CHAPTER 1

Problem and Its Background

Introduction

Poverty is amongst the major concerns the world faces nowadays. It

greatly affects health and education as it is the root of other major problems such

extreme hunger, maternal deaths, child mortality, illiteracy, and massive

unemployment due to lack of education and technical qualifications. Poverty

brings about the sense of powerlessness, which causes frustration and despair,

which leads to even more poverty. This vicious cycle has to end; but, breaking

that cycle may be a daunting task to be addressed nevertheless.

In the Philippines, Poverty incidence, has not improved that much since

the year 1991. Moreover, the magnitude of the poor families has increased from

3.3 million families in 2003 to 3.9 million in 2009 (National Statistical Coordination

Board, 2012). Compared to other Asian countries such as Indonesia, Malaysia,

Thailand, and Vietnam, Philippines is somewhat staying behind since these

countries have exhibited more significant reductions. Usui (2011) noted that the

challenges to poverty reduction in the Philippines is the following: limited job

opportunities caused by weak growth performance in the industrial sector; and

poorly targeted and fragmented social protection programs resulting in high

errors of inclusion and exclusion. According to Ali (2007) as cited by Conchada &

Marites (2014), inclusive growth is anchored on three pillars: 1) generation of full

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and productive employment, 2) providing mechanisms for capability

enhancement, and 3) providing social protection for the vulnerable.

Among the strategies devised by countries around the world and

international institutions to alleviate poverty is the so-called conditional cash

transfer (CCT). The CCT scheme was first implemented by Latin American

countries, like Brazil, Chile, Colombia, Nicaragua and Peru. It was then adopted

by other developing countries at a rapid rate including the Philippines. The

program grants poor families with financial support provided that they meet

certain conditions such as keeping the children’s attendance and progressive

performance in school, and maintaining the families’ health through regular visits

and checks-ups in local health stations. In the Philippines, it is dubbed as the

“Pantawid Pamilyang Pilipino Program” which was pilot tested in the year 2007.

The 4Ps had been one of the key means of the Philippine government in its

thrust to alleviate poverty. With the Department of Social Welfare and

Development as its lead government agency, the program was anchored on its

dual objectives: social assistance, by providing monetary aid to poor families to

respond to their immediate needs; and social development, by breaking the

intergenerational poverty cycle by investing health and education of poor

children. It further aids in achieving the Millennium Development Goals set by the

United Nations. The supply-side of the 4Ps program is ensured by the

Department of Education and Department of Health. Last year 102 billion pesos

is allotted for the construction of additional 1,200 health stations, health centers

and public hospitals. There is also approved budget last 2015 for the construction
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of additional 33,000 new classrooms and repair of 9,000 classrooms amounting

to 365 billion pesos. (Retrieved from www.dswd.gov.ph). According to the

Department of Budget and Management, the present allocation of budget is

amounting to 62.3 billion pesos, a 15.1% higher than 2014 allocation amounting

to 62.6 billion pesos.

There still are chances that the program falls short in meeting its

objectives due supply-side constraints – limited school and health facilities,

insufficient number of teachers and health personnel, and lack of medical

supplements and educational materials, issues on the implementing institutions

and financial banking systems (Son, 2008). In order to effectively cater the

beneficiaries of the poverty program, improving the accesses to health and

education must be given the foremost importance. School and health resources

should be sufficient to meet the increasing demand of such services as an

upshot of the conditional cash transfer program (Conchada & Marites, 2014).

The researchers believe that it is vital to know whether the city

government has the sufficient capacity, through its resources, to accommodate

the beneficiaries and fulfil the desired outcomes of the study. Thus, the

researchers ought to determine the efficacy of health and educational resources

in the city of Mandaluyong, as one of the prominent cities that are implementing

the conditional cash transfer program, in the delivery of the 4Ps scheme.
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THEORETICAL FRAMEWORK

The researchers endeavored on the research topic with the aid of the

following theories:

The Black Box Approach Theory. According to Gaarder et.al on the

study of the Conditional Cash Transfers: Unpacking the Causal Chain, a theory-

based approach known as “black box approach theory” is being used on their

study. This theory is developed by Ludwig Von Bertalantty in the year 1945.

Black box is a device, processor or system whose inputs and outputs and the

relationship between them is known. In order to evaluate a program all inputs

and outputs should be examined. For example in CCT, the “supply of services” is

the inputs of the supply side. This input is being used in the program impact

evaluation.

CONCEPTUAL FRAMEWORK

The researchers endeavoured on the research topic with the aid of the

following concepts:

The Role of Operations’ Analysis Concept. It is the concept used by

International Food Policy Research Institute in 2011 to evaluate the operation of

Mexican CCT the “Progresa”. This concept is used to analyze all issues about a

certain program to attain the desired evaluation. For a program as large as

CCTs, with a long gestation period and an intention to expand coverage more

widely over time, it is important to evaluate its operation and assess its supply-
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side at early level. Before being able to evaluate a program one must first

understand why it came about, what are its objectives and how these are

supposed to be achieved? Operations’ evaluation addresses the last component

in detail. It evaluates the operational performance of the program in delivering

crucial inputs. For example, it asks: Is the program functioning, or being

implemented, as planned? Are inputs (or resources) being delivered to the

appropriate levels, extent, quality and composition? Are they being delivered at

the right time and to the right individuals, household or localities? If the delivery

process is not adequate in any of the above respects, why not? What actions

can we take to improve delivery?

RESEARCH PARADIGM

INPUT PROCESS OUTPUT

• Profile of the • Gathering information • Delivery of
Respondent about the health & conditional
Health Stations/ educational resources cash transfer
Schools from health program in
• classification level personnels and school the City of
personnels through Mandaluyong
• location
survey questionnaires
• population and series of interiews
coverage
• Tabulation,
• number of interpretation and
classes/ enrolled analysis of the
students gathered data using
• Assessment on the different statistical
Health and method
Educational
Resources
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Figure 1

Figure 1 shows the input, which consists of the profile of the respondents

as to the classification level, location, and population coverage, number of

classes and enrolled students in schools, and information on the health and

educational resources of the City of Mandaluyong. The data shall be gathered

through survey questionnaire and series of interviews, which shall then be

tabulated, interpreted and analyzed with the aid of different statistical treatments

in order to produce the output – the efficacy of the health and educational

resources of the City of Mandaluyong in delivering the Conditional Cash Transfer

Program.

STATEMENT OF THE PROBLEM

The researchers aim to assess the efficacy of selected health stations in

the city of Mandaluyong in the catering the beneficiaries of the conditional cash

transfer program, dubbed as “Pantawid Pamilyang Pilipino Program (4Ps).”

Specifically, this research sought to answer the following:

1. What is the demographic profile of the respondent public health personnel

and schools personnel in terms of:

1.1. Position (nature of work); and

1.2. Length of service?

2. What is the profile of the respondent public health centers in Mandaluyong

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City in terms of:

2.1. Classification Level;

2.2. Location;

2.3. Population coverage/capacity?

3. Are the health resources sufficient to effectively deliver the conditional cash

transfer program in terms of:

3.1. Health care facilities and amenities;

3.2. Health care personnel;

3.3. Maternal health care service;

3.4. General health care equipments;

3.5. Essential medicines and/or supplements; and

3.6. Deworming?

4. What is the enrolment statistics of the respondent;

4.1 Day care centers

4.2 Public elementary schools?

5. Are the education resources sufficient to effectively deliver the conditional

cash transfer program in terms of:

5.1. School facilities and amenities;

5.2. Learning resource materials; and

5.3. Number of teaching and non-teaching personnel?

6. What are the suggestions, insights and strategies of the respondent public

health personnel and school personnel to attain sustainability of the program?

7. What is the impact of CCT on education and health?

8. What are the issues/problems that would serve as constraints towards the
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attainment of the objectives of CCT?

SIGNIFICANCE OF THE STUDY

This study is found to be significant to the following:

National Government may use the data in improving the present scheme

and in formulating future human development programs, fiscal appropriations

and other policies.

Local Government may use the study as a guide to devise better plans

and strategies in the implementation of the conditional cash transfer program in

the city or barangay.

Health Sectors may utilize the study as it manage and allocate resources

as well as know the possible deficiencies in the health care units.

Beneficiaries will be provided with the precise knowledge on the different

health services they are entitled with and the terms for them to acquire these

benefits.

Students will able to recognize the effort of the government in creating

programs to decrease the level of poverty in our country. Specifically, political

science students will benefit from this study since it is within the fields of public

administration, social services and policy-making.

Future Researchers endeavoring in relevant field of study will be able to

utilize this study as their reference.

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SCOPE AND DELIMITATIONS

This study aims to assess the efficacy of the health resources of the City

of Mandaluyong in delivering the services that are complementary to Conditional

Cash Transfer Program dubbed as the “Pantawid Pamilyang Pilipino Program” or

simply 4Ps. The researchers shall gather data from the target sixteen (16)

barangay health centers, eighteen (17) Elementary Schools and ten (10) Day

Care Centers, represented by authorized personnel-in-charge, and identified only

as to their classification level, location, and population coverage. This study

focused primarily on the past and present allocation of health and educational

resources and efficacy of health services that are part of the program

conditionalities starting from the pilot implementation in Mandaluyong City up to

present.

DEFINITION OF TERMS

Beneficiaries refer to poor households with pregnant women and/or with

children 0-14 years old selected by the Department of Social and Welfare

Development to be part of the program.

Conditional Cash Transfer is a program that provides cash benefit to

finance the basic needs and foster investment in human capital to extremely poor

households.

Efficacy is likelihood of achieving desired end by expending effort.

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Health Resources are the availability of manpower, facilities, revenue,

equipment, and supplies to produce requisite health care and services.

Human Capital Development refers to the ability and efficiency of people

to transform capital into goods and services.

Millennium Development Goals (MDGs) are goals established of the

United Nations in alleviating poverty around the globe, which also served as the

legal basis of the implementation of the Pantawid Pamilyang Pilipino program.

Pantawid Pamilyang Pilipino Program (4P’s) is a type of poverty

reduction strategy that provides cash grant to extreme poor households to allow

the members of the families to meet certain human development goals.

Proxy Means Test refers to the statistical treatment used to determine the

socio-economy of the families by evaluating certain proxy variables such as

ownership of assets, household head’s education, family’s livelihood and access

to water and sanitation facilities.

Social Assistance refers to giving monetary support to extremely poor

families to respond to their immediate needs.

Social Development is referring to as breaking the intergenerational

poverty cycle by investing in the health and education of poor children through

different program.
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Supply Side Assessment is a process that aims to determine the

readiness of the city/municipality local government units in ensuring delivery of

priority health and education services for the target poor households.