Bridging the Gap

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Bridging the Gap: Using Health Advocates to Improve Reproductive Health in Palawan

Puerto Princesa, PhilippinesPuerto Princesa, Philippines
Year Founded:
Organization type: 
nonprofit/ngo/citizen sector
Project Stage:
$100,000 - $250,000
Project Summary
Elevator Pitch

Concise Summary: Help us pitch this solution! Provide an explanation within 3-4 short sentences.

In the Philippines, 15 women die daily due to preventable complications of pregnancy and childbirth, because they lack knowledge and access to prenatal services. 20% of pregnancies are to teens. With education and clinical services, we empower women and communities to lead healthier lives.

WHAT IF - Inspiration: Write one sentence that describes a way that your project dares to ask, "WHAT IF?"

What if all pregnancies were wanted and planned?
About Project

Problem: What problem is this project trying to address?

Our project addresses two main problems: (1) The inability of women in Palawan to plan their pregnancies and have safe, healthy deliveries. (2) A high rate of teen pregnancy (25%), which forces girls to drop out of school, curtailing their education and limiting future economic possibilities. This is largely due to a lack of education, knowledge, and access to clinical services. These issues have also led to a high maternal mortality rate.

Solution: What is the proposed solution? Please be specific!

We propose to continue providing reproductive health education and services to communities all over Palawan, but to scale up our services, extending them especially to geographically isolated disadvantaged areas (GIDA). These areas lack facilities and services, so we will train Community Health Advocates (CHA) and Youth Advocates (YA) in providing reproductive health education and information. These advocates will be resources within their communities for years to come. We will also provide or facilitate access to free reproductive healthcare, including free contraceptives and free prenatal care.


Partnership with Gates Foundation Project, Election as head of Palawan Reproductive Health Advocacy Network, Vital Voices Fellowship, Asia Society Fellowship
Impact: How does it Work

Example: Walk us through a specific example(s) of how this solution makes a difference; include its primary activities.

Sharon was pregnant at 15 and dropped out of high school to care for her baby. When ROH began work in her community, she joined the Maternal Health Program and learned how to prevent or space further pregnancies. She was so active in class that she was invited to train to be a Community Health Advocate, to help with her neighbors’ health needs, including distributing contraceptives and scheduling prenatal exams. Today, she serves 25 women in her neighborhood. Her little girl is now five and Sharon is ready for a second pregnancy. ROH is happily giving her the clinical support she needs. We have equipped her with both knowledge and services, and prepared her to make an empowered choice.

Impact: What is the impact of the work to date? Also describe the projected future impact for the coming years.

The combination of information and services results in behavior change in a way that providing only one of these facets does not achieve. Since 2012 we have taught over 1,000 women in nine communities. We have trained 41 CHAs and 71 YAs to act as resources to their neighbors and provide services. We are currently providing family planning services to 1,250 women and prenatal services to 316. The impact of this has been that in 2015, the facility-based delivery rate is at 94%. The contraceptive prevalence rate is 71%. The dropout rate of the program is only 5%. In one community site, our client, Lorna, said, “Before Roots of Health was here in our community, you couldn’t find a flat belly anywhere, because everyone was always pregnant. Now, I see more flat bellies, because women have become empowered to control when and how many children they want to have.”

Spread Strategies: Moving forward, what are the main strategies for scaling impact?

Outside of the provincial capital, maternal mortality and teen pregnancy rates are higher, and contraceptive prevalence rates are lower. We aim to reach women in these further areas to improve these rates. We plan to replicate a targeted version of our educational programs, and support this education by training CHAs and YAs, and delivering clinical services. We will create hubs in geographically relevant areas to provide support to the surrounding municipalities. We will also leverage Local Government Units to improve their services and the provisions for women’s health under the law.

Financial Sustainability Plan: What is this solution’s plan to ensure financial sustainability?

80% of our funding is sourced from foundations and grant-making organizations. We plan to fund our expansion from funders interested in helping to reduce maternal mortality and teen pregnancy in Palawan’s more remote locations.

Marketplace: Who else is addressing the problem outlined here? How does the proposed project differ from these approaches?

We are the only reproductive health organization in Palawan. Local Health Centers have a limited supply of free contraceptives, and no prenatal vitamins. Because of this lack of supplies and a lack of nurses and midwives, women don’t access health centers. We partner with our government counterparts to bolster the services in areas that have poor maternal health indicators. We aim to increase the scope of this partnership, Our approach is community-based and focuses on efficient service delivery, which utilizes CHAs to maximize our clinical staff’s time to provide higher quality services.

Founding Story

Dr. Susan Evangelista and her daughter, Amina Evangelista Swanepoel started Roots of Health in 2009. Susan was teaching at the State University in Puerto Princesa, and voiced concerns about the unplanned pregnancies and lack of reproductive health knowledge among her students. Amina had just completed a double Masters Degree in International Public Affairs and Public Health at Columbia University in New York City. From there, an idea hatched. They started the organization teaching reproductive health classes within marginalized communities and to college students, thereby improving health and the general quality of life in this very poor province of the Philippines.


We have eight full time staff teaching, training health advocates, and providing clinical services. All of our teachers have several years of experience teaching in school and community settings, and two have experience in community organizing. Our clinical staff is three midwives and one nurse. We plan to add to our teaching and clinical staff as we expand and eventually have five to eight full time staff in each of the proposed expansion sites.
CO-CREATION IDEA: Please offer a brief description of how you imagine a win-win partnership with Boehringer Ingelheim to better serve unmet needs in health. (Hint: Please mention the underlying business model envisioned that would make such a partnership sustainable.)

Boehringer Ingelheim’s success is founded on innovation and sustainable growth, two essential components in our program expansion. We refuse to sacrifice the high quality effectiveness of our work as we extend to more remote areas, and Boehringer Ingelheim’s expertise would be a major asset during this transition. We’re open to a wide range of innovation including adapting our model of education and delivery, and shifting the structure of service delivery. For Boehringer Ingelheim, a partnership with ROH is an opportunity to further the mission of social entrepreneurship, “creating more health.” Palawan is a remote island and major tourist destination, and would provide a unique opportunity for the company to do this in an underserved area.

NEEDS: Based on you response above, please specify which of the following resources, operations or expertise by Boehringer Ingelheim you imagine leveraging to actualize the proposed co-creation opportunity. Please check all that apply. (Hint: while financing is often critical to scale, we are also interested in understanding what other assets or expertise could be leveraged).

Relationships/New Contacts, Marketing/Communications Support, Human Resources, Technology Expertise, Access to Capital.

EXPLANATION OF NEEDS: Please explain your choices in more detail.

○ Relationships/New Contacts – we’re a collaborative organization and welcome the opportunity for new and innovative approaches to the problems we are seeking to solve.
○ Marketing/Communications Support – we would welcome technical help to improve our marketing and communications.
○ Human Resources – we welcome technical support to help us manage a growing number of staff and ensure the continued high quality of our services.
○ Technology Expertise – to explore the potential to begin using more technology that may help us achieve our goals.
○ Access to Capital – fundraising support.

OFFER: What are the main assets you may contribute in a co-creation partnership with Boehringer Ingelheim that would better serve unmet needs in health?

Deep understanding of an unmet need in a specific market/context, Access to and established trust with customers/beneficiaries, Insights into behavior change.

FOCUS AREAS: Which of the following best describes the main focus of your project? (select all that apply)

Increasing physical access to healthcare to people with restricted mobility or restricted access (senior people, people with disability, remote or difficult areas, etc.), Holistic solutions that work across the entire care continuum (including education, prevention, detection, treatment, management, follow-up), Remote care solutions for health management, treatment, and diagnosis.

Please share what your organisation and Boehringer Ingelheim will Co-Create together
Please specify what your Co-Creation will result in:

If you selected "other" above, please explain:
Please provide a 1-2 sentence summary of your Co-Creation idea
How does this project link to the core mission of your organisation?
Beyond social impact, how does this project link to Boehringer Ingelheim’s core business?
What are the specific inputs and actions that each side will contribute to this Co-Creation idea based on each of your unique competencies and experiences?
Please describe the potential revenue model for this Co-Creation idea.
What possible risks or challenges do you foresee?
Is there anything else you would like to share about your Co-Creation idea?
How much input do you hope to receive from Boehringer Ingelheim?

If you selected "other" above, please explain:
Besides Boehringer Ingelheim, what other types of partners might be valuable to carrying out your Co-Creation idea, and why?