chapter 4 - the mdgs in bicol region

Chapter 4 THE MDGs IN BICOL REGION HOW ARE the provinces and key cities of the Bicol region doing in regard to the MDG goals and targets described in the preceding chapter? What local good practices have emerged in the effort to attain these goals, deliberately or otherwise? To answer these questions, the following tables – sourced mainly from existing databases of regional units of the national government – summarizes the relevant local information available and captures the progress made by the region, organized according to each goal and target. Findings

Goal 1 ERADICATE EXTREME POVERTY AND HUNGER GOAL AND TARGET INDICATOR

1 Proportion of population below $1 (PPP) per day

2 Poverty gap ratio (incidence x depth of poverty)

Target 1

Halve, between 1990s and 2015, the proportion of people whose income is less than one dollar a day.

3 Share of poorest quintile in national consumption

4 Prevalence of underweight children under 5 years of age

Target 2 Halve, between 1990 and 2015, the proportion of people who suffer from hunger

5 Proportion of population below minimum level of dietary energy consumption

Regional poverty. There are three relevant datasets for Goal 1. The first is wholly at the regional level, which provides poverty and subsistence incidence of families and population in Bicol. (Table 1.1) Using these indicators, and the methodology described in Chapter 2, we find that Bicol is on track in halving the number of poor families, both in terms of poverty incidence and subsistence incidence.*

* The difference between poverty and subsistence incidence is explained by the following, which is taken from the NSCB poverty website http://www.nscb.gov.ph/technotes/poverty_tech2003.asp:

The poverty threshold or poverty line... refers to the cost of the basic food and non-food requirements. The basic non-food requirements cover the non-food expenditure items of the total basic expenditures. Thus, the poverty line may be viewed as the minimum income required to be able to buy the basic food requirements and other non-food basic needs. The food and poverty thresholds are then used to estimate the subsistence and poverty incidence, respectively, using the income approach. The subsistence incidence refers to the proportion of families (or population) with per capita income less than the per capita food threshold to the total number of families (population). On the other hand, the poverty incidence refers to the proportion of families (or population) with per capita income less than the per capita poverty threshold to the total number of families (population).

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TABLE 1.1 Poverty and Subsistence Incidence of Families and Population, Bicol Region, 1985-2003

INDICATOR 1985 1988 1991 1994 1997 2000f 2000 (revised) 2003 Poverty Incidence

Families 60.5 54.5 55.0 55.1 50.1 55.4 45.3 40.5 Population 67.6 61.4 61.3 60.8 57.0 61.9 52.6 48.4

Subsistence Incidence Families 37.4 31.5 31.6 32.9 30.2 34.0 23.3 20.3 Population 44.4 37.8 36.8 37.8 36.5 41.4 29.3 26.6

Source: National Statistical Coordination Board The only exception concerns the proportion of the Bikol population (as opposed to households) living below the poverty threshold, which is not on track – the actual percentage as of 2003 is at 48.4%, higher than the ideal level for 2003 which should have been at 46%.

REGIONAL POVERTY ACTUAL TARGET INDICATOR

1991 2003 2015 2003 STATUS

Poverty Families 55.0 40.5 27.5 41.3 On track Population 61.3 48.4 30.7 46.0 Off track Subsistence Families 31.6 20.3 15.8 23.7 On track Population 36.8 26.6 18.4 27.6 On track

On track Off track

Sub-regional poverty. Previously, a serious limitation to more effective poverty targeting is the absence of data at the provincial and city/municipal level. Fortunately, a World Bank-funded study by the NSBC on estimating local poverty has addressed this gap. Table 1.2 provides these sub-regional poverty indicators for the six provinces and three cities.

TABLE 1.2 Poverty Incidence by Province/City, Bicol Region, 1997-2003

PROVINCE/INDICATOR 1991 1994 1997 2000 2003 Bicol Region 55.0 55.1 46.9 45.3 40.5 Albay 49.8 44.6 45.9 Camarines Norte 39.5 49.3 49.0 Camarines Sur 35.1 44.1 39.4 Catanduanes 29.6 43.2 21.9 Masbate 64.9 70.8 60.8 Sorsogon 50.3 52.9 34.2 Iriga City 29.9 Legazpi City 33.9 Naga City 18.9

Sources: NSCB; “Estimation of Local Poverty in the Philippines”

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According to the NSCB study, Naga has the lowest poverty incidence among all Bicol towns and cities at 18.9% of the total population – which means it has already met the 2015 target 15 years ahead of schedule. (A more detailed analysis of these local poverty estimates is available from the author’s weblog http://nagueno.blogspot.com) In the absence of provincial breakdown for 1991, the distribution of provincial poverty incidence for 1997 – the earliest provincial aggregation available – was used as pattern. For cities, the poverty estimates for 2000 were used. Again, if the targeted 50% reduction in poverty incidence between 1991 and 2015 are distributed equally, all – with the exception of Albay, Camarines Norte and Masbate – are on track to attain the MDG target.

SUB-REGIONAL POVERTY ACTUAL TARGET PROVINCE/CITY

2000 2003 2015 2000/03 STATUS

Albay 45.9 27.5 41.3 Off track Camarines Norte 49.0 27.5 41.3 Off track Camarines Sur 39.4 27.5 41.3 On track Catanduanes 21.9 27.5 41.3 On track Masbate 60.8 27.5 41.3 Off track Sorsogon 34.2 27.5 41.3 On track Iriga City 29.9 27.5 44.7 On track Legazpi City 33.9 27.5 44.7 On track Naga City 18.9 27.5 44.7 On track

Hunger. The situation of hunger – indicated by the prevalence of underweight children below 7 years old – is more positive. (See Table 1.3.)

TABLE 1.3 Prevalence Rate of Underweight Children 0-7 Years Old by Province/City, Bicol Region, 1990 - 2004 PROVINCE/CITY 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 20031/ 20042/

Bicol Region 68.3 66.9 65.1 54.8 53.0 50.2 48.2 45.9 43.5 42.1 40.9 38.3 37.2 33.6 22.6 Albay 70.5 67.9 66.7 59.3 58.2 55.4 54.0 50.6 47.5 45.9 44.5 41.3 40.5 40.5 23.1 Camarines Norte 70.4 69.4 65.6 47.6 46.8 44.0 41.5 37.7 34.9 34.1 32.8 32.0 31.7 21.2 17.5 Camarines Sur 72.9 70.8 66.8 57.7 56.3 52.9 53.6 51.4 50.1 47.7 47.1 43.6 43.3 41.4 26.5 Catanduanes 72.3 69.7 67.6 64.0 64.6 58.8 54.5 52.9 47.6 49.6 46.0 45.3 39.2 34.9 23.8 Masbate 60.2 63.5 63.4 57.0 55.8 55.2 49.0 48.0 46.3 45.8 41.4 39.7 38.0 35.5 24.4 Sorsogon 64.5 60.6 62.2 46.9 45.2 42.7 40.2 38.7 35.0 33.5 32.1 32.0 30.0 21.8 20.8 Iriga City 62.4 58.9 54.1 53.4 44.5 42.8 36.5 31.0 30.6 27.8 23.8 20.4 21.4 10.4 9.8 Legazpi City 76.9 70.5 65.4 42.9 36.2 31.9 31.7 29.2 31.3 30.7 26.1 23.9 25.2 25.6 16.0 Naga City 71.7 65.9 62.6 44.1 35.4 32.7 31.2 28.8 26.6 28.1 53.9 24.2 22.5 6.7 5.6

Source: Department of Health, Region V

Notes: From 1990 to 2002 underweight children were further classified as severely, moderately and mildly underweight. 1/ Underweight children were classified as "Below Normal" 2/ Underweight children were classified as "Below Normal-Very Low" and "Below Normal-Low". Coverage is pre-schoolers.

Compared to the situation in 1990, where between 60-77% of children were underweight, all provinces and cities are more than on track in meeting the MDG

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target. In fact, on the average, they performing twice better than expected as of 2003, led by Naga and Iriga which had registered single-digit figures over the last two years.

HUNGER ACTUAL TARGET AREA

1990 2004 2015 2004 STATUS

Bicol Region 68.3 22.6 34.1 49.2 On track Albay 70.5 23.1 34.1 49.2 On track Camarines Norte 70.4 17.5 34.1 49.2 On track Camarines Sur 72.9 26.5 34.1 49.2 On track Catanduanes 72.3 23.8 34.1 49.2 On track Masbate 60.2 24.4 34.1 49.2 On track Sorsogon 64.5 20.8 34.1 49.2 On track Iriga City 62.4 9.8 34.1 49.2 On track Legazpi City 76.9 16.0 34.1 49.2 On track Naga City 71.7 5.6 34.1 49.2 On track

Goal 2 ACHIEVE UNIVERSAL PRIMARY EDUCATION GOAL AND TARGET INDICATOR

6 Net enrolment ratio in primary education

7 Proportion of pupils starting grade 1 who reach grade 6

Target 3

Ensure that, by 2015, children everywhere, boys and girls alike, will be able to complete a full course of primary schooling

8 Literacy rate of 15-24 year-olds

Participation. Similar to Goal 1, there are three datasets that comprise the goal to achieve universal primary education. The first meets the specification of Indicator 6 – net enrolment in primary education. Its counterpart in the Philippine setting is the participation rate, defined as the proportion of all school-age children who actually enrolled in Grade I to the total population of those who should have enrolled. Table 2.1 presents this dataset for Bicol and the 9 localities under consideration from S/Y 1990-91 to 2004-05: a total of 13 years owing to the absence of data for two full school years. (For the cities, it is only 10 as data for S/Y 1990-93 are also unavailable.) TABLE 2.1 Participation Rate in Elementary Schools by Province/City, Bicol Region SY 1992-93 to SY 2004-2005

SCHOOL YEAR PROVINCE/CITY 1990-

1991 1991-1992

1992-1993

1993-1994

1994-1995

1995-1996

1996-1997

1997-1998

1998-1999

1999-2000

2000-2001

2001-2002

2002-2003

2003-2004

2004- 2005

Bicol Region 85.8 86.0 87.4 87.9 90.4 93.7 97.0 97.4 95.8 95.4 88.5 86.8 85.1 Albay 90.0 89.7 91.2 91.7 98.2 90.4 93.0 93.8 93.1 91.4 86.8 85.3 83.8 Camarines Norte 87.9 88.7 90.2 90.7 91.4 91.0 92.2 90.3 90.6 93.1 90.0 86.6 84.8 Camarines Sur 86.5 86.3 87.7 88.2 90.6 92.0 99.4 94.6 91.3 92.2 86.6 84.9 84.0 Catanduanes 88.6 89.3 90.8 91.3 91.7 93.9 93.5 94.6 94.3 93.6 90.4 89.2 86.6

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Masbate 75.0 75.7 76.9 77.4 78.0 99.7 97.8 105.4 105.5 96.8 94.6 92.2 90.3 Sorsogon 87.2 88.0 89.5 90.0 91.9 94.4 96.6 100.5 99.0 98.7 86.0 85.7 82.7 Iriga City 88.2 88.4 97.1 104.7 104.0 99.3 113.6 77.3 73.9 72.5 Legazpi City 91.7 92.0 97.4 111.2 97.8 97.6 107.6 75.0 74.3 72.5 Naga City 88.2 88.4 100.3 103.0 120.2 109.0 119.5 83.3 81.8 79.8

Source: Department of Education, Region V It will be noted that from 1997-2000, five of the localities registered a participation rate above 100% – with as high as 120% in Naga’s case (S/Y 1998-99, which was almost equalled two years later). Among others, these indicate that a 100% participation rate is attainable as envisioned under this MDG. But using the same methodology to assess progress, we find below that all 9 localities are not on track insofar as participation rate is concerned. Ideally, all should already have done 92.1% by 2004, but the nearest is Masbate which was still close to 2 percentage points behind (90.3%). The regional average was a full 7 percentage points behind (85.1%). This indicates much work needs to be done in regard to ensuring greater access to primary education in the entire region.

PARTICIPATION ACTUAL TARGET AREA

1990-91 1993-94 2004-05 2015 2004 STATUS

Bicol Region 85.8 85.1 100.0 92.1 Off track Albay 90.0 83.8 100.0 92.1 Off track Camarines Norte 87.9 84.8 100.0 92.1 Off track Camarines Sur 86.5 84.0 100.0 92.1 Off track Catanduanes 88.6 86.6 100.0 92.1 Off track Masbate 75.0 90.3 100.0 92.1 Off track Sorsogon 87.2

82.7 100.0 92.1 Off track Iriga City 88.2 72.5 100.0 92.1 Off track Legazpi City 91.7 72.5 100.0 92.1 Off track Naga City

88.2 79.8 100.0 92.1 Off track

Cohort survival and completion. The second and third indicators are equally, if not more, important. These are captured by Tables 2.2 (cohort survival) and 2.3 (completion rate) in the 9 localities. If participation is concerned with access, these two measures are concerned with the holding power of the public school system. Cohort survival looks at the proportion of those who reach Grade VI to the total population of a cohort that enrolled in Grade I five years back; completion, on the other hand, looks at the proportion of those actually able to finish Grade VI. Apart from the one-year data gap, two things stand out from both tables: (1) Bicol region, as a whole, managed to improve its performance in these two measures between 1990 and 2005 – including a 13-percentage point turnaround in cohort survival.

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(2) Holding power is a more formidable challenge, as only two provinces – Camarines Norte and Catanduanes – registered cohort survival and completion rates above 90% for the entire period. And only Camarines Norte, in particular, reached the 90% mark in completion rate (90.3% in S/Y 2002-03), which meant 9 out of every 10 of those who entered Grade I in June 1997 actually graduated from elementary schools in that province.

TABLE 2.2 Cohort Survival Rate in Elementary Schools by Province/City, Bicol Region SY 1992-93 to SY 2004-2005


1993 1993-1994

1994-1995

1995-1996

1996-1997

1997-1998

1998-1999

1999-2000

2000-2001

2001-2002

2002-2003

2003-2004

2004- 2005

Bicol Region 66.9 70.2 69.9 68.4 69.4 68.0 70.0 69.5 66.4 80.2 79.6 79.5 Albay 72.9 77.8 75.8 73.5 76.3 73.9 74.5 76.3 73.3 87.3 87.9 82.0 Camarines Norte 80.4 78.6 76.8 76.7 75.2 71.2 75.5 78.3 74.2 92.5 92.4 91.2 Camarines Sur 68.7 71.1 70.2 68.9 69.4 69.9 71.0 69.3 64.8 77.0 72.7 75.4 Catanduanes 72.2 75.3 74.5 76.0 75.7 72.6 75.4 75.5 70.4 91.3 89.7 91.0 Masbate 47.4 51.2 53.0 51.6 51.5 49.7 53.0 51.5 49.6 66.7 66.7 70.5 Sorsogon 65.0 72.4 71.1 69.5 71.0 70.1 73.9 72.7 70.2 80.1 84.7 82.5 Iriga City 77.2 76.4 83.5 80.4 84.0 84.8 82.1 86.9 81.5 82.8 75.4 83.0 Legazpi City 86.1 83.4 83.9 84.6 85.3 86.5 79.8 81.8 78.9 83.3 87.9 84.0 Naga City 80.7 77.1 88.8 78.9 85.4 81.3 84.1 79.2 77.7 79.0 81.0 77.0

Source: Department of Education, Region V

TABLE 2.3 Completion Rate in Public Elementary Schools by Province/City, Bicol Region SY 1990-91 to SY 2004-05


1991 1991-1992

1992-1993

1993-1994

1994-1995

1995-1996

1996-1997

1997-1998

1998-1999

1999-2000

2000-2001

2001-2002

2002-2003

2003-2004

2004- 2005

Bicol Region 61.4 64.8 62.8 65.8 65.7 51.4 61.3 62.9 62.1 56.7 63.2 69.2 66.2 67.0 Albay 66.2 71.4 71.0 75.8 75.0 59.2 70.3 67.4 65.1 64.1 69.2 80.0 81.5 73.4 Camarines Norte 69.9 74.6 73.0 69.9 57.3 50.7 70.3 71.4 67.7 59.6 72.4 90.1 84.9 85.3 Camarines Sur 65.4 68.4 63.4 66.6 62.1 49.9 56.0 64.2 64.4 54.4 61.1 65.5 56.8 61.4 Catanduanes 67.0 72.9 69.3 69.5 70.9 55.6 69.7 68.9 70.4 60.0 61.1 83.1 78.6 80.4 Masbate 43.2 43.9 44.4 45.5 57.2 40.1 47.7 45.6 45.5 45.2 48.6 50.2 48.2 53.7 Sorsogon 61.1 64.8 63.0 70.3 72.1 66.1 54.6 65.2 66.5 65.8 60.1 68.8 70.1 74.7 71.7 Iriga City 66.6 66.7 70.7 70.8 60.8 63.7 74.4 73.7 76.6 68.2 77.3 70.2 58.3 69.7 Legazpi City 72.5 76.5 79.8 78.4 69.4 58.7 71.5 74.0 76.6 66.3 80.5 76.2 82.7 74.9 Naga City 78.4 83.6 77.2 80.6 62.1 59.4 75.2 73.2 74.2 65.1 77.0 70.6 71.7 66.6

Source: Department of Education, Region V Applying the same methodology to assess progress, it is not therefore unexpected that both Camarines Norte and Catanduanes did very well in both – joined by the cities of Iriga and Legazpi in the cohort survival category. They were the only ones that managed to meet, if not exceed, the ideal 82.7% cohort survival and

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78.4% completion rate for S/Y 2004-05 that put them on track towards attaining the goal of achieving universal primary education. Which also meant that the region, as a whole, is off track on this one.

COHORT SURVIVAL ACTUAL TARGET AREA

1992-93 2004-05 2015 2004 STATUS

Bicol Region 66.9 79.5 100.0 82.7 Off track Albay 72.9 82.0 100.0 82.7 Off track Camarines Norte 80.4 91.2 100.0 82.7 On track Camarines Sur 68.7 75.4 100.0 82.7 Off track Catanduanes 72.2 91.0 100.0 82.7 On track Masbate 47.4 70.5 100.0 82.7 Off track Sorsogon 65.0 82.5 100.0 82.7 Off track Iriga City 77.2 83.0 100.0 82.7 On track Legazpi City 86.1 84.0 100.0 82.7 On track Naga City 80.7 77.0 100.0 82.7 Off track

COMPLETION ACTUAL TARGET AREA

1990-91 2004-05 2015 2004 STATUS

Bicol Region 61.4 67.0 100.0 78.4 Off track Albay 66.2 73.4 100.0 78.4 Off track Camarines Norte 69.9 85.3 100.0 78.4 On track Camarines Sur 65.4 61.4 100.0 78.4 Off track Catanduanes 67.0 80.4 100.0 78.4 On track Masbate 43.2 53.7 100.0 78.4 Off track Sorsogon 61.1 71.7 100.0 78.4 Off track Iriga City 66.6 69.7 100.0 78.4 Off track Legazpi City 72.5 74.9 100.0 78.4 Off track Naga City 78.4 66.6 100.0 78.4 Off track

Goal 3 PROMOTE GENDER EQUALITY AND EMPOWER WOMEN GOAL AND TARGET INDICATOR

9 Ratio of girls to boys in primary, secondary and tertiary education

10 Ratio of literate females to males of 15-24 year-olds

11 Share of women in wage employment in the non-agricultural sector

Target 4

Eliminate gender disparity in primary and secondary education preferably by 2005 and to all levels of education no later than 2015

12 Proportion of seats held by women in national parliament

At the sub-regional level, only the DepEd data on gender parity are actually available to measure the 3rd MDG; effectively therefore, it means the lack indicators for measuring that other half, which is concerned with women empowerment. But this is also this part of the goal where the region and the 9 localities under consideration really did well. This is shown by Tables 3.1 and 3.2, which measure gender parity in terms of participation and cohort survival in local elementary schools. (Again, there are no data for higher levels of education.) Consequently, it

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did not require applying the usual progress assessment methodology as the region and its localities are clearly on track towards achieving gender equality. Stated simply, gender parity seeks to equalize opportunities among sexes, e.g. in accessing basic education. As Indicator 9 above shows, it is measured by taking the ratio of girls to boys in primary, secondary and tertiary education. The ideal therefore is a gender parity of 1.0 – which means that girls and boys alike enjoy equal access. But given the bias against girls in most societies, a figure above 1.0 is to be preferred than those below it.

TABLE 3.1 Gender Parity in Participation - Elementary Schools by Province, Bicol Region SY 1992-93 to SY 2004-2005


1991 1991-1992

1992-1993

1993-1994

1994-1995

1995-1996

1996-1997

1997-1998

1998-1999

1999-2000

2000-2001

2001-2002

2002-2003

2003-2004

2004- 2005

Bicol Region 1.02 1.01 1.01 1.01 1.04 0.97 0.96 0.95 0.99 0.99 1.02 1.02 1.02 Albay 1.03 1.01 1.01 1.01 1.04 0.98 0.96 0.95 0.99 0.97 1.01 1.02 1.03 Camarines Norte 1.00 1.01 1.01 1.01 1.04 1.00 0.95 0.94 1.01 1.00 1.03 1.02 1.02 Camarines Sur 1.03 1.01 1.01 1.01 1.04 0.89 0.96 0.93 1.00 1.00 1.01 1.02 1.03 Catanduanes 1.00 1.01 1.01 1.01 1.04 1.10 0.95 0.94 0.99 0.99 1.02 1.02 1.02 Masbate 1.00 1.01 1.01 1.01 1.04 1.08 0.96 0.95 1.00 1.01 1.04 1.04 1.04 Sorsogon 1.00 1.01 1.01 1.01 1.04 0.99 0.96 1.01 0.98 0.99 1.02 1.02 1.01 Iriga City 1.01 1.04 0.89 0.96 0.96 0.99 0.98 1.03 1.03 1.02 Legazpi City 1.01 1.04 0.80 0.96 0.90 0.97 1.00 1.02 1.01 1.01 Naga City 1.01 1.04 0.97 0.96 0.96 1.01 1.02 1.03 1.04 1.04


TABLE 3.2 Gender Parity in Cohort Survival - Elementary Schools by Province, Bicol Region SY 1992-93 to SY 2004-2005


1994 1994-1995

1995-1996

1996-1997

1997-1998

1998-1999

1999-2000

2000-2001

2001-2002

2002-2003

2003-2004

2004- 2005

Bicol Region 1.11 1.14 1.15 1.15 1.17 1.16 1.14 1.11 1.12 1.13 Albay 1.12 1.16 1.13 1.13 1.16 1.13 1.06 1.07 1.10 1.12 Camarines Norte 1.11 1.10 1.16 1.17 1.12 1.12 1.15 1.02 1.03 1.04 Camarines Sur 1.10 1.15 1.17 1.14 1.14 1.18 1.16 1.14 1.13 1.15 Catanduanes 1.05 1.03 1.11 1.08 1.00 1.12 1.10 1.06 1.05 1.06 Masbate 1.23 1.24 1.25 1.22 1.26 1.26 1.22 1.26 1.34 1.20 Sorsogon 1.07 1.11 1.10 1.14 1.24 1.14 1.18 1.11 1.11 1.15 Iriga City 1.00 1.02 0.97 0.98 1.09 1.04 1.01 1.11 1.12 1.03 Legazpi City 1.09 1.13 1.17 1.12 1.17 1.16 1.15 1.05 1.05 1.12 Naga City 1.11 1.10 1.13 1.19 1.23 1.20 1.20 1.04 1.10 1.07


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Similar to the immediately preceding tables, Tables 3.1 and 3.2 cover between 10-13 years. With the exception of the five middle years, Bicol as a whole registered gender parity figures above 1.0. In terms of participation, it achieved 1.02 over the last three school years, with all 9 localities similarly registering figures above 1.0 – ranging from 1.04 of Masbate and Naga to 1.01 of Sorsogon and Legazpi. In terms of cohort survival, the regional average goes up to 1.13 as of S/Y 2004-05, again with all localities registering above 1.0, but this time of a wider ranger – from a high of 1.20 (Masbate) to a low of 1.03 (Iriga). The latter dataset however has a dire implication – boys tend to drop out of school than do girls, in Masbate’s case at a rate 20% higher.

Goal 4 REDUCE CHILD MORTALITY GOAL AND TARGET INDICATOR

13 Under-five mortality rate

14 Infant mortality rate

Target 5

Reduce by two-thirds, between 1990 and 2015, the under-five mortality rate

15 Proportion of 1 year-old children immunized against measles

Similar to Goal 2, the 4th MDG goal is another child-centered undertaking, this time focusing on health. The main indicator is under-five mortality rate, also known as child mortality rate, defined as the probability that a child will die before its fifth birthday. It is important, an ADB reference says, because “child mortality is a primary outcome of inadequate health care and sanitation.” Local data for this particular goal – including infant mortality rate (IMR) and immunization coverage – is available, courtesy of the Department of Health regional field office. (See Table 4.1.) As can be seen from the table, the region made impressive gains, both in terms of child and infant mortality rates. For the former, regional average steadily dropped by 11 points between 1991 (17.37) and 2004 (6.09); it was 10 points for the latter (from 19.89 in 1991 to 9.33 in 2004). An exception is immunization coverage, which actually saw coverage drop from 93% in 1991 to as low as 81.2% in 2001, only to climb back to 87% in 2004 (but still 6 percentage points worse than it was 13 years ago). These regional averages impacted individual performance of the 9 localities when the progress assessment methodology is applied, as can be seen below. In terms of child mortality, only Catanduanes did not make the ideal grade for 2004 (11.10); the rest – led by Naga, Albay, Sorsogon and Masbate which have already achieved the 2015 target – are well on their way towards reducing their 1991 level by two-thirds as envisioned under this goal. Infant mortality is mixed: this time, Camarines Norte, Iriga and Legazpi join Catanduanes in missing the ideal 2004 target (12.71); Albay, with its 4.83 IMR, on the other hand, has already achieved the 2015 target.

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TABLE 4.1 Under-Five Mortality, Infant Mortality and Percentage of Fully-Immunized Children By Province/City, Bicol Region, 1991-2004 INDICATOR ALBAY CAM

NORTE CAM SUR

CAT MAS SOR IRIGA NAGA LEGAZPI BICOL REGION

Under-Five Mortality Rate 1991 13.98 37.17 17.77 22.13 13.46 19.88 9.39 6.26 18.26 17.37 1995 9.32 6.85 5.26 15.34 10.23 10.18 5.23 7.69 11.89 8.48 2000 9.03 10.96 9.43 6.77 6.95 7.41 7.24 7.28 8.91 8.49 2001 8.74 9.86 10.57 11.35 7.89 7.82 10.98 8.29 7.83 9.20 2002 8.73 11.94 7.77 4.61 8.01 8.77 10.14 4.50 7.69 8.30 2003 7.45 9.24 7.23 8.27 7.43 9.04 6.90 7.47 12.02 7.94 2004 4.71 8.77 6.31 11.18 5.16 4.92 9.21 3.68 8.94 6.09

Infant Mortality Rate (Rate per 1000 Livebirths) 1991 17.36 42.39 19.98 22.48 14.66 22.52 13.41 8.68 18.26 19.89 1995 16.79 10.89 6.48 17.24 12.69 15.24 10.10 11.79 16.18 11.68 2000 20.11 19.84 12.42 18.85 11.41 14.16 10.65 13.24 21.32 15.32 2001 10.92 16.87 11.39 15.42 13.18 8.50 6.06 15.20 18.86 11.94 2002 11.38 18.37 9.37 14.20 13.48 8.46 12.01 7.99 19.24 11.67 2003 11.90 14.42 11.46 8.90 10.44 5.51 11.39 16.80 15.27 10.96 2004 4.83 15.48 7.98 14.78 11.07 8.25 16.49 8.96 13.26 9.33

Fully-Immunized Children (%) 1991 109.00 79.00 90.00 73.00 103.00 97.00 53.00 86.00 65.00 93.00 1995 104.16 58.76 82.50 81.94 77.81 100.56 75.60 118.36 101.51 87.59 2000 87.10 81.40 81.60 76.00 93.60 95.40 74.60 105.90 96.40 87.10 2001 87.20 68.60 87.60 80.40 53.60 92.40 88.90 92.70 90.70 81.20 2002 83.10 65.50 75.40 80.60 94.40 85.00 81.10 103.30 94.50 81.70 2003 85.30 83.00 95.10 82.40 90.10 88.30 79.40 106.20 94.50 89.70 2004 89.00 82.00 80.00 80.00 96.00 86.00 87.00 112.00 96.00 87.00


UNDER-FIVE MORTALITY INFANT MORTALITY ACTUAL TARGET ACTUAL TARGET

AREA

1991 2004 2015 2004 STATUS

1991 2004 2015 2004 STATUS

Bicol Region 17.37 6.09 5.79 11.10 On track 19.89 9.33 6.63 12.71 On track Albay 13.98 4.71 5.79 11.10 On track 13.98 4.83 6.63 12.71 On track Camarines Norte 37.17 8.77 5.79 11.10 On track 37.17 15.48 6.63 12.71 Off track Camarines Sur 17.77 6.31 5.79 11.10 On track 17.77 7.98 6.63 12.71 On track Catanduanes 22.13 11.18 5.79 11.10 Off track 22.13 14.78 6.63 12.71 Off track Masbate 13.46 5.16 5.79 11.10 On track 13.46 11.07 6.63 12.71 On track Sorsogon 19.88 4.92 5.79 11.10 On track 19.88 8.25 6.63 12.71 On track Iriga 9.39 9.21 5.79 11.10 On track 9.39 16.49 6.63 12.71 Off track Naga 6.26 3.68 5.79 11.10 On track 6.26 8.96 6.63 12.71 On track Legazpi 18.26 8.94 5.79 11.10 On track 18.26 13.26 6.63 12.71 Off track

Immunization coverage, on the other hand, is a complete reversal as all 9 localities – except Naga, whose 112% in 2004 already exceeds the 2015 target – all did poorly and did not make the grade. This is an alarming trend for the region: According to a World Health Organization advisory, “immunization is a key health intervention to reduce child mortality. Roughly one-quarter of the 2002 under-five mortality rate is

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attributable to vaccine-preventable diseases.” In Bicol, according to a report prepared by the DOH regional office, the Expanded Program on Immunization (EPI) aims to reduce infant and child mortality caused by six immunizable diseases: tuberculosis, diphtheria, tetanus, pertussis, poliomyelitis and measles.

FULLY IMMUNIZED CHILDREN ACTUAL TARGET AREA 1991 2004 2015 2004

STATUS

Bicol Region 93.00 87.00 100.00 96.79 Off track Albay 109.00 89.00 100.00 96.79 Off track Camarines Norte 79.00 82.00 100.00 96.79 Off track Camarines Sur 90.00 80.00 100.00 96.79 Off track Catanduanes 73.00 80.00 100.00 96.79 Off track Masbate 103.00 96.00 100.00 96.79 Off track Sorsogon 97.00 86.00 100.00 96.79 Off track Iriga 53.00 87.00 100.00 96.79 Off track Naga 86.00 112.00 100.00 96.79 On track Legazpi 65.00 96.00 100.00 96.79 Off track

Stated simply, worsening immunization coverage will undermine current gains in child mortality. As the same DOH report points out: “EPI had been universally known as a success program in reducing mortality and morbidity in children; letting go of its gains would be disadvantageous to the cause of MDG.”

Goal 5 IMPROVE MATERNAL HEALTH GOAL AND TARGET INDICATOR

16 Maternal mortality ratio Target 6

Reduce by three-quarters, between 1990 and 2015, the maternal mortality ratio 17 Proportion of births attended by skilled health

personnel

Allied closely with reducing child mortality is the 5th MDG that seeks to improve maternal health. The UNICEF website explains this quite clearly:

At least 20% of the burden of disease in children below the age of 5 is related to poor maternal health and nutrition, as well as quality of care at delivery and during the newborn period. And yearly 8 million babies die before or during delivery or in the first week of life. Further, many children are tragically left motherless each year. These children are 10 times more likely to die within two years of their mothers' death.

The two indicators for maternal health listed above are both available at the regional and sub-regional levels for the 9 localities. Table 5.1 presents maternal mortality ratio (MMR), defined as the number of maternal deaths related to childbearing per 100,000 live births. Like child mortality, it is also used as a measure of the quality of a health care system.

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Table 5.2, on the other hand, presents data on the proportion of live births attended by skilled health personnel. As UNICEF explains, “majority of maternal deaths and disabilities are preventable, being mainly due to insufficient care during pregnancy and delivery...Access to skilled care during pregnancy, childbirth and the first month after delivery is key to saving these women's lives – and those of their children.” Table 5.1 shows that between 1991 and 2004, MMR in the region hovered between a low of 0.99 (2001) to a high of 1.22 (1991). Unfortunately, it is again on the upswing, hitting its second highest level during the period at 1.16. Table 5.2 meanwhile shows that in terms of live birth attendance, skilled professionals account for a minority (41%), with traditional method still dominant at 59% of the regional total.

TABLE 5.1 Maternal Mortality Ratio by Province/City, Bicol Region, 1991-2004

YEAR ALBAY CAM NORTE

CAM SUR

CAT MAS SOR IRIGA NAGA LEGAZPI BICOL REGION

1991 0.83 2.93 1.46 1.22 1.57 0.93 0.67 0 0.70 1.22 1995 1.36 0.73 0.21 0.79 1.46 0.58 1.39 0.26 0.99 0.75 2000 1.12 0.87 0.91 0.18 1.16 1.59 0.43 0.22 1.27 1.03 2001 0.99 0.71 1.01 0.64 1.05 1.41 0.76 0.23 0.66 0.99 2002 0.79 1.94 0.5 0.18 1.38 2.11 0.75 0.25 0.89 1.06 2003 0.84 1.32 0.80 0.62 1.30 1.62 1.73 0 2.27 1.09 2004 0.56 1.34 0.87 0.76 1.11 2.83 1.53 0 0.29 1.16

Source: Department of Health, Region V TABLE 5.2 Proportion of Registered Live Births by Attendance and Province/City, Bicol Region 1990-2002

Year PROVINCE/CITY ATTENDANCE 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002

Region V Skilled Health Personnel 35.3 36.1 36.2 37.0 35.9 37.8 38.1 39.0 38.3 39.4 39.0 39.8 41.0 Traditional Method 64.7 63.9 63.8 63.0 64.1 62.2 61.9 61.0 61.7 60.6 61.0 60.2 59.0 Albay Skilled Health Personnel 30.5 31.0 30.8 30.9 29.5 32.1 32.5 32.6 32.3 34.1 35.5 36.3 37.5 Traditional Method 69.5 69.0 69.2 69.1 70.5 67.9 67.5 67.4 67.7 65.9 64.5 63.7 62.5 Camarines Norte Skilled Health Personnel 37.1 38.5 38.0 38.6 39.2 40.0 41.8 41.3 41.6 43.6 41.1 44.2 45.8 Traditional Method 62.9 61.5 62.0 61.4 60.8 60.0 58.2 58.7 58.4 56.4 58.9 55.8 54.2 Camarines Sur Skilled Health Personnel 24.1 32.2 33.2 35.9 34.4 35.7 36.2 38.1 36.6 36.2 36.3 37.0 37.9 Traditional Method 75.9 67.8 66.8 64.1 65.6 64.3 63.8 61.9 63.4 63.8 63.7 63.0 62.1 Catanduanes Skilled Health Personnel 41.0 44.4 41.1 44.2 42.4 43.3 44.2 45.9 45.1 47.8 44.9 45.6 47.9 Traditional Method 59.0 55.6 58.9 55.8 57.6 56.7 55.8 54.1 54.9 52.2 55.1 54.4 52.1

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Masbate Skilled Health Personnel 35.0 34.1 32.5 28.6 22.3 25.6 21.1 22.3 22.8 24.5 24.8 23.9 23.4 Traditional Method 65.0 65.9 67.5 71.4 77.7 74.4 78.9 77.7 77.2 75.5 75.2 76.1 76.6 Sorsogon Skilled Health Personnel 38.4 37.3 37.0 35.8 37.1 38.2 38.5 41.0 40.3 42.2 40.1 40.9 42.9 Traditional Method 61.6 62.7 63.0 64.2 62.9 61.8 61.5 59.0 59.7 57.8 59.9 59.1 57.1 Iriga City Skilled Health Personnel 39.4 44.5 46.4 47.5 52.4 55.9 60.6 59.5 60.5 60.9 63.8 62.3 66.6 Traditional Method 60.6 55.5 53.6 52.5 47.6 44.1 39.4 40.5 39.5 39.1 36.2 37.7 33.4 Legazpi City Skilled Health Personnel 59.1 54.4 56.9 57.0 56.6 59.1 59.1 59.9 58.4 60.4 62.6 61.1 63.4 Traditional Method 40.9 45.6 43.1 43.0 43.4 40.9 40.9 40.1 41.6 39.6 37.4 38.9 36.6 Naga City Skilled Health Personnel 75.8 60.6 62.5 69.2 66.7 66.5 67.7 67.2 67.0 69.8 69.3 71.7 70.3 Traditional Method 24.2 39.4 37.5 30.8 33.3 33.5 32.3 32.8 33.0 30.2 30.7 28.3 29.7 Note: Province/City refers to the usual residence of the mother.

Source: National Statistics Office These data again impact on individual performance in reducing maternal mortality by 75% when assessed using the methodology in this study. In terms of the ideal 2004 target of 0.72, all but three – Naga, Legazpi and Albay – missed the cut, as does the regional total which, at 1.16, is also off track. In particular, Naga (0) and Legazpi (0.29) have already attained the 2015 target. It is of little wonder then that these two cities also have the highest proportion of skilled professionals attending registered live births – 70.3% for Naga and 63.4% for Legazpi.

MATERNAL MORTALITY RATIO ACTUAL TARGET AREA

1991 2004 2015 2004 STATUS

Bicol Region 1.22 1.16 0.31 0.72 Off track Albay 0.83 0.56 0.31 0.72 On track Camarines Norte 2.93 1.34 0.31 0.72 Off track Camarines Sur 1.46 0.87 0.31 0.72 Off track Catanduanes 1.22 0.76 0.31 0.72 Off track Masbate 1.57 1.11 0.31 0.72 Off track Sorsogon 0.93 2.83 0.31 0.72 Off track Iriga 0.67 1.53 0.31 0.72 Off track Naga 0.00 0.00 0.31 0.72 On track Legazpi 0.70 0.29 0.31 0.72 On track

In addition to skilled health personnel, the DOH report also cites the following contributory factors to lower maternal mortality: availability of transportation, equipped referral hospital, quality pre-natal and post-natal coverage and access to family planning services. In areas where maternal access to primary health care is limited by geography, mothers double the risk of dying during childbirth as compared to those in areas where health care is more available and accessible.

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Goal 6 COMBAT HIV/AIDS, MALARIA AND OTHER DISEASES GOAL AND TARGET INDICATOR

18 HIV prevalence among 15-24 year old pregnant women

19 Condom use rate of the contraceptive prevalence rate

Target 7 Have halted by 2015 and begun to reverse the spread of HIV/AIDS

20 Number of children orphaned by HIV/AIDS (to be measured by the ratio or proportion of orphans to non-orphans aged 10-14 who are attending school)

21 Prevalence and death rates associated with malaria

22 Proportion of population in malaria risk areas using effective malaria prevention and treatment measures

23 Prevalence and death rates associated with tuberculosis

Target 8 Have halted by 2015 and begun to reverse the incidence of malaria and other major diseases

24 Proportion of tuberculosis cases detected and cured under directly observed treatment short course (DOTS)

The 6th MDG seeks to combat diseases, and UNICEF explains why:

Disease is a cruelly potent child killer, especially when combined with the poverty in which much of the developing world lives. In the absence of good nutrition, sanitation and health care, HIV/AIDS, malaria, measles, polio and tuberculosis mean certain end to millions of children who would survive and flourish elsewhere.

HIV/AIDS. In regard to HIV/AIDS, the only relevant tabular data available concerns condom use rate, which is among those presented in Table 6.1. On the whole, it has been going down, from a high of 3.03 (1991) to a low of 2.24 (2003). This information, however, should be taken in the context of the following related narrative from the DOH regional report:

Bicol accounts for 1% of HIV/AIDS cases in RP Of the 2,354 cumulative HIV/AIDS cases in the Philippines from January 1994 to September 2005, Bicol accounts for only 25 or 1.1 per cent. Seven out of these 25 HIV carriers in the region have already passed away. The surviving 18 ranges in age from 4-59 years old. By province, the HIV/AIDS cases are broken down into: Camarines Sur (10), Albay (8), Sorsogon (3), Camarines Norte (2), and Catanduanes and Masbate, 1 each.

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The major national mode of transmission is sexual intercourse with 86 per cent of the total prevalence while only a few are caused by blood transmission, prenatal origins and needle sharing among drug users. At the national level, 797 (34%) of those affected are OFWs. A total of 232 are seafarers, 132 are domestic helpers, 69 are foreign employees, 66 are health workers and 62 victims are entertainers.

Malaria and TB. A more familiar concern in the region, on which tabular data are available, is the prevalence (morbidity) and death (mortality) due to malaria and tuberculosis. The remainder of Table 6.1 presents these data, most of which are only limited to the current decade. What immediately stands out is that both diseases are declining, both in terms of morbidity and mortality – which enable Bicol on the whole to generally achieve to goal of halting and reversing the spread of these diseases.

TABLE 6.1 Rate of Condom Use, Morbidity and Mortality for Malaria and TB by Province/City Bicol Region, 1994-2005

INDICATORS ALBAY CNORTE CSUR CAT MAS SOR IRIGA NAGA LEGAZPI REGION V Condom Use Rate

1991 3.22 2.68 3.58 2.00 2.24 3.40 3.78 2.88 1.47 3.03 1995 5.28 5.08 4.46 3.73 5.85 12.35 2000 3.26 3.68 2.09 0.59 1.64 1.91 0.57 9.44 3.15 2.56 2001 2.98 2.62 2.22 0.84 2.09 6.18 0.59 2.38 2.29 2.86 2002 3.29 2.61 0.74 3.08 1.18 7.41 6.99 2.37 3.30 2.79 2003 4.06 2.14 0.97 1.31 0.95 1.51 7.04 11.11 2.16 2.24 2004 4.27 2.13 0.83 0.44 0.85 2.15 7.05 9.93 2.26 2.25

Morbidity Rate for Malaria (Per 100,000 Population) 1991 1995 2000 0.21 19.03 0.15 0.00 0.00 0.79 0.00 0.00 0.00 2.18 2004 0.70 2.80 0.07 0.00 0.00 0.43 0.00 0.00 0.00 0.50 2005 0.25 4.54 0.18 0.00 0.00 0.56 0.00 0.00 0.00 0.65

Death Rate for Malaria 1991 1995 2000 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 2004 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 2005 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

Morbidity Rates for TB (All Forms, (Per 100,000 Population) 1991 516.99 1995 249.18 2000 225.13 605.05 231.96 191.81 222.28 321.12 248.20 429.14 280.79 2001 254.00 137.96 219.78 166.34 138.38 59.65 293.18 418.70 186.18 2002 206.17 557.59 116.64 86.37 114.20 142.90 157.64 245.44 234.92 187.69

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2003 95.40 126.92 126.74 86.49 66.11 150.69 285.40 150.47 75.83 2004 34.44 82.28 30.39 131.91 75.15 199.65 275.18 365.74 71.03

Death Rate for TB (All Forms) 1991 40.26 1995 26.89 2000 42.86 28.24 38.21 42.58 29.32 36.07 32.56 64.87 51.88 37.85 2001 40.93 35.19 40.37 48.57 27.93 30.58 49.76 50.65 42.56 37.65 2002 40.22 36.79 45.95 23.06 32.37 17.27 47.83 41.37 36.90 36.39 2003 32.82 31.36 38.65 24.17 33.42 34.20 29.64 25.98 31.31 2004 29.14 29.03 36.31 19.38 26.67 27.79 30.47 18.30 51.06 30.59

Source: Department of Health, Region V In view of this, the original progress assessment methodology was modified to address the data gap covering the ‘90s – comparing only the 2005 status of the localities concerned with their 2000 regional performance to see if a reversal was attained.

PREVALENCE OF MALARIA

DEATH RATE DUE TO MALARIA

ACTUAL ACTUAL

AREA

2000 2005 STATUS

2000 2005 STATUS

Bicol Region 2.18 0.65 On track 0 0 On track Albay 0.25 On track 0 On track Camarines Norte 4.54 Off track 0 On track Camarines Sur 0.18 On track 0 On track Catanduanes 0.00 On track 0 On track Masbate 0.00 On track 0 On track Sorsogon 0.56 On track 0 On track Iriga 0.00 On track 0 On track Naga 0.00 On track 0 On track Legazpi 0.00 On track 0 On track

As can be seen from the above, malaria has been mostly halted and reversed, as all localities – with the exception of Camarines Norte where the 2005 prevalence rate is higher than the 2000 regional level – made the cut.

PREVALENCE OF TB

DEATH RATE DUE TO TB

ACTUAL ACTUAL

AREA

2000 2004 STATUS

2000 2004 STATUS

Bicol Region 280.79 On track 37.85 30.59 On track Albay 34.44 On track 29.14 On track Camarines Norte 82.28 On track 29.03 On track Camarines Sur 116.64 On track 36.31 On track Catanduanes 30.39 On track 19.38 On track Masbate 131.91 On track 26.67 On track Sorsogon 75.15 On track 27.79 On track Iriga 199.65 On track 30.47 On track Naga 275.18 On track 18.30 On track Legazpi 365.74 Off track 51.06 Off track

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The same can also be said in regard to TB: All localities – except Legazpi whose 2004 morbidity and mortality rates exceeded the 2000 regional level – have halted and reversed it.

Goal 7 ENSURE ENVIRONMENTAL SUSTAINABILITY GOAL AND TARGET INDICATOR

25 Proportion of land area covered by forest

26 Ratio of area protected to maintain biological diversity to surface area

27 Energy use (kg oil equivalent) per $1 GDP (PPP)

28 Carbon dioxide emissions (per capita) and consumption of ozone-depleting CFCs (ODP tons)

Target 9 Integrate the principles of sustainable development into country policies and programmes to reverse the loss of environmental resources

29 Proportion of population using solid fuels

Target 10 Halve, by 2015, the proportion of people without sustainable access to safe drinking water

30 Proportion of population with sustainable access to improved water source, urban and rural

31 Proportion of urban population with access to improved sanitation

Target 11

By 2020, to have achieved a significant improvement in the lives of at least 100 million slum dwellers 32 Proportion of households with access to secure

tenure (owned or rented)

The positive outcomes in the previous MDG cannot be said about the region’s performance in regard to Goal 7, which is concerned with ensuring environmental sustainability. This can be inferred from Tables 7.1 and 7.2, which are the only indicators available at the regional and sub-regional levels. At a glance, Table 7.1 points to marginal improvement in maintaining protected environmental areas in the six provinces under consideration, led by Albay and Masbate which both registered incremental percentage points between 1990 and 2003. Nonetheless, Bicol’s protected areas practically stood still at 25% within the 13-year period. TABLE 7.1 Proportion of Area Protected to Maintain Biological Diversity to Total Land Area by Province Bicol Region, 1990-2003 AREA 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 Region V 25.25 25.25 25.25 25.25 25.25 25.25 25.25 25.25 25.25 25.25 25.33 25.33 25.33 25.33 Albay 7.71 7.71 7.71 7.71 7.71 7.71 7.71 7.71 7.71 7.71 7.81 7.81 7.81 7.81 CamarinesNorte 3.85 3.85 3.85 3.85 3.85 3.85 3.85 3.85 3.85 3.85 3.81 3.81 3.81 3.81 CamarinesSur 3.75 3.75 3.75 3.75 3.75 3.75 3.75 3.75 3.75 3.75 3.68 3.68 3.68 3.68 Catanduanes 8.67 8.67 8.67 8.67 8.67 8.67 8.67 8.67 8.67 8.67 8.67 8.67 8.67 8.67 Masbate 0.05 0.05 0.05 0.05 0.05 0.05 0.05 0.05 0.05 0.05 0.13 0.13 0.13 0.13 Sorsogon 1.22 1.22 1.22 1.22 1.22 1.22 1.22 1.22 1.22 1.22 1.22 1.22 1.22 1.22

But environmental sustainability is not about protected areas alone. In a rapidly urbanizing world, it is also about improving access to safe water and sanitation services to the populace. UNICEF explains why: “Safe water and sanitation are

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critical for survival. A child dies every 15 seconds from disease attributable to unsafe drinking water, deplorable sanitation and poor hygiene. As of 2002, one in six people worldwide – 1.1 billion total – had no access to clean water. About 400 million of these are children. Four of ten people worldwide don't have access to even a simple latrine.”

TABLE 7.2 Access to Safe Water and Sanitary Facilities by Province/City, Bicol Region, 1994-2005

INDICATORS ALBAY CNORTE CSUR CAT MAS SOR IRIGA NAGA LEGAZPI REGION V HH with access to Safe Water A. Level II

1991 2.40 17.86 4.49 29.52 9.16 17.73 1.79 7.96 9.24 1995 19.12 17.34 9.82 29.50 9.81 17.72 6.38 4.32 1.37 13.97 2000 19.47 20.36 10.65 30.38 11.56 20.00 7.10 18.21 1.13 15.33 2001* 2002 18.36 19.69 12.63 42.13 16.34 27.87 5.79 13.82 11.52 17.78 2003 18.49 15.68 12.87 40.57 16.52 36.50 5.83 3.36 11.98 18.32 2004 17.30 17.00 13.90 30.60 20.80 23.90 6.70 1.80 11.70 17.50

B. Level III 1991 60.48 20.01 8.11 33.36 4.86 25.49 53.38 63.64 22.76 25.79 1995 34.75 23.55 10.52 33.36 1.77 25.49 41.59 80.22 20.17 20.61 2000 28.41 32.67 12.84 21.38 7.50 43.30 45.50 62.40 35.26 24.43 2001* 94.48 65.67 77.23 77.51 55.26 100.00 93.35 83.33 100.00 80.66 2002 29.52 32.07 14.98 17.27 4.25 38.71 49.31 65.97 80.13 25.19 2003 29.74 30.34 14.61 25.80 6.16 45.93 50.62 96.61 60.85 26.79 2004 27.90 33.40 16.50 26.90 7.20 40.30 50.00 98.20 61.00 27.70

C. Total 1991 62.88 37.87 12.60 62.88 14.02 43.22 55.17 63.64 30.72 35.03 1995 53.87 40.89 20.34 62.86 11.58 43.21 47.97 84.54 21.54 34.58 2000 47.88 53.03 23.49 51.76 19.06 63.30 52.60 80.61 36.39 39.76 2001 94.48 65.67 77.23 77.51 55.26 100.00 93.35 83.33 100.00 80.66 2002 47.88 51.76 27.61 59.40 20.59 66.58 55.10 79.79 91.65 42.97 2003 48.23 46.02 27.48 66.37 22.68 82.43 56.45 99.97 72.83 45.11 2004 45.20 50.40 30.40 57.50 28.00 64.20 56.70 100.00 72.70 45.20

* No breakdown by level for CY 2001 (data integrated under Level III)

HH with Sanitary Toilets 1991 65.58 61.49 63.53 69.56 28.61 56.48 67.07 93.04 54.49 58.33 1995 66.95 59.66 59.53 73.18 22.56 65.20 65.85 97.09 59.72 58.13 2000 71.78 71.20 69.81 65.10 33.30 72.66 77.78 77.82 61.82 65.42 2001 72.98 71.41 69.98 63.26 42.69 86.05 79.46 81.71 71.94 69.28 2002 71.93 69.36 7.04 68.78 39.66 92.58 80.38 74.58 90.00 49.40 2003 73.65 67.64 72.74 69.67 33.52 91.11 80.62 95.91 65.08 68.94 2004 69.85 67.51 73.93 68.73 45.98 66.86 80.10 100.00 64.43 67.85


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On the surface, Table 7.2 will show that the region did quite well in halving the number of Bikolanos with no access to safe water and sanitary toilets, thanks to a 10 and 9 percentage point increase, respectively, between 1991 and 2004. But applying the same progress assessment methodology, it appears these gains are not enough to keep in on track towards attaining Goal 7.

ACCESS TO SAFE WATER

ACCESS TO SANITARY TOILETS

ACTUAL TARGET ACTUAL TARGET

AREA

1991 2004 2015 2004 STATUS

1991 2004 2015 2004 STATUS

Bicol Region 35.03 45.20 67.52 52.63 Off track 58.33 67.85 79.17 69.62 Off track Albay 62.88 45.20 67.52 52.63 Off track 65.58 69.85 79.17 69.62 On track Camarines Norte 37.87 50.40 67.52 52.63 Off track 61.49 67.51 79.17 69.62 Off track Camarines Sur 12.60 30.40 67.52 52.63 Off track 63.53 73.93 79.17 69.62 On track Catanduanes 62.88 57.50 67.52 52.63 On track 69.56 68.73 79.17 69.62 Off track Masbate 14.02 28.00 67.52 52.63 Off track 28.61 45.98 79.17 69.62 Off track Sorsogon 43.22 64.20 67.52 52.63 On track 56.48 66.86 79.17 69.62 Off track Iriga 55.17 56.70 67.52 52.63 On track 67.07 80.1 79.17 69.62 On track Naga 63.64 100.00 67.52 52.63 On track 93.04 100.00 79.17 69.62 On track Legazpi 30.72 72.70 67.52 52.63 On track 54.49 64.43 79.17 69.62 Off track

In particular, it is 7 points short of the ideal 2004 target of 52.63% in regard to safe water and almost 2 points short in regard to sanitary toilets. This performance is weighed down by the fact that only Catanduanes and Sorsogon, together with the three cities of Iriga, Naga and Legazpi, will make the cut in the former. For the latter, only Albay, Camarines Sur, Iriga and Naga are on track.

Goal 8 DEVELOP A GLOBAL PARTNERSHIP FOR DEVELOPMENT GOAL AND TARGET INDICATOR

Target 15 Deal comprehensively with the debt problems of developing countries through national and international measures in order to make debt sustainable in the long term

44 Debt service as a percentage of exports of goods and services

Target 16 In cooperation with developing countries, develop and implement strategies for decent and productive work for youth

45 Unemployment rate of 15-24 year olds, each sex and total

Target 17 In cooperation with pharmaceutical companies, provide access to affordable, essential drugs in developing countries

46 Proportion of population with access to affordable essential drugs on a sustainable basis

47 Telephone lines and cellular subscribers per 100 population

Target 18

In cooperation with the private sector, make available the benefits of new technologies, especially information and communications 48 Personal computers in use per 100 population and

internet users per 100 population

Of the eight MDGs, Goal 8 is the most difficult to assess, mainly due to the absence of indicators that can be used to measure it by. Actually, the unavailability of relevant data can be traced to the general unwillingness of private telephone companies to provide data at the sub-regional

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level – at least in regard to fixed line and cellular subscribers (Indicator 47) and PC use and internet users (Indicator 48) which are the most feasible. The author actually encountered this very problem in gathering data for an ADB study sometime in 2000. Claiming that these are confidential information that will benefit competitors when released to public domain, approvals from head offices based in Metro Manila are usually required. Summary So, on the whole, how does Bicol region and the 9 localities under consideration fare in regard to the eight MDGs? The following color-coded table maps their comparative performances in a visual way. GOAL INDICATORS ALBAY CAM

NORTE CAM SUR

CAT MAS SOR IRIGA NAGA LEGAZPI BICOL

REGION Poverty incidence Family Population Subsistence incidence Family Population

1

Hunger Participation rate Cohort survival rate

2

Completion rate Gender parity Participation

3

Cohort survival Under 5 mortality rate Infant mortality rate

4

Proportion of Fully-immunized children

5 Maternal mortality rate Prevalence of malaria Death rate due to malaria Prevalence of TB

6

Death rate due to TB Households with access to safe water

7

Households with sanitary toilets

Off track On track No data

Regional. Bicol’s progress relative to the MDGs is mixed, with it on track towards achieving 4 of the 7 goals. The absence of data for Goal 8 (“Develop a Global Partnership for Development”) precluded progress assessment at the regional and local levels. Its performance by goal is summarized as follows: Goal 1. Mostly on track towards reducing poverty by half, both in terms of

income and subsistence incidence.

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Goal 2. Off track in ensuring that all children are able to access and complete primary education (up to Grade III). Mostly like to miss target in regard to full elementary education (up to Grade VI).

Goal 3. On track toward attaining gender parity towards girls. Tends to come at the expense of higher levels of dropouts among boys.

Goal 4. On track towards reducing child and infant mortality by two-thirds. But declining immunization coverage might put it at risk.

Goal 5. Off track in reducing maternal mortality by three-fourths.

Goal 6. On track towards halting and reversing the prevalence of and deaths due to HIV/AIDS, malaria and TB.

Goal 7. Off track in halving the proportion of people with no access to safe water and sanitation services.

Sub-regional. The same table shows that Naga City is on track towards attaining all MDGs save for the 2nd, thereby validating the recognition it recently earned from the UNDP. One of its good practices – on MDG-aligned local planning and budgeting – is described in the next section. On the other hand, performance among provinces is mixed, with Albay, Camarines Sur, Catanduanes and Sorsogon satisfying the most number of indicators (11 each). A Good Practice: Naga’s Participatory Planning, Budgeting Initiatives Beginning this June 2006, the city government, through its local planning office, has begun updating Naga’s development and land use plans, providing it an opportunity to further institutionalize participative approaches in local planning and budgeting under the Public Governance System (PGS). In so doing, the following innovations were adopted: 1. Using the Millennium Development Goals (MDGs) and the PGS outputs as

planning targets. By adopting the MDG and the PGS vision-mission statement and scorecards, the city will no longer need to reinvent the wheel and go through a time-consuming visioning process. This also means that it will be updating the local land use and development plans with a 9-year time horizon. The planning process will therefore focus on revisiting these outputs, refining the targets set, and aligning the city plans towards attaining these 9-year targets.

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2. Working with existing and mandated local councils and special bodies as basic planning unit. This involves tapping the 16 existing and mandated councils under the umbrella of the City Development Council (all of which have strong civil society representation) in coming up with sectoral components of both the land use and development plans. For instance, in regard to the social sector, the city had to work with the children, women, youth and senior citizen councils; the Health Board and the NCUPF, in establishing the baseline data, assessing needs; crafting programs, projects and activities (PPAs) that will respond to these needs in the context of the MDG and PGS targets; costing out these PPAs, and laying out a 9-year action plan for implementation, monitoring and evaluation.

This approach has the following advantages:

Higher data quality as stakeholders have the opportunity to validate and reconcile both official (i.e. those generated by the city planning staff) and non-official data

Shared ownership and responsibility over the output plans, and A more strategic and meaningful role for local councils and special

bodies in the city government’s institutional planning processes. 3. Multiple levels of consultation. With all sectoral planning sessions

completed, the stage is now set for two additional levels of consultation: at the sectoral level, where consolidated outputs will be presented, discussed and revised (thus, the six councils mentioned above will have the opportunity to critique the draft plan for the Social Sector); and at the city level, where the revised drafts will again be presented to all sectors comprising the City Development Council.

4. Participative budgeting at the departmental level. Even as the plan is being

crafted, the planning process which heavily involves the Naga City Peoples Council (NCPC) and its member NGOs has positively informed local budgeting processes and practices of the city government. Their presence and participation in the crafting of departmental budgets is yet another guarantee that budgetary allocations will be aligned with the city vision and mission statements and scorecards that incorporate the MDGs.

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chapter 4 - the mdgs in bicol region

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