidity Rate (per 100,000 population)

2015 target



231.1

137.43

174.03

46.22

0

50

100

150

200

250

1995 2000 2005 2010 2015


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The increasing incidence of Hypertensive Cardiovascular Diseases (CVD) which is a degenerative disease affecting mostly persons in the upper age bracket needs to be given emphasis and appropriate interventions. Caraga Region ranked 8th in CVD morbidity rate in 2003 in the entire country, with 556.03 per 100,000 population. Morbidly rate rose to as high as 826.24 per 100,000 population in 2004 and declined sharply to 231.34 per 100,000 population. No big disparity between both sexes was observed as female cases accounted 50.18 percent and 49.82 percent were males. CVD Morbidity rate was highest in the Province of Surigao Del Norte with 585.91 per 100,000 population followed by Butuan City with 297.41 per 100,000 population in the same year.

Table 30. Cardio Vascular Disease Morbidity Rate Per Province and City, Caraga Region, 1995-2005


Province/City 1995 2003 2004 Agusan del Norte 153.1 380.2 392.76 Agusan del Sur 148.5 398.51 238.25 Surigao del Norte 271.1 630.16 482.09 Surigao del Sur 335.1 1276.7 1600.3 Bislig City - No data 4459.9 Butuan City 184.2 No data 336.66 Surigao City 891.5 1002.9 1418.5 Caraga 330.58 556.03 826.24 Philippines (2003) 415.5


Hypertensive Cardio Vascular Diseases is the number one cause of mortality in 2003-2005. In a span of seven years, from 1999 to 2005 the mortality rate increased from 70.1 per 100,000 population to 80.61 per 100,000 population. On the average from 1998-2002, about 1,764 Caragans die every year because of CDV related diseases. In 2003, 2,217 died or 100 per 100,000 population because of the same diseases. This rate will continue to increase due to the growing unhealthy lifestyle of individuals.

Table 31. CVD Mortality Rate Per Province and City, Caraga Region, 1999-2005


Province/City 1999 2000 2003 2004 2005 Agusan del Norte 107 120 131.91 131.85 No data Agusan del Sur 27 51 65.19 48.52 47.16 Surigao del Norte 72 75 95.5 95.01 106.01 Surigao del Sur 68.1 70 118.67 124 102.92 Bislig City - - 127.4 155.8 113.95 Butuan City 117.6 120 97.36 151.27 128.5 Surigao City 94.2 120 134.86 121.6 160.75 Caraga 70.1 93 100.39 103.86 80.61


Epidemiological shift is very evident at the turn of the new century. In the years 1990-1999 the ten leading causes of morbidity were filth diseases which shifted to degenerative or lifestyle related diseases in the years 2000-2005. Among the ten leading causes of illnesses in 2005 were hypertensive cardiovascular diseases, accidents/injuries, genital-urinary and musculoskeletal diseases which ranked 2nd, 5th, 7th and 10th, respectively. In consonance with the promotion of healthy lifestyle, case findings have been intensified. There has been an increasing number of diabetes cases in the region.

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In line with the Cold Chain Equipment project has been extended region-wide to improve the health status of infant, young children and mothers through efficient and safe administration of potent vaccines stored under optimum cold chain condition. The region is also a recipient of the Quality Tuberculosis Control Project which is aimed at improving the case finding and treatment of tuberculosis through enhanced utilization of the primary health care services, together with strengthened bacteriological service and patient education; strengthening Information, Education and Communication (IEC) activities for tuberculosis and related activities; and establishment of a national TB reference laboratory. Under the National Tuberculosis Program intensified case finding was done through continuing motivation on DOTS implementation among barangay officials, awarding of top DOTS performers, and establishment of TB diagnostic committees and operationalization of TB clinics in all retained hospitals. Private-Public Mix DOTS were also established. Advocacy and IEC campaign were also conducted through Focus Group Discussion on DOTs among family members and at the barangay health stations. The DOH continues to provide drugs and other logistics such as TB drugs, laboratory reagents and NTP forms. Trainings on basic sputum microscopy, external quality assurance and refresher course on sputum microscopy were conducted. For malaria control, of which Agusan Del Sur was identified as severely affected, the region is one of the beneficiaries of the global fund known as the Global Fund Project Malaria Component (GFMC) Project. The project is expected to augment the on-going Malaria Control Program by making malaria intervention accessible to underserved communities including the indigenous peoples in selected provinces. Training and orientation on basic malaria management and severe malaria management among hospital-based physicians were conducted by the DOH. Capability building interventions were extended to medical personnel including nurses who were oriented on the national chemotherapy of drug policy in malaria, medical technologists trained on Basic Malaria Microscopy, basic training course on malaria microscopists and rapid diagnostic test training among barangay health workers. Augmentation of anti-malaria supplies and drugs such as laboratory reagents, anti malaria drugs, insecticides and larvicidal for bednet impregnation was continuously provided by DOH.

The civil society is also actively involved in the provision of interventions in curbing malaria mrobidty and mortality rates particularly in Agusan Del Sur. The Agusan for People’s Health Development Foundation Inc. is an NGO which actively provides malaria control drugs and supplies at the provincial and municipal levels. In early years of its existence, its interventions have been limited only during malaria outbreak but today it is able to embrace a holistic approach and deal with promotive, preventive and curative aspects in addressing malaria and other communicable diseases. Among its priority services are the provision of malaria outbreak containment fund and ensuring its proper management to make available the necessary medicines and supplies, capability-intervention programs and collaboration with organizations dealing on preventive and curative aspects of malaria and other communicable diseases. The Caraga Health Services and Health Support Infrastructure Extension (CULION) which has a budget of P152,000,000 in 2005 is also identified as supportive to the MDGs. The CULION seeks to support the efforts of LGUs in the region in the prevention and control of communicable and infectious diseases (i.e. filariasis, schistosomiasis, malaria and tuberculosis), and specific illnesses afflicting children and mothers (i.e. child malnutrition, pneumonia and other acute respiratory infections among pre-school children, and anemia and vitamin A deficiency among pregnant women).

In addressing lifestyle related diseases, several advocacy, IEC and social mobilization activities were conducted on healthy lifestyle. Hataw has been institutionalized at the LGUs. Indigent patients were also provided with anti-hypertensive and anti-cancer drugs along with logistic support.

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Improving service delivery Current constraints on service delivery should be addressed to improve the quality of services delivered. This can be done through enhancement of the capability of health workers, upgrading of laboratory services and facilities and ensuring adequate financial resources for field operations. There are RHUs which do not have medical technologist who are essential in diagnosing TB and malaria cases. Experts and consultants can only be found in the DOH retained facilities. Medical staff of hospitals and some RHU staff need orientation on the standard treatment protocol and on DOTS for effective implementation of the program. The health facilities in the region have limited laboratory services.

Strengthening public-private, NGO and community partnerships to sustain interventions

Involvement of the various stakeholders should be maximized to generate logistic and financial support as well as the expertise of the other service providers. Sustainability of program interventions can only be guaranteed with the strong support and participation especially at the barangay or community level. The community needs to be empowered through participation in decision making and in program implementation per se.

Inadequate IEC materials

To further increase the knowledge of the public on infectious diseases, it is necessary to address the shortage of IEC materials. Tapping NGOs like World Vision and Culion Foundation will help in addressing this shortage.

Goal 7: Ensure Environmental Sustainability Target 10: Implement national strategies for sustainable development by 2005, to reverse the loss of environmental resources by 2015 STATUS and TRENDS

Caraga Region is recognized to be very rich in natural resources. However, its environment has been gradually deteriorating as a result of the pressures from increasing population and poor management of land, freshwater, watershed and other natural endowments which all lead to the decline in land productivity and food security. These undesirable results pose formidable challenges to poverty reduction and to the achievement of the millennium development goals. Forest Resources Forests provide numerous functions that are vital for humankind. These include the provision of wood and non-wood products and services as carbon sequestration, watershed protection, soil conservation and recreation.

Table 31 shows Caraga Region’s total land area of about 1,913,842 hectares of which 70 percent are classified as forestlands while the remaining 30 percent are alienable and disposable (A&D) lands. Forestlands are classified as protection and production forests. For Caraga Region, 26 percent of the forestlands are classified as protection forests by reason of their unique physical and biological significance, while the remaining 74 percent are production forest.

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Table 32. Total Land Area, Caraga Region

Land Classification Area (ha)

A & D 582,351

Timberland Protection Forest Production Forest

1,331,491 339,963 991,528

Total 1,913,842

Source: Department of Environment and Natural Resources Caraga

Based on the 2003 satellite data provided by the Forest Management Bureau, Caraga’s forest cover totaled to 546,086 hectares or 29 percent of the total land area. Of these, closed canopy forest covers 13 percent or 71,722 hectares, open canopy forest 82 percent or 447,571 hectares and mangrove forest 5 percent or 26,793 hectares. While there was an increase in the country’s forest cover of about 11 percent in 2004, Caraga’s forest cover showed a noticeable decrease of 45 percent in 2003 with 1987 as the base year. This means that the region’s forest cover decreased by 2.84 percent or around 28,340 hectares annually (based on straight line formula). Apparently, the closed canopy has declined by 74 percent, the proportion of land area covered by open canopy decreased by 36 percent while mangrove forest increased by 32 percent which has been enhanced by the Community-Based Forest Management Project. Increasing agricultural development, immigration flux, rural settlement programs, encroachment, inappropriate land use, unsuitable forestry practices and high market prices for timber are some of the other causes of deforestation. These can be associated with insufficient awareness of the people on the ill-effects of the above activities to the environment; inadequate forest rangers to guard the forest (given the total forestlands of the region); conflicting laws and policies which resulted to inconsistent forest land uses i.e. RA 7942 (Mining Act), PD 705 (Forestry Code), RA 8371 (IPRA), DENR issuances (allowing 10 percent of CBFM areas planted with oil palm), etc.

Figure 25. Forest Cover, Caraga Region, 1987& 2003

(In hectares)

0

500,000

1,000,000

1,500,000

1987 999,527 276,469 702,785 20,273

2003 546,086 71,722 447,571 26,793

Total Forest

Cover

Closed

canopyOpen Canopy

Mangrove

Forest


The decline of the forest cover is also attributed to the continuing illegal activities affecting forest products. As shown in Figure 29, from 2001-2005, a total of 33,380.47 cubic meters or an estimated 333 to 417 hectares of illegal forest products have been confiscated with an estimated value of P58.8 million. (Based on a study conducted in PICOP area, old-growth forest produces 80-100 cubic meters of

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merchantable timber). These illegal or unsuitable forestry activities affected not only the production forests but also the protection forests.

Figure 26. Confiscated Forest Products,

Caraga Region, 2001-2005 (In cu.m.)


To address the declining rate of forest cover, the government implemented several programs. The DENR, in five (5) years time, rehabilitated approximately 37,163.99 hectares of forestlands with an average reforestation rate of 7,433 hectares.

In addition, the government recognized the participation of the private sector in forest development and management through the issuance of tenurial instruments. At present, the forestlands covered with tenurial instruments accounted for 21 percent or a total of 276,056 hectares of forestlands.

Figure 27. Area Reforested, Caraga Region, 2001-2005

(In hectares)

0.00

5,000.00

10,000.00

15,000.00

Area reforested 2,969.68 2,223.02 9,752.88 12,932.24 9,286.17

2001 2002 2003 2004 2005


0.00

2,000.00

4,000.00

6,000.00

8,000.00

10,000.00

12,000.00

Total Confiscation 8,590.98 7,204.27 3,079.55 4,757.86 9,648.31

2001 2002 2003 2004 2005

T

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Figure 28. Area Reforested, By Category, Caraga Region, 2001-2005


Watersheds

About 1.2 million hectares or 62 percent of the region’s land area is within watershed. These areas support irrigation system, livelihood, transportation route for the watershed occupants and source of domestic water for the rural and urban areas. Table 32 shows the seven proclaimed watershed forest reserves of Caraga covering 38,241.44 hectares. A lot of programs and projects have been implemented within the watershed areas which focused on soil and water conservation. One of these is the rehabilitation of 8,165.18 hectares with the assistance from foreign funding institutions, LGUs, line agencies, non-government and the people’s organizations.

In spite of the visible advantages the watersheds provide, said areas are not free from adverse activities which threaten its safety and protection. These include Illegal logging and mining operations within watershed reservations. In effect, drinking water in rural and urban areas sometimes is not safe for drinking. To safeguard these watersheds from further degradation, the region employed and implemented rehabilitation programs and project of which almost 32 percent of the total area was rehabilitated as of 2005.

Table 33. Rehabilitation Projects Implemented within Watersheds as of 2005, Caraga Region

2. Structural Measures Watershed/Province Area (ha)

Agusan del Norte

Taguibo Watershed 35

Agusan del Sur

Adgaoan Watershed 61

Surigao del Norte

Surigao City Watershed 35

Surigao del Sur

Tago Watershed 35 Source : DENR

1 . Soil and Water Conservation Measures

Watershed/Province Area (ha)

Agusan del Norte 105,666.00

1. Taguibo Watershed 20,000.00 2. Cabadbaran Watershed 20,000.00

3. Lake Mainit Watershed 65,666.00

Agusan del Sur 210,600.00

1. Gibong Watershed 95,300.00

2. Mt. Diwata Watershed 70,000.00

3. Adgaoan Watershed 45,000.00

Surigao del Norte 18,772.00 1. Surigao City Watershed 18,772.00

Surigao del Sur 51,000.00

1. Tago Watershed 51,000.00

TOTAL 386,038.00

1% 5% 6%

37%51%

Government-Regular Fund

Foreign Assisted (JBIC)

Timber License Agreement

Integrated Forest

Management Agreement

Private Lands

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Biodiversity Resources Caraga region is not only known for its cultural heritage but also for its equally rich biodiversity. It is one of the few regions in the country that is biotically intact from the forest ecosystem down to the coastal and marine ecosystems despite the pressure and risk from increased population, modernization and industrialization. The National Integrated Protected Areas System (NIPAS) Act of 1992 (RA 7586) outlines the biodiversity resources management. To date, there are two proclaimed NIPAS areas in Caraga, the Agusan Marsh Wildlife Sanctuary (AMWS) covering 19,197 hectares and the Siargao Island Protected Landscape and Seascape (SIPLAS) covering 278,914 hectares. The region also has eighteen (18) proposed protected areas covering a total area of 370,308 hectares. Given the gains of maintaining biological diversity and balanced ecosystem through the provision of species habitat and the preservation of genetic resources, these protected areas likewise contributed a broad collection of ecological and economic benefits. The AMWS and the SIPLAS are also widely recognized as places of high social and economic value because they can support local livelihood, protect soil and watersheds from erosion, and support tourism, science and research. Coastal and Marine Resources Caraga has a total shoreline of 3,235 kilometers which comprise of 46 coastal municipalities or 66% of the total number of municipalities and three cities. Coastal resources are considered vital due to its capacity to produce goods and services which support a significant portion of the Caraga population. Continuous unsustainable management practices such as over fishing, destructive fishing methods, siltation and pollution would eventually lead the coastal and marine ecosystem of the region into degradation and destruction. Among the key players in preserving the coastal and marine resources are the vast mangrove areas in Caraga. Aside from its economic uses, mangroves serve as nursery and feeding areas that support coastal fisheries. Reported data from DENR Caraga showed that 3,447 hectares of mangrove areas were rehabilitated from 1997 to 2005. Mining Resources Caraga Region is rich with both metallic and non-metallic minerals such as gold, silver, copper, nickel, cobalt, chromite, limestone, silica, shale and phosphate. A large portion of nickel, chromite and limestone that are being mined are located in Surigao City and Surigao del Norte operated by the following mining companies: Taganito Mining Corp., Hinatuan Mining Corp., South Dinagat Nickel Project, Hinatuan Mining Corp.-Taganaan Nickel Project, Cagdianao Mining Corp., Pacific Cement Philippine and KROMINCO, Inc.

It is recognized that these mineral deposits are considered one of Caraga’s significant assets. It contributes much in enhancing the region’s national economic position. However, along with the obvious advantages of economic development in the region due to exploitation of mineral resources, is the possibility for severe environmental impact. The accelerated rate at which the region develop its resources is paralleled by the risk unregulated development may inflict on natural resources and even on human health.

Results of the preliminary environmental sampling/assessment conducted by the Department of Health in 1999 done in Placer, Surigao del Norte showed that elevated levels of lead, nickel, mercury and arsenic were detected in the water and soil/sediments samples taken in the farmlands affected by the mine tailings spillage from a mining company as compared with water quality standards for irrigation. Further, sulfate levels were also higher in Bacuag and Tagana-an as compared with Placer while fish samples taken from Bacuag also showed total mercury levels which exceeded the recommended FDA standards of 0.5 ppm. Sediment samples taken from Magallanes, Agusan del Norte also showed an elevated mercury level. These results if not mitigated may lead to the possibility of acute health effects upon contact with the contaminated wastewater.

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Meanwhile, for the restoration of the degraded natural resources affected by mining activities, the Mines and Geosciences Bureau reported that as of 2005, ten mining companies were able to reforest 645.19 hectares mining areas. Air Quality

Air pollution is one of the greatest environmental evils. The air has not only life supporting properties but also life damaging properties. Tiny airborne particles of solid material or liquid aerosols, defined collectively as particulates, are present in the air, and at high concentrations, may become an air pollution concern.

With its limited facilities for monitoring ambient air quality, the office of the Environmental Management Bureau of Caraga Region is monitoring only one parameter which is the Total Suspended Particulate (TSP) at Butuan City. Data gathered from 2000 to 2005 showed that the TSP for Butuan City ranging from 186.1 ug/Ncm to 83.42 ug/Ncm is still within the National Ambient Air Quality Standard as provided for in Section 12 of RA 8749 of the Philippine Clean Air Act of 1999, which is 230 ug/Ncm.

Figure 31 reflects the TSP Level Sustained in Butuan City. As observed in the graph, there was an abrupt decrease in the TSP level of about 47 percent from 2001 to 2002 and remained below than the 90 ug/Ncm target for the succeeding years. This was made possible by instituting various strategies such as strict industrial enforcement, coordinating with the DOTC-LTO for the control of mobile sources emissions and other activities which contributed to the reduction on TSP in the ambient air.

Figure 29. TSP Level Sustained, Butuan City, 2000-2005

Source: Environment Management Bureau Caraga

Water Resources

Water of good quality and in appropriate quantities is fundamental to the ecosystems, human health and in boosting the performance of the region’s economy.

Caraga Region is blessed to have a total of 36 principal rivers and lakes, each of which has a drainage area of not less than 40 square kilometers. Of these, about 19 water bodies have been classified as of 2005. Pursuant to DENR DAO No. 34, series of 1990, 63 percent of these are classified as Class A which requires complete treatment in order to meet the National Standards for Drinking Water (NSDW). Thirty two percent fall under Class C or with quality which supports for the propagation and growth of fish and other aquatic resources. These fresh water bodies have diversified usage ranging from Public Water Supply Class I and II, Recreational Water Class I and II

8783.4287

99.32

186.1175.38

0

20

40

60

80

100

120

140

160

180

200

2000 2001 2002 2003 2004 2005

TSP Level (ug/Ncm)

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and other uses that gave economic benefits to people living in the community such as fishery, agriculture and industrial waters. It could not be denied that because of such uses, these water bodies were subjected to environmental stresses and abuse.

Everyday, primary manufacturing and service industries, institutions and households discharge hundreds of different substances, directly or indirectly into rivers and lakes. These discharges include toxic pollutants although in smaller amounts but significantly affect the quality of the different water bodies and the ecosystem.

Table 34. Classification of Water Bodies, By Province, Caraga Region, 2005

PROVINCE NAME OF RIVER

CLASSIFICATION

Agusan River C Cabadbaran A Ojot (Bugabos) A Taguibo River A (upstream)

B (downstream) Tubay River A Lake Mainit A

Agusan del Norte

Puyo River C (upstream) D (downstream)

Adgawan River A Andanan River C Gibong River A Simulao River A

Agusan del Sur

Wawa River A Magallanes C Sungao River A Taganito Bay Class SA along the coast of

Brgy. Urbiztondo, Class SB along Brgy. Hayanggabon, and Class SC along

Surigao del Norte

Taganito River C Tandag River A/C Tago River C

Surigao del Sur

Bislig River C Source: Environment Management Bureau Caraga

Based on the 2002 study conducted by MGB XI and XIII, EMB XIII and DENR XIII on the assessment of the contamination of mercury at Agusan River, results showed that there was no evidence of mercury found in the surface water of the river and its tributaries. However, a relatively high concentration of mercury was found in the bottom sediments at Veruela of about 1.670 ppm Hg compared to the 1.0 ppm toxic effects threshold established in the Sediment Quality Criteria for the Protection of Aquatic Life. This data is of the same magnitude as the 1.50 ppm Hg value taken during the 1995 MGB-BGS study (Breward 1996) in the vicinity of the same Municipality. These data however, needs further investigation and thorough analysis.

Further, results of the Resource and Social Assessment of Butuan Bay conducted by the Mindanao State University at Naawan, Misamis Oriental in 2002 showed that mercury, cadmium, copper and lead were detected in Butuan Bay at alarming levels. A need to validate this data should be undertaken by concerned authorities to come up with appropriate solutions in the earliest time possible.

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Waste and Toxic Chemicals

R.A 9003 or the “Ecological Solid Waste Management Act of 2000” provides a systematic, comprehensive, and ecological solid waste management program in the country. This advocates for the proper handling of wastes which covers waste avoidance, waste reduction, and recycling, composting, and waste disposal.

Caraga has an approximate daily waste generation of almost 624 cu.m. daily. EMB Caraga has employed the following strategies to monitor and regulate solid waste management in the region:

a. Creation of Four (4) Solid Waste Management Task Force to validate and evaluate LGUs compliance to RA 9003 (One Task Force per province)

b. Issuance of Cease and Desist Order (CDO) to 52 LGUs with existing open dumpsites

Out of 87 municipalities of the region, only 19 percent practice controlled dumping. Almost 60 percent have open dumpsite and about 21percent proposed for controlled dumped facility issued with Notice to Proceed.

Table 35. Status of LGU Compliance to RA 9003, By Province, Caraga Region, 2005

LGU With open dumpsite

Practicing Controlled Dumping

With proposed controlled dumped facility (CDF) issued with

Notice to Proceed (NTP) Agusan del Norte 8 3 2 Agusan del Sur 11 3 8 Surigao del Norte 19 7 4 Surigao del Sur 14 4 4 TOTAL 52 17 18


R.A. 6969 otherwise known as the “Toxic Chemicals and Hazardous and Nuclear Waste Control Act” is a law designed to respond to increasing problems and associated with Toxic Chemicals and Hazardous and Nuclear Waste. R.A. 6969 mandates control and management and import, manufacture, process, distribution, use, transport, treatment and disposal of toxic substances and hazardous and nuclear wastes in the country. The Act also seeks to protect public health and the environment from unreasonable risk posed by these substances in the Philippines.

From 1999-2005, 179 Hazardous Waste Generator’s ID were issued by EMB Caraga of which over half or 52 percent of it were issued to the province of Agusan del Norte. Only two Chemical Control Order (CCO) Registration Certificate were issued from 2003-2005.

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Table 36. Number of Hazardous Waste Generator’s ID Issued, Per Province, Caraga Region, 2005

PROVINCE YEAR Agusan

Del Norte Agusan Del Sur

Surigao Del Norte

Surigao Del Sur

TOTAL

1999 0 0 1 0 1 2000 2 1 0 0 3 2001 34 1 11 2 48 2002 27 4 9 1 41 2003 13 9 11 1 34 2004 7 1 2 0 10 2005 10 10 7 15 42

Total

93

26

41

19

179


Table 37. Number of Chemical Control Order (CCO) Registration Certificate Issued,

By Province, Caraga Region, 2003-2005

Year Province 2003 2004 2005

Agusan del Norte 1 - - Agusan del Sur - - 1 Surigao del Norte - - 1 Surigao del Sur - - - TOTAL 1 0 2


PRIORITY POLICIES AND PROGRAMS

Guided by the aspiration of attaining a balanced and healthy environment, the region through the collaborative efforts of the government agencies, local government units, non-government organizations, people’s organizations, private investors and the academe, is currently employing innovative strategies and techniques to address further degradation of its natural resources. Forest Resources and Watersheds DENR Caraga in coordination with other government agencies, local government units, non-government organizations, people’s organization, private investors and the academe, in adherence to its thrusts, undertakes activities for the protection and preservation of Caraga’s forest cover and its watersheds and at the same time uplift the socio-economic conditions of the natural-resource dependent families.

The efforts implemented includes the preparation of Regional Forestry Master Plan, Proclamation of Caraga Forest Plantation Corridor, providing technical support to private individuals in the establishment of Forest plantation corridor, organization of Caraga Tree farmers federation, reforestation of denuded watershed areas, institutionalization of Community-based forest management in stewardship and rehabilitation of degarded areas though agro-forestry and industrial tree plantation,delineation of permanent forest lines, distribution of land titles for the landless, research and development of new technologies, packaging and transfer of tested technologies.

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On Community Based Forest Management (CBFM), empowering the upland and coastal communities encourages them to take social and environmental responsibilities, hand in hand with their economic concerns. Utlizing this concept, the region implemented different CBFM activities. This includes monitoring of the status of livelihood projects, performance evaluation of CBFM-POs, facilitating the implementation of KALAHI Livelihood Projects in Agusan del Sur; and conduct of workshops, which support skill augmentation of PMOs, PO Officials & members, & CBFM personnel.

On regreening efforts, the region intensified its reforestation activities through different approaches

such as the forging of Memorandum of Agreement between academe/LGUs in the establishment of mini-forest parks and roadside trree planting and close monitoring and evaluation of four existing TLAs and IFMAs spcecially in their reforestation activities.

On the aspect of co-management, the region had successfully forged an agreement with different

Local government Units and other entities such as the Bislig water district which lead to a combined effort in forest restoration and rehabilitation through plantation establishment and assisted natural regeneration.

In the survey of forestland boundaries, a cost sharing scheme of DENR with the LGUs have been

adapted in Surigao del Norte and Agusan Del Norte. For Agusan Del Norte survey has been completed and appropriate bill is now pending in Congress. Survey for Surigao Del Norte is still on-going.

Biodiversity Resources Degree of threats to biodiversity increases as human population grows. Unless strict conservation and protection practices are adopted, many varieties of flora and fauna as well as ecosystems in the uplands, wetlands and coastal areas will face extinction and deterioration.

In arresting this crisis, DENR Caraga employed various strategies which include intensified IEC

campaigns on wildlife, protected areas, biodiversity, cave management laws, policies and related regulations, production of posters of RA 9147, enforcement of the regulation of wildlife collection pursuant to RA 9147 which resulted to the issuance of 77 Certificate of Wildlife Registration and, rescued and released 14 fauna.

On protected area management, the region had endorsed protected areas with pertinent documents

to the Secretary for review prior to submission for Presidential Proclamation, facilitated the drafting & passage of House Bills No. 5532,1379 and 1953. These proposed House Bills were already approved in principle by the Committee on Natural Resources. The region has also issued Protected Area Community-Based Resource Management Agreements (PACBRMA) within SIPLAS and monitored the management of AWMS & SIPLAS-the only two proclaimed PAs in the region.

Meanwhile on cave management, cave assessment and classification are being implemented and

the Regional Cave Committee has been operationalized.

Coastal and Marine Resources In cognizance of the theory that all interventions in the upland ultimately affects the lowland and coastal areas, DENR Caraga engaged in collaborative measures with coastal LGUs in order to arrest inland, coastal & marine resources destruction.

Survey and mapping of mangrove areas and two marine protected areas had been conducted in

order to delineate the region’s coastal areas. Also, development of livelihood enterprise had been prioritized through which Coastal Resource Management livelihood projects for coastal people’s organization were implemented and covered with Memoranda of Agreement. These are enforced through the conduct of trainings/seminars/workshops pertaining to coastal & marine resources management to the different coastal LGUs, government agencies, non-government organizations. Moreover, technical assistance were also provided to LGUs, NGOs and POs involved in Coastal Resource Management.

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Mining Resources By virtue of the DENR Administrative Order No. 96-40, the Revised Implementing Rules and Regulations of Republic Act 7942 known as the Philippine Mining Act of 1995, the following programs and activities were implemented. a) Environmental Work Program (EWP) The EWP is required from exploration companies detailing the environmental impact control and rehabilitation activities during exploration including costs to enable sufficient financial resources to meet the environmental and rehabilitation commitments. b) Environmental Protection and Enhancement Program (EPEP) Pursuant to Section 169 of DAO No. 96-40, mining companies have to submit an EPEP within 30 days upon receipt of the Environmental Compliance Certificate (ECC). The EPEP shall provide a description of the expected and considered acceptable impacts and shall set out the life-of-mine environmental protection and enhancement strategies based on best practice on environmental management in mining. It shall incorporate the Final Mine Decommissioning and Rehabilitation Plan including a statement on post-mining land use potential for various types of disturbed land and extend to the completion of the commitments in the rehabilitation of the disturbed land in a technically, socially and environmentally competent manner. c) Mine Environmental Protection and Enhancement Office (MEPEO) All mining companies are mandated to incorporate in their organization a MEPEO which shall be responsible for setting the level of priorities and marshal the resources needed to implement the environmental management program through adequate and sustainable projects. d) Environmental monitoring

1) Operating mining companies

Pursuant to Section 185 of DAO No. 96-40, Multipartite Monitoring Teams (MMT) have been created to monitor operations of operating mining companies in the region. Conducted every quarter, basis of the monitoring is compliance by mining companies with conditions stipulated in ECCs and commitments in the approved Environmental Protection and Enhancement Programs (EPEP) and Annual EPEP. Reports of MMTs are being deliberated/reviewed by the Mine Rehabilitation Fund Committees (MRFC) who in turn indorses recommendations to concerned agencies like the EMB for final action. So far MMT findings indicate that most companies have substantially been able to comply with ECC conditionalities and EPEP commitments. There was no indication that water quality of river systems and ground water were affected by mining operations. River systems affected by small scale mining also are being monitored. Particulate emissions are within DENR standards including toxic gases like SO2 and NO2. A total of about 10 hectares have been disturbed per year by mining operations but these have been rehabilitated and planted with fast growing species through the Adopt-a-Mountain, Adopt-a-Mining Forest Program.

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2) Exploration companies

MGB Caraga initiated the operationalization of Community Technical Working Group (CTWG) to monitor compliance with approved Environmental Work Program (EWP). Although not mandated by law, the CTWG elicited wide acceptance and appreciation from interested residents who were oriented on the provisions of the Mining Act and its Implementing Rules and Regulations and trained as active participants in a monitoring team.

e) Adopt-a-Mountain, Adopt-a-Mining Forest Program It is aimed to rehabilitate degraded/denuded forestlands in order to improve its cover, restore the ecology and enhance biodiversity that may create possible source of water and wood supply through reforestation within mining companies claims. A total of more than 460 hectares have been rehabilitated and reforested through the program by all mining companies in the region. f) Mine Safety and Health Standards Mine safety, health and sanitation standards are covered by DENR Administrative Order No. 2000-98 which has been promulgated to promote a culture of safety and health, provide for the strict enforcement of safety and health measures, provide for effective monitoring systems, inspections, investigations and inquiries to improve health and safety; establish tripartite linkages in promoting safety and health matters, promote training and human resources development, and comply with international law obligations of the government relating to mine safety and health. The Order governs all employers, employees, contractors, permittees, service contractors and other entities engaged in any exploration, mining, quarrying, mineral processing, and other allied or related operations. Compliance with the standards in the aforementioned Order is being monitored regularly and regulated by the MGB regional office. A contest on best safety performance is held annually among mining companies to recognize and award deserving performers who excel in the field of promoting safety of workers and environment. g) Presidential Mineral Industry Environmental Awards (PMIEA) Pursuant to Section 177 of DAO No. 96-40, the PMIEA is given annually to exploration and operating mining companies based on their yearly environmental and safety performance and accomplishments. h) Contingent Liability and Rehabilitation Fund (CLRF) The CLRF is established to ensure just and timely compensation for damages and progressive rehabilitation for any adverse effect mining activities may cause. It is in the form of the Mine Rehabilitation Fund (MRF) and the Mine Waste and Tailings Fees Reserve Fund (MWTFRF). The implementation of the CLRF has been institutionalized and operationalized through an individual Memorandum of Agreement (MOA) for each mining company signed by all members of the MRFC. i) Creation of different committees to conduct monitoring and evaluation and ensure environmental compliance among mining companies to wit, Mine Rehabilitation Fund Committee (MRFC), Contingent Liability and Rehabilitation Fund Steering Committee (CLRFSC) Air Quality In line with the objectives of the Phil. Clean Air Act, the department launched several programs that promote clean air and air quality management such as: a. Linis Hangin Program, Bantay Usok/Bantay Tambutso Recognizing that motor vehicle emissions are major contributors to air pollution, the celebration of the Clean Air Month focused on the goals of curbing air pollution from vehicular emissions. EMB- 13 initiated a roadside emission testing, an activity that will serve as a sustaining mechanism to the anti-smoke belching program of the government. Its specific objective was to check whether drivers

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and owners of motor vehicles plying the major thoroughfares of Butuan City are exercising proper and regular engine tune-up to prevent smoke belching. b. Bantay Tsimneya As an effort to strengthen the compliance of the stationary sources to the provisions of R.A. 8749, EMB 13 Air Quality section and the Butuan City ENRO jointly conducted a visual monitoring of the smoke stack emission of the industries within Butuan City using the Opacity Test. Per observation, industries monitored were within standard. The activity allowed the bureau to check the efficiency of the air pollution control installations of the industries. Water Resources Several activities leading toward the objectives of the Clean Water Act were undertaken, such as monitoring of firms, issuance of Notice of Violation to industries that violated the laws and regulations, strengthening of the Industrial Ecowatch, Beachwatch and Tapwatch programs. Toxic and Waste Chemicals Being the line bureau mandated with the implementation of RA 9003, EMB is putting efforts to fast track the implementation of the salient provisions of Ecological Solid Waste Management. Initiatives in Waste Management include: a. Linis Estero (North and South Montilla) Linis Estero is one of the flagship environmental events of EMB-13 which underscores the concerted efforts among all sectors in working towards a healthy and sustainable environment. b. ESWM Seminars ESWM seminars were conducted in schools, municipalities, market vendors association and industries. Topics discussed focused on the salient provisions of RA 9003 and related local laws on ESWM. c. Waste Characterization Study Waste Characterization Study is conducted in the different municipalities in Caraga Region for the solid waste generation and identified kitchen/food waste and yard/landscape as the most generated and common waste followed by the cellophanes/plastics. d. Wastepaper Exchange Program EMB Caraga and PICOP jointly initiated the Waste Paper Exchange Program for the recovery and recycling of waste paper not only in Butuan City, but in the entire Caraga Region as well. These two entities forged their alliance for the enhancement of the environment and protection of Mother Earth, thru a Memorandum of Agreement, in undertaking the waste paper recycling program. CHALLENGES and PRIORITIES for ACTION

Environmental concerns are often lacking in development practice and policymaking and yet are a fundamental component of sustainable development in the long term. Efforts must be made to improve understanding of the environmental impact of development strategies and to recognize the link between environmental degradation and poverty. Lack of technical personnel to monitor the status of Caraga’s resources is one of the limitations of the region. Support from the national government is needed and complete staffing should be provided to create and ensure an enabling environment.

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Forest, Watersheds, Biodiversity, Coastal and Marine Resources Despite various policies and master plans to protect forest cover, deforestation still continues. The policy environment should be strengthened and enforcement facilitated. Further, forest areas are being inundated and converted to agricultural purposes and settlement projects. There is a need also for the local communities to be mobilized for forest management through education and awareness building on forest conservation. Forging of Co-Management Agreements should also be encouraged. Mining Resources Studies conducted in the past pertaining to contamination of toxic elements accumulated from mining areas presented critical issues that need validation. A committee or task force should be created to conduct environmental assessment, monitoring and evaluation of the areas at risk particularly in marine and aquatic resources, vegetation and agricultural livestock and sources of drinking water. To investigate whether the mining activities affect the health of the people in nearby communities, a health assessment should also be conducted. Air Quality Monitoring of ambient air quality including ozone, carbon monoxide, sulfur dioxide, and nitrogen oxides should be facilitated not only in Butuan City but also in other relevant areas of the region. Additional facilities and personnel are necessary to facilitate this task. Strict execution in the conduct of emission test, suitability test and roadside inspections of smoke belching system of all vehicles should be carried out by concerned agencies. Information campaigns and assessment should be facilitated among locals on health, environmental, legal, enforcement, and safety concerns regarding open burning of garbage and household waste. Water Resources For water resources, monitoring of the quality of all classified water bodies in the region should be conducted annually. For this to be accomplished, additional technical staff is needed to undertake yearly monitoring activities all though the region. For the issues identified in previous studies involving Agusan River and Butuan Bay, an assessment/in depth study should be conducted by concerned agencies to validate the findings. Presented below are the actionable plans and strategies to control the level of pollution of the Priority Rivers in Caraga Region that addresses the various sources of pollution, such as stationary sources, agricultural sources and run-offs, and household sources.

Stationary Sources

1. Strict enforcement of environmental laws, rules and regulations in the regulated community which includes, but not limited to the strict compliance to effluent standards, regulating maximum pollutant discharged to the river as allowed in the issued Discharged Permit, and self-monitoring and reporting requirements to industries.

2. Provide incentives to modernizing manufacturing plants that are adopting cleaner production and waste minimization technology, and installing/ improving pollution-control facilities to minimize pollutant discharges to the river system.

3. Implement the Industrial Ecowatch Program and the Public Disclosure System for all industry sectors at the Regional Level, as a deterrent to industries that are not complying with the environmental laws, rules and regulations.

4. Strictly enforce the permitting system provided for in R.A. 9275, “the Clean Water Act of 2004” to provide option to the industries whether to improve for a better effluent water quality

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and to pay less in the Wastewater Discharge Fees implemented in the permitting system or to pay the relatively high Wastewater Discharge Fees for not improving the wastewater effluents of the existing wastewater treatment facility.

Household Sources of Wastewater

EMB coordinates with the LGUs on the implementation of the Sanitation Code, such as provision of septic tanks by each household in the community, provision by LGUs of the sewerage system and provide treatment facilities for the disposal and treatment of sewage and sludge produced by household.

Agricultural Run-offs and other Non-point Sources

The DENR-EMB shall encourage all concerned agencies such as the Department of Agriculture (DA), National Irrigation Administration (NIA), Local Government Units, and other concerned sectors to work side by side to implement programs and practices in the agriculture sector that would abate or minimize the use of agricultural inputs and other farming practices that could bring adverse effect to the environment especially the river ecosystem.

Toxic and Waste Chemicals The region through EMB Caraga continuously provides technical assistance in properly containing toxic and waste chemicals and in the closure of open dumps/conversion to controlled dumps/development of SLFs. Strict and immediate implementation of the environmental laws provided in RA 9003 should be administered to facilitate fast and efficient compliance among LGUs.

Target 11: Halve the proportion of the people with no access to safe drinking water

and basic sanitation, or those who cannot afford by it, by 2015. STATUS and TRENDS

Safe water supply coverage now increased from 70 percent in 2001 to around 82 percent in 2005, with 23 percent, 25 percent, and 32 percent of all households now enjoying Level III, Level II and Level I water system respectively. Compared to the national average, the region has a slightly lower figure. Among the provinces, Agusan Del Norte had the highest coverage of safe drinking water posted at 95.81 percent followed by Surigao City with 95.63 percent.

Table 38. Percentage of Households with Access to Safe Drinking Water, By Province and City, Caraga Region, 2001, 2004 and 2005

(In Percent)

Province/City 2001 2004 2005 Agusan Del Norte 93.01 74.87 95.81 Agusan Del Sur 73.00 65.87 67.2 Surigao Del Norte 70.47 94.08 94.33 Surigao Del Sur 63.07 72.15 76.05 Bislig City 74.74 67.67 67.67 Butuan City 52.62 90.57 89.43 Surigao City 93.05 94.80 95.63 Caraga 70.61 78.09 81.93 Philippines (2003) 82.30

Source: Department of Health – Center for health Development Caraga

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Major rural water supply projects were undertaken since 1990 to increase the number of rural communities with access to safe, simple and low-cost water supply and sanitation facilities in line with the Government's Social Reform Agenda. This project also aims to improve the health of the rural population by reducing the incidence of water-borne and related diseases.

Figure 30. Improvement of Access to Safe Drinking Water Caraga Region, 2001-2015

The households with complete sanitation facilities which include sanitary toilets, access to water supply, proper drainage and garbage facility were below 50 percent of the total households from 2004-2005. Butuan City has the highest sanitation coverage with 85.70 percent. Table 39. Percentage of Households with Complete Sanitation Facilities Per Province and City, Caraga Region, 2003-2005

(In Percent)

Province/City 2003 2004 2005

Agusan Del Norte 65.0 52.0 52.03 Agusan Del Sur 50.0 41.9 43.39 Surigao Del Norte 42.7 36.9 44.00 Surigao Del Sur 27.0 21.5 21.99 Bislig City 58.5 54.9 54.86 Butuan City 82.7 76.9 85.70 Surigao City 60.8 61.1 61.45 Caraga 51.3 44.5 47.23

Source: Department of Health – Center for health Development Caraga

The low level of sanitation is a threat to public health. Water-borne diseases are still prevalent in the region and remains to be at the top ten leading causes of morbidity.

Percentage of Households with Access to Safe Drinking Water

2015 target



Percentage of Households with Access to Safe Drinking Water

2015 target



81.93 87

70.7

0

20

40

60

80

100

2001 2004 2010 2015


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The Government’s Social Reform Agenda play a big role in the installation of low-cost facilities for Water Supply Projects in the Region (Level III, Level II and Level I), local and foreign funded projects like the ADB Package Projects for Improvement of Existing Water Supply Systems, KFW Package Projects for Construction of New Water Supply Systems and Improvement of Existing Water Supply Systems, LWUA Locally Funded Projects for Improvement of Existing Water Supply Systems, Barangay Water Program (BWP), Rural Water Supply and Sanitation Sector Project (RW3SP). Agusan del Sur and Surigao del Sur have a relatively higher number of Level III facilities but safe water supply and sanitation coverage continues to be unsatisfactory especially for those living in remote barangays. The proportion of rural population unserved by safe water supply and sanitation facilities is much higher compared to the northern provinces of the region.

Table 40. Level III Water System Coverage, Caraga Region, 2004

Location Total Number of Municipalities/Cities

with

Municipalities/City Level III Water system

Agusan del Norte 11 4 Agusan del Sur 14 13

Surigao del Norte 28 26 -Surigao City 1 1 Surigao del Sur 19 15 Butuan City 1 1

Caraga 73 59 Source: Local Government Units

San Vicente, Surigao Del Sur Water and Sanitation Project

The 136 households of San Vicente, Marihatag, Surigao del Sur has benefited from the LGU initiated Level I & II Rural Water Sector Project which provides the locality of more than 500 people with safe drinking water. The project represents an effective marriage of initiatives from the Local Government Unit of Surigao del Sur and its beneficiaries, including its locally elected officials and identified groups of the community who need improved water supplies. These groups take ownership of and maintain their completed water supply as they organized themselves into Barangay Water Sanitation Association (BAWASA). Internal laws were formulated for their own guidance such as: (i) keeping in mind that water is an economic good, (ii) water usage and disposal in an environmentally sustainable manner, (iii) plan, operate and maintain the waterworks, (iv) full participation of the users and have special emphasis on the participation and needs of women. The association has collected a monthly due of P10.00/month per member at the start of the project in order to maintain the projects operation. Now that the organization has already an accumulated amount of P40,000.00 from the monthly dues , they decided to stop the collection of the monthly dues, instead used the 75% of the money to extend for credit loans to members and keep the 25% of the money for the maintenance of the project.

The project contributes to the improvement in the health of the barangay’s population since it provides safe and clean water services to the beneficiaries and practice of proper hygiene brought by the accessibility of clean water. It also enhances the quality of life of the beneficiaries because the project enables them to spend their time on more productive activities and make the members of the family becomes closer, for they could spend more time together instead of consuming time for fetching water from pumps or nearby springs. Water-related diseases were also reduced since the project operated.

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Improvement of health sanitation In informal settlements and slums, sanitary and hygiene conditions stemming from the lack of adequate wastewater and human waste collection, treatment and/or disposal are dangerous and even life-threatening for the environmental health of the community and will deteriorate the overall environmental quality. Around 52 percent in the region do not have access to complete sanitation facilities. Children and the urban poor are especially vulnerable to the public health problems stemming from poor sanitation and water-related diseases. Strengthening community participation & capacity building to plan, manage & maintain rural water supply infrastructure Enhancing community participation in building, monitoring and maintaining rural water supply schemes is integral to the success of the Water Supply Projects. However, this is constrained by the lack of incentives offered by the Local Government Units due to lack of funds for the projects sustainability. The involvement of the local government and the external agencies could aid the preparation, planning, implementation, and management of such systems, and that sustainability is improved when these processes are permanently monitored by the Local Project Monitoring Committee. Strengthening of Structure Regulation and Capacity Building of the Stakeholders for Sustainable Water Supply Project/ Rehabilitating existing water supply schemes Increasing and maintaining access to safe drinking water is a more pressing issue in rural than in urban areas. A critical challenge in maintaining and further enhancing safe and improved water coverage to rural populations will depend greatly on the maintenance and rehabilitation of older water supply schemes. Meeting the goal of attaining complete safe water coverage will not only require the annual construction of new schemes, but the rehabilitation and proper maintenance of the existing schemes to avoid contamination and total dilapidation of the structures.

Bislig City Watershed Co-Management Strategy

The health of Bislig City’s water resources is essential to the quality of life of its populace. Whether swimming in a river or creek, casting a fishing line into meandering tributaries of a river, or drinking a glass of crystal clear water, the environment provides the basic necessities of life, which cannot be taken for granted. That would be the major reason why a watershed plan for the areas of Mangagoy, San Antonio, Kauntuan and Cumawas with an aggregate area of 991.57 hectares was made to address the pressing concerns of Bislig City’s water domestic supply with the directions of the Bislig City Watershed Management Council and the Task Force created by the Regional Development Council.

The Watershed Management administers a variety of programs aimed at protecting and restoring water quality, controlling water pollution and ensuring adequate water supplies by means of managing valuable water resources and holistically addresses water pollution and supply issues so that more comprehensive strategies can be implemented. These motivated the residents in the locality to participate and organize themselves as responsible key actors for a sustainable supply of quality water and enhanced eco-tourism and venues for research and development to Bislig City. These also prompted the Civil Society Organizations in the City strengthened their relationship with the Local Government Units by adopting an area for watershed reforestation.

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Supportive Environment The implementation of the 1991 Local Government Code (LGC) and the formulation of the Clean Water Act in 1993 greatly spurred the initiatives to improve the water supply and sanitation situation, however the emerging regulations has limited external support for enforcement. In as much as inadequate hazardous waste management infrastructure against regulatory mandate and the awareness/information dissemination, deficient agency resources against the growing needs of the community like technical support and continuity of programs against changing governance continue to beset the Act’s smooth implementation. Increasing clean & improved water supply coverage in rural areas through the Water Supply Project Adequate quantities of safe water and good sanitation facilities are necessary conditions for healthy living which will help Caraga in its poverty alleviation efforts. High incidence of hunger and child deaths caused by diarrhea combined by acute gastroenteritis, cholera, typhoid fever and other water-borne and sanitation-related diseases will also be minimized if not entirely eliminated. At the community level, water users associations were organized to oversee the operation and maintenance of the water supply project. This, however, has not proved to be very successful since there are still many water supply projects that are poorly maintained and in dilapidated condition, with water quality monitoring aspects largely ignored. The Planning & implementing framework for remaining urban & satellite towns The Fixed water resources vis-à-vis changing growth patterns and increasing use of water by a rapidly expanding population necessitates the construction of more water supply system and creation of more efficient water districts. However, public authorities face the policy challenge of defining a standard of water service that meets critical health objectives, is financially sustainable within the resources available to families and the public water supplier, and yet is acceptable to the community. Public participation in water supply planning and implementation is part of the solution. Establishing & monitoring water quality standards through surveys and programmes Project completion or success should be measured by sustainable outcomes rather than inputs such as the number of hand pumps or pipe networks installed. This will require the introduction of water quality standards monitoring and evaluation tools, long-term impact assessments, as well as the introduction of more reliable and sustainable databases. The Local Government Units (LGUs) in the region must be primarily responsible for promoting and ensuring health and hygiene of the systems by providing water facility disinfection, water quality surveillance and control programs and public and household toilet facilities to control communicable diseases, reduce morbidity due to water-borne and sanitation-related illnesses such as diarrhea, tuberculosis, intestinal parasitism, schistosomiasis, malaria, infections, hepatitis, typhoid fever and even dengue hemorrhagic fever. However, given the significant costs involved the establishment and monitoring of water quality standards is still a primary concern of the region.

Target 12: Achieve a significant improvement in the lives of at least 100 slum dwellers by 2020 STATUS and TRENDS

In response to the need for updating local statistics on the number of informal settlers, the LGUs conducted a survey to ascertain the housing needs in the localities. The survey was done per municipality and city. In 2003, the estimated number of informal settlers or those who occupied private and public lands which they do not own numbered to 48,138. Among the provinces and cities, Agusan Del Sur accounted for the biggest number of informal settlers about 44 percent or 21,209. This was followed by Butuan City with 10,886 informal settlers or 23 percent and by Surigao Del Sur with 5,791 slum dwellers. Among the cities, Bislig had the least number of informal settlers.

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In the case of Bislig City, the figure did not account all informal settlers due to the limited scope of the survey conducted by the local government unit. The survey only covered two urban barangays while others remained unaccounted. Most are located in Road-Right-of-Way, river banks and in government and privately-owned lands. The areas where informal settlers were concentrated are characterized by congestion and poor sanitation, limited access to basic services and facilities. Problems relating to safety and order are also apparent in these areas.

Table 41. Magnitude of Informal Settlers, By Province and City, Caraga Region, 2003

INFORMAL SETTLERS Province/City Magnitude of Informal

Settlers Percent

Agusan Del Norte 2,113 4.3 Agusan Del Sur 21,209 44 Surigao Del Norte 4,481 9.3 Surigao Del Sur 5,791 12 Bislig City 438* 1 Butuan City 10,886 22.6 Surigao City 3,220 6.7 CARAGA 48,138 100

Sources: National Housing Authority and Local Government Units

Addressing issues on security of tenure especially among low income families along with the needed auxiliary services remains a major challenge in the housing sector. Resettlement sites are confronted with problems of accessibility to services and alternative sources of livelihood. PRIORITY POLICIES and PROGRAMS

The lone shelter agency in Caraga which implements housing programs and projects is the National Housing Authority. Provision of shelter is being undertaken by NHA in partnership with the local government units. For the last 9 years, government programs on housing have been intensified with the increasing demands for housing units and security of land tenure. Through Executive Order 90, Series of 1986 efforts to provide housing assistance to the lowest 30 percent urban income-earners were intensified. Various mechanisms have been utilized in the pursuit of addressing shelter needs of the informal settlers. Republic Act 7279 otherwise known as the Uban Development Housing Act of 1992 provides for the implementation of relocation sites for informal settlers, persons living in danger areas and those displaced from sites earmarked for government infrastructure projects. The most widely availed housing program by the lgus is the Resettlement Assistance Program (RAP-LGU). The beneficiaries of the program belong to the 30 percent low income families of the urban population who are informal settlers, living in danger areas and those displaced from sites earmarked for government infrastructure projects. From 1994-2005, a total of 10 project sites have been established with 4,014 family beneficiaries. The Community-Based Housing Program which involve mobilization of community resources in the resolution of land tenure issues, site development and unit consolidation. It is one of the most widely implemented program in the region. It includes Land Tenurial Assistance Program (LTAP) where NHA extends credit assistance to Community Associations for the acquisition of land they occupy or intend to be resettled. Another program under the community based approach is the Community Land Acquisition Support Program (CLASP) which aims to facilitate the acquisition of land by organized Community Associations through direct purchase of land they occupy with financial assistance other entities. Under the CBTAP, the intended beneficiaries are organized into Community Associations so that they can avail of the tenurial assistance there were a total of 2,615 family provided with assistance.

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Under the Community Mortgage Program (CMP) a total of 16 Community Assistance were assisted by the National Home Mortgage Finance Corporation (NHMFC). However, they closed their satellite office in the region in the year 2001 due to financial constraints. The slum upgrading program is also being implemented in the region. The slum upgrading program in Surigao Del Sur included on-site improvement of occupied lands through the introduction of roads or alleys and basic services such as water and power. This program benefited 464 households with two project sites.

Table 42. NHA Housing Programs and Projects, By Province and City, Caraga Region, 1994-2005

Province/City Program Classification No. of Projects

Land Area Number of Units/

Beneficiaries

Amount (In Million)

Agusan Del Norte Lingap Para sa Mahirap 8 994 2.7750 Local Housing Program 1 1.8 94 3.1250 Agusan Del Sur Resettlement Program 4 28.6700 1558 32.0447 Community-Based Housing

Program 7 38.7506 1,338 4.7088

Lingap Para sa Mahirap Program 5 1135 2.8000 Local Housing Program 3 18.5000 1100 3.1250 Cooperative Pabahay Program 2 17.3930 430 44.0401 Surigao Del Nprte Resettlement Program 1 10.0800 484 9.6840 Lingap Para sa Mahirap 2 350 2.9000 Local Housing Program 1 3.4764 92 1.6780 Surigao Del Sur Resettlement Program 1 384 9.3781 Lingap Para sa Mahirap Program 3 13961 4.8000 Emergency Housing Assistance

Program 1 100 1.000

Local Housing Program 3 2.1118 297 4.4970 Slum Upgrading 2 35.4418 464 96.3794 Butuan City Resettlement Program 3 28.4982 1,515 70.5082 Community-based Housing

Program 5 4.1661 322 7.6747

Joint Venture Program 1 6.4950 365 49.1000 Lingap Para sa Mahirap Program 19 1923 2.3520 Local Housing Program 1 1.1770 104 3.1250 Poverty Alleviation Fund 2 2 1.3485 85 3.0100 Surigao City Resettlement Program 1 5.9100 457 7.5560 Community-Based Housing

Program 4 25.3981 955 18.2700

Joint Venture Program 2 14.1500 448 46.7900 Lingap Para sa Mahirap Program 2 1.1200 251 2.9000 Poverty Alleviation Fund 2 1 1.5050 Local Housing Program 2 7.000 319 3.1250 Cooperative Pabahay Program 2 280 16.5500 TOTAL 89 265.0065 29,807 455.4010

Source: National Housing Authority

Partnership between the LGUs and NGOs in the provision of shelter has helped in addressing the shelter needs in Caraga. The two leading partners of the LGUs are the Gawad Kalinga and the Habitat for Humanity. Gawad Kalinga 777 is a growing phenomenon and strategy in addressing housing shortage which directly benefits the poorest of the poor. Partnership with Gawad Kalinga has started in 2000 and a total of 500 beneficiaries (311 in Butuan City, 59 in Agusan Del Sur, 35 in Surgao Del Norte, 57 in Surigao City and 38 in Surigao Del Norte) have availed not only of the shelter component of GK but the other programs such as livelihood, community empowerment and education. In 2005, there are already eleven (11) GK sites all over the region. Most of the GK beneficiaries are families who live in the riverbanks and shanties.

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To attain the MDG goal on improving the lives of informal settlers in the region, the following challenges and priorities must be addressed: Strengthen LGU-NGO-led Housing Programs Established linkages and partnership between local government units and non-government organizations in the provision of shelter should be strengthened as this provides viable solution in addressing housing shortages. Bislig City and municipal governments should take a pro-active role in tapping NGO partners such as the Gawad Kalinga and the Habitat for Humanity to map-out possible partnership. While the provincial governments in Caraga have signified their support and have projects sites directly supported by the province, only a few municipalities have accessed the

BALANGAYAN BUTUAN HOUSING PROJECT Balangayan Butuan Housing Project is a convergence effort among the city government of Butuan, the Gawad Kalinga, the Habitat for Humanity, national elective officials, private sector and civil society organizations to provide homes for 6,488 families living along the West Bank of Agusan River who have been affected by the Cotabato-Agusan River Basin Development Project (CARBDP). Before the start of the housing project, all residents of the riverbanks were tagged and censused, providing the city with a masterlist/basis for beneficiary selection. Prior to each major step in the relocation process, consultative meetings are also conducted as avenue by which beneficiaries can air their concern and suggestions. At the site, the organized communities can write to the Project Management Team and/or visit the City Housing and Development Office, or talk with the representative of the Balangayan Butuan Committee on Programs to air their concerns/complaints. Built-in programs such as values transformation and socio-economic related activities are introduced to prepare beneficiaries on viable livelihood and other schemes that would bring them better lives and further facilitate the proper implementation of the project. Consequently, livelihood projects are based on the expressed need of beneficiaries with consideration on the potentiality for generating income and availability of resources. Along with partners and sponsors, the project has successfully relocated 455 families in the 4-hectare relocation area in Pagatpatan, Butuan City. Moreover, about 50 housing units already have sponsors while another 260 housing units are projected to be established by 2007. Other major accomplishments of the project include the comprehensive database of all settlers along the riverbanks, formulation of stringent guidelines on selection and implementation, zero duplication/selling of awards, continuing social and financial support from various sectors, development of road networks and drainage canals, sufficient water and electricity connections, establishment of 2 health centers, basketball court, community playground and 2 day care centers, provision of livelihood programs, organization of beneficiaries into model communities, clear and well maintained area along the priority 7 barangays in the riverbank, and the sustained values transformation activity primarily provided by the Gawad Kalinga through its Christian Life Program (CLP). The city government of Butuan is still continuously seeking financial support through partnerships with other entities including overseas workers’ organizations and private individuals which can provide land development through grant/loan, housing unit construction as well as provision of regular LGU allocation to ultimately attain the vision of Balangayan Butuan re: to achieve uplifted standard of living for the poorest of the poor; maximized involvement of the LGU, civil society organizations, and private sector in socialized housing; enhanced people and community participation in shelter development; and, operational urban land development framework.

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said partnership. Thus, the municipalities are encouraged to avail of the partnership scheme that the NGOs have. Between these kind of partnership the least counterpart of the LGUs is the land acquisition and site development. Thus, identification of resettlement sites is an essential factor for any partnership undertaking to commence. For the provision of auxiliary services, the lgu and the NGO shall support each other to facilitate the sourcing of resources outside the regular budget of the lgu and to be complemented with the resources of the NGOs/civil society.

Provision of updated data and identification of resettlement areas

Absence of updated data on housing specifically on the inventory of informal settlers hampered effective planning and identification of target beneficiaries. Tracking and conducting surveys among informal settlers remain costly for LGUs. Conscious effort to track the number of informal settlers especially along urban areas remains weak. The major constraint in conducting inventory is the cost it entails which the LGU will shoulder. Moreover, the delineation of areas intended for resettlement or relocation areas is necessary to jumpstart the implementation of housing program intended for informal settlers. A task force shall be created to assess and classify the inventory of lands in the different provinces and cities which is suitable for socialized housing and resettlement to include public lands and properties foreclosed by the government financing institutions.

Increase accessibility and livelihood opportunities in resettlement areas

Inaccessibility and limited access to social services have caused resistance among target beneficiaries to be relocated to resettlement sites or relocation areas. Relocation areas are usually far from the source of livelihood of intended beneficiaries. Moreover, adequate social services and basic facilities need to be made available among the beneficiaries to ensure that they are afforded with decent life.

Provision of technical assistance to organized People’s Organization, cooperatives and LGUs

To guarantee proper planning as well as efficient implementation, operation and management of the housing project, the NHA shall continue to provide its joint venture partners, the required technical support. This shall include all the aspects of project development, project planning and packaging, project implementation, supervision, beneficiary selection as well as estate management. To the LGUs, the NHA extends technical support in the formulation of Local Housing Plans that would make clear the programs, strategies and approaches the LGU can adopt to effectively address the housing problem in the locality.

Comprehensive and rational urban and city development and management strategy

Policy measures should be established to stem the growing undesired consequences of migration and unmanaged urban growth and at the same time efficiently provide favorable development opportunities to the growing number of migrants and settlers. The local government units need to pursue policies that address the basic needs of migrants such as food, health services and housing. Policy formulation should likewise consider relevant measures that provide assistance to sending localities, which suffers the loss of its human resources, and consequently affecting its productive capacity for development. Establishment of HUDCC and NHMFC in Caraga Key shelter agencies such as the Housing and Urban Development Coordinating Council (HUDCC) which exercise administrative supervision over other housing agencies should be established in the region to facilitate and coordinate the implementation of the much needed housing programs. The establishment of National Home Mortgage Fund Corporation (NHMFC) shall likewise facilitate the provision of assistance to Community Associations so that they can avail of financial assistance in the acquisition of land and in expediting the process of credit and payment.

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Goal 8 : Develop Global Partnership for Development Target 13: Develop further an open, rule–based, predictable, non-discriminatory trading and financial system, including a commitment to good governance, development and poverty reduction STATUS AND TRENDS

Banking/Capital Market Status Due to limited data and information, the discussion on the capital market is limited to the banking sector. Banks are source of financing to spur economic activities that can aid in job generation and poverty reduction. For the region, the banking and financial industry has consistently grown in the last five (5) years. In 2005, the number of banks in the region totalled 114, a big improvement compared to the 2000 figure of 95. 34 percent of these banks are classified as commercial banks while the rural and the thrift banks comprise 61 percent and 5 percent, respectively. All in all, from 2000-2005, a total of 19 new banks set up branches across the region. In contrast, bank closure was low. In 2003, only two banks closed in the region: one in Agusan del Sur and one in Surigao del Norte. Other bank closures were recorded in Agusan del Norte and Surigao del Sur sometime in 2001 and 2002, respectively.

Figure 31. Number of Banks in the Region, 2000-2005

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90

95

100

105

110

115

120

2000

2001

2002

2003

2004

2005

Source: Bangko Sentral ng Pilipinas

In 2005, Agusan del Norte had the most number of banks (36), followed by Agusan del Sur (27), Surigao del Sur (26) and Surigao del Norte (25). From 2000-2005, 7 new banks were added in Agusan del Sur, 5 in Surigao del Sur, 4 in Agusan del Norte and 3 in Surigao del Norte. The years 2003-2005 were rapid expansion years with 14 new banks putting up branches in the region. Banks have certainly intensified lending activities in the region. Net Loan Portfolio reached Php 5.4 billion pesos in 2005, a 3.51 percent increase from previous year’s level, and compared to the 2000 figure, a 51.77 percent increase in lending activity. Excluding the 9 percent decrease in lending activity recorded in 2004, the growth in banks’ net loan portfolio in the region has been steady, with rapid growth recorded in 2001 and 2002.

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Figure 32. Net Loan Portfolio of Banks in Caraga, 2000-2005

5,400

5,217

5,727

5,412

4,330

3,558

0 1,000 2,000 3,000 4,000 5,000 6,000

2000

2001

2002

2003

2004

2005

Source: Bangko Sentral ng Pilipinas Agusan del Norte banks account for the bulk of the net loan portfolio in Caraga at 34.20 percent as of 2005. Second in rank were the Agusan del Sur banks which accounted for 26.52 percent of the net loan portfolio in Caraga. Agusan del Sur posted an impressive 162.27 percent increase in net loan portfolio for the period 2000 – 2005 inspite of a 5.19 percent decline in 2004. Like banks in Agusan del Sur, Surigao del Sur banks also had a 15.94 percent decline in net loan portfolio in 2004. For the period of 2000 – 2005, however, net loan portfolio increased by 150.30 percent, from Php 493 million in 2000 to Php 1.234 billion in 2005. Surigao del Norte banks’ net loan portfolio stands at Php 887 million, a 45.41 percent increase from the 2000 level of Php 641 million. Net loan portfolio of Surigao del Norte banks account for 16.43 percent of the total net loan portfolio in the region.

Table 43 shows us the number of banks in the region and in the four provinces, as well as the number of banks per classification. Per data form the Bangko Sentral ng Pilipinas, Caraga has universal and commercial banks, thrift banks and rural banks.

Universal and commercial banks represent the largest single group, resource-wise, of financial institutions in the country and in Caraga Region. They offer the widest variety of banking services among financial institutions. In addition to the function of an ordinary commercial bank, universal banks are also authorized to engage in underwriting and other functions of investment houses, and to invest in equities of non-allied undertakings. The thrift banking system is composed of savings and mortgage banks, private development banks, stock savings and loan associations and microfinance thrift banks. Thrift banks are engaged in accumulating savings of depositors and investing them. They also provide short-term working capital and medium- and long-term financing to businesses engaged in agriculture, services, industry and housing, and diversified financial and allied services, and to their chosen markets and constituencies, especially small- and medium- enterprises and individuals. Rural and cooperative banks are the more popular type of banks in the rural communities. Their role is to promote and expand the rural economy in an orderly and effective manner by providing the people in the rural communities with basic financial services. Rural and cooperative banks help farmers through the stages of production, from buying seedlings to marketing of their produce. Rural banks and cooperative banks are differentiated from each other by ownership. While rural banks are privately owned and managed, cooperative banks are organized/owned by cooperatives or federation of cooperatives. 1

1 Information gathered from http://www.bsp.gov.ph/about/overview.asp

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Table 43. No. of Banks in Caraga Region, per province and per classification

as of June 2007

Region/Province No. of Banks

Universal and Commercial Banks

Thrift Banks

Rural Banks

Caraga 114 38 6 70

Agusan del Norte 36 17 3 16

Agusan del Sur 26 6 3 17

Surigao del Norte 25 9 - 16

Surigao del Sur 27 6 - 21 Source: Bangko Sentral ng Pilipinas

Based on the table above, 61% of the region’s banks are rural banks, while universal and commercial banks only make up 33% of the total number of banks in the region. This indicates that in terms of access to credit facilities, the region’s rural folks, most of which are employed or under the agriculture sector, can easily tap rural banks for their credit needs, aside from other credit sources. The universal and commercial banks in the region, as with the thrift banks in the region, are concentrated in the cities and rapidly urbanizing municipalities in the region, so the presence of rural banks provides much needed stimulus to bolster growth and development in rural areas.

Agusan del Norte has the highest number of universal and commercial banks among the provinces in the region (17), while Surigao del Norte has 9 universal and commercial banks, with Agusan del Sur and Surigao del Sur having 6 such banks each. Agusan del Norte and Agusan del Sur has three thrift banks each while Surigao del Sur has the highest number of rural banks (21), followed by Agusan del Sur (17) and Agusan del Norte and Surigao del Norte (16 each). With the region’s rosy economic prospects as well as the creation of three new cities and a province, it is reasonable to expect an increase in the number of banks in the region. Trade and Investment Trade and investment support systems have been set up by the LGUs and concerned regional line agencies to improve access and maintain transparency of trade and commercial activities in the region. City/Municipal/Provincial Investment Boards have been set up at the LGU level. Policies on trade and investment have been maintained and updated by these board to meet the dynamic nature of commerce and trade. Websites of various LGUs highlight the priority investment areas, cost of doing business and other related information such as ordinances in line with investment incentives for micro, small and medium enterprises (MSMEs) among others. The Small and Medium Enterprises Development (SMED) Councils are also in place at the local level in accordance with Republic Act (RA) 6977 in 1991 (known as the Magna Carta for Small Enterprises) as amended by RA 8289 in 1997. Said RA is in line with the promotion and, development of small and medium scale enterprises through the creation of small and medium enterprise development (SMED) Council. Specifically, the Surigao SMED Council has established a web-based local business development and trade promotion center which keeps local and foreign prospective/existing investors informed on the available services offered by the center. The center also showcased various products and investment opportunities of the province. The private sector on the other hand, has been initiating activities specifically business conferences which showcase business ventures that would reduce poverty and generate job opportunities in the region. The Eastern Mindanao Business Council (EMBC), which spearheads such activities, is the regional umbrella organization of the Philippine Chamber of Commerce and Industry. In the 2005 Caraga Business Conference in Tandag, Surigao del Sur, business sector passed a resolution to

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address initiatives for development of the dormant agriculture sector, ecotourism development and the revival of the mining industry. Exports The region has maintained an impressive increase of exports from 2003 to 2005. In 2005, exports totalled $60,173,838, a 273 percent from 2003 exports of $22,024,254. The region’s exports contributed 5 percent to the Gross Regional Domestic Product in 2005 and consequently contributed 0.13 percent to the country’s export earnings in same year. Asia remains the dominant destination for the last three years, buying 86 to 89.5 percent of the region’s total exports. Australia is the second export market accounting 10 to 14 percent of total export from 2003-2005. Europe has become a new market for other semiconductor devices in 2005 with total exports of $139,556.

Table 44. Caraga Exports, by Area, 2003-2005

Value in US $ Area 2003 2004 2005

Asia 18,969,918 35,166,598 53,868,380

North America 0 17,940 114,227

Europe 1,200 0 139,556

Australia 3,053,136 5,735,223 6,051,675

Total 22,024,254 40,919,761 60,173,838

Source: NSO

On a commodity basis, mining (nickel and chromium ores), veneer sheets and other semi conductor devices are the top export commodities in 2005. There is a need to sustain export of aquamarine products such as crabs, cuttlefish and lapu-lapu; arts and crafts like basketworks; and coconut and other coconut based products such as virgin coconut oil.

Table 45. Caraga Exports, 2005 (Value in $)

Commodity 2004 2005

Aquamarine 286,543 72,300

Mining 39,088,240 57,570,378

Veneer/plywood 57,951 143,422

Coconut *5,002,922.31 *5,955,679.23

Other semiconductor devices 6,390 2,271,282

Clothing 2,330 114,227

Arts and Crafts 0 2,229

Source: NSO *DTI In support to the mining industry, a community-based mining conference was conducted in Surigao City with the participation of foreign and local mining investors with representatives from foreign embassies such as Canada, Australia, China, France and the United States of America as well as the LGUs, indigenous peoples, religious and community environmentalist groups. The conference which was spearheaded by the Community Relations, Education and Development Officers of Caraga (CREDO) in cooperation with the Chamber of Mines Caraga and the Mines and Geosciences Bureau (MGB-13) aimed to reinvigorate the Philippine mining industry for sustainable development. The conference showcased the impact of the Social Development and Management Program (SMDP) on the mining industry. The SDMP is a five-year plan required of mining companies as proof of goodwill and as their social responsibility toward their host communities The SDMP contains social and environmental programs and projects for the development of the host and neighboring communities as mandated in the Philippine Mining Act of 1995.

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Tracking the capital market There is a need to track the lending activities in the region other than those operated by banks to come up with a real picture of the capital market. Other indicators which need to be tracked would include proxy indicators for the region’s exposure to mutual funds and other financial/stock market derivatives. Bank expansion and accessibility Banks are seen as development catalyst in the region. Setting up banks to cater to sub-urban and even far flung areas in the region could reduce the travel time, cost and hassle for entrepreneurs/MSMEs in the region to avail bank services. In one hand, there is also a need to encourage savings to increase resources that can be tapped by banks to support the MSMEs. As another source of capital, lending institutions are encouraged to aggressively operate in the countryside to increase access of micro and other household-based enterprises to credit. Also helpful in the development process is the setting up of a regional bankers group to boost the industry’s profile which would allow it to influence policy and decision making at the regional level. Likewise, the opening of a Bangko Sentral ng Pilipinas branch would speed up the bureaucratic process that banks have to undergo. It would be beneficial to the banking community of the Region to have a BSP branch opened at the soonest time possible. Establishment of a favorable business climate LGUs promulgated investment incentive codes to attract investors in their respective districts/localities. Advocacy materials on cost of doing business, tax incentives and investment priority areas have also been made available in the local offices and even disseminated to business establishments and existing/prospective investors. However, LGUs must also be receptive to establishing simplified steps on business registration. LGUs are advised to adopt a one-stop-shop system whereby a flowchart is posted where each step in availing business permit and other administrative requirements has corresponding timetable which is strictly observed by the concerned local offices. A study on the time and cost of meeting the local business requirements would be helpful to derive the most effective and facilitative operation system. LCEs and the local investment boards should also come up with a system that reduces administrative hassles of paying taxes without sacrificing the tax amount due to the government. The LGUs/government is also challenged to track the performance of the underground economy so as to come up with more realistic economic situationer and consequently set effective policies to solve the underlying issues. Furthermore, all indicators that would track the accomplishments of this specific MDG target should be integrated in the Regional Database Indicator System and be updated regularly. Intensify implementation of trade and investment laws/policies/strategies The region is guided by the following strategic framework to improve productivity and competitiveness in the global market: (1) promotion of quality standards and global competitiveness, (2) promotion of business matching, trade fairs and missions, and (3) the exploration of emerging markets and business opportunities. The Industry Clustering (IC) is a strategy adopted by the Regional Development Council (RDC Resolution No. 6, series of 2004) to boost regional development. The IC in the region, which was officially launched in May 2005, would relieve local producers’ difficulties in achieving economies of scale in the purchase of farm inputs, machineries, raw materials and technology among others. Relatedly, the RDC created the Regional Investment Promotion and Export Committee (RIPEC) (RDC Resolution No. 14, series of 2005). Said Committee is focusing on the harmonization of various investment and export promotion activities in the region. Also, the implementation of the Barangay Micro Business Enterprises Act of 2002 (BMBE Law) must be intensified to achieve significant increase of approved BMBE law applications.

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Revitalization of the mining industry The revitalization of the mining industry is seen as propeller of economic growth in the region. As presented in the region’s export performance (2003-2005), the mining industry continues to contribute significant share of the region’s export inspite of the non-operation of the Nonoc Nickel refinery and the closure of the Manila Mining Corporation (in 2001) among others. The full revitalization shall be done through the following strategies elaborated in the Regional Export Development Plan, 2006-2007: (1) Pursue aggressive investment promotion activities for the mining sector, (2) Implement manpower development program for the mining industry, and (3) Provide policy support mechanism such as the harmonization of the municipal/provincial/regional land-use plans to include mineral reservation areas and other special zones Development of the wood industry Caraga is the country’s timber corridor as it supplies nearly 70 percent of the country’s wood supply needs. To fully develop the wood industry and further increase exports of veneer/plywood, wood boards and other wood finished products there is a need to lobby for the full implementation of the Caraga Timber Corridor Program. The conduct of inventory and delineation of potential production areas for tree farming projects is also critical. In the provision of market enhancement support, seminars relative to export documentation and processing should be pursued. There’s also a need to expand the establishment of clonal nurseries for continuous supply of quality planting materials as well as establish two (2) tissue culture laboratories in Surigao del Norte and Surigao de Sur to support the expansion program of corporate and individual growers. There’s also a need for intensive skills training on tree farming and furniture production technologies to compete with the world’s best. Intensification of Abaca Production and Processing Specifically for abaca, the biggest plantations are located in Surigao and Agusan provinces. In support to abaca production, the Fiber Industry Development Authority-Butuan Office drafted the Mindanaowide roadmap for said industry to boost not only production but also marketing of abaca fiber-based products in domestic and export markets. The Philippines is the leading supplier of abaca fibers and abaca-based products accounting for 84 percent of the world's requirement of which an average of 27 percent is contributed by Mindanao. For the region, the provision of equipment for abaca processing is identified as a strategy to sustain its production. Also, a critical area to be pursued is the implementation of regular technology transfer program on abaca production and disease prevention/eradication and the promotion of “abacahoyan” concept. Latest technology/ies in fiber processing should also be timely advocated to keep abreast with the world. Pursue export quality arts and crafts As a new export commodity, the region has to actively participate in nationally conducted trade fairs similar to the Hinang Caraga Trade Fair conducted in Manila in 2000 and the Manila FAME International-Partner Region Program in 2003. The DTI-Caraga with the assistance of Arts and Crafts Cluster should take the lead in developing internationally competitive arts and crafts. Among the activities to be pursued is the establishment of pool of local and in-house designers, localization of the Product Development and Design Center of the Philippines (PDDCP’s) product development programs, establishment of Caraga Raw Material Center, capability building on negotiation and customer satisfaction skills and the continued program for craft workers’ skill enhancement. The region also need to address financial resource mobilization concern through the establishment of mobilization fund which will be used to finance working capital requirement, participation fees to trade fairs, and the freight and handling expenses among others. The establishment of prototype financing scheme is further identified as a priority action to support capital requirements of local producers for new product design and development. Target 15: In cooperation with pharmaceutical companies, provide access to affordable essential drugs in developing countries Through the availability of the Botika ng Barangay (BnB), the access to essential affordable drugs has been improved. While the initiative started with the national government through the Department of Health, the Local Government Units have expanded the currently operating BnBs.

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Thus despite the closure of some DOH supported BnB, the LGU-supported BnBs continue to respond to the needs at the barangay level. STATUS and TRENDS/PRIORITY PROGRAMS

The Department of Health-Center for Health Development in the Caraga Region implemented GMA 50 or Gamot na Mabisa at Abot Kaya and conducted advocacy efforts in its different program orientations, seminars and other activities as well as monthly inventory of drugs. It also promotes equity in health by ensuring the availability and accessibility of affordable, safe and effective essential drugs to all, with priority to marginalized, underserved, critical and hard to reach barangays. In 2004, sixty-two (62) Botika ng Barangays (BnBs) became operational to augment the existing ones located in some urban barangays in the city. Systems are put in place, to ensure the sustainability of drug outlets that sell quality medicines at the lowest possible cost in strategic places where it is most needed. Seventy-four (74) more BnBs were established in 2006. For its impact, retail prices of essential drugs were reduced by 22 per cent up to 93 per cent.

Table 46. Number of Botika ng Barangay, By Province and City Caraga Region, 2000-2006

Province/City 2000 2001 2002 2003 2004 2005 2006

Agusan Del Norte 2 - - - 18 - 18

Agusan Del Sur - - - - 19 - 1

Surigao Del Norte - - - - 17 -

Surigao Del Sur - - - - 8 - 15

Bislig City - - - - - - - Butuan City 64 64 35 35 - - - Surigao City 10 16 75 - - 49

Caraga 76 80 35 110 62 - 74

Source: Department of Health – Center for Health Development Caraga Other activities conducted include: identification and evaluation of BnB sites; signing of the Memorandum of Agreement (MOA) between and among DOH-CHD Caraga, Local Chief Executives and Non-Government Organization/BnB operator; training of BnB operators per province; regular monitoring of BnB provincewide; distribution of drug packages/initial capital to the different barangays in coordination with the Provincial Health Team in Provincial Health Offices and the Local Chief Executives and submission of documentary/legal requirements as set by Administrative Order No. 70 dated 03 January 2003 for the issuance of BFAD Special License to Operate. BnB outlets established in the Caraga Region are located more than one (1) kilometer away from the nearest regular drugstore and more than one (1) kilometer from the nearest BnB. They are usually reached on foot, bicycle, motorcycle and some through pump boats for the river and island barangays. Most of the BnB outlets cater to buyers within the barangay and its catchment area which on the average covers two (2) nearby barangays. CHALLENGES and PRIORITIES FOR ACTION

Some of the identified priorities for action are enumerated below: Unauthorized drug outlets Sari-sari stores selling medicines shall be discouraged to continue selling such products. There is a need to lobby for local legislation based on Sec. 11-K of Republic Act No. 3720 which states that “the manufacture, importation, exportation, sale, offering for sale, distribution or transfer of any drug or device by any person without the license from BFAD is prohibited.

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Expired medicines from the drug package BnB outlets shall be advised to follow the procedure on how to handle slow-moving medicines and to order only fast-moving ones in order to minimize losses from expired medicines. Intensive advocacy and IEC efforts More advocacy efforts shall be conducted on the benefits of having an accessible drug outlet in the community and to encourage people to pay for the medicines they need in order to help sustain the operation of BnBs. Intensive information, education and communication campaign on Republic Act No. 6675 or the Generics Act of 1998 needs to be sustained at the barangay level for people in the community to patronize the BnB outlets in their respective locality. On the issue of profit generated by BnB operators to finance operating cost and honorarium of pharmacists; there is a need to lobby to the Barangay Captains to provide honorarium for the BnB operators and pharmacists. Monitoring of BnB outlets Constant monitoring shall be done for BnB outlets offering other products not specified in the drug package and provision of additional traveling expense allowance for DOH staff on top of the agency ceiling be considered. The regular monitoring shall also track BnB outlets selling medicines above the 30 per cent allowable mark-up as well. However, in cases of stock shortage, BnB operators shall be advised to review inventory and re-order quantities. Medicines without drug outlets There is a need to lobby to Barangay Captains to provide a permanent site/building to serve as drug outlet where medicines can be safe and stored at appropriate conditions. Proliferation of alternative drugs and medicine The proliferation of alternative medicines provided by various sources and available even in health shops in malls should be looked into. There is a need to check the sources of these drugs and medicines to ensure that these are safe for human consumption and are duly licensed by the Bureau of Food and Drugs (BFAD). The absence of data on the portion of population with access to affordable essential drugs on a sustainable basis is also another priority for action. Efforts should be exerted to determine the percentage of the population who has access to, and have actually availed of affordable essential drugs.

ADVOCATING AND LOCALIZING THE MDGs

In line with the advocacy and localization of the MDG, the Regional Development Council of Caraga Region passed two (2) resolutions in 2005, namely: the RDC Resolution No. 28 entitled, Promoting and Supporting the Mainstreaming of the Millennium Development Goals Concerning Children in the Planning Process at the Regional and Local Levels (Annex 1) and the RDC Resolution No. 54 entitled, Mainstreaming of the Millennium Development Goals in Local Development (Annex 2). Copies of said resolutions were disseminated to concern offices and agencies to gain further support toward the realization of the MDGs.

Furthermore, the targets of the MDGs have already been integrated in the Caraga Regional Development Plan (CRDP), 2004-2010. Said development plan is periodically monitored and assessed through the Implementation, Monitoring and Evaluation (IME) Plan, 2005-2010. Furthermore, a Multi-Sectoral Forum on International Conference on Population and Development (ICPD) at 10/MDGs was conducted on 11 October 2004 to further increase awareness not only on the ICPD + 10, but more so, on its interrelatedness with the MDG commitments. Various

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approaches and success stories in bringing MDGs at the community level were highlighted in said forum. The forum ended with the adoption of the Declaration of Commitment to ICPD at 10 and the MDGs by the newly elected officials in the executive and legislative branch, program stakeholders, and other participating partners for regional development.

The Department of Interior and Local Government (DILG) 13, as the primary government agency in the region responsible for localizing the MDG, conducted an Orientation Seminar on MDG Localization for Local Budget Officers in Davao City in 2005 to ascertain that MDG-responsive Programs, Projects and Activities (PPAs) are given top priority in the annual budgeting of the LGUs. The seminar highlighted the DILG Memorandum Circular No. 2004-152 re: Guide to LGUs in the Localization of the MDGs. Manuals on LGUs Guide on Millennium Development Goals Localization have also been distributed to all 77 LGUs (provinces/cities/municipalities) in the region. Said manuals served as guide for LGUs in responding to MDGs in as much as the menu of PPAs per MDG goal and target is already provided. Further, the DILG 13 developed a tool to monitor the implementation of MDG responsive PPAs by the LGUs. The tool captures the extent of MDG localization with the LGU-Local Poverty Reduction Action Plans (LRAPs) as benchmarks since it utilizes the 14 Core Local Poverty Indicators (CLPIs) in diagnosing poverty situation in the locality which then, harmonizes with the MDGs.

MDG localization mainly includes the formulation of MDG Baselines, MDG Localization Plans and MDG-focused programs and projects incorporated in the annual plans and budgets. In compliance with the monitoring tool designed by the DILG 13, the 4 provinces and 3 cities of the region submitted reports on the status of monitoring for MDG localization for the first quarter of 2006. Based on the MDG localization reports of the provinces, about 66 percent or 46 out of 70 municipalities in the region have crafted their LPRAPs. The reports also show that PPAs implemented at various areas in the region are responsive to the goals of the MDG.

Currently, the DILG 13 is advocating the use of the Community Based Monitoring System (CBMS) as a more efficient monitoring and benchmarking tool for the MDG. To date, the provincial government of Agusan del Sur has institutionalized the CBMS and implemented the program in selected pilot areas while Agusan del Norte is also moving towards the same direction with the assistance from the United Nations through the National Anti-Poverty Commission (NAPC).

Other LGUs in the region are set to take actions to institutionalize the MDGs with Butuan City experience as one of the models of the MDG Localization. Consequently, the LGUs in the region aside from Butuan City have started their undertakings as they created Provincial/City Technical Working Group/s which focused on the assessment and analysis of MDGs vis-a-vis data generated and considered in preparation for the formulation of the MDG progress report. Other initial actions toward the institutionalization of the MDGs as identified by the LGUs during the FGDs include the passage of a Provincial/City Development Council (PDC/CDC) Resolution for mainstreaming the MDGs in local development; collaborative and concerted efforts of the major stakeholders – national and local government entities as well as the private sector necessary in the provision of development interventions which have direct impact in attaining the MDGs; and the regular monitoring and tracking of progress to periodically assess performance against set goals and targets.

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Socioeconomic development actors in the region are doing their roles to address poverty issues which are in consonance with the MDG. However, there is a need to synergize the actions of these actors to gain more impact and meet the MDG targets. Moreover, MDG has specific timetable that has to be observed. Systematic approaches and strategies which are more fitting in the region have to be adopted the soonest time to meet the MDG targets as programmed. Following are the challenges that have to be dealt with and the priority actions to be implemented. Collaboration with academe, NGOs and Private Sector in meeting the MDG Briefing and consultation activities among the academe, NGOs and Private Sector in the region should be conducted to gain full support to the MDG as well as formulate/generate and synergize Framework for Action to attain the MDG. The framework should spell out not only the MDG supportive policies and advocacy activities in their respective fields but also translate initiatives into concrete programs, projects and activities (PPAs) with specific contribution targets and timetable vis-a-vis the MDGs. Timely reports on the conduct and outcome of the PPAs are crucial in the monitoring and assessment of the MDG. Status and shortfalls if there is any, will have to be reported accordingly to keep the focus on the MDG.

Localizing the MDG: The Butuan City Experience The City Government of Butuan has institutionalized and localized the MDGs as one of the 14 resource cities of the Local Inter Governmental Actions for Integrated and Innovative Solutions towards attaining the Millennium Development Goals (Local GAINS for the MDGs). Butuan City has implemented and is currently implementing various programs and projects that would lead to the attainment of the MDGs. It has been initiating activities for the MDG localization by observing the preliminary cycle of MDG localization as prescribed by the UNDP and the UN Habitat. The cycle involves mainstreaming MDG targets in the city’s development and investment plans, passage of legislative measures, appropriating resources, actual implementation of programs and projects, monitoring and assessing impacts and instituting constituency feedback systems. The City is currently drafting its MDG-supportive Executive and Legislative Agenda (ELA). Also, activities relative to Local GAINS for the MDGs have been realized in 2005 such as the institution of formal and informal, multisectoral consultative bodies on localizing the MDGs. MDG monitoring and program-related consultations, focus group discussion and meetings have also been conducted. With the help of the DevInfo 4.0 and the CBMS, the City has set-up an MDG Observatory and Information Tracking Statistics Repository System to keep its partners and the public abreast on the socio-economic development of the city and the MDG. For the mainstreaming of the MDG down to the community/barangay level, the City is currently scaling-up barangay capacities in conducting MDG and Human Resource (HR) focused MBN. MDG and HR focused MBN and Integrated Rural Accessibility Planning (IRAP) surveys are currently conducted in selected barangays while Barangay Development Plan-MDG-HR/Rights Based Approach (RBA) workshops are also being performed. Furthermore, the constituency feedback mechanisms are also currently being developed by the city with Father Saturnino Urios University (FSUU). This mechanism shall serve as instrument to ensure local accountability and transparency in meeting MDG targets. For the rationalization of government services as well as the promotion of ethical behavior and mitigating corrupt practices, Butuan City is closely reviewing its budgeting, planning and procurement processes.

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Strengthen advocacy and localization efforts With the given timetable for MDG, the current performance of the region on the MDG calls for the adoption of pro-active approach in advocating and localizing the MDG. The DILG as prime mover of localization is challenged to pursue innovative strategies in selling the MDG to all LGUs in the region. Technical assistance in the form of capability building should be provided while fora on the MDG Localization Guidelines should be conducted to be participated by the Local Chief Executives (LCEs) and heads of concerned government offices as they are the direct initiators and decision-makers in the local level. To fully institutionalize the MDG, LGUs are challenged to include MDG targets in the Local Development Plans (LDPs) and further increase their budget for MDG-related PPAs. Local policies that facilitate actions toward the attainment of the MDG have to be in place. Documentation on good practices is also encouraged for replication. The LGUs should also be ready to adopt an effective system to measure the status of the MDGs and in the process fast-track the analysis of reliable data allowing time to take corrective actions to be at par with the targets of the MDG.

FINANCING THE MDGs

Internal Revenue Allotment The Department of Budget and Management (DBM) considers the ratio 70 (other income) : 30 (IRA) as an ideal income mix for fiscal independence of the LGUs in addressing their development requirements. However, only Surigao City has managed to reach nearest to the ideal ratio when it posted an IRA rate of 59 percent to its 2003 total financial resources. Agusan del Sur also has managed to progressively decrease its IRA dependency ratio from 91 percent in 2003 to 81 percent in 2005. On average for the 3-year period, the IRA dependency ratio of the region is decreasing although it is still a long way from the ideal ratio set by DBM. Financial source of LGUs other than IRA is the tax revenue which comprises real property tax and business taxes. Currently, the LGUs in the region are actively haggling with there reasonable share from the national wealth as well as seriously exploring economically feasible activities and projects to increase percentage from government/local enterprises.

Figure 33. Percentage of IRA Share in Local Income, By Province and City Caraga Region, 2003 – 2005

Source: Local Government Units

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

2005 0.83 0.65 0.71 0.85 0.81 0.93 0.93

2004 0.81 0.66 0.70 0.85 0.88 0.90 0.94

2003 0.86 0.59 0.66 0.88 0.91 0.96 0.96

Bislig City Butuan City Surigao CityAgusan del

NorteAgusan del Sur

Surigao del

NorteSurigao del Sur

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National Government Agencies The actual budget allocation from the Agency Central Offices (ACOs) to their Agency Regional Offices (AROs) in Caraga has significant impact in the achievement of the MDGs. Based on the sectoral distribution of actual budget allocation from the 26 AROs in the region, Social Services Sector ranked first with a range of 68.00-75.24 percent in terms of growth in the total budget for the periods CY 2003-2005. Significant contributors to the Social Services sector budget are the Department of Education (DepEd) and the Department of Health (DOH) with more than 90 percent share. The Infrastructure and Economic sectors consistently ranked second and third, for the 3-y ear period. Bulk of the Infrastructure budget was contributed by the Department of Public Works and Highways (DPWH) whose main projects involved the construction and improvement of roads and bridges in various areas of the region.

Figure 34. Sectoral Distribution of Actual Agency Budget Allocation Caraga Region, 2003 - 2004

Source: Agency Regional Offices in Caraga

Local Government Expenditures The Local Government Expenditures of Caraga Region is based on the total expenditures of the four (4) provinces and three (3) cities. There is a slight yet progressive increase in the total local government expenditures from 2003 to 2005. In similar trend, social services expenditure in 2003 reached PhP 476,951,500 which slightly increased to PhP 515,074,650 in 2004 and further rose to PhP 580,001,520 in 2005. On the average, 22 percent of the total expenditures of the seven (7) LGUs was spent for Social Services. General Public Services accounted for majority of the expenditures which on the average amounted to 36 percent while Economic Services ranked second at 23 percent.

0.00

0.20

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Social Services 0.71 0.68 0.75

Economic 0.07 0.07 0.09

Infrastructure 0.18 0.21 0.11

Development Administration 0.04 0.04 0.04

2003 2004 2005

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Figure 35. Sectoral Distribution of Local Government Expenditures

Caraga Region, 2003-2005

Source: Caraga LGUs

Among the LGUs, Agusan del Norte provided biggest share to social services in CYs 2004 and 2005 with 34.51 percent and 35.09 percent from its total expenditures, respectively. Agusan del Sur came in next with social services consumption of 26.33 percent and 26.92 percent, respectively. Consistently though, bulk of the total expenditures of the LGUs have been allotted for General Public Services specifically for the consumption of the general administration subsector. Over the years, Health consumed biggest portion or an average of 54.57 percent of the expenditures for social services of LGUs. Bulk of said expenditures was spent for the maintenance and operation of district/city hospitals. Social Welfare and Development ranked second with an average share of 11.29 percent while Education closely came in next at 11.21 percent. Consumption of other social services posted an average of 0.51 percent in 2003-2005.

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Social Economic Environment General Public

Services

Economic

Enterprise

Infrastructure Others

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os

2003 2004 2005

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Figure 36. Subsectoral Distribution of Social Expenditures Among LGUs, 2003

Source: LGUs

Interestingly, Butuan City allotted 1.4 percent of its expenditures for housing programs while Surigao City allotted about 17 percent of its annual social services expenditures for protective services. Official Development Assistance Based on the data generated from the foreign assisted projects handled/lodged under the Caraga Regional Line Agencies (RLAs), the Official Development Assistance (ODA) funded projects implemented in the region within 2003-2005 amounted to PhP 4,333,443,723.37 of which Social sector got 20 percent third to Infrastructure and Economic sectors which got 48 percent and 30 percent, respectively. It is worth to note though that Social sector got its biggest share of 31 percent from the ODA fund in 2004. The education subsector has utilized 68 percent of said fund through the implementation of the Secondary Education Development and Improvement Project (SEDIP) and the Third Elementary Education Project (TEEP). Certainly, ODA supportive to MDGs has been extended to the Region. Moreover, projects categorized under the economic and infrastructure sectors complement in attaining the MDGs. Consequently, a number of projects proposed to be funded through ODA that could significantly contribute to the MDGs are now under review which includes among others the Strengthening Health Delivery through Health Facility and Human Resource Development in the Caraga Administrative Region with project cost amounting to PhP 1,147,051,098.00. CHALLENGES and PRIORITIES for ACTION

Decreasing IRA Dependency In response to the national call for an IRA-independent/self sustaining LGU, the LGUs of Caraga have to exert extra effort to accelerate the increase of Other Income. The LGUs will push for the conversion of lands still classified as forestlands but currently/actually utilized as residential and/or

0.46%

13.96% 13.86%1.40% 0.39%1.82% 0.62%

67.48%

Education Health Nutrition

Social Security Housing Support to CFM/CPC V

Protective Services Others

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commercial areas located within the city proper into Alienable and Disposable lands through a Presidential Proclamation and/or Act of Congress. This action can then simultaneously increase collection in real property taxes. The LGUs should also strengthen revenue generating activities and develop innovative programs and schemes that can contribute to the increase in revenue collection. Further, LGUs need to improve efficiency on the use of assets and resources and finance more developmental projects from other financial sources such as foreign and local grants, capital income, special levies and public-private partnerships among others, rather than relying on the national government through the IRA. To further augment LGU resources, several relending windows from Government Financial Institutions (GFIs) and commercial banks such as the Development Bank of the Philippines (DBP), Land Bank of the Philippines (LBP), Philippine National Bank (PNB), Quedancor and the like offered loans for, among others, environmental and natural resources, forest program, social services, sanitation, solid waste management, water supply, public hospitals, school buildings and sustainable logistics development program. The Kreditanstalt fur Wiederaufbau - LGU Investment Program (KfW-LIP) may also finance up to 80 percent of loan amount coursed through selected GFIs/banks while the Asian Development Bank (ADB) may finance the same percentage of loan amount to the LGUs through its Mindanao Basic Urban Services Sector (MBUSS). Increasing Expenditure for Social Services A major indication that MDG PPAs are well-supported is by looking at the budget allotted for Social Services. LGUs are encouraged to provide more allocation on Social Services so that MDG-PPAs will be implemented in bigger scale which would result to a much significant impact in the civil society. Social infrastructure is also a priority of the region. This comprises a considerable amount in the budget from Infrastructure Sector. A continuing support on this sector would ultimately redound to better social services activities and programs. ODA Utilization Social Sector has a fair share in the ODA fund. However, initiative to improve impact assessment of PPAs supported by ODA specifically on Social Sector/Services has to be explored so that further ODA allocations will be utilized at optimum level. The ultimate consideration though is that the positive change/impact of these ODA-funded PPAs should be felt by the ultimate beneficiaries, the general public especially women and children.

MONITORING THE MDGs The DevInfo 4.0: Tool for Monitoring the MDGs Through the Regional Development Council Resolution No. 7, Series of 2005, the DevInfo 4.0 Software was adopted as the regional monitoring tool for the Millennium Development Goals and for the establishment of the regional database and for other purposes. The software compiles and stores data from different sectors. DevInfo 4.0 is a user-friendly software which allows the user to define its indicators and other features. To date, a total of 23 agencies and all the provinces and cities in the region have been capacitated in building database using the software. In 2004, a training workshop was conducted by the Regional Committee for the Welfare of Children (RCWC) and in December 2005 another workshop was conducted by the Regional Statistical Coordination Committee (RSCC) participated by the regional agencies and all the provinces and cities. Technical assistance was also extended to the regional line agencies and local government units in view of establishing a functional database system. In order to ensure that the utility of the software will be maximized, the RDC through the RSCC has widely advocated and capacitated partner agencies and local government units in using the software. A regional indicator system was also established and adopted by the RSCC which served

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as a standard template of the region in agency and lgu databases. It incorporates indicators which will be used to track the progress of the region per target. The said indicator system cum standard template is a product of consultation and participation among various stakeholders during the workshop conducted in December 2005. The establishment of a standard template has in effect, ensured that consolidation and updating of data across levels will not be problematic thereby facilitating access and sharing of information. Tools Development By virtue of Social Development Committee (SDC) Resolution No.1, series of 2003 entitled “Expanding the Functions and Composition of the Multi-sectoral Committee on International Human Development Commitments (MC-IHDC), Amending SDC Resolution No.1, Series of 1996”, the Department of Interior and Local Government (DILG) has been tasked as the lead agency for localization of the Millennium Development Goals (MDGs). In response to this mandate, the DILG - Caraga not only initiated advocacy on the MDGs, it has also developed a tool to monitor the implementation of programs and projects geared towards the attainment of the MDGs. The monitoring tool is designed to capture the accomplishments of program/project implemented by the local government units. Said tool has been distributed and used by the LGUs in tracking their performance in terms of program implementation per target. Institutional Arrangements The Regional Development Council - Social Development Committee (RDC-SDC) has spearheaded the conduct of the MDG monitoring. It has convened a Regional Technical Working Group for the Millennium Development Goals tasked to spearhead the conduct of assessment and other MDG-related activities at the regional level. The TWG is composed of thirteen (13) regional line agencies and seven (7) LGUs. CHALLENGES and PRIORITIES for ACTION

Unavailability of data Unavailability of data is a pressing concern in the region in the effective monitoring of its progress. Lack of provincial and city disaggregation of data on population below minimum level of dietary energy consumption, total fertility rate among others further aggravated the situation. Provincial disaggregated data cannot be obtained especially on surveys conducted at the national level. The local government units have also difficulties in their data gathering efforts as conducting surveys are expensive. Lack of updated and sex disaggregated data Absence of updated data on population affected the tracking of the region’s performance as the projected population used in obtaining rates that used population as a factor in its computation has distorted the computed performance of the province or city. The projected population is higher than the actual population thereby negatively affecting the LGU’s performance. Lack of updated environmental-related data and informal settlers have also limited the extent of analysis of the report. In the light of establishing a more accurate picture of both sexes’ participation and contribution to the socio-economic spheres in the region, data banking with gender disaggregated data is a necessity. However, gender disaggregated data is limited to some extent and more efforts are needed to ensure that standard indicators are gender-disaggregated.

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Regular updating of the Regional Database Through the Regional Statistical Coordination Committee (RSCC), the region shall update the Caraga Regional Database during its quarterly meetings. The RSCC has already established the procedures and mechanics in the updating of the database which involves the LGUs and data generating agencies. The RSCC Secretariat is in charged in the merging and consolidation of the agency and lgu databases. The updated database is made available to all members of the RSCC and partner agencies trained on DevInfo. Conduct of expansion training is also a target of the Committee to generate wider utilization of the software and for synchronized database system. The Regional Database will also be a repository of CBMIS generated data. Capacity building on the use of the Dev Info should be intensified to cover not only the provinces and cities but expand it to the municipalities and other partner agencies. Technical assistance to LGUs and RLAs should be provided whenever necessary to sustain the building of databases and expertise of partners. Conduct of impact assessment of implemented programs and projects Impact assessment should be undertaken to assess contribution of programs and projects in attaining the MDG goals and targets. There is a need to strengthen the monitoring mechanisms at the LGU and RLA level to identify outcomes and impacts of projects implemented along with its contributions to the attainment of the goals and targets. This shall bring about effective planning, project prioritization, budgeting and investment programming at all levels. Conduct of regular monitoring and tracking of progress There have been little conscious efforts made among the LGUs to track their progress and performance relative to the goals and targets set. Not only the LGUs but even the key agencies have a limited effort to assess the region’s performance on the targets prior to the preparation of the report. The conduct and preparation of progress report should be made in an annual basis to provide an assessment on how the region and the respective LGUs are faring relative to the attainment of the set targets. This will also provide directions and serve as a planning and advocacy tool. Establishing Institutional arrangements at the sub-regional level Institutional arrangements in monitoring the local government units’ progress and compliance to the country’s international commitment particularly on the MDG remain weak. There is a need to establish clearer mechanisms and institutional arrangements at the sub-regional level. Local Chief Executives should have clear direction in making conscious efforts to monitor its progress in the MDGs by mobilizing key agencies. Involvement and contribution of local institutions such as the barangay councils and other barangay-based institutions are equally important and needs to be maximized. The participation and involvement at the barangay and household levels is vital to the localization of the MDGs. Expansion of Regional Technical Working Group (RTWG) Membership The RTWG for the MDG has limited membership which needs to be expanded to cover other major agencies and participation of the academe, private sector and non-government organizations. Their participation in the monitoring process would lead to more meaningful and encompassing assessment of the region’s performance. Moreover, their involvement in any MDG-related activity whether at the regional or local level will improve cohesion and convergence of efforts in attaining the goals and targets. Moreover, the RTWG should be directed to a more pro-active approach in providing technical assistance to LGUs in their MDG-related efforts.

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R E F E R E N C E S Beinhoff, C. (UNIDO) and JP S. Calvez (DENR-MGB, Manila). 2000. The Effect of Mercury Emissions from Diwalwal Small Scale Gold Mining Operations to Environment and Health. Bureau of Fisheries and Aquatic Resources – Caraga. List of Fish Sanctuaries and Fishery Reserves Established in Caraga Region for CY 2005. Commission on Higher Education. Annual Accomplishment Report 2003-2005. Butuan City, Philippines. Department of Education. Annual Accomplishment Report 2000-2005. Butuan City, Philippines. Department of Health – Center for Health Development. Annual Accomplishment Report 2000 – 2005. Butuan City, Philippines. Department of Health – Non Communicable Disease Control Service and UP National Poisons

Control and Information. 1999. Preliminary Environmental Monitoring Results of Water, Fish and Sediment Samples for Heavy Metals in Identified Areas in the Caraga Region.

Department of Environment and Natural Resources. Annual Accomplishment Report 2003-2005. Butuan City, Philippines. Department of Environment and Natural Resources - Caraga Accomplishment Report for the

Millennium Development Goal CY 2005. Department of Environment and Natural Resources – Caraga Accomplishment Report CY 2005. Department of Education. Annual Accomplishment Report 2000 – 2005. Butuan City, Philippines.

Environmental Management Bureau – Caraga Accomplishment Report for the Millennium Development Goal CY 2005.

Environmental Management Bureau – Caraga Accomplishment Report CY 2005. Caraga Region. Local Government Units. Mines and Geosciences Bureau – Caraga Accomplishment Report CY 2005. Caraga Region. Mines and Geosciences Bureau – Caraga Accomplishment Report for the Millennium Development

Goal CY 2005. Caraga Region. Mines and Geosciences Bureau - Caraga List of Approved Mining Claims within Caraga

Region.2005. Mines and Geosciences Bureau, Department of Environment and Natural Resources, North

Avenue, Diliman, Quezon City. 2000. Report on the Assessment of Mercury Contamination of Agusan River and Its Watershed, Eastern Mindnao, Philippines.

Mindanao State University – Naawan. 2002. Resource and Social Assessment of Butuan Bay. National Economic and Development Authority Caraga Region. Regional Development Report 20004. Butuan City, Philippines. National Epidemiology Center of the Department of Health. Field Health Service Information System Annual Report 2003. Philippines. National Health and Demographic Survey 2003.October 2003. Manila. Philippines.

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National Housing Authority Caraga. Physical Housing Framework Plan for Caraga 2000-2025. Butuan City, Philippines. Philippine Population Management Plan 2005-2010. 2004. Manila, Philippines

Philippine Progress Report on the Millennium Development Goals. January 2003. Manila, Philippines.

Second Philippine Progress Report on the Millennium Development Goals. June 2005. Manila, Philippines.

http://www.adb.org.ph

http://www.doh.gov.ph

http://www.dep-ed.gov.ph

http://www.dswd.gov.ph

http://www.fnri.dost.gov.ph

http://www.nscb.gov.ph

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Annexes

105

Annex 1

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Annex 2

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Annex 3

Regional Indicator system

Goal/Target Indicator Unit of Measurement/ Disaggregation

Goal 1: Eradicate extreme poverty and huger Target 1. Halve the proportion of people living in extreme poverty between 1990 and 2015 Annual Per Capital Poverty Threshold Total Annual Per Capital Subsistence Threshold Total Poverty incidence of population Total Poverty incidence of families Total Subsistence incidence of population Total Subsistence incidence of families Total Gini Concentration Ratio Total Target 2. Halve the proportion of the population below the minimum level of dietary energy consumption and halve the proportion of underweight children (under five years old) Prevalence of Malnourished Children 0-5 Years

Old Total

Proportion of pre-school children with weight below normal

Total

Percentage of 6-71 months old children given 2nd dose of Vitamin A

Total

Percent of 6-71 months old children given 1st dose of vitamin A

Total

Proportion of school children with weight below normal

Total

Percentage of Infants Exclusively Breastfed up to 6th month

Total

Percentage of Infants Exclusively Breastfed up to 4th month

Total

Percentage of HH with less than 100% energy adequacy intake

Total

Mean One-Day Per Capita Intake and Percent Adequacy

Total

Goal 2: Achieve universal primary education Target 3. Achieve universal access to primary education by 2015 Elementary Enrolment Rate Total Elementary Participation Rate Total Elementary Cohort Survival Rate Total Elementary Completion Rate Total Elementary Drop-Out Rate Total Elementary transition rate Total Elementary classroom-pupil ratio Total Elementary classroom-pupil ratio Total Elementary textbook shortage Total Elementary class size Total Elementary textbook-pupil ratio Total Simple literacy rate Total Functional literacy Total Goal 3. Promote gender equality Target 4. Eliminate gender disparity in primary education and secondary education, preferably by 2005, and in all levels of education no later than 2015 Elementary Enrolment Rate Male, Female Elementary Participation Rate Male, Female

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Elementary Cohort Survival Rate Male, Female Elementary Completion Rate Male, Female Elementary Drop-Out Rate Male, Female Secondary Enrolment Rate Male, Female Secondary Participation Rate Male, Female Secondary Cohort Survival Rate Male, Female Secondary Completion Rate Male, Female Secondary Drop-Out Rate Male, Female Secondary Retention rate Percent Distribution of TVET Enrollees Male, Female Percent Distribution of TVET Graduates Male, Female Percent Distribution of TVET Completers Male, Female Number and Percentage of Enrolment in

Higher Education Male, Female

Number and Percentage of Graduates in Higher Education

Male, Female

Number of employed Persons Male, Female, Urban, Rural, Total

Employment Rate Male, Female, Total Unemployment Rate Male, Female, Total Employed Persons by Major Occupation Group Male, Female, Total Number of graduates by program level Male, Female, Total Secondary completion rate (base on year 1) Male, Female, Total Secondary completion rate (based on grade 1) Male, Female, Total Secondary repetition rate Male, Female, Total Goal 4: Reduce child mortality Target 5. Reduce children under-five mortality rate by two-thirds by 2015 Under Five Mortality Rate Total Infant Mortality Rate Total Percentage of Fully Immunized Children Total Goal 5. Improve maternal health Target 6. Reduce maternal mortality rate by three-quarters by 2015 (half by 2000, half by 2015) Maternal Mortality Rate Total Percentage of Births Attended by Skilled Health

Personnel Total

Percentage of Pre-Natal Care Coverage Total Percentage of Post-Natal Care Coverage Total Target 7. Increase access to reproductive health (RH) services to 60% by 2005, 80 percent by 2010, and 100% by 2015 Contraceptive Prevalence Rate Total Total Fertility Rate Total Desired Fertility Rate Total Goal 6: Combat HIV/AIDS malaria and other diseases Target 8. Halt and reverse the spread of HIV/AIDS by 2015 STI Prevalence Rate Total Target 9. Halt and reverse the incidence of malaria and other major diseases by 2015 Malaria Morbidity Rate Total Malaria Mortality Rate Total TB Morbidity Rate Total TB Mortality Rate Total Cardio Vascular Disease Morbidity Rate Total CVD Mortality Rate Total Goal 7: Ensure environmental sustainability Target 10. Implement national strategies for sustainable development by 2005, to reverse the loss of environmental resources by 2015 Land Area Total, A & D &

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Timberland Forest Cover Total, Close Canopy,

Open Canopy, Mangrove Forest

Confiscated Forest Products Total Area Reforested Total Area Reforested, By Category Government Regular

Fund, Foreign Assisted, IFMA, Private Lands

Rehabilitation Projects Implemented within Watersheds

Total

TSP Level Sustained Total Classification of Water Bodies Class A, B, & C Status of LGU Compliance to RA 9003 Total Number of Hazardous Waste Generator’s ID

Issued Total

Number of Chemical Control Order (CCO) Registration Certificate Issued

Total

Target 11. Halve the proportion of people with no access to safe drinking and basic sanitation, or those who cannot afford it by 2015 Percentage of Households with Access to Safe

Drinking Water Total, Level I, II & III

Percentage of Households with Complete Sanitation Facilities

Total

Target 12. Achieve a significant improvement in the lives of slum dwellers Magnitude of Informal Settlers Total NHA Housing Programs and Projects Total Goal 8. Develop a global partnership for development Target 13. Develop further an open, rule-based, predictable, non-discriminatory trading and financial system; include a commitment to good governance, development and poverty reduction - both nationally and internally Target 14. In cooperation with pharmaceutical companies, provide access to affordable, essential drugs in developing countries Number of Botika ng Barangay established Total Target 15. In cooperation with the private sector, make available the benefits of new technologies especially information and communication technologies

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Annex 4 DILG 13-OSD (MDG Form No. 2)

MONITORING FORM ON THE LOCALIZATION OF MDG For the ________ Quarter, CY 2006

PROVINCE: _________________

ANTI-POVERTY PROGRAMS: PROJECTS/ACTIVITIES IMPLEMENTED FOR THE PERIOD

Municipality

LGU w/ LPRAP ( / ) if Yes; X if No

LPRAP P/P/As Incorporated in the Annual Dev’t Plan

Name of P/P/As Implemented Location Status (completed, on-going)

Remarks

Prepared by: ________________ Noted: ___________________________________ Provincial Director

Documents

THE DEVELOPMENT CONTEXT - s3.amazonaws.com · 4 Table 2. Caraga Socio-Economic Targets, 2004-2010 SOCIO-ECONOMIC INDICATORS ANNUAL TARGETS GRDP annual growth rate 4.40 % Service sector