27593 H U MAN DEVELOPM ENT November 2003 FOR PEACE AND PROSPERITY f- .1~~~~~~~~~~~~~~~~~~~o r _... THE WORLD BANK GROUP . . ..~~~~~~~~~~~~~~0 - 0 X C to o I- 21 _ a .2- Cn 0F- A < n 0 m32a C-C rJNW&4U Human Development for Peace and Prosperity in the Autonomous Region in Muslim Mindanao The World Bank Human Development Sector Unit East Asia and Pacific Region November 2003 Acronyms and Abbreviations ARMM Autonomous Region in Muslim Mindanao Selected regions CIDSS Comprehensive and Integrated Delivery of Social Services Region IX Western Mindanao CMEP' Comprehensive Mindanao Education Program Region X Northern Mindanao DBM Department of Budget and Management Region XI Southern Mindanao DepEd Department of Education Region XI Central Mindanao DHS Demographic and Health Survey Region XIII CARAGA DOH Department of Health DSWD Department of Social ' it i-r and Development IRA Internal Revenue Allotment LGC Local Government Codce LGLT Local Government tUnit MOOE Maintenance and other operating expenses NCR National Caipital Region NGO Nongovernmental organization NSCB National Statistical Coordin,ation Board ODA Off, ,Ii development aid PhilHealth Tiii 'II'' '., Health Insutrance Corporation PHP Philippine peso RHt- Rural healthl unit RLA Regional Legislative Assembly tTNICEF UTnited Nations Childr-en's Fund Acknowledgement This report was prepared hy a team led by Teresa J Ho and Elizabeth King, and wvhich included josefina Esguerra, Mario Taguiwalo and Damaso Vertido. Other i.rl .111..1 to the report were Joven Balbosa, Marv Judd, Lloyd McKay, Miriam Pahm and Lynnette dela Cruz-T'erez. Gary Tlheisen, Sarah Cliffe and Haneen Ismail Sayed served as peer review- ers. Cynthia Manalastas assisted with document processing. Supervision from Emmanuel Jimenez and Rohert Vance Pulley is gratefully acknowledged. 2 1 V I Table of Contents Executive Summary 7 Scope and objectives of the study 7 Three factors contributing to the human development lags in ARMM 7 Autonomous governance for human development 7 Public expenditures for human development 8 The education system 9 The health system 9 The social protection system 10 Closing the gap in human development outcomes-A strategic framework for the coming decade 10 Human Development for Peace and Prosperity in the Autonomous Region in Muslim Mindanao l Scope, objectives, and methods of the study 13 1.1. Scope 13 1.2. Objectives 13 1.3. Data and methodology 15 2. Challenges of human development in ARMM 17 2.1. Worst human development indicators in the country 17 2.2. Extreme poverty, armed conflict, and historical disadvantage 18 2.2.1. Extreme poverty 18 2.2.2. Armed conflict 19 2.2.3. Historical disadvantage 20 3. Autonomous governance and public financing for human development 23 3.1. Legal and organizational structures of autonomy 23 3.1.1. Legislation for autonomy 23 3.1.2. Implementation of regional autonomy 24 3.1.3. Current regional organizational profile 25 3.2. Public sector financing in ARMM 26 3.2.1. Sources of financing for the Regional Government 26 3.2.2. Budget process for regional government expenditures 28 3.2.3. Financial profile of ARMM local government units 30 3.3. Levels of public spending on human development in ARMM 30 3.4. Prospects for increased human development spending by LGUs in ARMM 32 3.5. Input mix of human development expenditures in ARMM 33 3.6. Official development aid for human development in ARMM 34 3.7. Toward a governance and financing framework for human development in ARMM 36 3.7.1. Increase public expenditures for human development in ARMM 37 3.7.2. Increase regional government autonomy in budget allocation and management 38 3.7.3. Define the basic policy direction for human development 39 3.7.4. Conduct an organizational ancd staffing review and develop a human resources management plan 41 3.7.5. Increase transparency and accountability 41 4. The education system in ARMM 43 4.1. Educational progress and challenges 44 I L2u: lJ pm; , m !c' , PL'>tc , ld h pci 1 i) rhL AR\I.Mi 3 Table of Contents 4. 1. Enrollment and literacy 44 41.2. Test scores and systemii throughput 45 4.2. Supply conditions 47 4.3. Demand factors 48 4.4. Determinants of enrollment and completed years of schooling 49 45. Challenges in delivering education under autonomy 51 4.5. 1. Articulate a clear and broadly shared agenda for educational development 52 4.5.2. Increase the efficiency of the eclucation sector 54 4.5.3. Ensure adequate resources for educational development 57 4.5.4. Strengthen links between hasic eclucation and tertiary education institutions 59 5. The health system in ARMhl 61 5.1. Health status and its determinants 61 5.2. Health care system 63 5.3. Determinants of health system utilization 66 5.4. Getting the health system to peak performance 67 5.4.1. Bring more funds into the health system 67 5.4.2. Establish an efficient health care delivery system 69 5.4.3. Establish efficient support systems for managing health operations 70 5.4.4. Promote programs that respond to the special health needs of the Region 72 5.4.5. Autonomy: ARMM's version of devolution? 72 6. The social protection system in ARMM 75 6.1. The datu system in Muslim communities-The traditional safety net in times of peace and of conflict 75 6.2. Social protection-Traditional social welfare services 76 6.3. Evolution toward development of community-based social structures 77 6.4. Proposed steps in the delivery of social protection services 78 7. Closing the gap in human development outcomes-A strategic framework for the coming decade 81 7.1. Recommended strategy 81 7.2. Implementing the strategy 82 7.3. Key actors 83 7.3.1. Regional Government 83 7.3.2. National Government 84 7.3.3. Local government units 85 7.3.4. Donor agencies 85 7.3.5. Civil society 86 References 88 Tables Table 2.1 MDG and other indicators of human development in ARMM 17 Table 3.1 ARMM Local Fund 27 Table 3.2 Government expenditures in the RMM Regional Government 27 Table 3.3 Percentage distribution of income sources of ARMM and non-ARMM LGUs, 2001 30 4 I 1u. 1p- l) ir Ikui,, Cn Pr < N m(l n Th! K, M Table 3.> Consolidatecl public sector expenditures in human development in ARNINI and non-ARMNII areas, 2001 31 Tahle 3.5 LGU human development expenditures as share of total LGU expenditures, 2001 32 Tahle 3.6 Human development expenditures in ARMNIM, by expenditure type, sector, and level of government, actual 2001 3s Tahle 3.7 National government human development expenditures, by expenditure tvpe and government department 35 Table 3.8 Official development aid projects in the human development sectors, ARMM 35 Table 3.9 IPost-conflict assistance to ARMNI funded by official development aid 36 Table -41 School enrollment rates of 6-12 year-olcls, by wealth quintile: Philippine and cross-countrv comparisons 45 Tahle 4.2 Literacy rates for women agedl 15-49, hy wealth quintile 49 Table 4.3 Mean test scores for clementary and secondary stucdents 46 Table 4.4 Cohort survival rates in elementary andl secondary education, 1995 and 2001 46 Table 4.5 Number of schools per 1000 children of appropriate age, 2001 46 Table 4.6 Number of public school teaclhers, 2001 4 Table 4.7 Disruption of education among children lue to armed conflict, and length of disruption 48 Table 4.8 Labor force participation and unemployment, 1996 and 2000 49 Table 4.9 Average childlren's clharacteristics 49 Table 4.10 Regression results-Determinants of enrollment and years of schooling comiipleted 5( Table 5.1 Life expectancy in ARMNI the Philippines (national), and comparable countries 61 Table 5.2 Factors ii. ii,, health outcomes in ARNIM 62 Table 5.3 Health system outputs in ARMNI 64 Table 5.4 tnmet need for family planning, 2002 65 Table 5.9 Health system capacity in ARNIM 65 Table 5.6 Regression results-Dcterminants of receiving some vaccination and visiting a health facility 66 Figures Figure 2.1. Distribution of Householcls in National Wealth Quintile 19 Figure 2.2 Distribution of Urban Households in National Urban Wealth Quintile 19 Figure 2.3 Distribution of Rural Households in National Rural Wealth Quintile 19 Figure 3.1 Autonomous Region in Muslim Mindanao Executive Branch 26 Figure 4.1 Primary and secondary enrollment rates for ARMINI and the Plhilippines, 1992-2001 44 Figure 4.2 Age specific enrollment rates in ARNIM and other regions 44 Boxes Box 4.1 Islamic education-The experience in Indonesia 59 Box 6.1 Working together as a community through the provision of a safe water system 82 Annex. Matrix of Strategic Actions for Achieving Human Development in ARMM 1. Government and Financing 91 2. Education 95 3. Health 98 4. Community-Led Social Protection 101 LtRIP.X; I)c'cI,)}pnL:M H(I K ,i L(1 d ,.> )cl ! il rF ABI\O 5 1 - - ,---- '*4- N N m * Yi- - I / j iJ I r ¾.¾ / t I i'J Ii ATMU' IIIjb 2 %j)PJJ  I L I 4q I f tf 1 p. iil ' I  ' -, 4b4I1l *1 j -.  IL ', , *  A.. Executive Summary Scope and objectives of the study Three factors contributing to the human development lags in ARMM v aliiost any measure, the Autonomicous Region in Muslim Mlindanao (ARNINI\) has the poorest huan Thiee critical factors unederpin the substantial disparities developienlit outComICes am0ong the 16 regions in the in basic edlucation andl hlclth indicators between ARNINI Philippines. Poverty incidence (63 percent) is wice that for tile and the rest of the country-extivene porertit. coolflict, lid nation as a whol.e Life expectancies for men ( y5. ears) and bistoriicul (lis(l(lflhtntar{g Data on the .1 ri 'ii -, of xwellth womeinn (593 years) re imore than 1(0 years belovw tile nation- indicate that 64 percenit of ARAINI houseCholds belong to the al rates. Infant and miaternal mortality (at 63 deathis per 1,O()( poorest quintile (20) percent) of all househIoldCs in the countyN, live births andl 32(0 deaths per 1()S)0( live births, respectively) and another 22 percent belong to the secondl poorest dIuintile. are 39) perentit indi 81) percenit highel than the national rates. Since 86 percent of all ARNIM households are aniong tie -() And net priltn irv and secondary cnronliient rates (at 82 percent percenit of poorest households in the country, income transters and 39) perceit, respectively) are 14 and 33 percentage points within the Region-through which the ricil couldl help tihe lo wer than the national rates Any effort to rebuild tell societ, poor-lve liiimited potential l'or ii Il i the C01nditio( sol' and econ1omy11 of Muslilm Mlindlanao after decadeis of sporadic the poor, leaving the Region exceptionally dependent on contlict-in fEt, ainv effiiort to bring sustaJined peace to external resources for econoi mic growvth or for human devel- Nlintidanao-mnust includei a comilpotient to enhance suhstan- opment. Continuing, thiOgh spor niadic armed conflict has put tially the prospects f rr human devehlopment in the Regiol. significant stress on the delivery of eduliCation , health, anid Thlis review of human dceelopient inARNANI is a key part social protection services, hoth on the supply and demand of th NNk orld Bauink's program to support the Philippine sidies. In addition, the Region's h lng historv of indlepcienlenlce Gov errlmets.t effolts to rCn\e Mislim S lidtlalnao, IS laid out in separatism, atd Culturral assertivoeness has created deep-seated the alknk's Cotintrv Assistance -ii i. - foi- r20)0) )30((5 (WNorld blairliels hewcntC thie colnirmoiwnity of Muslims in M indanao and BI-ank 2()12 .) The stuckd drtl licmits the state of huri dn eev lop- the rest ol' the Il J r - alntion-and has ledl to an abisence ol mnlIt in the Rltegioll explr X ires fac'to I.o ledilng to 1pn ir hUmalnl tile ilstitutirolld 11Lmi1 omanla sd oCia l Capital that is 'io essceitial deCvelopmlelnt outCOlines, andl exanillnes the eXten1t to \\hiCh pbtl)- to human devJelopmenrt. lie anlld privatc s,ctOi r s'elices have helped mnitigate (ir x1taer- i)teL! thleCe ollteol1ies. TLe stuLCIV exalmllinteS \w1hy these huallin Autonomous governance for human development devei rpmen1Cot rollter is icS si SOp p)r Coimpared wvith tIlose in othcr 1-regiolns in tIlic P'hilippines an111d wvcih rintri iti ng Factors Thie UnlliLue CirCuL1mtaStCleCs r i NIusiliil Mim linI1dlo n 1arnhe cJ1a-nrl illneedC, 1hiiU1d-bc2 c11hange.L i\Cl aii avai lahkl lrSnUR'Ce drawn Li nUL 1reh`Spiol1sS, frOuiii the crcatio 6 on f special task Indl the eXistilng p Ilitit li and si icial coi nditiorns in the Rlegioin. forcs and cormmissio(ns in the 19-His to the creation of A1RN\I tinder Republic Act No. 6734 in 1989, and thc amiencdlient of for its f Pr 1 1clistinct mandate than other nonaUtononICc)us that Act 1y Repuhlic Act No. 9054 in 2001 (the Organic Ltav). administrative agencies of the National Government. The latter contains detailecl provisions that pertain to the gov- Furthiermore, the structure and itemiization of the national ernance, regulation, anti funding of the humLIuan deevelopment government hUdiget for ARIMM is too tietailed and gives no sectors in the whole Region. Among other things. the Organic flexibilitv for management discretion anti accountability by Law states that the Region's schools wvill adopt the hasic core ARIMINI clecision-makers. N\'iile the Department of Bucdget cotirses, minimuim curriculuLIm and textbooks reqciirecl by the and Management is trying to reorient implemilenting agencies National Government, hut will have thc prerogative anti toxvardl resUlts, butiget maniagement in ARIVIM continues to responsihility to add other cotirses anti instructional m;ateril.ls he preoccupiedl with expenditures for inputs rather than pro- in keeping with the teaching of Islamic values. ltiction of outptit. In practice. the ARVINM Regional Government hals taken lit- In contrast to the Regional Government. local government tle initiative to assert its prerogatives under autonomry. It has units (LGtIs) within ARMNIM-inclutding provinces, cities, and foctised mainly on seeking hUdget suppolt fr-om the national municipalities-enjoy di ' 111111 more financial autonomy legislature or the national chief executive, In atitlition, there than the Regional Government. In aticlition to the standard Internal Revenue Allotment, wvhich is derived from total national revenues and which is granteci to all LGL's in the The human'developmentsectorsinh country uncler the Local Government Cocle, LGt's in ARNIM Region clearly are starned of resources, receive a share of national internal revenues collectecd in the Region. They also have more leeway to make resource alloca- judging by standards prevailing elsewhere tions in accomdance with locallv determined priorities. On the other hantl, while the Local Government Cotle, whichi man- in the Philippines.daltes the dievolution of many human development-relatedl functions anti responsihilities to local governments, has been has heen little or no direct assistance fromil the National in effect natiorvvide since 1991. the regional version of tlevo- Government in capacity ' 'H. ii for regional autonomy. ILition, atloptetl in 1995, essentially preserved edLucation, The Regional Government's timiclitv is untlerstanclable health, antI social protection services as regional government given its heavy dlependence on the National Government for . - liii.. The result is almost total i Iii I l: among its financing. The Region's funtling comtes from two main LGI lealdership towarti these hasic needs of their constituen- sources: (a) a Local Fund consisting of revenues fromil local cies anti correspondingly meiager ill I., , of LGLU hutigets taxes, fees, anti charges. and the Region's Internal Revenue for humLan tlevelopment seni ices (1.5 percent of total expendi- Allotment, set at 35 per-cent of national internal reventies col- tures amuong ARMNI LGIIs as opposeti to 21.5 percent anmong lectecl fromil the Region: antI (h) national goivernment hutiget- r' , I I LGIts. ary transfers to cover the cost of regional administration anti deliverv of dev'olved public services, Wh'lile the first source is Public expenditures for human development relatively stable and secure, anli more -1 lI 1 the latter is sub- ject to all the uncertainties and political horse-trat-ing sur- Per capita spentling on hulilan development in ARININI rounding the annual butdget process. Infortunaitely, the bulk from three major public sources-line departments of the of regional revenues falls untler the latter categoryv with the National Government, ARNIM Regional Gox-erninent, and Region receixving PH1P20 in national government transfers for LGIAs in ARNMMI-.amounted to PHP1,393 (U'S$28) in 2001. even- PHP1 in the Local Fund. Which Was equivalent to only two-thirtds of the level for the Central control of the btulk of ARMNI expenditultres rest of the countly. Health spencling suffers most, xwithi per untlerlines the governance issue of a i. c ii autotomo)tisi capita puthlic spending at only 41 percent of that for the rest of regional government that has no0 more real or practical auton- the countrv. Educiation and social protection expentlitures in omy in deciding the level and allocation of ftincis intentlecl ARNIM wvere 75 percent of the correspontling levels for the rest 3 i I l of the country. The hulimian development sectors in the Region The numibhers of public elementafry and secondclar schools cleatrlv are star'Ved of resources, jucging by standards prevail- relative to populaltion size ancl student-teacher ratios in ARMNI ing elsewhere in the l'hilippines. ippear to he on a par with the rest of the country, a1thilugh the At the regional government level, huliman development relative supply of private schiools is smaller. Howvever, there sector expenditures are heavily weighted in favor of personnel are questions as to whether the schiools provide the necessary costs, which receive 93 percent of total expenclitures in this environment and imiterials for students to learn and whether sector (compared with 85 percent at the national government teachers are aidequately trained ancd motivatecl. The ongoing leveh. Provinces in ARNIM also show- a hias in favor of per- conflict in the Region presents clifficult challenges for tecihers sonnel expendlitur es (90 percent). Overall, municipalities tendct and school principails to keep students in school. Sonme stu- to cnd up filling the galp in the input mlix, with their share of clents, is wxell ais teachers, are reported to lhe manifesting ps\-- mIaintenance aod other operating expenses aIt 73 percent of c10ological stress clue to the violence Armed conflict appears tlhcir tot.l 111.1'uian development expendituL-es. There is a strong to he causing delays to sclioolihig I I I II of .bout av vcar clue argumenit here to quCestion the efficiency and quality of hunirn to intermittent disruptionis to school activities. developmienit services, given the skewed input mix. On the demnand sicle, the slow, economilic growth, and the uncertaintv- and isolation broiught about hy the conflict make The education system investment in education less attractive. In addition, lower enrollment proThabilitv and educational attainment are associ- AlthougIl the gap betseen ARNIM and the rest of the ated xvith belonging to a poorer houselholdl, having parents country in enrollimenits has narroxv ed for primnry education with a lower level of edtuctition. and belonging to a larger fzan- since the 1990s, it remilains substantial at nearlN- 20 percentage ilv. A large pool of illiterate or semiliterate adolescents and points btceen school-age children in ARNIM in the poorest adults. a vicious cycle of poor schools yiecling poor gracluates (i- id, and those wvho are Cqually poor in other regions, and thus poorly trainedI teachers, and fe-w opportuinities for Children begin schiool later in ARNINI .d are only .ab)out one- local resource mobilization to upgrade schools make the chal- hallf aIs likely to continue thl-oughi the elementawr grades. TIhe lenge even more daLunting. transition to higil school is particularly clifficult, -ith a clip in NW'hile the needs are great, perce-ived conflicts between enrollment for children at around the age of 14 years-and the the goals of building a unicque Islamic community and of cul 'IIlnut gap for secondary edlucation appears to he wideln- remaining fully integrated in the larger l'hilippine nation has ing. Fewer than 2 out of 10 chiidren wNho enter grade I stay on preoccupied edlucaltion sector lea,idership in ARNINI and, to a to complete high school, large extent, prevented the Region fromii I i , the imore _-mundane b ut very real i ii of saving an education svs- teml that has deteriorated dLuring decades of neglect and con- flict. Steps must he taken inmiedialtely to resolve the ongoing debates on the appropriawte goals atnd institutiohna formins of thie regional edtucation system. lboth public and private. to ill - a M11111111 real start on education sector-'l- . ' landt development. The health system Health indicators for ARNIM show a region that is far less advanced along the 'health transition curve." with levels of life expectancy in the Region to)day miore akin to life expectancy in the lPhilippines in the late 19WOs and wNith patterns of mor- tality marked by high prevalence of communicable diseases. __ __ ....as is characteristic of poorer countries in Asia and Africa. This H'>. -K V'',i 't ''¼,K ' - 1 k ;' ' Sj F fi ( 9 is no surprise given the higlh incidence of poverty, which in Recently, however, a strategic slift fromil traditional welfare to tirn leads to poor nutrition, poor water andl sanitation, l - lit- development of Il-i i ''I comi unity netiork.s has startedl tak- eracv, andc higlh fertility, all kno'wn correlates of poor health. ing place, a shift that is living the foundations of a solid social pro- The ongoing . ii I also directly affects healtlh outcoMCes with tection systerm that is particularly appropriate for situations of traumra gunsliot wounds aniong the principal cLauses of cleatlh conflict, extreme polvrtc, and geographic isolation. Programs ini- and with acute symiptoms of post-traumnatic stress disorder tiated, hy the ARNIIM Department of Social Welfare and apparently present amiong a large proportion (arouncd 2 per- l)evelopient and led hy the comlutinity, that identilt local prior- cent hy one estimate) of the f1li. '-affected population. ities thlrougl a participatory process and that contrihute to WUild- ARNIM shows poor, if not the poorest, performance ing comlmlunity-based social stiLictures, are the imost promilising for amaong all regions in the liii Plq l.'' for comm1111on0 indicators the Region. The challenge is to fincd the appropriate halance of sernice coverage including prenatal care, immrnunization, between the inmmnediiate need to provide reoie/'ndcl rehabilitation nutritional supplementation, and i'' I planining services. It hetx-veen episodes of conflict, anl the neecd to prepare the ground would he reasonahle to argue that the healtlh system's very for long-terimi social cohesion aind dIielopienLt. low level of ftunding is causing this poor performance Incleecl, there is a strong argument to call for an imminediate Closing the gap in human development outcomes- increase in hicalth systemn fuinding, particularly twking inlto A strategic framework for the coming decade accotlnt the acdditional burden placed on the system h y the Ii II.i, 'ii scervice conditions, with large expanses of imoun- This stucl, puts forward a set of recomimiilenclecd actions to tainous areas ancl extremcly reniiote island locations. lBut a break the cvcle of under- i I.,,: andc delayecl developnient. closer examination of cdata on health systemn reso(urces in the The effort requireed is enorniiius, coriresponding to the cleptl Region shows a more nuanced situation. As with education, and expanse of the need. But two strategic themiles domuinate: the ratio of health service personnel to population in the Region appears to he comiparable to the rest of the country. * yI. is ample justificationi for ,li, ai ill.. increas- Also, although there Ire fewer hospitals ancI ha)irIm,}ana health ing the level of public expenditures for hurman dlevel- stations per capita. the nuriher of rural health units per c api- ta is higher than in mnost other regions. Inceecl, it w ouldCI appear that efforts to use the availahle liinitecd resources inure efficiently. e.g., to deliver a mor-e cost-effective paickage of -' : hasic services using niore cost-effective inptit comnhinations L throui oh a stre,aimlinedl netwoirk of facilities. couldl help AL improve health sector perfoiirmance. *4t*1 The social protection system |00_- To cope with the psychosocial and econiomiiic stresses resulting fromii the cycles of, i-il i the people of ARNEM have relied mostly On li fll il\family- and Clai SU tnetworks. The traclitioima 1 ntit system thilt gmeir1s the major uthnic gl'OUpS i n t h e R Ugioi l still domial.tes c\rve aspect of life in ARhIM. BLut O\ier tilC last CentuIy. the /aliti sy'ste(m1 and thIC ioc.tl ioivernuicnt have meshiedl into one systemn, and tracliitionallv accepted clan-hased forms of siicial piiiteeth i ( si1iCStimes I earni over iln the foi-ir of nupOtiSll alldCi COirl'UptiiOl lude2r the 9 i imioldern governance: sy-stem. -' lo opnicnt in ARNIMll aiid this study nIAcs thc caisc fo 2. A rclgionnl policy agenda (hacking the expcnditure rea li/i ng SuCIIh an incrca isc frOi il a fhll ia ngc of piart- frianewiork) wh ich estalisl ics thc fria ewiork ir1 ncrs. hult cSppccialltv I' lir tim' Natioinal GCovernment, hnmin dcclopmcnt spcndtliilg and cicnionstratcs LGt s, and donors. At thty saimt: ti c, thc key stike- hiro ac-Ihascd po ilitical consensuts 0n key human dlcd-(:I- hoilders itn ARNIM micrnl an cc, part tictcnari v thl oiipmcnt sectio r polic\ directions and foi- rgrcatcr tralln- ReI;oIn aI (ti mcxlrnmlint l,cc(i to denimonstra te that pa cncX aId AimaCCilitalIhiiitV ill maningeimecnt of staff thlcc is ind.ccd hi road-lhascd \\ ill to relorm internal aIlndi Othel rcsiircc.s. t1( AiAcrnCa Mi ad rctlli ma, ISO-Cricccr I CiThi n-1,1cc, \\h li ch 3.A rcuional b asic cdncatio n phail n \ hich ntl rincs thlc xxi 1 Id grcaitl lhlclp sc c nrc inc ica scd.' rs ICclrcc.S hac Sio ia; is. cssctltial Standa rds cr1itical impoliiemenctlic nis. H1Iict'. oilic t't SO iC'ri cmii) iLl tidatio)I1s (SCCt ii I / t' pi ii t01i I)/n imdar Os, k(c changc ill managctillcnt and 1li(ic )11c1 livs aomiduii/ I s0 cr/tS I 'p/It'! SinC ' (I iFcltilhg SVstCil1l ,itinlinig Ullditi'iS, Cicili-SiCS pI-n cICloIs to inlitciC'(INC' 11P1li/ibic C'x')C'1ili/ilIC'> ni') hiiallii il Vt C lsan link>ht'bxwccn tcrti alrx i nstitntiOin. amld tC(l/c'(Ii)iimc'iit aili/ ilici''t''vsc r'ioiillg/ ut/nIiiii) ' ill hasic cdtdcation. 1)b idi.'/ m1010ct/li iciit iii'bilct' i ci'vaIsIinl Irt1/ 1r1ci 4i/ct' A A IA liOIl li/ ItiOIl inl pin iLir timo ' irgc-iomaIl liltcit! llcmtirkI. tmiii (IC-( C111ait/l//it)t mcib (icniIstiraliit/ brdIiatI- cdC'd wh'lich pritleds 01i mid i ldcI' i 'I'crxicc tdicicr\x, facilitx CM'lS(C' I/SiIls oil t't' /k / polict titIC drctioins l 1himia10/ investillmlct po liicics Soiirccs oi itIt il nlilng. sunpprlit 5- tdircV'ii/lC'milt. tcIIS. :iltd 111iISURi2CcS to llncct S)cciatl hcitii ncCltl TIere icrc ari nLirhcrl of strlatcgic- actions ill tihe indiCid- A >'1 i a protc ution proi gram niP li c ccnitclrcdi 0n tllil SaI 'cMIct i> cC(iL tiC l n0 li .hitIh a1im, 1 ictfd Ipr IFotcc- CIOiLiii it v-V 'Cl diCV2' 'Oii-ICIt, Whincl LISC'> tllc tiOl inthat rcinfiorcc as1 \w'l a> articiilate' aInd amlplify cxpci'lericc frOIlm Sutcccssftil (li imprchC'tnSi c aimd tilm' irgcrl IncUSSagC o n' i- Crc l pLblic V'nCC'ItLlihg aim ttiCitC'llCltcr l)tcli' D 'crv' of sociall Scrxiccs priojccts anim impri vcCd gm icvnanllcc fh0ir humnuin dcvcli ipmcn(2t. aCl I(ptS C0iimninLtitV-h ia>Cd pI irt-CiVtpigiisr 'cctmoirtl atllncics in ARNIM, \ wilih tIC SUIppl'It iof thCilr mcnts, suclh as thic itinimiiLimi haisic r'CiS a> its ci orc ciOL itntcipa it agV'lciV's att tim' natiolnal lIev [mx c1\e amplc ta rIgcting to(). oppo irtuinlity to pI)LstSL'e ctoi'raI in itittiv'cs tilm t can11 l lp thi Rc!gimion ill Immixtig iO nt oi it> sx>tclilic cio nstra intl. I'lc *i I - calls fhr participaItiOnl ix 111allrailI :tctoI in1 /IcitlC-c', ai st'col 1d Set I?! r'e'cominc1it ltis /S ccI Stliol 's tilc Rcugion-nat iiia, reglil a lIandIiCiI 0\( ixc Ig Ci1i iiV'ts; CdLtI- t,, -I i/ IC' A11/1/w) r'C'1 Iol/s 'C 111111(1 scct'lr is'-sIIi/c C1ltii11, hcatitli la iL!l socialI pl'otc VtiOIi officialls Indl stalfl: civil IIIM'iIXsIt'S /I( c(klrIt scctCrIYIa t/I)t/is (1/1(d s(criC S1 ICiVt\ anCi thc cmi iilillitics' it rcprcllSctS: adl cxtcrnaI sI(lldardi,ix, sivilC,pl)(i'l1 man(wtiiclit /il (il it)iYliti,,ll(d i tin tiCs andI I'Lil1 ilng tI gcn iCS-\Wilhi tIi cltd' 1C02 Ci ' Oini I ca-l/l(cit i (c/C 111(1 il/i iC'r't(&Ct' Sctlt'ic iliv'' f cl/li t'S/ i ll tO theh RV2'gnaiO-II Giixc1111nmnt - x t,i\\ 1i(' i1hi St Ilioti\dxttc pallrt ncr> i/c it itli Sct c1o-s)cuciC /i' prio'itiexs ti i ' ak' onClcrtecl actioIin. ithliin tIIV Rc,ioi 1;1 ic ernmenCiitV, lecadershi 111ipn t coi lV' friom til c tOi i iil thtc fce i if thIt' ''lic fildl SV't i) Sj)5V'ifitC ICCclI'm ntICCLI actiollS ilns.n iCiCling R)cgiotlnll (i Cmit'1' , joiil lcd hy ithlclr part> (I' tlhc RcggiOllal tl icir prliopiosc'Vi tiiliiig aimV l recoimmed gC'tic h ir ( i ivc' rn tmIcIIt ill I 'ClClilnig Sulp pO1t li tio c thlethl CCC \i VtcpiOiinalI imp1plclnmlcta1tiOn. is pruc'>itV'Cd in tliV Aniicx. Tticsc caln im' sLIn1- scctoiir aelltcic>. mlaizV'Cid ill hriml ill tV'Cllit iifl'i\ c SV'l)fXitC' lhlt iiitric'latcCd o. in- Finall.v, lii stal/cetg ' jor Li/(mia (1C'viioi/)iit'it /[ ii'oidd uc CIct(V' CIc\xcol)MCipcts, 11nanm ' lcimpic)'IC' ul'itLioit t( CYI fiw i umialicit' tiidl pIr'nilicit'it r'C',S)iltiIii (hifLit' Ibc o1oin/t/' - .' in t/lt Ri,,iIIil. It is hiipc.l A M'tCiiC-114-tcm111 CI 'lic(' ('X)V'ClitClI raiI'xIxtmir\N ( M-k filI tlalt t lis >tCtld s C(IV'iCtiol n i if tl CistS i if te h , II 1, I in tcrmls ARNIMII. Ahiiili oi_itline> atn illdliCatiV'c phlil hI talrgctcCl iof Iosses tO IhiliaIIl iC'e0iip11C'1t. pall'ticCilaIV fo0 tilC Childirll incrca.scs in puiblic spci-cling on htum'stn ev'xeliopment of thc Rcgiotin xvill scrc ais (nc iiVoirc rceimiler of xvhv an cndci icr aI thlcc- tO five-vear periodl fIuldteld from all tO the I . l ill iUSflilm linVl1na1i; I mutst lFc thc: si itirc'c> ohjcctivc h ir all coincernet. F ---z -a A j-~. , -.--g- ~ ...zr. -_.r p._- _ ,3 0 v r ~~~~~~ a~ ~-e -5 I - : -Cr , 4VA. . ,t, ~ 1 iE _ F _KM 1. Scope, Objectives and Methods of the Study 1 .1. Scope exclusion that have built up over decades, even centuries, among the inhabitants of Muslim Mindanao have been kev factors in the ocated in the southernmost reaches of the Philippine regional contlict. These very issues that created conditions for archipelago, the Autonomous Region in '. 1 l i. Mindanao conflict, have been only exacerhated hy the conflict itself. Service L(ARMM) consists of five provinces (Lanao del Sor, delivery systems, already w,veak in the past, have been ruptuLred. Maguindanao. Sulu, Basilan, and Tawi-Tawi) and one city Eclucation and health resources-infrastructure, equipment, sup- (Marawi City). The Region had a total population of 2.8' mil- plies and, most critically, human resources--have deteriorated. lion or 3.75 percent of the total national population in 200(\ These assets must be restoredl and enhanced to create an envi- and occupies an area of 13.435 square kilometers or 4.5 per- ronment wliere children receive the nurturing ancl eclucation they cent of the total national land area. need to flourish into wvholly fulfilled individuals, where adults are By almost any measure, ARMM has the poorest human healthy, productive members of society, ancl where every indi- development outcomes among the 16 regions in the vidual feels part of a society that embraces diversity and respects Philippines. A child born in the Region today has venx limited their own-and others'-traditions and culture. prospects for a long, productive, and healthy life compared with children in the rest of the country. This child has a sub- 1.2. Objectives stantially higher than average chance of being born to a moth- er who is not ftnctionally literate and into a family sharing a This review of human development in ARMNI is a key part lower than average income, and of living in a home without of the World Bank's program to support the National access to safe water or a sanitary toilet. The child will have Government's efforts to renew Muslim Mindanao. as laid out in higher chances of dying as an infant and, having survived the the Bank's Country Assistance Strategy for 2003-2005 (World first year of life, will be more likely to suffer chronic undernu- Bank 2002). The study documents the state of human develop- trition and anemia. The child's chances of enrolling in primary ment in the Region, tracking indicators of education and health school are lower than elsewhere in the country, and substan- outcomes and the existence and nature of social safetw nets that tially lower for secondary school. And if that child is female, prevent families from suffering the worst consequences of and she lives to become a mother herself, her chances of hav- poverty and conflict. Using quantitative and qualitative ing an unwanted pregnancy or of dying at childhirth will be approaches, the study explores factors leading to poor human higher than in any other part of the country. development outcomes, including economic, social, political, Any effort to rebuild society in post-conflict Muslim and cultural factors, and examines the extent to which public Mindanao will have to include a component to substantially and private sector services have helped mitigate (or exacer- enhance prospects for human development in the Region. The bate) these outcomes. The study attempts to examine why lack of access to quality social services and the general sense of ARMM's human development outcomes are so poor compared [k fllix 1) li-n i I t, mA P p i 1 ml '. .r tc11 \k\1>'i 13 V with other regions of the cointry and which of these factors on directions to channel their efforts in a situation where the can-or indeed, should-he changed, given currently, II ,11, challenges are enormous and the resources limited. resources and the existing political and social context. Looking internally, the study addresses the World Bank Based on these analyses, the study examines options for a itself, recommending ways to ensure that the potentially large coherent strategy to renew and accelerate human development infusion of resources that the Bank (and other international in ARMM over the next 10 years, in what sequence the strategy partners) can bring into the Region are used efficiently, but in should unfold, at what pace and with what resources, as well accordance with local priorities and with respect for local tradi- as who should be the key actors in carrying out this strategy. tions. More specifically, the study recommends ways in which This study is addressed, first and foremost, to the ARPAIM the resources to be made available through the World Bank- Regional Govern Ment. This includes all levels of the Regional funded ARMM Social Fund Project-of which a significant part Government, from the Office of the Governor to all oversight is intended for investments in the three human development and line agencies, foremost among the latter being the man- sectors-can be put to maximum use to accelerate human agement and field staff of the three human development sector development in the Region. Possible further actions to comple- agencies-the departments of Education, Health, and Social ment the ARNIM Social Fund Project and other World Bank- sponsored activities in Muslim Mindanao, as well as those of By almost any measure, ARMM has the other international partners, are also highlighted. The study is organized into seven chapters. This first chap- poorest human development outcomes among ter gives an overview of the scope, objectives, and methods of the 16 regions in the Philippines. A child born the study. The second chapter documents the state of human development in ARMM and introduces three critical factors that in the Region today has very limited prospects put the Region at a distinct disadvantage relative to the rest of the country in its efforts to achieve human development-extreme for a long, productive, and healthy life com- poverty, armed conflict, and historical disadvantage. The study pared with children in the rest of the country. then proceeds in chapter three with a discussion of the Region's experience with autonomous government and explores ways to maximize the opportunities presented by autonomy to acceler- Welfare and Development. The study's aim is to provide prac- ate human development in the Region. A review of public sector tical and effective recommendations for actions to be taken by expenditures on human development in ARMM is included. the Regional Government over the next five to 10 years, within Chapters four, five, and six take a closer look at the three main a consistent longer-term framework for human development. human development systems in the Region-education, health, The study also aims to provide strategic support to counterparts and social protection-in an attempt to discover the key factors in the National Government, recommending ways in which the that explain ARMM's poor human development outcomes and National Government can make the most productive use of the the impact that each factor has on these outcomes. Each of these meager but valuable financial resources that it channels to the three chapters identifies opportunities for improving outcomes, Region and of the political partnership it is starting to develop with a particular focus on measures that could bring the human with the Regional Government. An equally critical audience are development service delivery systems in the Region to peak per- executives of localgovernment units(LGUs). The study aims to formance over the coming years. The seventh and final chapter help these executives define their roles in improving human draws together the previous chapters' recommendations to form development outcomes for their constituencies within a com- an overarching strategy for improved human development in plex governance structure and with their limited financial ARMM, proposing a ptioritized time frame for implementation of resources and strategic and technical capacities in the three the strategy and identifying specific roles for governments, local human development sectors. Finally, the study addresses the communities, and donors. The annex expands on these recom- leadership in local civil society, including both traditional and mendations, including their proposed timing and recommended newly emerging agents of change. The study offers guidance lead agencies for implementation. ¢ 14 Ii-i., tx, , tu F l'2( . f',-nD vi Ill c 1.3. Data and methodology such as those i. , :I in the Demographic and Health Survey (DHS) of 1998,' allowv an investigation of the systematic links The stLudyv employs a range of quantitative and qualitative between poverty and different measures of service utilization data and analyses. First, published sources such as past studies and and human development outcomes. The DHS covered about (mainly national) government reports from the relevant govern- 10,000 households, of wvhich ablout 5 percent were located in ment departments wvere reviewed andi analyzel. In addition, this ARNLM and another 30 percent in other Mindanao regions. Of the review looked at the economic ancd political history that underpins national sample, ablout 10 percent of households were Muslim. the Regions current level of clevclopmient, its cultuiral diversity. Lastly. research for the study included rich qualitative fact- acnd the issues related to its state of human clevelopment. It is with- finding through interview s and meetings with the various cunm- in this historical context that the stLdy assesses the impact of munities of stakeholders vithin the Region and with national poverty and economic underdevelopment. autonomy, and pro- leaclers, and througlh site visits by the study team. Site visits took longed conflict on humran development indicators, place over a period of one week cduring January 2003. These Second, the stuly is also hased on administrative data, imost- interniews, meetings, ancl site visits helpecl elaborate on the Iv from publishcd, national government sources (but also includ- impact both of the prolongedI conflict in the Region and of ing unpublished as .-II as regional sources), that provide information on hbasic huimi.nn development Lutc0i mes in ARNIM IuI and on the availability of ecducation, hea,lth, and social protection services. But there is no question that the collection of adiminis- trativ daltat has been limited in the amount of detail that the data can provide with respect to vLrious aspects of service dlelivelA' NX'hile senr-ice facilities tencl to halve information on many other aspects of deliverv. these dalta are not necessarily comiipiled at the .: I -. -£ regional or nationall levels of government, nor can they be assumned to he accurately repotecl. For example, in educaltion, -: clata on the physical condition of scliool luildings and classrooms ' 6 Ik 4 %,# 4' _ and the numbler of community-funded temporary teachers are not readily available: in h-alth. periodic slhortages of certain phar- autonomy and they point to areas for polic dialogue and ma1ceuticals in local facilities are notecl bry rLral health workers, chalnges toiward a coherent human development strategy in the hut this level of information is not seen in published sources. Region. The conflict ancd resulting security risks have cliscour- As noted elsewhere in this study, ARMIM is not a homoge- aged data collection in the past, i; l1, contributing to scarce neIous region and thus data that permit Solile level of ethnic and and sometimes spotty data. ARMMI'Is statLs as a higlh-secturity geographic disaggregation within AR\NINI are important in pro- risk area has limited the extent of stucly team visits in the field. a clearer description and analysis of the Region's prob- Teams were able to travel only to Zamboanga andc Cotabato lemrs andl resources. Secondarv and administrative data are not cities and their iinmediate surrounding areas. Every effort has able1 to support an analysis of the state of humran development as b-een made to come as close as possible to the principal subjects it relates to this diversity and to various socioeconoliiic factors of the study. Consultations with individuals with first-hand that alffect the economy of the household and the community. In experience or direct responsibility for ARNINI activities have orcler to identify and unclerstand the harriers to access to basic been an essential part of the study 1... 1.1 These consul- educattion and health services, ',. ,1I as they' vary between tations have macle the fact-finding undertaken for the study that Nluslim NMindanao and the other regions of the countrv, the studcyN much more valuable in shedding light on specific issues in includles a third approach-analyses of house hold survey data human development in ARNIM. using multivariate regression methods. Houselholdl survey data, II ii I iimg r.III ,,rp l L il l i rd icA th s 1)0>-i-) ft i lt) 1. tht tliircd CoIsIix*ct xLt'MN IrIltlridlc proj *it initiitcd It Phc tll Agcncx for Inm niition.il DI oplixii t (l SAIDI) to p lro id dii it .sahi on tPm p lle 1 iik iii.Xi rtii ,Iwa l th iitiin'd if xx,of liiini 'in l ililnltLmn in dc-eiwlring c,uiintniwc In tle hllilipllilel' thlS '11',I xxiC . l nnLhtill in t)t9 ziim i QtL)S yR - ¶ ? :' i, Ut.' 's --- ¼~~~~~ i- sti .btri , i.i._. :.%1 4Il.l l\'vlilCl il[/2 ',lk Pl)lL rl 111. tit'" U 2. Challenges of Human Development in ARMM 2.1. Worst human development indicators .. in the country goocd place to begin a rex rev of humil;an clevelopmient in Incidence of poverty by population 2000 62.9 34.0 16 ARMMI\ is how it me.asuicx up to the t,l II ARNINI is how i ilieastircs Lp to the ' lil. i,i .... i,, Average household income, 2000 (PhP) 81,519 144,039 1 5 Dev-elopnocnt Goals (IM)DGs) introdIticedl at thc United Life expectancy among women, 2000 (years) 59.3 71.6 15b Nations Mvillenniium Sulimillit in 2(000) The NDGs pertain, among Life expectancyamong men, 2000 (years) 55.5 66.3 15b others, to tairgets relating to poN-xrt\x enrollnment rates in primnary Infant mortality, 1995 (per 1000 live births) 63 49 14' education, gender equ.ality in i il a rates at the prinmar\ Maternal mortality, 1995 (per 100,000 live births) 320 180 15 and seconlary- levels, uLinder-fie clhild minortalitv ratc, ancl the Net enrollment rate in primary education, 2001 (%) 82.0 96.4 15i naterrnal inortllitX ratio. While the T'hilippines as a wxhole per- Net enrollmentrate in secondary education, 2001 (%) 39.2 72.2 lSb formiis relati-ely wN-ell, ARNIMI is far fromii imieeting the 1basic goals a A rank of I indicates the most desirable outcome for education, hl,th, and gender equality. b Shows rank among 15 regions, no data availab e for Region Xlil Sources Tralc 2.1 givnes . pictuire of the extent to whichi ARMIM On poverty and ncome: Nat onal Staistics Coordination 8oaod web site (wwv nscb gov ph>) On life expectancy and mnoartlhS National Statistical Cooordiation Board, 200? Philippinte Statistical Yearbook falls behind the Irest of the country. 2kAiming the o iIl I If On enroliment Department of Educationo Culture and Sporl, Annual Report, 2001 the statis of humian dev-elopment in ARN"I are: * In 2011, the incidenice of poverty in ARNLMI was alimost twice thalt for the nation as a whole-fo2.9 percent of the both womnen andc men hut ARM;vlNl's life expectancy nuLii- population could he consideredc poor coitiparecl with hers foir wOmietn ancl men ate 11) years ancl eight years 34.01 percent for the country as a whole.' The other less, resptectively, than the lowest numibers for the other regions of Mincldnao fell between these two numbhers, hut regions of Mindanao, (These figures refer to mtcdiuti poe rtry incidence in ARMMNT was strikingly higher than in assumiption of moderate fertility and mnortality cleclines. ) those other regions. Moorcoover, the average annual ho1Use - * Infant nmortality has declined in ARNINI as wNell. The imost holdl incoiie in ARNUM was only 57 percent of the nation- recent data, for 1995, show the rate dropping from 74 in al average. 1990 to (13 per 1,000 live hirths. This is a faster redLuction * Life expectancy was 59.3 years aniong w omen andi 5~.5 than that for the ciountrly as a whole, but the rate is still 31) years amioong mten moore than 119 years less than the percent higher than the national rate ancd is the secondl national , ic, in 2(000. Life expectancy lhas imnproveld fotr highest amioong all regions. tihess fnisoco~to ,tintrn,is, one tokein frorlri tlhe \ots, inol Stititso,srica ,irclroiirin s i fsi,so A i vneson 1oo.inooNlnB.rpio sin 1)1> andl ire e,Iirsst.rs I Lr'Iog thel '\SO'life uni-)1roof1 Ifsg n i nicthl),- ,logn .as,f t el)nnn-Nr ''1' ) 111C lt-h)ttilrti l it sii t lz i nuiiet tiie NS(M 23'fj 9 P/-lr/lily,i,.) .8tistitc,iI tzlb,,W , 11.!.. 1z vil,o differ i r (u )llic l.l Vn t, itk',iae Isll r st L'I'is fl lfefl s-t s i s, floes ltnes e tirn1 n tt fo r in s if e aespli h) u T h' W r-If l of liao i stifin.(tes, pi, sitj insiclenCstlrissig Oonsrli- finel t I.t:n' U i 11f t1o fo r un i ft irs.tirOin fiok >lin, t ernre rof f(i- poerc,nit iso AiMNlIS .in,l 2' S per-rit sin thn coLinto' s, n mt ,l ARMNIM orasks poo0e0t inning sr1l regsinu, Uring litiher itsetsrlologsI I l ,l:!l, 1,'r : i. SIr'? 17 * Maternil mortality has also fallen in ARMtift fromil 37' cation and health ser-ices, both on the sopply and per 100,000 live hirths in 199(1 to 329 in 1995, hut this demand sides. rate rem ains about 80 percent higlher than the nation- * The Region's politic l tin! eCConmniC history has been al rate-and, interestingly, aboot double the r1ate in marked by7 exCLusion and instability, leaving it with lim- Central Mlindcanao. It is. in fact, the highest armong all itedl institutional and human capitil on Which to build regions, the foundations for accelerated humalin developmeit. * ARNIMI does better in terms of baISiC eduCation than in Thise three factors influence outcomes in education, health, but there are significant gaps nonetheless, health, and social protectioni in diffetemi ways. Each factor is Between 1990 and 2001, the net enrolliment riate in pri- intioduced brieftly here as a general background for subse- malry eduCation for the country as a whole rose froimi queLlt discussions in later sections of this study. 84.6 percent to 96.4 percent. In 2001, the primary net enrollment rate in the different regions of the Country 2.2.1. Extreme poverty exceeeded 9(9 percent, except in Western, Sotitleri, and The level of poverty leterimiines the albilitv of households to Central Mindanao and in AR\INAI-and anmong the four t aSs1umC direct or indirect costs of sclhooling and health care, to regions, this rate was 1O> vest in ARNII, at 82 perceit. help prevent househohld memIlbers fromn1 falling ill or droppinig out The gap atnong the regions is larger at the secondary of sclhool and halving to fall back on houselhold reserles during level: the net enrollment rate was only 39.2 perenit in times of crisis. In addition a community's level of economic 2001 in ARNIM as compared with more than m(1 percerit development deterimiitnes households' abitity to maximize in other ,Mindlanato regions antIl 72.2 perccnt for the expected returns to human development investments. It also country as a whole. determines the extent to which society, or its representative gov- * The gross patterns and trends in human developimient ernient can respond to the needs of the poor. indicators Imlask important differences aithin AR.llII As mentioned earlier, poverty incidence in ARINMNI is high- itself, as there are significant differ-ences aniong the er than in anv other region in the Country. In fact, data from provinces comilprising ARNIM. ASCBs 00()0 Fa,nll IJncomue mid Evpeai!itares Sai cive shi)w that poverty inicilenice increased by seven percentage poiits 2.2. Extreme poverty, armed conflict, and in only thiree years, fromii 55.6 percent in 1997' to 62.9 percent historical disadvantage in 20)0(. I'oerty also increased for the country as a whole, but frtio a lower level and at a slower rate (from 33.) percent in The MDJG indicators illustrate the vast lii y. that 1997 to 3.0 percent in 2000). For ARINM, povertI incilence in must 1e addressed in improving human development itn 20(1() was high even in urban areas (51.0 percent), though still ARMINI and the urgency of t - I ty,hem. The substantial dlis- lOwer than it was in rural areas (08.2 percent), in contrast to the parities in hasic education and health indicators between rest of the country where urban poverty, at 18.6 percent, was ARMNII and other regions in Mlindanao as 1 as between 3( percentage points lower than rural poverty, at 48.8 percent. ARMIM and the rest of the country can be explained in the light Finalty, as a meiasure of the dlegree of deconcentration in the of three critical factors that, together. contribute ", 1. r ,I . to distrihution of incoiime the Gini i n l . i from the samne the Region's human development lags: surVey kata was the lowest in the country in ARNINI (10.33 ver- * The Region as a whole is mtici poorer than othel areas. sus a national Gini coefficient of 0.4t). Critically, the poorest segments within the Region stiffer l)ata on the I .11 of householdIs by wealth groups fromii extreme poverty, making it more dlifficult folr fronm the 1998 DHS give furthier evidence of the breadth and households and colimiiuinities toi meet the needs for depth of poverty in the Region. 'sing national wealth qtuintiles hasic services and seriouslV limiiiting the Region's ahility estimated from the survey as a benchmark foir coilmparison, to respond to those needs. figure 2.1 slhox-s that as mranly as 64 percent of households in * Continual, thougih sporadlic, arni(el conflict in the ARNIIM had measured wealth - llm, within the equivalent Region has put significant stress on the delivery of edol- range for the poorest 20 percent in the country as a whole. 18 _ I'reviouslk , the outer rea.iches of Muslim Mlindanao had gone thlrougl a historv of indcependence and w\arfalre agatinst the 70 64 Spanish colonizers beflore CUltiVatinlg a deli1cate lalance o'f - 60 _ ----- - -- 5 resistance and ciolhabloration t(vard the Amnerican colonizers e 40 wh io. with greater imilit;a-ry pow,-er than Sptin, \Nere nore sue- .o 20 22 20 1 ARM cessfil at integrating themin ito the larger Philippine nation. -20 h in - erging front the Secondl W har with little damiage citim- 21 ct 10 ----- ;2 2 pared with the dcev-astation in the rest of the Philippine,s, 0 Ql Q2 Q3 Q4 QS Nlindinao in 19lIS haidc a populaktion of 2,941324, wN-ithi Muslim.s E Quintile (1 lowest) being a mini irity ( 32 percent) of that population ( S intois 2t( I , Darort- Arr i bd d3doooor otte on 199a rn-phr ,d HeAthj citedl in Blararldiaa n 200)t. Throiiugh theI 19n()s and 19(i)0s Mindanao enjoyed relative peace, except for interimiittenit hut locilized 1I Iii 11' suclI as Karmlon's Solt uprising in 19'1-z. Thrioughout iiost of the 19 hs, therl was largely 1 00 8 spontaneous and oiniumianaged in-m igrationin attlacted hv the 9() ' 8010 \84 pper-cenit of lindanai is area classified as public land (Alhinales CY \ '(2000 pp. 9(-97) Thcni large-scale, arned coiniflict in Mlindaino .2 60--- U ARMM eg-an with local encounters hetw~een Mluslimil aind Clristiain z 40 21 \21-- 20 P0 18 _P fppIines - paramilitary UnitS, WhiCh Cqluickly- led to a iuclh wider c ionflict 21 21 20 20 1 8 o 20 hetwcen a ralpicll organized Bangsa Nloro (ItMuslim Nation) o 0 ArImyN and the urgently mobilized Arimieed Forces of the Quintile (1 lowest) Philippines, from 197 3.1y 199), after severil decades of high in-migr;ntion andl alimost two il ecades of armeicd conflict, D3t Glt e Autho, s Wtu , nsbsd on d3l3 f-o 13993 Demog,,ph,t 3n H,Jftb S- -ora noroe ASnhrr to ooat'oro ooneo to otta horn liii Denrogropor - Mindanao's population aCCointecl f ir 23. percent of the national population aind MLusilil ha1d shrLink to 19 percent of ATothler 2 21 percent of households in ARMM- t fell within the that (Barandliaran 2002, Santos 2)()()). seconcd lowest national wealth quiintile, leaving few-er than 1 TI'he- conflict in the Region contitiLues to this dacy thougIl it perceltl of ARNIN households with measuled wealth falling is largely sporadic in nature (Barandiaran 20)0t2, Danguilan- withini the range of wveailth of the 60 percent least poor house- V"itug and Gloria 2(0)))). A partictular commlunity may see no hioids in the country. Figure 2.2 shiws striking results for urban outbreak for several mionths then suddenLy he sulhje2t to fire- households in ARNIM, which appear to he considerably poor- fights or large-scale hiostilities-the community coiuld evacu- er than their Counterparts in other urhan areas in the eountry. ate, return, and evacuate again, or receive evaciuee.s from other As mnany as 84.-4 peretnt of urhan househokls in ARMBMI fall wvithin thie low-st natioinal urhan wealth quintile. I - All the ahove data indlicate that househiolds in ARNIM are __ so not only ver-v poor on average; they are for the large part equal- ly poor." This means that there is little rooim for incoine transfers within the Regioni througili which the ricil Coulcd heclp the pooi 3 ARMM leaving the Regioni exceptionally cdependent on external = 20 _ - Ph ippines resources for econoiimic growNth or for huliLman dtevelopillent. 10o3 2.2.2. Armed conflict Q1 Q2 Q3 Q4 Q5 Mindanao wvas the soLIthern frontier of the Philippines Quintile(11lwest) diuring muhtil of the first 10)0 years of the Plhilippine reptiblic. Dora urce Autho rrarronS bserondationtior 1. i 9rIti 19| communities. Significant hostilities occurrecd in the Region or affecting their ahility to learn in school and threatening their its surroundings in early 2000, in late 2001, and again early this chances for long-term psychosocial stability. Conflict also year (just wveeks after the study team's visit to the Region). exacerbates poverty, with incomes of conflict-affected com- Between major outbreaks, or or smaller inciclents occur munities .l iIri considerably f 11 1' armed hostilities ii iii,> I to guerrilla wvarfare tactics adopted by separatist (World Bank 2003) fuLrther deepening the cycle of conflict, groups aiming for a secular Bangsa Morn state or an Islamic poverty, and poor human development outcomes. The con- state, personal and familial grutdges and rivalries, or kidnap- flict and the lawlessness associated with the Region present it ping for profit (UIP 2002). as a higlh investment risk, affecting its ability to muster Armed and violent conflict makes the delivery of servic- national resources and buildl public trlst. Further, the conflict es even more difficult because of the disruption it produces. in Mindanao is a serious obstacle to increased investment The threat of death or injury as a direct consequLence of the I - from abroad into the country as a wvhole. Concern for conflict affects those providing the services, while the psy- chosocial impact of the traum;a affects li l. iii; mental Households in ARMM are not only very poor health and society's ability to return to steady productive aictivity. The impact on children is . I" prolemiatic, on average; they are for the large part "equally poor." There is little room for a income transfers within the Region through -. N which the rich could help the poor, leaving the Region exceptionally dependent on external resources for economic growth or -5,- ;,5_.wBrmworB.; T2'P for human development. .L. S-,'stdSE i4tthis constraint on countr)Nicle economic growth-i.e.. the .6_haZ eagerness to reap the benefits of the "peace dividend--is a -. - -zmain driver of thc National Government's peace 1i. in -,-,1~r i, the Region. 2.2.3. Historical disadvantage A Its long history of independence, separatism, and cultural assertiveness has created deep-seated harriers between the community of NMuslims in Mfinclanao and the rest of the fl o A Pihilippine nation. The price this comrmunity has paid has been C 34 8i_* * ! exclusion and alienation. Consciously or unconsciously L.e = - ~snational authorities responsible for guiding and supporting the -;> j -v-jj >l@ts t Pllilippines through decades of development have tended to C9 '-e ., -- ~neglect Mutislim Mindanao. More rl,i' iI 1a, ,the underpin- '' ! i ;-^¢-1 nings of nationhood that define the Region's ties to the rest of These trends in Muslimi leadership and the cintrxt ot hisrotn icl dti% el i pme Btf Mindind i i deri e deriedl frmi u reading of Ahmniles i 2dl(0u hu,h provides un icct'int ,if the peniLod fri iri the Arnericinn colminil em the eve of trmt,einirriai li . 'nd fromi rlD 'giil,un-\VrtIg rind ([1ri (21 0 ii) hIiicli i fers.m . ClC( 'ic nt of the licrid fri n )i rind lthe lite I(1 Ls to the rite iShl9 s 20 r .'i.r.,l ) I , ,' Y ! 1 '1 ,i (, t '\) .1\1 the countrv continue to be questioned on both sides, obstruct- ing the Region's ability to participate fully in the progress and developmeiit enjoted lzv the rest of the country o a . -, The provinces aincd peoples of ARMINI also lack some of the critical factors thalt Wouldt unify them internally as a soci- etyv MIacle, ovcr time, from five original territories constituting -; what xvas called Mloro Plro-ince" or Nlinclainao-Sulu unlder the colonial administration (IDavao, Zamboanga. Cotahato: Lanao, anti Sulul), tolay's ARNIM is less homilogeneous as a - region than is generally assumed. Basilan province xvas carved out of Zamboanga in 1973. Maguindanao province is one of the five provinces that xvere spun out of the original LI -T Cotahato territory. Lanao del Sur came froim Lanao. The orig- , -_ inal Sulu territory became Siulu province in 1917, from which . S i - a separate Tawi-Tawi province was formed. Hence, except - - for Sulu and Tawi-Tavwi, the ARNIM provinces vwere formed from different territories, eachi having hlad qutite diFf' ii _Ii colonial and postcolonial administrative experiences (Abinales 2000) pp 17-44; Casino 2u00. pp. 8-7 2). In addi- tion, these five provinces ar-e homne to as tmany as 13 ethno)- . linguistic groups, the major ones being the Maguindanaoans 51 of the old Cotahato Province. the Maranaos in Lanao, and the _ Tausugs in the Subl archipelago (Casino 2000, pp. 23-64). Abinales (p. 3) notes that Muslimtl communities shared little aside from Islam. They spoke related but mutually unintelli- gible languages ancl differed socially and politically in signif- ' - icant wvays." These broad historical trends in the Region, substantial dlemographic shifts over the past century, and major institu- t __ _ tional initiatives have shaped the qualities and features of ARNIM's institutional and human capacity to meet its current ers obtained reasonably good basic edLication cluring the rel- human development clallenges. What would -.l!ii 11i. consti- atively peacefuLl 1950s and 1960s, and survived the armed tote the web of relationships that together form the social cap- conflicts of the 1970s and 1980s, to become the most respect- ital on which human development efforts are huilt remains at ed professionals, persons of authority, and opinion makers of a primitive stage. While famnily ties are strong. organized sup- their communities today. But as these leaders age and retire, port systems such as community-based associations, people's those in the generations now under the age of 30 are bound organizations, and indigenous nongovernmental organizations to succeed into positions of i. .1-r I-,h; in their localities. (NGOs) have failed to emerge in the large numbers observed These younger generations, howex'er, may have been severe- in the rest of the country. That family and clan rivalries contin- Iy c1 E ii .-.1 by the limited opportunities for good basic ue to factor prominently in the conflict demonstrates the extent health and education during the last three decades of conflict of thc i: ili l-, that remains. and turmoil in their localities. NWithout the stabilizing influ- These historical underpinnings also influenced and pro- ence of significant improvements in the welfare of these pop- duced the level of human capital that the Region now has to ulations, it is difficult to find durable sources of sustainable work with. For example, the current cohort of Muslim lead- communal harmony. IV:'.f r, ii'rl <'il i FI L' 1 f 1' tlk \ 21 -a- ,^ 9^ _a ,e 7 r A I ,~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~.r 4 4:;_ s f -4 s*1 * _ t - ,4N f w v ~~~~~~~- 1t F-~4 AML ~L _l£+ ~~~~r ^ ' r.A~~~~~i 22 ~~~ ~ ~ ~ t Ii '1 dM: _,__ ;afl - } |E! , 'We ; er@v ern 4 3. Autonomous Governance and Public Financing for Human Development he Uni(ILu Ctnir stances n f (NI lilldallao 1 1Ve to National Governiitrtit to decades of war hctween the prusent dirrr.loci.lent (ibIOdiecd in tile (..irlt of al-tOl- IPhilippine entratl AtitllofitiCs and Muslimi isustgenits in the omly fo[i the group of five pro vinces ancld one city that con- sotitlern lPhilippinies. Just hefore the declaraution of mnartial law stitute ARMINM. Atitoruoiiv gives the goverIalnlace struLCtuls of in 19)-2 the Philippine Congress created a Commission on the R2gion the 'ibilitv- to ldefine its palth to p andie ind prosperi- Nationail Integration and a Mindinto I)eve\plilpCnt Autiloiity t\ suhlect to cxplicit legal standards and guided hyNr the p)- ais key national igencics focusecd on the development of the ple.s sharttedi va.flues andel atspirattions expressved throughl their south. D)uring thle niartiatl lawu period, w^-hichC statrtedl in 1972 elected leadetrs. Hl1um1an dcvelopiprent in ARM\RNN is ohviou-slv and cndedld in 1980. the Nationail Government created a influeneecl hv the inandate of auttonoliy and its practice thuis Presidential Tasisk Force for the Recotistiuction and far. Consequently, this chaipter first reviews the nominal scope, D)evelopment of Mindanaio Iand later a Southernl Philippines legal uniidet-pinnings, and practical implications of regional Development Administration to carry out an ainhlitious evel anitono ilrn It thetn assesses whether the political aLutoi oi my optient agenda clespite arnied c otlict in the Region. The enjoycd hy the Region is hacked hIyN a correspoinding m.lanage- Tripoli Agreemilent of 197( sought to settle the conilict hzetw\ecn rial and financial autoitnwi). Muiving from the general financ- the National Gi \ernemient and MIuslihI insurgents-who were ing, of rutonoliy to time specific financing of humnan led hy the Moro Nationial Liheration Front, the iin orgi- nizra- developnment in ARNIM, the chapter takes a closer- looik at one tion of the insurgents-lw, proividing for political .autmonoily ol of the major defining facitors in the response of the various lev- Muslim Mindanao within the territorial integrity and constitu- els of government to the huiman clevelopient needs of the tional legal processes of the Philippines. people of ARMMNI i.e., the levels, patterns, and soiurces of pul- Since this landmark agreement, the ilain arena( of the lie spending on education, health, and social pnotectioil serv- National Government's institutional responses to settlinig the ices. The chapter enicis w-ith a set of recommendations for arnmed conflict in the southi hais lheen the clefinition and Opera - establishing a public finance and public admiinistration Infillam- tionmalizatio n of vanrious versions of regionmal autollorinm foir work appropriate to thle exercise ol regio( nal atitorloniy in pur- southiern localities with predomiinantIv MItuslilml populations. suit of hetter hUmnan developmient outcolmles. The initial version of regional .lutitolommy offered 1w the M.arcos administration ( 19605 6) t.ws the crealtion in 19-- of two 3.1. Legal and organizational administrative rcgions (Regions IX and XII) coimposed( of lf structures of autonomy provinces, which voted for lutlonorwl- at a go-vernment-spon- sorecd plebiscite. The version Of atinflhoiny froi the Aquino 3.1.1. Legislation for autonomy administration ( 1986-92) was the creatioin in 1989 of ARNINI ARNINI, as a political-aidministiative entity, is the product uncder Republic Act No. 673i, undlcr- which four provinces of several policy and institutional apprimaches attempted by the voted for autonolniv at another plebiscite. It shiouuld he notecd that the Moro National Liberation Front did not take part and universities within its area of autonomy, and that the in either the Marcos nor Aquino efforts toward regional Region's education system will function as a subsystem to the autonomy. national education system. following the same structure, hut The latest version of autonomy, which came as a clirect with emplhasis on the autonomy of the subsystem. The Organic consequence of the 1996 peace treaty between the National Law states that the Region's schools will adopt the basic core Government and the Nloro National Liberation Front, was courses, minimum curriculum, and textbooks required by the defined under Republic Act No. 9054. This amended the earlier National Government, but will have the prerogative and 1989 Law, ancd became .1 I ii,-.. l . in 2001. Five provinces and one responsihility to add other courses and instruLctional materials city voted in another plebiscite to form the new ARMM. NWhile in keeping Nwith the teaching of Islamic values. these various versions of regional autonomy were being intro- ducecl, local governments at provincial, city, municipal, and 3.1.2. Implementation of regional autonomy bctrangaj' levels, including those in ARIM, had assunmed their In practice. the Regional Government has taken little initia- respective expanded functions and authorities under the Local tive to assert its prerogatives under autonomy. Bacani and Government Code (LGC) of 1991. Republic Act No. 9054-the Ambolodto. authors of an annotation of the Organic Law of Organic Law of the current version of ARMM-contains Muslim Mindanao in 2002. note that since the 1989 passage of the detailed provisions that pertain to the governance, regulation, first ARMNI law, jurisprucdence on autonomy in the southern and funding of the human development sectors in the Region. Philippines has been almost nonexistent. Only two cases on The 1991 LGC. however, mandates the devolution of many regional autonomy have been decided by the lPhilippine human development-related functions and responsibilities of Supreme Conrt. The Supreme Conrt has merely affirmed the the National Government-notably health and social protec- legality of administrative actions by a regional body and the con- tion services-to provinces, cities, municipalities, and stitutionality of the first Organic Law. The Supreme Court has not barangas,s that involve far more than wvhat is mandated hy the even decided if the Regional Government created under the laxv ARMM Organic Law. is merely a form of decentralization of administrative powers or Several provisions of Republic Act No. 9054 pertain to the a decentralization of political power by the National human development sectors. For example, Article III, Section 3, Government. As the two authors further observe, "in other states: "The Regional Government shall adopt a policy on local decentralized systems of government ... legal questions are fre- autonomy whereby regional powers shall be devolved to local quently raised before the courls on the interpretation of consti- government units particularly in the areas of education, health, tutions and organic laws regarding powers that are reserved for human resources, science and technology, and people empow- the central govermnent and those that may be exercised hy the erment. Until a law implementing this provision is enacted by states .. A growing body of jurisprudence on the extent of the the Regional Assembly, Republic Act No. 7160, the Local powers and authority of the autonomous government is sign of Government Code of 1991. shall continue to apply to all a robust and dynamic autonomy? (p. xvi). From the standpoint of provinces, cities, municipalities, and harangays within the this limitedl jurisprudence, therefore, regional autonomy has not autonomous region." The Regional Government passed its own only had a short history' but also a relatively neglected one. re: l - l . lLGC in 1995 (Muslimii Mindanao Autonomy Act The kev organs of political governance created for the No. 25), which essentially preserved cducation, health, and autonomous Region have not heen consistently vigorous and social protection services as basic services delivered hy the assertive champions of autonomy. The Regional Legislative Regional Government wvhile alloming provincial, city', and Assembly (RIA) of ARMILM has passed laws mostly' abouLt local municipal governments to deliver, in parallel, health and social rather than region-wide concerns. Regional laws on economic protection hut not education services. development or government revenue generation have been few. In another example of the provisions of Republic Act No. 9054 The Regional Governor has spent much of his efforts seeking the relating to the human development sectors, specifically educa- support of the national legislature or the national chief executive, tion, Article XI\V, Section 1 stipulates that the ARNIMM Regional as the hulk of resources for the Region have remained depend- Government will be responsible for existing schools. , I ,,. ent on what is allocated and released under the national budget. Yet as the two ahove-mentionedl authors state, '.. the Organic civil servants in the localities, such as provincial healtli offi- Lav.. governs the political, social, and economic life of the cers and education division superintendents. While substan- inhahitants of the autonomous region. It is not an ordinary tial nominal legal powers have heen grantedl hw law to statute since it w-as ratified hy the inhabitants of the atutonomous ARMM, the lack of a consolidated political leadership \vithin region just as the Constitution was ratified hV the sovereign the key organs of regional power makes suchI powers impos- Filipino people." There is, therefore, I great ncecl for "... creativ- sihle to w-ieldl effectively for the Region's henefit. ity andl hold initiatives on the part of the autonoinous govern- trent in asserting its autonomy and in uplholdling the primacy of 3.1.3. Current regional organizational profile the Organic Lan over national laws The current ARMLNI Regional Governor assumed office in Thc transition to regional autonom hlas been poorlv 2002 after having won the first elections for the expanded managc d h1 the National Government since 1989. There has ARMNIM under Republic Act No. 9054. There are 30 cabinet been little or no direct assistance in capacity 1,1 'l for niembers led by an Executive Secretary. The Regional regional autonomy. While hudget support for ARMVINI has var- Government is mtaade up of 25 agencies that includc a counter- ied over the yeTars, a stable, secure, and substantial multivear part office for virtually ever\ national government agency. In financial support plan has not been put in place. The formu- total, the regional organization employs 21,974 personnel. la-hased allocation of national government resources including staff working alt regional offices in Cotabato City (i.e., reserved for ARNIIM, over xvhich the Region has discretion, is outsicle ARMID) as well as field personnel assigned in the five miniscule in comparison with annual budget transfers to provinces and one city that constitute the Region. ARM,INI allocated under the National Government's annual As part of its organs for exercising autonomous political General Appropriations Act that is subject to the discretion of powvers of government, ARMNM has an RLA that has the poN-er the Presidlent and Congress. Notably, Tunlike the Internal to pass legislation vith local as well as region-Nide application Revenue Allotment (IRA) formula for LGLTs in the countrv, and enforcement. The RLA comprises 23 elected representa- which is computed on the basis of national revenues, the tives from eight legislative (I ii, i ARAIMN revenue allotment formula is baised on revenues from Development plans, prograts, and projects of the ARNINI the Region, clearly a less stable source of funds. In addition, Regional Governiment are approved by the Regional the ARMINI formtlal leaves no room for cross-subsidization Economic and IDevelopment Planning Board. As provided from other wealthier regions, unlike the general IRA formula. under Article XII, Section 10. the Board is chaired by the Plolitical facilitation for ARNIMI at the highest levels has been Regional Governor with membership consisting of all provin- provided mainly to secure ARMNM support for a succession of cial governors and city mayors in the Region, the Specaker of national administrations rather than to strengthen the capacity. the Regional Assembly plus txvo other assembly persons, and effectiveness. anol authorityv of the Regional Government over five private sector representatives selected li to a the Region's development. Formation of a strong rlling coalition process defineol hy the RLA. This body, which had been svithin the Region, a necessari- condlition for effective exercise of ignored hy previous regional governors, wvas revived in 2002 the autonomous poxvers granted undler the Organic La,N has not and an Executive Committee currently meets quarterl The been a major concern of the national or regional authorities. Regional Economic and Development Planning Office ser-es The ahsence of a ruling political coalition in ARAIMIV as the teclhnical staff of the Board. makes the passage of regional laws and compliance with Much of the wiork in implementing policies, programs, such laws h1- the Region's LGUs difficult; at the samc time, and projects and in delivering basic public services in the the Region's influence at the top, in the national Congress Region is carried out by the Executive Department, which has and on national executive bodies, is also weakened. Even the a regional organization structured according to sectoral Region's executixe agencies are hampered hy the patronage departments as well as autonomous local organizations under olemands of, for examuple. regional legislators dcuring the con- each respectiv-e provincial, city, andc municipal government. ifrmation of political heads of regional departments or of The schematic struCture of the regional executive branch is LGLT heads in the appointment or oleplom ent of regional outlined in figure 3.1. K - Cl ; 25 S .. . ** @6. . Oevelpmem Kwan Bo4wd eDeve" Plmfl Executive Seceary I I$h Mug M.MRTI'ksmc. Mragm- Setyke 3.2. Public sector financing in ARMM taxes, fees, anti charges. It also receives 35 percent of national internal revenues-the IRA- .1 i I from1 the 3.2.1. Sources of financing for the Regional Government Region.' These two sources constitute the bulk of revenues As the above discussion on regional autolot11my suggests, generated annually bIy the Regional Government anti are the ARNINI Regional Government has a dual nature as (a) a h1ell hy the Regional Treasurer in the Local Funcl. The Local special type of local government with political powers Ftuind is allocated to programs anti projects endorsecl hy the assigned to it by the National Government, ancI (h) a special Regional Econolmiic and Development Planning Board to type of national government agency vith a specific local the RLA. development mandate. In keeping N-ith this dual nature, the The Local Funcl of ARMIMI reached l'IPI 75.7 7 I in resources that I. into the Regional Government comile pri- 1997, coinciding wxith the first year of the peace agreement mnarilv from two sources: (a) the Local Funcl consisting of local between the National Government and the Mloro Nationad reVenues similar to those of local governients, suclh as pro- Liberation Front. For 1998-)001, the level remilained ceeds fromii ARMINI taxes, fees, and charges, and the Region's modest-between l'HI1()3 million aind P111"13() million shlare of national internal revenues; and (h) nation tal govern- annuallv-althougll the Local Funcl started growing each ment hutdgetary transfers to cover the cost of regional admin- year by smiall incremilents when the amended ARIM] Organic istration and delivery of public services devolved to the Law set the IRA share of ARMlSI at 35 percent. The Regional Regional Government. At present, the national government Treasurer estimates that the ARNSI revenues for 2002. transfers vastly outweiglh the Local Fund, consisting largely of the regional IRA, would give the Local FundJ The Regional Government is vested -with Regional Government PHI2770( million in programmtdale the power to create its own sources of revenues and to levy funds for 20(3 (tahle 3.1). pm nIL Ir edL inder Re)uLi H IL ALI Ni. CA-3 ind am MCIRellede r Rnd iR ll II,At A NIt \ 'I QO ( , u11itic ret inerN.i I leLN entr Ciildeted in tire Regr iii are di h eld as t;rid xx 33 e i lt' c Reru nut) C0(nix rnnretn L( lcl ii l 3$ i t 1s hiied lant Oi L t a in tilie egrui (:in t -, 3) 2i I rei eni .inoi,mu the priitin..e itfiitie.iplitt hi tti n n i i percent Iiett en the Lrt .titd rrtit;Wrilui, iri1 n),J thIe retl inum An I l t Iperelt ILier ii L the N 1t1.. 1 nil t Au rIniIttiI t 26 ih . i '. . .I Y1r io ,efi'i:sfi-ai /ihc INltionl( (,'6ov r/ wIncit. National g( )- regsmionll adnlin ist ratiC ye ffic.ee of naltionmlI agencies in Other erinent tni nters to ARNM ar I ippro priated a nnutivy as par1t regio/ns Third, tic pilhlic srvies alvadv dcvOtv to local ol thIe IlMtitlk ml gI ivernlnn1t I Iudget t IIt is (F rIluL Lted I LvI tle goI-cCrnhCllilts eisewhSeCre in the CouLIty (tsul h S Is h ;alth, socialt I )epIltmII It olf 13LuIeCt aIndl NilInageniIet (I )NI), endlorsed I) prOte etion andl i agrieIltrl e exte/nsion) Iarc still bcing per- the Ilresidenit to COngress, fi i fo imed hv the ARNINI Regional Government even with tile enactmt ent nuderLC the annultltltl RLA's atdIOptioIn of t regioil LGC in 1 99g. FouLth, puhlliC srx - Gencral Appropriaih ins Act, 231 ices that have not vet been deviOlvcrI to lical governments Ihese natiotnAl govCeIrnment 1994 26.5 elsewheeI (sLIh aS Ce AtiOll. puhlic \w'OIrk' lld highways. transfer-s a-re meant, in the 1995 26.9 and the cnvironierit) aIre alsi heing perfoirmed L)v thie ARNINI LItngu age o f the G(Jeneral';I 1996 41.1 Reghional Goivcrnmien/t. All these mean that ARNIM costs tend to Apprplrialtioins Act. iFior gener- 1997 1757 lhe higher than thosc in other regions. a11 adllil1istl atioTin til sUPipolt D)espite thlese key featIuCes thtt make ARNIMi regional goy - services sLIpp)( t to operations, 2000 1219 em,1nen21t OpCraltionls unllieLI, and i /ioc expensive, thc preparl- 111nd OperaltiollS, iludilig IiOCia- 2001 1300 tion of the ARNIN I)uclgUt uLnerCl- the General AppropriatiO s Iv ftinde d and ft origi assistedl 2002 270 0 Act is (gi virnedl lbv generl; standlards ind restrictions that are pri-ijects i the Ati/ t llm O iris 5oOrce Oice ofthe legona Tieas,er,0RMM intendledl to apply- to tIle hlideCts of all ither niatii inal agencies Reg ional a I G i ernrinet in NILislinm Nlindlan;t ii. Preparation of Owr dlepartmients. Rigid naltio(natI gOvernment standards On Iiunits the ANiM INICIudget is goVernle_ lV a sCt of gIliCeClines issred li foir estimnating expentlitule iteills." enforcing ceilings on liudYg- 1)1DIM to all atgnci es aIt thle sta1rt of thC h)ulCgct (calendar andl this eta vallo;cations, and impOiising cuts Orw reserves a ppl to the is I roright (l m\\i to a level fr)r eaLch agency thatt fits In aggre- ARNIN I hrtidgct aIs thet dlito ottit hel- natiima I igcncies' liudgets. ga1te Ii iit of tot tl spending foir tihe eutii n Nationmal GCovern ment. Foir tIle periiodl 1')9c-2(i(I/ the Regionmal G /ernninenit had A in muiehr of inipOirta/it pOi nts shouil he nitedl in cOi m- rinder-prigra ined its expeiilit[ires liV alitL t 18 Perenlt of its p;llilag this pa It of tIle A RNIMI expenditilRes financelv I ibidlg- irnILgeta a:ppriOpriatioi. This intlicates thlat ahls rpiti v capac- ct tlal'stisers frI 1r tlhe Natio/al Gio vernment with similar itv inav hav\ bieen a priOhllin fir- the Regioimal GoGivernmlent. spelnding lv the Natio nal Giivcruniehict Iir Otlher regioins that altio tigl the Region's Licilgct perforimailuce l'or 21)t2 alIppIars to dlo i)/i/t haVe Mn anltoiOi/t/lit ts goICVer1111e/It .Filst. tIlie AR M II L\i- hae\ el iulli natcr. tliis cOin/straintI tio /n otf the General Appi pliriatioins Act inli-Icres thle csts / Of tIle Thecre ; has hieen a1 rIlILCtii / i/i the ARNINt lI)rlget in real /Fg/io/lnl elected rh/l e xecLIti/ve a/1I thle RIA: thCe NIitl her ter/s si/le 1')9X. It lalstgn iwr liv v Onlv 1) Percenit m r its /1le\ torill p oliticll trinctioiis tlhat di /()t exist in OtIler regdi/s / f the in 1918 i i t a InIr/al /\ ge g/i AVtl1 rIte Ioif t inlv althrOLit 3 per- ciL/1t1/v. scOd/ltl tIle rcgioi i/i Ii le depia rtilic/its of ARN IN IPer- cent a rilte Iio\er tl//lli the intlf/tii/ /iate. Thle I)ilr/Iget fO r r/pi- l'OF1ti /llrCl /1110ir e\xte/1siVe trl/litio in 1I theirlci C n/teLplalt tal i rtIlVs, \\wIli1 is thle /1/am s/()eLIif Ol'eifItFIds for inhatIstriLctrlne. ~~~~~~~~~~myai I' m lgTr 11;- I11 1 111 1i1l M1 1 1;1i ARMM expenditures Natiroal budqet TEar Salanes MOOE Capita outlays Total appFowallon' 1998 2,848 60 540.60 1,551.30 4,940.50 4,083.80 1 999 3,072 40 752.10 545 80 4,370.30 5,250.00 2000 3,434.80 554.60 678.40 4,667.80 5,632.50 2001 3,894.30 572.30 514 00 4,980.60 5,612.50 2002 3,997.60 708.40 696.50 5,402.50 5,402.40 2003 ' 4,115.80 1,001.70 467.90 5,585.40 5,585.40 Note MOOE M3 ntrnance and other cperat ng erpenses a f/atren3a udg. t .pprc,pr aDon ref,ects actualou ogo t for ARMM to include acrover funds fonm prntlous year and to exclude reseroes and unre e.ers 0 otme/ts as ,eported by DBM in tfre fiatronalE \perdiare Program b Expend t .res and aporopr:ot on fcr 2003 are taken from the President's budget prorosa , which had yet to be enacted by Congress as of Marcnh z 2003 Source of doato oe ARr fAi eAperrdrtores Olf e of the Regional Governor ARMiM 27 has remainedl virtually stagnant at a 1)w lev-el for the last five Regional Government to undertake a review to iclentify non- years. Salaries have consistently taken tip a large share of the performing or under-performing hulilan resources, as a prel- budget wA-ith imorc than 70 percent of the total, compared with oide to substantive civil service reform. onIv 35 percent on average for the National Government. Ihe Careful and selective use of foreign-assisted projects to most serious deficiency appears to he in the budget for main- provide vital material inputs, training, equipment, and capital tenance ancd othier operating expenses (MOOE), which comes goods that best coimplemilent available personnel woould also to ahout 14 percent of total ARNIM expenditures. while the he an area of potential benefit. Recently issued executive average for the National Government is 55 percent. orders granting mnore power and responsibility for programrs In 2002, the two main souIces of funding for total ARMNŽd ancd projects to the Regional Government, including foreign- regional government expenditures consistcd of P'H1P1S,400 mil- assisted projects (Executive Orders 125 and 125-A), open up lion in national government transfers and IFHIP270 million in greater opportunities for the Regional Government. Technical the Local Fund (which consists mainly of the regional IRA), at ancl material assistance from national government agencies a ratio of 20:1. This makes ARtNIt expenditures heavily mighit also be a major source of complemilentary inputs for dependent on national government transfers, which them- ARNIM so that its relatively large wvorkforce can be made more selves are subject to expenditure limits and restrictions productive. The National Government should consider delib- imposed on national government agencies. As it stands now, crate ancl planned inclusion of targeted resources eamarkecd regional government cxpenclitures appear muclh too person- for mLiterial or tecinical assistance to ARMNI activities ancd nel-intensive and probably deficient in other current operating setvices, as part of regular budgets of national government expenses. It might be that ARMMl regional government opera- agencies, consistent with the agencies' mandates. Inclusion of tions rely too much on hiring people rather than on buying these inputs from national agencies will complement current goods ancl services comparcd with typical national govern- efforts of AIRIM to deliver better public services in the Region. ment agencies. As the typical local government also tends to In the end, however, the best support that the National have higher shares of personnel expenses in total expendi- Government can provide to ensure rapid and stable develop- tures, it could be argued that the ARMM spending pattern mimim- ment in ARMIM entails providing the Regional Government ics too closely that of typical local governments even when with appropriate levels of direct funding and the correspon- ARMMNI funding comiies largely from the National Government. ding flexibility to ll... ii. suci fluncling in accordance wvith The indicative directions for the Regional Government are local priorities. This befits an autonomous government, and clear. It will need to contain further increases in its personnel would help ARMM build institutional capacity to use these expenditures through the adoption of alternative methods of resources responsibly. implementation that involve a more productive balance between personnel and other operating inputs. This will be a 3.2.2. Budget process for regional government slow incremental process because the future annual increases expenditures in funding, even if exclusively allocated for nonpersonnel Central control of mizost ARTMI expenlditffres. For the expenses, will take some time to cumulatively effect a - 95.2 percent of the regional government expenditure that is cant change in the overall pattern of expenditures. And given financed by national government transfers, the budget prepa- the need to add teachers and health workers as the population ration follows exactly the same process as that for all depart- increases, it might be impossible to avoid completely any addi- ments of the National Government. DBM issues a budget call tional personnel expenditures. that spells out some financial guidelines for the preparation of Of more immediate impact on overall efficiency might be agency cost estimates for the following year. Technical a more consistent focus on increasing government worker pro- M\Ianagement Services (TMS) of the Office of the ARMM ductivity through supervision, redeployment, retraining, and Regional Governor disseminates these guidelines and sets judiciously targeted increases in MOOF that best complement internal deadlines for submission of inputs from the various personnel efforts in delivering more benefits to the Region's operating units. The Office then holds internal meetings to poorest. Even more potentially useful wvould be for the deliberate on the budget proposal of ARMM operating units. In 28 1 [ iv f. , ;Th' <["i 2' 171 prioritizing budget reCluests TNIS uses thte hudget guidelines outlat-s were not allowed and, for somne aigencies such as issued hy DBMI ralther thatn regional government policies and ! 1, fund releases for capital outlays wvere dela;yed hr sever- strategic plans. The rcsult of the process. as sho-wrn in the iiost at months. This hlas wvorsened the state of the Region's ca;pital1 recent huidget cycle, led to the ipproval hy TNlS of all hudget assets. N1OE outlays w,ere controilled hy DBLI policies thalt requests as proposed by the operating units. This - . that 11 - . growth onlV up to a ceiling to cover 1ill h' 1 Since the decisions reached during this internal budget preparation ARMMll started froii a low hase (haiving been created in 1991). its process at the level of the Regional Government a,re driven MODE budget was unable to grow to the reasonable levels nec- more hy the clesire to haximize the potential transfers that tssarv for effective delivery of puhlic sectiics hefore nl ARNIM can secuLe from the nationa,l hudgett rather than the increments, hbasec on the inflation rate, could have allowved need to arrive at the most efficient 11. ii.. of limitetd expansion in real terms. During hudget execution. DBMI has fir- resoiurces. ther prioritized releascs of prograimmed expenditires. especial- Central control of the hulk of ARAINM expenditures uncler- lv when the cash position of the National Government is tighter lines the governance iSSUe (f a a 1, autitonoioius' regional than usual. Since payment of salaries is not deferred, even dur- government that has no mzore real or practical autonomy in ing perioids of restricted cash 1.- ARNINI hls sometimes decicling the level ind allocation of funds intended for its polit- received o(nly fund releases for salaries, ' Ii . to a furthier dete- icallyc distinct mandate than other nonautonoMous administra- rioration of actual ARNINI expenditures, and further exacerblat- tive agencies of the National Government. FuLtherimore, the ing the ias toward personnel expenditures. stnictuire and itemization of the national government butdget for Possibilities for iMipmi'ed 1?1uidge't Lnalrt6goelt Ill(le'r ARIN1Nl is too detailed and gives no flexibility for mianagement (nitoolOOi}'. The process can be improved considerably, first discrction and accountahility hy ARNINM decision-makers. While with a mediumn-terim expenditure framie-work that projects DBMI is trying to reorient implementing agencies toward results, prospective multivear allocations to ARNIM based on clear budget management in . I I continues to he preoCCupied a;nd explicit policy cdirections and goals. SiuCII a framework Nwith expenditures f(or inputs rather than procluetion of output. will allow for inore predictable medium-termi planning of In tracing the steps leading to the final budget allocation public spending and investments. For each budget year. the for ARMNIl, Congress appeatrs to have had a more direct role early announcemrient of the budget ceiling for ARNINI, based not only in setting the total funding level hut also in dcterimin- on the confirmation or adjustment of the indicative target in ing how these fincis are allocated to the final objects of thc medium-ter-mil expenditure framew-ork, would triggcr a expenditure. The RLA. in contrast, has been unable to assert its more deliberate budget preparation process within the I .! . . nwith regard to the allocation of the far larger Regional Goernmient. An awareness of haird budget con- amiounts of regional IesOiirCeS made aVailable throuLIl ni1tion6- straints would force the Region's policvrnakers to eValualte al government transfers. As long as the RlIA is solely focusedi hudget proposals of their operating units more I ,, . This on deterinining tht allocation of the Local Fund-constitutinu may also lead tom II prepared and w-ell-palckaged justifica- a mere I 8 percent of total regional expenditure-it is hardly tion for its budget proposals for consideration by DBNI in its likely to assert its infliueice olver national government transfers own hudcget evaluation. to the region. Incremental hudget allocations that the Regional Adverse ; centr(l Colitt)ol (o/ ntgioluil cApCellditlIJv'S. Government hald cenjoyecd in the past wvere mostly allocated to In the ftew years since the onset of the Asian financial crisis in salaries of personnel. This is a pattern that hals been !!. .. - . .J 1998 when the fiscal position of the National Government dete- not onnly hr DBI hut also by leaders of ARNINNM. While hiring riorated, the preparartion of the national hudget h.as been gov- additional staff is not alwavs a had idea, it limits management erlnecl hr stringent measures to control expenditires as the main control over the budget in future years because the funds are approach to contain the public deficit, against a background of tiedl up in recurrenit expenditures that are (lifficult to reprogram considerable shortfalls in projected revenues. These expendi- to whhat become more pressing priorities. In a worst-case sce- ture management measures have furthier distorted levels and nario, it leacds to the cormmonly observed negative examiiple of patterns of regional go-ernment spending. Increases in capital an idled, salaried, civil servant unahle to deliver a service prop- li''l i',)t "~ ,'! t1 '',1 1' s,t ,,' 1, n : t 29 erly beCaLuse of lack of necessaty- supplies, absence of essenitial Table 3.3 Percentage distribution of income sources transport, or obsolete equipmenit and facilities. Tie Regional of ARMM and non-ARMM LGUs, 2001 Executive Agenda of ARNINl has rightly adopted a streamlifning LGU Local sources Internal Revenue Other sources prograim to stem tie unplanned growth of staff. This should Allotment give thI Regional Governmnent lbetter w l ' witlh tiem ARMM ' n ARMM ARMM National Governmient in its future buhdget requests, if it muakes Provinces 4.0 16.6 96.0 77.5 0 5.8 assurances that additional budiet flexibilitv will not he w asted Cities 3.5 50.5 96.5 43.5 0 5.8 on excessive biring of additiornal iF Municipalities 2.5 22.0 94.9 75.4 2.6 2.6 All LGUs 3.1 32.8 95.4 62.5 1.6 4.1 3.2.3. Financial profile of ARMM local government units Source CommissiononAud,t,2001 AnnxalFinanci3tReport LGOTs in ARNIM enjosy substantially mnor-e financial autono- nmx and indlepenclence thian the Regional Gosverninent. ITndler public sector services thliughiLut the Cosuntrv. ARNMZI staff, hoN- tbe LGC, LGtIs h1ave heen assured of the tinmely release o f pre- ev er, einsistently expressed the view that their Regiosii su-ffers from dlictable levels of nationsal governmienti transfers, in the fsorili of tesource limitations to a imltc greater extent than other regions. the IRA, equivalent to -40 percent osf total national revenues. In Onfori tration gatherel for this studcy on public sector addition to their standlardl IRA, LG[ts in ARNIMI also receive expedtditures in huiin clevelopimielit in ARNINI gies credlence 35 percent of natioinal internal revenues collected in the to claimus that resource constraints are muLch more restrictive in Regio, shared anmsng theml in percentage terimis as fsollows: the Region. Table 3.4 shows consolidated public expendituires 45 3- 20 anong tdie province imnicipality: bvofgol'i-r 5i) 5(1 in education, health, and social welfare in ARMINI in 21101 fsoim between the city and banryt'. Notw-itlhstanding soime spend- three maijor public funding sources-national gosvermcr ent line ing limits on personnel (which shoukl not exeedl clepartmuent spending on ARMNINM the ARMIM'I Regional 55 pelCent of total LGt- expenditures) andc a mandated ear- Goverrnment line clepartimient budgets, and ARNINI LGOU hudg- marking sf 21) percent of its funidis for their Local Developiierit et allocations ftrO humian clevelopmeicnt sectors. Thiesc are com- Fund, the LGts appear to have maore than enoughl leewaVvy to pared with humian de\velopiment expendittiues in :' i '.l make resource allocations in accordance with local priorities. areas fruolm national goivernmient line departmuents and LGts. Despite the clevolution policv that prolilises mole authsori- The table shoiws the following: tv for LGtTs to leVy local taxes, LGO-s in ARMINNI derived onsl * Pler capita public speIndling on human developimient in ahsout 3 percent of their income froim loical soiurces in 2()1( ARMNMI anoiunted to IHI,1393 in 2001, which is equiv- (esoiparecd with the national average for all LGUis of alent to onlv two-thirds of the level for the rest of the 32 percent) Whereas the average city osbtained 51) percent of country WIHI1P2,04.) Although national governmnent its income fromn real property taxes and husiness taxes, Mlarawi soiiuces, incIluding the ARMIIM Regional Government City in ARMfII generated only 3.5 percent foim sucl sourCees. buiget, mnake up 98.5 percent of total huiman clevelop- Municipal and prosiincial governments of ARAIMI localities were ment expendittires in the Region, as coistpared ws ith 71 also wax bhehind their counterparts in oither regions in this percent for non-ARNINI areas, per capita national gov- regard, as shown in table 3.3. erminent spending on humran dlevelopmient in ARMINM is still losNer than in non-ARMINI areas (I HI 1373 for 3.3. Levels of public spending on human ARNIM comparedl with I'Hl'l,i56 for non-ARMIMf areas). development in ARMM Considlering (ta) the grealter human clevelopment necds A conmmon theme heard in interviexes xvith managers andc in ARNINI resulting froiim extensive posverty and the field staff during the study team's visit to ARNI w-as the lack of long-dravn-out conflict, (I) the higher cost of service fRincs to carrv out e-en the most basic services for huiman delivery stemimiing from the Region's geographic con- development. This message is not a new one to anyone famtiliar figuration ancl the security situation, and (c) the with the til that the tight hudgetary constraints are having on improved chances for lasting peace if people's hasic ~The dasU Lld or t S ic ps r~acsls in LGt inucosm~ 0ss stskcss fciois In.2( nic cucci t4jc.cucf ic. ccssissionol A('cc u t National government line departments 0 0 t38.1 88.1 2.6 36.52 ARMM Regional Government 2,755.30 404.4 63.4 3,223.1 0 95.9 1,336.19 LGUs 7.7 20.8 21 49.5 1.5 20.52 Total 2,763.00 425.2 172.5 3,360.70 100.0 1,393.23 Per capita expenditure (PHP) 1,145.45 176.26 71.52 1,393.23 Non-ARMM Areas National government line departments 97,580.30 8,304.00 1,973.70 107,858.00 71.1 1,455.84 LGUs 15,495.10 23,348.60 5,000.20 43,844.00 28.9 591.79 Total 113,075.40 31,652.60 6,973.90 151,702.00 100.0 2,047.63 Per capita expenditure (PHP) 1,526.26 427.24 94.13 2,047.63 Notes (a) National line department expenditures reported for ARMM are derived from the regional breakdown of actual expenditures reported to the Conmmission on Audit. Additional expenditures made on behalf of ARMM but lumped under other budget headings are not reported here. For national DepEd, for example, it is esrimated that an additional PHP88.8 million was allocated forARMM in 2001, including allocations for school buildings, teacher items, and foreign- assisted projects (textbooks under the Third Elementary Education Project and counterpart funds for the Basic Education Development Assistance for Mindanao Prolect). Adjusting for this amount, and assuming that all allocated amounts were actually spent, total education expenditures for ARMM would increase to PHP2,85t 85 million or PHPIt , 182.28 per capita Correspondingly, the non-ARMM figures would decline to PH P112,986.55 million or PH P1,446.94 per capita. Per capita education expenditures for ARMM would be 82% of per capita non-ARMM expenditures (b) National line department expenditures for health in non-ARMM areas exclude national Department of Health expenditures on national specialist hospitals, medical centers, and centers for disease prevention and control, which theoretically serve all regions including ARMM, but include Department of Health expenditures in other retained hospitals located in various regions (c) Population figures used to estimate per capita expenditures were 2,41 2,1 59 for ARMM and 74,086,576 for non-ARMM areas. Source. Authors' calculations based on data from Commission on Audit and Regional Planning and Development Office, ARMM neecls, suclh as educatiotn and hclatih, aire Imlet, thelre is Abtout PHI'2.8 hillion or 85 percent of tottal hutitman C\eCvry reason to Call for il 1 Il lH highe2r per capita clc\clopinent expenclitUreS of the Regional natio l.m go\ternttncnt spelining oIt hutrtan deveClopmnent G(o ernmient xxent to edtucation in 20101, shotwing the in the Region than in the t'CSt of theC COuntry. The importanice it giv-es tO ect ac';ltion. Nevertlhcless. tOtail prospect of cconotitic gain foIr the cofuntry as a w h1tIC if per cuapita expenldittire on eC'altioIn in ARININ was a credihie peace is attainried :1nd SustaSined Ithe p.eac only 75 percent of the iii. -i l n, level for the rest cliv-idlencl ) w'oUtild justify the cross-sL1hsidizatiotn thalt of thle cotintryT (I'Hl'I 1,45 ersus I'HI'l. 526i). L(GIls in grealter niatio snal go\verniment spendiing mnight entail. ARI?.M spenlt . 0,Iil,ki 1. a 0lutltS on cdu 'cation (less * The dtifferenice in per- clpita huiman devClopiment than I percent of total CedUCatiOn spendiing in the spending lies largely in the failure of LGt-s in AR MINI to Region). This comnp;areS Unfaotorahlv wN'ith the share of rIiake :t significant , il ., Ii. 'i in the financing of LGIt spendling otn education in the rcst of the countrl- human dev peN- nlopi t expenditures: 1.5 percenit LGIT 114 percetnt of tOttlI CdLuCtiOt expet3dittores), notxvith- share of puhlic sector p. I lil , in ARNINMM colm[p:tlredc standing the fact thalt eCduCatiOn hals not heen cldevNtled vith 28.9 percent LGli share for the rest of the cotl-ntlrv to LGIts. Giv-en the extetnt of needs, aind the critical aIndL pel Capitat LGUI spenclinig on hut33an developmenit importance of eduCation to the people and lealdership of P[H-11 in ARNIM compipared with PHP592 elsewhere, of the Region. the Natiolnal Gotverninent should con- As arguied in the .11. i section, LGt-s in ARMINM sider nmajor increases in dulcation allomcations (dlirectly ha-e the resoueres to increase this h umllan dcvelop- thiotugil its transfers to the regiotnal gotvernrent budg- ment spendling I .' 1 . et aind or indlireCtly tllroLtoogh natiotnal t)epartment of * IPuhlic ecLtication expenditures claimied a subastantial Education [lI)epEdI] support to .-! l Is 1 is shotoldL the shlare of the ARiM\ regiotnal gotvernmnent hudget. tLIGUs in thte Region. * Health spending faces the higgest challenge in terms of helonging to ARMINI receive their corresponding IRA shares, catching tip with the corresponding levels of health which were increaseCl under the LGC of 1991, yet uLilike these spending in the rest of the country, with per capita other LGTs. ARNINI LGUs do not hear the costs of devolved ftinc- spending at only 41 percent of that foir the rest of the tions, including htiiiton development functions stuch as healthl country. Almxost all spending on health in ARNINI ind social protection. In short, ARMMIT LGT's receive the higlier (9t percent) coimes fromil the Regional Government. In revenues mandated by the LGC vet dO not hear the increased order for pcr capita spending on he althi in AlRV%I to costs of devolutisin mandated hby the samie law. Recalling that match and exceed that in non-ARNMI areas, major ARMLMI LGI US, in addition, receive a share of national internal rev- increases in LGt- ., Is.. to health spencling have cnties collectecd in the Region, it is evident that compared cwith to OCCUr, as LGI-s in non-ARNINJ areas now- account for LGT's in otlier regions, theyv enjov a better financial position from close to three-fourt-s sof total pulblic spending on \vhich to stipport natioinal or regional investment programs for health (compared with only 5 percent for ARNIM). the development of education or heialth services in their area. Furthermore, there is also rooml for increased spending Table 3.5 shows that there are substantial differences in the lev- on health in ARMNI 1w the National Government, given els of support given to htiman development bI LGLTs in ARlINI that even in non-ARMINI areas w-here LGt s haV. compared with LGTTs in the country as a Nwhole. NW'hile LGIOTs in already assumed the main i.- i i- 1 I. for health, ARNIM allocate onIv 1.5 percent oif their total expenclitures to nationial government j1- l on health still accoulits human dev elopimienit, LG(US elsewhere devote an average of 1N. for 26 percent of total pulbliC sector health spending. percent of their spending on these sectors,- At present, the bulk * Social welfare was financed bv all thiee levels of goy- of LGI speniding goes to general public services to support oper- ernment, with LGtis cS ontributing 12 percent ufs total ating expenises. Gi(Ven the .111 1i il poorer humani develop- social welfare expendittires in the Region. The nation- ment outcomes and the significantly lower per capita total public al Department of Social Welfare aid Dlevelopimeit l on humian dcevelopiment in ARNIM comparecd with (DSiNWD) was the onlv one of the three national line other areas in the country, it SCeIemS OhViOtiS that LGtls in ARAIM departments that allocated funds explicitlN for ARMNI. will need sonehli sv to he encouraged, if not manldated, to use Its level of ftinding exceeded the amiount spent hy imiore ol' their revenue resources to finance major increases in DSWN;D-AR.NI. This implies that the national DSWD humian development spending. remains an important agency for actual delive sA of LGLG representativcs who wvere constilted hy the stutid social welfare servAices in ARMIMI and its owNn exper-i- te(am expressed their lun.- . to take an active part in pro- ence in dealing with barriers impiosecd by regional atitoinomn and the devolution policy should be instrtic- | MINIM tive Ii- irtthe design of collabusrative imiplemieniting 16 111 arrangements in huiman develupment. TIihe high level of national DSWD involvement likely reflects national ARMM Areas government effforts to mitigate soiime of the aiverse Provinces 1,146,964 12,958 1.13 of the Cities 167,700 10,280 6.13 Municipalities 2,015,408 26,258 1.30 3.4. Prospects for increased human development Total 3,330,072 49,496 1.49 Non-ARMM Areas spending by LGUs in ARMM Provinces 34,487,704 9,675,484 28.05 Cities 59,820,649 13,028,919 21.78 LGIIs in the Region shoUtld be able to dis more to improve Municipalities 50,271,586 8,343,470 16.60 the level of resources that go to human development. Like LGI's Total 144,579,939 31,047,873 21.47 all isver the country, tie provinces, municipalities, and city Source: Authors calculations, based on data trom Commissiroon Audit, 2001eAnnualFinancialReport. In contrsts5. tsi RHcgionol (0 cfl-miXelit spcnl(N 4t 35 pcrccnst ot 1i. reoui 0k y , inh Isiniss dcti eclsoni cOnt sissiariu 1 t f i :f s ni l go rsseOineiit expendcitsires .aw a .kltitlI to inodiCle only tli s en- it i \sitis cr i e spoinng Wrypnsihiitie, dcx,li cd ,d) to A R NEi, sltei l 1 c 5 r p ser i nt liet .di lic ustied ti' ml c.xpenditsnii 55 t5,) huni550i5 dcvxelipinent 32 ii il I ' 1 i1i I I 1 - , I - , ; t 1 \ l grams aiming to improve education, health, and social protec- Government defines the overall input mix for eaclh of the three tion for their communities. Despite the lack of a clear responsi- hunman ce1velopment sectors. Education is the most personnel- hility assignmicnitc tdiere was broad agreement among LGtI intensive sector, with a personnel MOOE/capital outlays per- reprcsentatives that these services are hetter administered bv centage breakdown of 9 i 1. t11.1 lby health at 7622 2. lower levels of government. anld social 'welfare at 66 33 1. Tlere is a xvidely held assuiliption The Regional Government has tlhus far mrade little effort to that NIOOE and capital outlays sutffer most when budgets are engage its LGl1s in a r,''- I- t. n, ' for the develop- constrained: also previous data suggest that ARMNI is seriously meint of upgraded yet sustainahle public services. It has focused under-spending on health (less than half of comparable spend- on uSin1g a iLx of national government budget transfers and the ing elsewhere) and somewhat less, but still II *i ii ill ,I under- regional Local Fund to support models of service delivery hased spencding on edtucation anid social welfare (aroincl three-fourths on - ,'II celitralized rnanagemnent and administration. Two of comparahle spending elsewhliere). Consequently, the input ma1jor factors argue against the likelihood of this approaclh suc- mix dlata could he interpreted to mean that, of the three sectors ceeding. First, the geographiic and ethrno-cultural ... U ii in ARAIM, health services are iF. '''- the most seriously (from of ARMNI makes cost-effective service deliverv diffiCult to shortages of drugs and other supplies and from deteriorating administer froi i a single regional center. Provincial, district, and facilities) with education and social welfare services suffering even municipal decentralization of service delivery is a practical only somewlhat less (from shortages of texthooks and other sup- necessity. Seconc, the financial contribution of LGt's to human plies and from capital deterioration). development will he essential to health and social protection At the regional government level, total humnan developiment activ-ities and important for edtucation services. Some mecha- expenditures are heavily wcighted in favor of personnel, nism for LGt's to participate in service delivery acdministration accounting for 93 percent of the total, primarily in the education might have to he estabilished in order to attract their financial sector, DepEd-ARNMMI employed more than 15,000 people in participation. These t-o factors suggest that the right policy 2001, and this took up the hulk( of the Regional Government's environment and minagement arrangemilents for more lyni:mic staff positions (21,374 in that year). Provinces in ARMIvI also public service delivery in the Region wrill neecl to involve LGt show- a hias in favor of personnel expenditires (90 percent). participation and financial contrinhution. The Regional Overall, municipalities tend to end up filling the gap in the input Government has both the authority and the need to provide nix, with their share of MlOOE at '3 percent for total human regional legislative policy guidance and to( design executive development expenditures. They also allocated the largest share implementation arrangements, based on regional autonom.v of their total huliman development spending on capital outlays, These arrangements wvould put into effect the desire of the althouglh the aniounts inv(olved w ere virtually negligihle coill- Regional Government and the LGtls to jointly provide their citi- pared xvith overall human development spending. These pat- zens with good public services on the basis of an ARMMII-specif- terns suggest a largely unplanned allocation of spending ic version of devolution that assigns financing ancd ser-ice responsihilities, as neither the total levels of spending nor the responsihilities to each level of government. Serious reconsider- o(bjects of expenditures for eachi level of government are agreed ation of the current provisions of its regional LGC, so as to intro- heforehand. dlice more explicit provisions assigning such responsihilities. Although there are no general standard.s for assessing opti- should be a high priority task for the Regional Government. mal input mixes for education, health, and social w\elfiare servic- es, a comparison xvith national government perindin.g allocations 3.5. Input mix of human development hy expenditure type (tahle 3.7) demonstrates the extent of the expenditures in ARMM bias to(vard personnel expenditures in ARNILNI. Comparison of the ARMINI-wide input Inix for education wvith that of the nation- Tahle 3.6 summarizes the pattern of human development al DepEd is probabily the most appropriate. Since healtlh and sector expenditures in ARNIM according to input categories such social - . (F", have been devolved in the rest of the country, the as personnel, NOOE and capital outlays. For the whole Region, national Department of Health (DOH) and DSWD spending pat- the comhination of spending by LGUIs and the Regional terns have to he considered in comhination with LGU spencling I~-11a:,in,-, h I' , ,; : . e's - :, 1A: 'I' I hIN 33 Table 3.6 Human development expenditures in ARMM, by expenditure type, sector, and level of government, actual 2001 Health Provinces 90.45 9.55 0.00 0.00 8,870,899 Cities 73.80 25.23 0.97 0.00 3,091,318 Municipalities 24.88 68.57 6.55 0.00 8,797,643 LGU Sub-total 60.18 36.90 2.92 0.00 20,759,860 ARMM Govt. 76.74 20.79 2.47 0.00 404,420,000 Total Health 75.93 21.57 2.49 0.00 425,179,860 Education Provinces 42.05 57.95 0.00 0.00 486,238 Cities Municipalities 4.86 69.97 13.51 11.66 7,224,122 LGU Subtotal 7.20 69.21 12.66 10.93 7,710,360 ARMM Govt. 96.20 3.76 0.04 0.00 2,755,284,000 Total Education 95.96 3.94 0,07 0.03 2,762,994,360 Social Welfare Provinces 95.11 4.89 0.00 0.00 3,601,334 Cities 64.32 35.19 0.49 0.00 7,188,619 Municipalities 17.35 78.60 4.05 0.00 10,235,772 Subtotal 46.73 51.13 2.14 0.00 21,025,725 ARMM Govt. 73.07 26.77 0.16 0.00 63,442,000 Total Social Welfare 66,51 32.84 0.65 0.00 84,467,725 Total Human Development Provinces 89.93 10.07 0.00 0.00 12,958,471 Cities 67.17 32.20 0.63 0.00 10,279,937 Municipalities 16.44 72.86 7.49 3.21 26,257,537 Total LGU 46.21 47.98 4.11 1.70 49,495,945 ARMM Govt. 93.31 6.35 0.34 0.00 3,223,146,000 TOTAL Human Development 92.59 6.98 0.40 0.03 3,272,641,945 a. Continuing appropration reflects expenditures of LGUs drawn from the previous years budgetary allocations. Source. Authors' calculations, based on data from Commission on Audit, 2001 Annual Financial Report. on health and social welfare to get a total picture comparable to ment spending should be able to address both the increases and that in ARMM. Education, however, is not devolved, which the input mix adjustments. means that the national DepEd spending pattern can be proper- ly compared with the ARMM-wide spending pattern for educa- 3.6. Official development aid for human tion. The national DepEd has a personnel/'MOOE/capital outlays development in ARMM percentage breakdown of s 1 compared with ARMM's 96/4/0. These data suggest that ARI\LIMs overall spending on It is difficult to determine the total amount of official human development requires not only an increase in levels hut development aid (ODA) funds going to ARMM as these funds also critical adjustments in the input mix in favor of higher shares are extended to ARMM beneficiaries through various channels. for MOOE and capital outlays. Better coordination between the Based on information from the ARMM Regional Government Regional Government and LGUs with regard to human develop- through the Regional Economic ancl Development Planning expressing or articulating the aspirations of ARMMI as an (ilitotliol(ts gC4v'ernoneu)t. Most often, these pr-ojects feature planning and implementation strategies that go directly to the lowvest possible LG{Ts, in somie eases the communities thieml- Health 51.42 43.41 5.18 10,945.52 selves, and involve minimal tecinical participation. financial Education 90.49 8.42 1.09 97,580.46 inputs, or managerial involvement from agencies of the and Development 26.34 71.62 2.04 2,061.82 Regional Government.8 In fairness to thle managers or finders Total human of these projects, the noninvolvemilent of the Regional development 85.42 13.06 1.52 110,587.80 Government in some cases dicl not happen by design hut Source: Commission on Audn, 2001 Annual Financial Report. occurrecd hy default clue to wveak capacity. Furtheriiore. inci- dents of conflict have been known to lead to the scaling clown, Office, there are about 29 ongoing foreign-assisted projects suspension, or cancellation of project components and activi- that reach ARMNI. Seven of these projects are in human devel- ties in ARMM in favor of more hospitahle areas where needs opment and thcy aim to improve the delivery of basic social exist hut conditions il. - for development work to proceed sernices, 1 i 11 in poor and vulnerable communities (table more predictably. 3.8). Most of these projects are, however. national programs of In ARNIM, where public services are often short on con- national government agencies in which ARMM's involvement sumables, essential colimmodities, operating funds, and hasic is driven by the need to reach targeted communities within the facilities. managers of the Regional Government and LGtls Region. There are a number of Mindanao-xvide programs, such have made obtaining access to ODA resources an important as Basic Education Development Assistance for Mindanao. and high-priority task. While success in mobilizing Ol)A Growth with Equity in Nlindanao 11, and the Midwife resources may provide some relief from the supply problems, Entrepreneurs Program, where ARNIM is one of the more the added btirden on overworked and underpaid local man- intensively targeted areas for ODA resources. agers creates unintended difficulties that may sometimes wors- While these ODA projects provide supplementary en service delivery. Time spent by managers to satisfy the resources welcome to such a l, 1 i Il .1 area like ARMM, requirements of various ODA sources for different projects is the projects themselves, being of nationwide or .Mindanao- also time spent away from attending other vital managerial and wide application, are unlikely to be suitable channels for supervisory finctions in field service delivery. Local resources, Family Planning and HIV Prevention Supplies and Equipment Germany Contraceptive supply Fifth Country Program for Children UNICEF Health Support to the DOH on Reproductive Health UNFPA Health Midwife Entrepreneurs Program USAID Development of private midwife clinics Growth with Equity in Mindanao 1I USAID Capacity building of Dept of Education Enhanced and Rapid Improvement of Community Health (EnRICHn USAID Family planning, maternal and child health services and tuberculosis control NoSe, ADB = Asian Development tank; EU = tEuopean Union, HDV FHman lmmunoaefciency V[rus; UNICEF =Unind Nations Childrno's Fund; UNFPA = Unied NatinstPopuatin Fund; BSAID = Uniid States Agency for Internatinnal (nEelopment. Sonrce: Compilen by Wnrld Bank staff. ' Hosical p- vi* c pepot Ausuld ae ilitipi 0tcI,apnacnt P1r,t xcinch aindd conlr-cia.alc tiar r t indr siteimalgeuipent l lit It I Ii' <'< c. iF/> 35 already stretched thin by governmient btuleaLucratic require- already important for an area With SuChI limited options. ODA ments, are further dissipated to meet competing needs of ODA resouL-ces, particularlv those ftinded by grants wvith minimlial projects. At the extremie, local managers hecomne preoccupied counterpart requiremnents. can support "catalvzing" activities w ith specific project objectives wvhilc losing sight of thcir own that build regional government and LGU c apacities or that development goals for ARIVIN. create essential institutional preconditions for enabling the The Regional Government now- tries to maintain a strong public service delivery system to eic- crib absorb highier presence in donior consultations and projects wvell the ODA levels of budgetary resources. including loan-funded finan- needls of ARIEMM in the context of post-conflict rehabilitation cial flows. ODA resources can pave the way7 for a sustainable and as a vital comilponenit of lincldanao-wvide concerns. Table and accelerated effort for better humilan development out- 3.9 shows that there arc at least four donor-funicled programis comes, which is domestically self-reliant throughi a comibina- for contlict-affected communities and forner rebel combrat- tion of national, regional, and local governil]ent resouirces a.s ants. These projects, by their very nature, require close coorili- well as privatc sector contributions, from hoth inside and nation bv the Regional Government (even as programi outside the Region. management and financial operations are carried oLut 1ws exter- One good example of these catalyzing ODA activities is a nal agencies) Notwithstanding tiesc promilising regional llitia- long-standing technical assistance prograim fundced b)y the tives in ODA coorclination, the Regional Governiment has vet Canadian Governiment that provided timely assistance for the to develop a broad-hased,i multiyear and - I, . i legislated foitrmulation of the Regional Executive Agenda of the regional framework for allocation of ODA resources and setting prioii- adrministration. Other donors concerned w-ith humnan devel- tv directions in project design and implemnentation. opment mighit also consider various areas for attention, suchi While no reliable estimates of the sizes of ODA flowTs to as public expenditurc imanagemnent, deVOILution policy and ARMNM are available, it is unlikely that the ODA funds being administration. poverty targeting, and design of poverty used for human developiment are bridging the gap hetween rcduction programs. An urgent need is in the for1mu1lation of a per capita humain devclopiment spending in ARNIM and the strong humnan development policy framework in which the average in the rest of the country. Current magnitudes of ODA principles of regional autonomny are integrated more closelv resources are nil-. i to il -i oon ill. alter the previotus find- in the design of futire ODA projects in the Region. ings on under-spending on human development in ARNIM. Increased levels of ODA flow-s for human dev-elopment 3.7. Toward a governance and financing framework in ARNINI could help alleviate the severe resource constraints, for human development in ARMM Better coorclination of multiple channels of ODA resources could also mitigate the undue management hurdens on the Evidence presented in this chapter shows that human Region's public sector managers. The ODA commiLunitv can developiment activities in li l .1 are significantly underfuind- go beyiond simply providing supplementary resources to ed, with per capita i,ll. ii , for human development from meet hasic needs in the Region. even if this function is both the National Government and LGlis falling below the I - -I l p i- averages for the rest of the cotintry. Tle chap- ter also demonstrates thlat, althoughi autonomious in namie and Table 3 9 Post-conflict assistance to MMlegal status the ARINI Re(ional Governent has alillost nO funded by official development aid io independent source of incomiie and has little flexibility in hudget m anagemnent. It depends hugely on the National UN Multidonor Programme 3 Australia, Netherlands, New Zealand, UNDP Governimtent for financing of significant devolved responsibil- (Special Zone of Peace and Development) World Bank, Saudi Fund ities, including humilan development. In contrast, LG['s in the ARMM Social Fund Canada, Japan, World Bank, Region enjoy fiscal autonomy in management of their IRAs Livelihood Enhancement and Peace us under hoth the national LGC of 1991 and the regional IGC of (Growth with Equity in Mindanao) 1993, but have few mandatedl i l l ilirJo . for the humian Source: Compiled by World Bank staff, deelopment sectors. 36 lli , l \ l, l I ! ' X " " . To close the gap in human development outcollmes at first. Again, the human development sectors should expect hetween ARMM and the rest of the country, it is essential-and to receive a greater share of these increasing revenues. In addi- urgent-that the National Government. Regional Government, tion. LGl.s must recognize their obligation to help their con- and LGLts in the Region negotiate ancl implement a medium- stituencies meet their essential needs in education, health, and term governance and financing framework that would provide social protection, and accept that it will take participation from for: all levels of government to meet the funding needs of these * increased public expenditures for human development high-priority sectors and eventually pull ARMM up from its in ARNIM fundecl through national government, LGU, current last-place position on almost all measures of human and ODA sources; and development. This would require each LGU to undertake a * increased autonomy in budget allocation and manage- close examination of its current pattern of expenditures to ment for the Regional Government conditioned determine which of the public services and investments it cur- (a) on increased transparency and accountability. par- rentlv finances would really make a greater contribution to the ticularlv with respect to human resources management, long-run welfare of its constituents than investments in human procurement, and financial management; and (b) on development, and which ones should, in fact, he replaced. demonstrated political consensts on key policy direc- It will he important for the Regional Government to nego- tions in human development. tiate with the National Government and LGUs the estimated The elements of this proposed governance and financing total size, duration, and uses of increased public spending on framework are closely intertwined. They must move forward human development to he financed hv each of the three levels in tandem through a negotiated stepwise transition, involving of government. An outcome-driven medium-term hudget a series of confidence-building measures to be taken by all framework for human development expenditures in ARNIM sides over, perhaps, the next five years. Over time, both would go a long way to improving the quality of regional gov- increased resources and increased autonomy can he expected ernance. Such a framework could govern the level and pattern to be forthcoming as the Regional Government shows of national government transfers to the Regional Government increased responsibility in spending these resources. ancl its component LGUs, including those directly allocated to Specific measures that can he undertaken to achieve this the Regional Government and those allocatecl to national gov- stepwise transition to sufficient and appropriate funding for ernment agencies but earmarked to ultimately benefit the human development are discussed in this section. ARMM Region. Within the framework, grant-funded ODA could serve to partly substitute for portions of national gov- 3.7.1. Increase public expenditures for human ernment budget transfers while loan-funded ODA could development in ARMM financc part of a higher expenditure ceiling for national gov- With income and output in ARMIM at their current low lev- ernment transfers to ARMIM. els. and with continued uncertainty about the chances of last- The same framework could indicate the required contri- ing peace. financing human development expenditures from bution from LGtOs. It will he important to resolve the current I ... sourced revenues is a long-term prospect for the fragmentation of financing sources and expenditure flows for Region. For a sustained period, at least in the mcdium term, it education, health, and social protcction and improve the clari- should be expected that the Region will continue to rely on net ty and focus in the accountahility for results in these areas. A transfers from the National Government. Negotiatecl measures key legislative measure consistent with the mecliumn-term to increase the overall transfers from the National Government expenditure framework will have to be a revised version of the to the Regional Government, and accompanying measures to regional LGC that improves on the current regional situation yet ensure that a more than proportionate share of those increas- moves beyond the current situation in the rest of the country. It es are reserved for education, health, and social protection, might he useful to develop a devolution schcme that rationally will he required. At the same time, the Regional Government combines regional government and LGtT financing for educa- should commit to continuing expansion of the range and level tion, health, and social protection services in a management of local revenue sources, no matter hov limited these may be and delivery structure that takes advantage of regional scale 11 I'3 t , i j, Illil >l} 1e n t '1 i i 1 37 economilies as wvell as of LOU focus on local conceins, For 3.7.2. Increase regional government autonomy in example. ARMMEI couldl adopt a regional devolution of heallth budget allocation and management and ecluation services, which creates integrated piovinciall- To adequately perforimi; a proactive role in guiding region- Wide and citv-xvicle health or education dclivery organizations. al developim-ent in general, and llhulimaLn development in partic- jointly governed and fuindceci by the Regional Government and ular, the Regional Government neecds considerably more LGU. An alternative version of health seA-ices cdevolution- tlexihility and conitiol o\er the allocatio n of resources intencl- assigning i - 'i. i for all local heallth services to the ecl for the Region. Though ino dest in am1ount, the Local Funcl, province rather than firagmenting serv ices amnong several jlris- consisting mainly of the regional IRA, is an important souLCe of clictional levels (as is currently happening in the rest of the funds vhiose allocation is already left entirely to the Regional country)-could, for example. hetter preserve the contilluitN Government. Tle process of allocating this funcinig should he of care that is so important for quality health serv ices as well as made fully transparent and routinely incorporated in the annu- better allow the advantages of scale economies. al budget and planning calendar of the Regional Government. To protect comILmunities fromi any cdeterionation in puLhlic A more critical requiremilent for obtaining greater control services for humanin development, the National Government oxer illocation of resources is to negotiate wvith the National dlevelops and dissemninates standard.s against which to rneas- Government for less itemizaltion of its hudgetary appropriation ore the perforinunce of different government agencies oper- to ARNIM. tinclel the present systemi of budget preparation and ating in ARMINI (and the rest of the countryt. Even uLnelr an execution, DBNI stiLictures the ARNIM hudget in such CICta il thalt autonomious administrative structure and devolved service it leaves velry little leewxay for regional prograLimiming to acco in- delivery policies, the national line departments have the in 0date local priorities and reforiml strategies. If ARNINI xvere responsibility to ensure that minilnlnmIL standards for public given tlexihility, there is a greater chance that regional initiatives services aIre met hy all responsiBle agencies in ARNIM. This to improve un developilmenit outcomes would he supported couldl provide an ohjective hasis for DBHM, regional line agen- bv informiecl decision-makers in the Regional Government. Wt'ith cies, and LGtls for determining the ftunding gaps that have to f)BNI moxing towvarcl performance-ha,ised hudgeting for other he addressed hy an appropriate financing strategy for eCduca- national aigencies, there is no reason xwhy similar methocds tion, health, and social protection sernices in ARNIM and lhelp shouldl not he applied to the ARNINM hudget. As with other determine xxhat mix of inputs xvould he required to meet the national agencies, however. DBNI shouldl hind the ARNINI desiredl technical standards. National government agencies Regional Government to a set of enforceahle agreemrients to link shouldc also provide technical assistance and institutional sup- this increased management flexihilit-v with greater accountahili- port to the Regional Government and LG1ts in ARNINI provid- tv for meiasurahle outputs and targets. ing the same opportunities for learning and systems Exen greater autonolmy Could he obtained if part or all of upgrading that they offer to other regions uncler nationxvide the national government transfers to the Region-2) times as programs. large as the Local Fund-xxere dlefinecl undler a transparent One good example of suicl collahoration hctween nation- IRA-type formula. This would provide a more stahle funding al and regional governments can he founld in the health sector. source th;an the annually negotiated hudget. The formula- The national DOH has developed and promotecl countryxxide hased IRA shotild he conmputed as a share of totail national its Healtlh Sector Reform Agencla (HSRA)( xhich clefines a internal revenues (as applied to the LGtl IRAs countrvwide) long-term - i,i t. U for development of thie countrys heallth sys- rather than as a shalre of national internal revenues collected tenm Through its NMindanao Office, the national IDOI-I has made from the Region (as applied to the current ARMIM IRA). This availahle technical assistance, and even financing wlhen extra WvoUld alloxw scope for cross-suhsidization from other regions. funds haxve heen avxailahle. to counterparts in the Regional In the long nin, ARtIMI can only enjoy real financial Government and LGtTs to allow them to clevelop and imple- auton tiny if it suhstantiallx- reduCes its cdependlence on nation- ment an ARTINI-specific version of HSRA. There is similar col- al government hudget allocations Miost of the resources nec- lahoration on other maijor health programns. suLch as those for essarv for the Region's development currently flow into the ilimmunization, tuherculosis. and family planning. Region through two miain channels anid one minor clhannel. 1 38 a I -, lotil the ii LtjrI (ldt l nils flot friont t111 Naittional GovtxCri-iifnt tIo tI IC Rgi oilII ( ;(t i etInliCelit viLi t IIttiLl ilt floiatit )i to t tli AR\N IN I d h LI t. i II t o tthe gtI I I iL t1 ( 'l I" \ i the It III]ilt ill II( Ct;- tioIl of their .1 ttc itt IiIc IRA. Thie ittiiioi durind is tile f( inut iLi-liLiitI iCgi i)IILil I RA, tied It tIltti( tL1 t-etIL\1e L iLt )ILL ii icil p Mi itttc,c. In tiWi' littitt, it \\ ill 1hC fl.lVttN ti ctnd it i - c- CI LICt, <)I tilC L lYti( )IIJ Gxo ACV1111Ilet JrX l(,ll IS t IS.h = i f f I'o i11 I t Ie legtl flit iVi>i( oii> ii LltOitii t1vil, tile tII( dcndllicll. 1L ie' llit\V is till tt ilc Rcgiol tiLil ivcttit oplt l , )rJtex2 Iitxx ccii r it Iti11 tl (x crut'tlict'it tiltlt ciintlrol s tiic imjllr pt rIt ol its ftiruntticcx Litid IGt s tihLit enl jov conixii,i,iLtidl\ inot ti finLinciab Atitorlolm! tha n it dloCs 'I'he RU(Y Gin (oWel-LIFFeIIlt' al Lilit\ to 9 iciiicx c tlIC Lilititl- iii> lit iiisc otf Ltiti iit liir Li> L StLit 1w Clinh-mt-kiig onl tilv fc\x stupns spzelludl oLit al)(VCe-\\ ill thcruf'or _u (dCcnd uti oni dIC C\tlIt to WhiiCi it is Lthie to IniifstCr lie ICIdC-'- sIlip rtluiredlin i tio wori k iLt: orLtivtglv withl tlicxe t itilur lcxix I if - goxcrnnictit This colltliro -;tiont \\ill not ii;Ippell spontaitiotls -i- Iv, tilic re- io ll Iieldcl-txhip x ill hia\tc to taikc ii initiitiL e. Thc IeC,efxliCI x-hi uJ to iicCti to [cil itit lit hVi tiMtI tle xttttiItt'. oitt gm critiiieiIt to wxxork directlV Wx-ith hl.lsixICxSSxSc rigiotLts LI CId sCetiLit t tiCLiLiitix. ci itililiti gti0tis_1S, JLtld Otilcr ilstittLl- tionts thlrotughi x'iciCh it c'Lii likti up with its ciinstitLuc1Cy. wiork for Serxice celix-erx in cducation, lieilti, aLnd sciaLl pro- FinaL ,tid all 2 pcuhLi;ps tiotst eciticall . tlic Rcgioni's leLiders teetion. Foir eximiple regiotnal legislation tiiLit priotriti/es the xxWill need to lieLir in tnild tilLt to fully expilioit lnd eXCICisc the attiinmiielit of uniiversaLl coverage ol' safe \\xIter aLtid ,LitiitLtion aLtutIMOiiiis litlitiCLil IlAixxet's r1Litited to it lix i1wx, sotine type would lie a maljor liuiling loei ck for ietter hilthi ottetoliies. of unifiedl regionilt politicLal conliseistis ix tieceLtl amiioig thle (Dr in edCILICtiotl i rCgiotll legislLtioil tilLit speCds tip the efrad i- maiiL ttg-Liis otf pi xwer in ARI\lAI includling the 0)ffice of the caLtioni of illiteraLey tlrotuglil tftifortiall edCtCLGtioln Ltlititig ALd- RegionLil Gotvcrtior the RLA aLitd the LGI's. SLiclI L etinserisux lescents aitld lutilIts txxIit lILixe less thlLn thic niiniiiiLtii desiled eotiul eriierge whciiL a politiecLi ll oc or pLirtv wins aLi explicit lc\-cl of scliooling eLn ereaLte the itlipetus 1iccessLi`V for popUlar ilLiidLtc in regionail t Li loitl elettiois o r it toultd le ipii-ixing 1 asic edtucaition c0i iipetncisics in tlic Region s pop- bUilt aLiittg key leviClers frttii dlifferentit hlois or factions thlt tilLttion. tThe next three cliLipters give the lctLiils of tihcse ice- obitaint poixer ifter elcetiois. NW"ithtOitt sucLhI ptlitiCl1 C011SuxtiSUS, orniiierldcd polihy clidiectiotns.I trlue LWtOnotilx inh liud et Ll11leLitioll Lltid nii\LtiLieliecit xxtrtl A criticaLl test for ARMILI go\vernLince is t 'e prioritv i\xci to he xrxv haLrd, if not impossible, to Lilhieve. ensuritig thiLt tlie Region's poorest benefit froiii putilic spend- inig AR\'I leuLders iiLix tCndi to iieLsure aLitioininiy in termis ol' 3.7.3. Define the basic policy direction for human the le\cl olf nLitioniiLl resources lheiiig prt' ided to iilLIke it SLe- development ccecd. To the eotistittients oti the gri 'Mund, hituvexr the reLil test It xiii lie impoittL1tit til Lt i tCgioiLl Pt piiticLtl dehfiitioti tof is the v I yield tif concrete henenits to th Pt ()rest. Tust Lisx prioriuly pblite purposes in educaLtion iiicLlthi L td SiciaLl pro- primatily persons in politica;l piwet'. tiose With Iliglitr CdtLILC- tctioti hie cle;Lrly estLlilishied. ticii Li definitioti slioutld he seeii tion, or thosei \ h-tlj politicLil connectiotis Captule tile heneflis in the pLissLige otf regiotiuiLl legisiLition on thle struCtuc n and pio- Ftronlt public resotituees I - inito the Rcgion. so it is thiLt the grLiiis of thiese tliree sectors, which goes hetiond the tlirtist intd pootest those lixing in the l iitost reilmote oLeLi or tilosc whio autiloitvt of the regionaLl govxernor's executive ordlers. RegiontLl arLe ltIst disaidvLiutaLged are deniedl their- ftili iiLare of these legislatio in Couldl laIy dion a iituicli mlfe stihii policy fralie- hienlefits. The viaLility, le(titiiLcvy ianed sustLiliihilitv off .: 'i J'" !, ,: ! 1' I : : ' \V 1 39 I facilities that best meet the needs of the poor, or through demnand-side initiatives that channel funcls directly to poor houselholds to enahle them to access services. Examples are edtucation sclholarships or voouchers, or the Sponsored Program of the I'hilippine Health Insurance Corporation (PhilHealth), which runs the National Health Insurance lProgram. Targeting in ARIvIM wvould require community-oriented approaches, effective partnerships between the Regional Government and I.GiTs, and the integration of Islamic values ancd social struc- tures in delivery systems. It requires considerable investments in social preparation and a strong commllitment from imple- iiimenting agencies to respond to the diverse needs and field * I | | T_ ._ conditions of poor communities. Such targeting also calls for a Xll| .I., i of ARIMM resources from region-wide programs to - l,,. area-focused projects. Most importantly, it will require the on , Regional Government and LGLUs to commit to channel more .. aE 7=3 =# v resources to social expenditures. While the Regional Government orchestrates efforts to national resource transfers (including ODA resources) to an generate more resources ancl target these resources to the poor, autonomous Regional Government wvill depend greatly on it the main focus of improvements should be to obtain more out- demonstrating that public spending benefits the poorest. Such put ancl henefits from current resources. There are many spending achieves various results: it improves the outcomes opportunities for these types of improvements, including elim- for those segments whose human development levels current- inating overlapping functions and uncoordinated spending of ly drag down the whole Region; it strengthens the moral stancl- the Regional Government and LGITs; containing and reducing ing of the autonomous government among its constituents; it the high share of personnel costs in current operating expendi- reduces the vulnerability of the poor to the agitation of groups tures; and containing and reducing the costs of regional admin- driving the armed conflict in the Region; and it generates eco- istration relative to the costs of direct service delivery. Several nomic benefits among the poor, wThich will be crucial to policy options exist to pursue these aims. Passage of regional achieving greater regional output and eventually higher local laws to cut costs, increase revenues, improve targeting of pub- revenues that can gradually replace the current dependence lic spending, and increase development benefits of current on national government transfers. public spending could be one. Another would be for the Poverty targeting has been an important strategy of the National and/or Regional Government to apply funding formu- national antipoverty program in the area of public expenditure las for human development services that would make the allo- management reform for a number of years. At the local level, cation of finds to services more predictahle hut leave to the for example, some of the more dynamic municipal govern- regional agencies and/or their individual facilities the preroga- ments in ARMM select a few bairan)lgays where povertLy is most tive and responsibility to allocate the funds as efficiently as pos- prevalent and give them highest priority for the allocation of sible. For education, for example, budgeting and funding on a local finds. The community-based poverty mapping instri- per student basis, cost-indexed, and linked closely to the sector ments, discussed in section 6.4 below, constitute one objective plans that the Regional Government has discussed and negoti- tool for targeting poor communities or households. The chal- ated wvith local stakeholders would help improve efficiency, lenge for the Regional Government is to bring these initiatives transparency, and equity. For health, the capitation formula together in a coherent antipoverty strategy for human devel- currently used by PhilHealth to pay rural health units for serv- opment. Targeting the poor can be done either through sup- ices rencdered to members is also an example. Yet another ply-side initiatives that support programs and/or service approach is to compensate the Regional Government (or its I 40 .. C I , agencies) on the basis of outputs and benefits achieved, thus priorities for capability- il.l - training, liii - etc., to converting the transfers into rewards for good performance improve the match hetwveen staff membhers and their job (e.g., number of graduates and achievement levels, or coverage descriptions: (e) undertake to define or update job dcescrip- of fully immunized children). Broad political consensus on the tions for all positions in the Regional Government and define advantages of measures suchI as these, and a legislative framne- results agreements for each i ill membrher on the basis of these xvork that leaves room for adoption of these and similar initia- jolb descriptions: and ( f) institute regulaLr performance evalua- tives, would ill. the Regional Government to demonstrate its tions based on these results agreements and define region- determination to raise the standards for human development wide policies for rewawirds and sanctions linked to performance while using limited resources responsibly. evaluations. 3.7.4. Conduct an organizational and staffing review 3.7.5. Increase transparency and accountability and develop a human resources management plan A regional effort to increase transparencv and higlhlight The need to clheck the growth of the salaries budget has accountability in the allocation of public resources for human heen articulated by planners ancd policymakers in the Regional development, to a ;i l 1 higher degree than at present. Government. The comnmiion explanation for its persistence is an is an absolute preconclition of the entire process. The strength accommodation of a situation wvhich is outside their control of ARMIN'Is negotiating position vis-i-vis the National1 and about which nothing can be clone. While this may be so in Government as well as its credibility with potential taxpayer.s the short iLn, the Regional Government should embark on a in the Region will he bolstered considerably if more convinc- meclium- to long-termii i l, - to sustain the expansion of ing action were taken to lemonstrate tlat any additional finan- public service delivery without having to employ more people cial autonomy gained by the Region hvould he responsibly directly. The Regional Executive Agenda already inclucdes as exercised. one of its programs the reorganization and restructuring of Two areas where the most immediate gains can be made agencies to rationalize the regional bureaucracy. This policy are in procurement and financial management. Regional gov- statement can be taken one step further by translating it into ernment leadership should undertake to ensure that all agen- operational guidelines so that implementing agencies can start cies in the Region immediately enforce the new Procurement mapping out practical ways of achieving higher administrative Law (Republic Act No. 9184) and its Implementing Rules ancd efficiency. As argued in the previous chapter, a budget that Regulations. Enforcement will be assured by establishing a favors salaries disproportionately ties down a '1*,t.. 'I por- regional procuremiient coordination and monitoring unit, and tion of the budget for years and leaves little management flex- more especially, by introducing civil society participation in ibility for reallocation to achieve a better mix of inputs. In monitoring public procurement activities. addition, it leaves the system vulnerable to attempts by well- To enhance financial management ancl accountability, the placed individuals to curry favor, a sure recipe for corruption Regional Government should also implement an automated in a region that can harclly afford such a waste of resources. accounting information system, across all agencies, or perhaps In adclition to the planned restricturing of government starting with the human development agencies. To facilitate agencies, among the concrete steps that could be taken to this process, it could link up with the national Commission on improve human resources management and productivity in Audit to gain access to the simplified bookkeeping software Government agencies are: (a) conduct a census of regional that has been developed for this purpose, as well as to request government staff to update the staff rolls and identify nonex- technical assistance for establishing the system. More exten- istent, absentee, or unqualified employees; (b) clarify and sive reforms in financial management should also be intro- enforce standards and processes for hiring andl firing of region- duced in the long term. but imimediate implementation of the al government employees, and ensure that these policies are accounting informiiation system wouldl be a realistic first step transparent and widely disseminated; (c) develop staff deploy- and a simple way to demonstrate the Regional Government's ment plans basedl on sector-specific standards of quality and intentions to improve accountability ancl to minimize corrup- access and on the needs of the population served; (cl) identify tion in the Region. I,'1\1 41 | 9 - K 9 n ,nrr t uilU PiS 'h~~~~~~~~~~i,," S %S ' t-~U - (r . ... g L. 4. The Education System in ARMM cIlucation lies at the cOre of humLIan development for ARINI, Comhlining a variety of adclministiative data with household sur- in itS cu;al ahilitv to (a ) transmit and ineulelate valIues and vev clata and qualitative infoirmatiin frio1m local eduatLCtioi ofti- eulture thalt allow\ young residlents of the Region to form cials hlcps delineate a imore complete ind accurate pictuLe of the their identities as citizens of the l'hilippine nation and of the Region's ecatecltiontl development. Often missing from previous unlique Isulaic community within thatt nation, aind (h) prnvide studies is a discussion of the cliffercnces aimiong grouis and ARMNI citizens with the capacity to putrsue econiomilic oppornlmi- aimong aireas wTithin ARNIM, which neglects the diversity within ties insicle and outside the Region. The builders of ARINI were the Region. The almiost universal focus in previous sttidics on the fullv awaire of this central poSitiOnl of eduCCLtioi, hence the pro- Region ais a whole imasks the important (1,1 .1'. within it that visions in the ARNIMI Organic Law pertatining explicitl- to educa- provide the key to progresst for example, breaking down these tion In fact, eduCation remai;ns at the center of the political patterns helps identify which demographic or socioeconomilic aigencla to the present day. groups are lagging hehind and thus w,vhich groups might henefit As shown earlier, ARNINI lags hehind the rest of the coon- most from public programs. Nationailly representaltive survev try w-ith respect to educational development, even it the hasic data from the 1998 DHS prnvide the oppoltunity to examine sys- levels. so it mikes sense to focLs on issues related to improv- tematic group dlifferenCes-sucIh as enrollment variations ing the prini'mi and secondary levels. Thee .-re severil goocl hetween m;ales atnd lemrales, between urban and rural groups, reasons, however, for keeping an eve on the ftull picture of the and between income (or wealth) groups-while linking thcm to education sector. Higher ecaLeCtion institmtioi s in the Regioni socioeconomiIic and deni ograplhic factors. a1bssorh a large maijority of the graduates of the loi-ier levels of I II - a discussion of the Region's state of' educLationnal its eclucation systemr, train teachers wvho are neecledl by all ecdu- developimient, this chapter analyzes the undlerlying fLactors. Some Cation levels, and provide the knowledge amni skills hase of the of themil 0I i AltNIdN's socioeconomic aincl political realities tha .t Region's professionals, technicians, and leaders. Regional influence clemnand for education, andl soime reflect the cfficiency aUttOnomny wa;is granted partly in recognitioni of the unique with which its education systemi is governed ancd managed. That characteristics of ARIMNM-and the education systemi both analysis is 1 lI hy a cliscussion of policy reforni d ;uid specif- reflects and suffTers from the relative isolation that coutl result ic actions that could aiddress the problems of the sector. fiom that autonomvy. The education systemil also stands to hen- Obstacles to attending better schools are formis of exclusion that efit firom autonomiyv hut to realize these henefits requires a can result in a growing sense of grievance amiong the citizens, in clear and 'I1 shared vision of where the svstenir should schlools being regarded as discriminatorv and irrelevant, and in a go, appropriate policies on how to achieve this vision and loss of legitimacy for hoth the Regional Government and the efficient opcrational or minan;lgerment systems. National Governmtent as providers of services and protectors of This chiapter begins with a fuller discussion than seen in rights. For these reasons, solutions need to he found to the proii- chiapter 1 of the state of edUcational development in ARNIIMM lemils of edLucaltion in AlAIM. 4.1. Educational progress and challenges 4.1.1. Enrollment and literacy l---------- As presented earlier, ARIM trails behind all regions wvith respect to basic indicators of educational development, though. the gap, especially with respect to enrollments in primary edu-i. cation, has narrowed since the economic decline and stagnation ----- - during much of the 1990s. With respect to secondary education, - - -- ------.-.-__--- however, the gap appears to have been widening between AGE 6 8 10 12 14 16 ARMM and the rest of the country (figure 4.1). Total enrollment rates tUsing the 1998 DHS data, it is instructive to break down Soue 998Do.Nraph,, adH.IthS-ney the enrollment data by region and by age to see where the fault lines lie (figure 4.2). ARMM's enrollment profile is well When the age profile of enrollment is broken down by below the curves for other areas of Mindanao and other parts gender. another feature of ARMM's overall enrollment pictuLre of the country. Children start school later in ARiMM; there is a is revealed. Its age enrollment profiles for boys and girls are larger than 20-percentage point difference in roi 'lii- li rates below the corresponding profiles for the rest of the country, at age 6. The enrollment gap closes as more children in ARMM but the pattern in this disparity with the rest of the country dif- enter school, but the gap remains at about 10 percentage fers for boys and girls. In the early primary grades, boys' points throughout the elementary school ages. A. ill, enrollment rate in ARMM peaks closer to that in the rest of the explanation for this later age of entry is that the physical devel- country, in comparison with girls' enrollment rate in ARMM opment of lriI..Ii.-rt in ARNIM may lag behind that of other relative to that in the rest of the country. But in ARMM many regions, an explanation suggested by past studies for other more boys drop out of school in their early teens, and this regions in the country (Glewwve, Jacoby, and King 2001). increase in the dropout rate happens about two years earlier There also appears to be a distinct dip in the ARMM -i, . 1 ,,. l . than among boys in other parts of the country, and about three curve at age 14 that is less noticeable in the other regions, years earlier than anmong girls in ARMM. This pattern could be implying that the transition to high school may be a particular- due to the continual armed conflict in the Region, its disruptive ly vulnerable age for youths in ARIM; but the dip could also effects on homes and sclhools, and its adverse impact on the be a matter of a small survey sample at that age. Without the economy. These consequences appear to have had a more dis- dip, it would appear that youths in ARMM are at least as likely ruptive effect on young teenage boys than on girls of the same to stay in school as vouths in other parts of the country; in fact, age. At the same time, early male dropout itself feeds the sup- the interregional gap dissipates in the late teens. ply of boys who take up arms. Disparities within ARMNIM are striking, when patterns by household wealth are considered (table 4.1). The enrollment l l _I _ M rate of children in the poorest wealth quintile (20 percent) of 120 the population is more than 30 percentage points below that l --------------- -------_--- of the richest quintile. In fact, the education gap among wealth groups within ARMMI is so wide that the enrollment ! 80--- - rate for the poorest quintile is similar to enrollment rates in 60 - -auritania and Senegal, while that for the richest quintile is 40 ------ ---- similar to those in Australia and Canada. tsing the same 20 ARMM Secondary - - - ARMM Primary wealth distribtution for the whole country, a comparison Phi ipp nes Secondary - - - Ph lippines Prrmary 0 1992 across wealth groups indicates that the difference between 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 ARMM and the rest of the countrv is concentrated among the Data sou,re P,Iipprne Srat,st,aai tea,baok s vant us years _t~ Pn,pp~Srsto Yeks,y-poorer segments of the populations. The richest quintiles do 1 44 niwrr rrnrrq, n, Kri ,li l , . Pr', , l: Cr 11< Table 4.1 School enrollment rates of 6-12-year-olds, Philippilles outside NIindanao. Broklen (.hoN-n by we;alth by wealth quintile: Philippine and cross-country comparisons quintiles, literacv nttes point also to the marked disadvan- ARMM tage of AREIMMs poorest quintiles and the need to target ecu- cati on ass istance in thieir clirection Ammong the poorest cjulintile. the literaIcy rate ainyoni vomnen agedl 15-. is 33 Poorest 0.583 0.704 0.768 0.564 Senegal 60, percentage points lower thaln for the rest of the l'hilippines, Mauritania 61 while among thc richest cilintile. the literacy gap is 14 per- 2 0.829 0.877 0.850 0.538 centage points (tahle 4.2). Comiparing ARNIM with other 3 0.888 0.881 0.880 0.635 the poiest tiintil is siiir t 4 0.948 0.935 0.937 0.847 countries the literacy rate in Richest 1 0.950 0.98 0.885 Australia95 thatt in Rv'anclda anl Ghana. while the literacy rate in the r-icth- Richest 1 0.950 0.958 0.885 Australia 95, 1 Canada 95 est cItiintile is simiflar to that in Singapore ancl Southi Africa. Q5/Q1 1.61 1.36 1.25 1.57 V _ Notes: The wealth distribution used for columns 2-4 is based on a national distribution, while that used in column 5 is based only on the wealth distribution within ARMM. Data source. 1998 Philippine Demographic asd Health Surveys. Country comparisons are from UNDP's 200t Human Development Report reflecting 1995-97 net primary enrollment data, not show a large ennroilment gap hetween regions, hut the 2 0.843 0.966 0.973 poor in ARMINM h1aVe a nutCh lower enrollment rate than the 3 0.931 0.990 0.985 equally poor in olther regions. Incleed. within-region 4 0.930 0.995 0.995 inequalaity is mutc larger in ARMI than in the other regions. Richest 0.842 0.994 0.996 Singapore 88, South Africa 84 The enrollmnent disparitN (as tneasLtred hy QS, Ql, 1.61) is larger than that hetween the corresponcding cluintiles in otther Q5/Q1 1.43 1.13 1.07 parts of NMinlanao ( 1.361) and in ttlier patts of the country Source 199B Philippine Demographicand Health Surveys. The DHSdatabasedoes notprovide literacy data on men, country comparisons are from UNDP's 2001 Human Development Report, reflecting 1995-97 (1.25 1." These patterns suggest that, at least for 6-12-vea,r- net primary enrollment data. ddis. efforts to improve access to schiools mulst he directedl at the poo(rest segments osf the population in orcler to ohtain the largest effect on ARMIMI's enrolliment rntes. Ignoring these patterns arisong wealthj groups Will tnot reclce ARNIMls 4.1.2. Test scores and system throughput enrollilment dleficit. School-leavirlg test scores, a siinple meastire of learning NW'hile eur 'llr t crt rates measure the systemn's ctirrent achieved, indicaite that ARNIM stucdents perform relatively 11 c.apacity to deliver eucluation as wcll as the current deinmand comparedcl with studcents from other parts of Mindanao, espe- for it, literacy rates reCflect the Cumulative effect of historical cialiv in the elementary grades. ioNw ever, thev do not cosnpare trencds in enrollment. Literacv rates indicate the system's past favorahl1 w-ith studcents in the countryn as a wOhcle at either the alhility to provide sclhools ancl to retain stuclents in sclhool erncnt rry or Iigli scllool level. What is also striking is that, at losng cnsutgIl to build sustained realding and wlvriting skills, the seconclarv level, Nhile other Mvinclanio rcgions shoved a The 1998 l)HS data show- that the literacy of xvoimen agecd large increase in test scorcs f-om 1L99 (except for Region XII, 15-49 (the survey dloes iTot prosvide inforisration on men's lit- wvhich had only a slight increase) ARNIM students shosvedl a iracv ), dlefinedl as the ahility to read a nw-spaper, is lowvr in slight clecreaise in test scores. ARNINI than in othel- regions. On average, the literacy rate in In interpreting these test scores, one nedcls to note that ARNINTI stands at 7i) percent comparecl w-ith 96 percent in the the trendI olver time reflects, in part imnprovemients in stu- rest of Mlind-lanao ancl 98 percent in tht rest of the clent perfOrifs iance and, in part. greater selectivity in the \\liwn .i rciorJlslrc, \, an l lisirikiiiaiiis in ISi LI iilsstCLIL. satc iluch tsht t lh ii ich n Ai tli. r,h,,t .)CIs tl 1s rst a iliuiil,ls Niihlin Ml NI s i,inil oild ik o 1i tli, giuon ls l iscl ii \A ti . tli nr, JIlcitsi ratI'li tl E lkh S ilinIil' 1i ca c'ilcdi l t-l i ' bc 1as<-. 1 -t p 4CIni t iii) pmt 1,1 a if ARNIrILitll 1sin nonUliinirs a W t. IrmAat l.itrl thsrt rs -ii.- th-isa, t nilli nin r,itc ar s j-,rn- (IlillitilcIII C1L'111 tYt thlt I)thcLl rc'gl,('l liiflil 5l:.zr ,'lnIn.is I III t 1 0 I il I IC ' lislnlcis ric I, IC \'' oL cl rd c 'gIcLHc'>>n11 Ie I UnOn c ic' ri ,sc'ri L itrcc IL .' i i'sn, ~ ~ n I i ns s,, consLIL I l linked I, tlleir .nc ,de',ccnnto in slct" In \\ sII -sn 1 5\ LC 1' , m c n NI LaII INC I ( eI I sI O.ur ics di uscs' 'Is i fiIuno II sit' mu lin I , I Lss IIc'm in III st I tlC - IL1 1 c IlOULIIIC U In C LIcfi dititc expandedOs.'I crc'.s''svinn lOou D 5I I I n e h t Ic iier lnc'r','c'nt Cd I''. mII( cel It isr 'inro 1, C Iftn)I, c , .'c'I '.eC'&to on I is'J.. IsC'ciO J LI c IC '4I05II .5II I I " IC''Ic'.i In, C I[mn JI CI'isn Ls I I tcsl' . nn -1 I'Llcm I ' 1 1 u te lIe 'LI .n2it IInnIl I s Isl,slss'1. un'n. inIn I uth II '' .0*'mi. Iii.lc'1de tnt' - Inn tl s't -m,I ir Inc' AR's\I C'111d[-til.i'. ic Is inn 11 slnc'It U1 it'4c'c-Id HIss ,,I Iin I,]c cICdcl IC ti IL II i mI, sc'. ir necm t cr.i, C\ i nnc-l tiol ikc Is rlim t rIs c' ,I I C tI 0.inll' I , - l lscIm I mrs I I in es rnI n II I c' I nc-sI n Ic c> i- i in sI II s1 silos tlnc' Iwmnt,c'I ct\Nc' 5eii tiic IC'IclCc'I i, in LI c'xtendedlc1c tiOni c,sItiatini In, iI'IsI C I rC'n lt L i c'I S re inni,ori t,I II( C II 'n i s' II.rcIk I I 1C C I IIIIIIi IU \ IL I'' iiI IIL]soc t I It.'(In Iii Lunnc' lm., ms111nnncLiciI.1oICict II'1,1nnn1 .ic,.i lls (II, imOciliri n.nmitc.. lii nn'nlic ). im iIti )'.l'.'Icc C le cc' I .ic(LnI rii t mi, I L i()I IsLntg. Isitiil\ in,civil. and o1 misnisnsissrn denL! )Ic'In l tis'n tcc l!oer Clc'cIlcct mlilit cIIn ic' sittl1ciccItd vs cill (IJCli II(c'sci c')m i mn1 intlc''if li nlmdi IUc'scl ctiinic dilui'cscnim.c'' rcinn.tin mn's. iftic.- n'inc\sccitIcIUI'. IAnolc',, irn, King,. scsd Va'nt'4 2Nil'3 50~~~~~.) i terimi hetween li\ving in ARMM anmd leing f'en;alh. Indeed, this Thle previous analvsis of education outcomees and thlci specification indicates that the female atage is halved foir determiiinants reveals the many,v cdaunting X I .', that the those residing in ARINI. To) the extent thalt malternal (as Regional G¾overnment faces in f ,i ,i ,- the education mandaite opposed to parental) edoucatio n prolimotes hetter eductiLtion contained in the Orgyanic Law. In SUIIm, these challenges arc: o-tCoMes. CLetirrt suCCesses in increasing enriolliment rates * The Region's educaLtionlal (eve- Ipmlent lags II amiong girls in ARMM would yield hrenefits for the Regions behind thatt of other re-ions NlMuchi needs to be donie future educational developiment, to improve the Region's schools. especially in the mIore reml ote comimiuitiniities andl in conflict-affected 4.5. Challenges in delivering education aireas-and this is a task mnadle imiore dlifficult by the under autonomy problems that exist in chilcdren's holies andl collimuni- ties. The parents of these children are themnselves This sectioni dliscusses policy options that cotildt mitigate undereducated; many have large families with coli- the supply- and demrand-related problecms discussed in earlier peting needs but low incorlies and families halvie to sections. 'I'he Organic Law that created the ARNIM Regionall cope with the uncertainties and risks that accomiparrny Government coIntains a - I 1l Article XIV with 27 sections lii situtatiolns. In areas where children are less tha,t pertain exclusively to matters of education, science, tech- likelv to receive support at homie, the school systemn nology, ats, and sports. This palrt of the Organic Law is more will need to he that mucIh mor-e appealing and thatt extensive thanl the articles on the economioy and patrimonmy, mticl inore n j in teaching pLillic order and security, or even the aidministration of justice. * Past decades of relatively low ....... i rates in ARMNI The beginning of this Article, 'Section 1. Qualitv EduIcaItion, A have resulted in a large pool of illiterate anid Linder- Top Priority' states: "The Regional Government shall establish, schooled aedolescents and adlults. While the cun-nt maintain and support as a top priority a complete and inte- colIort of schioolchildren deserves the greatest atten- grated syster 1 (fI qLialitv education and adopt an edlucational tion, continiuing the edtication of these dropouts from framework that is meaningful, relevant, and responsive to tbe the systemi is also a problem that awaits a soluition. needs, ideals and aspirations of the people in the region." The * Since the Region's basic education system depends imppor-tance of education in the affairs of the Regional largely on its own tertiary, education graduates for the Government is also reflected in the fact that education spend- supply of its teachers, it is already part of a vicious ing accounted for as much as 62.5 percent of total regular pro- cycle of poor education quality, where poorly eclucat- grami spen(ding for the Region in 2002. ed teachers deliver poor instruction that yields poorer To enable the Regional Government to filfill this respon- than average candidates for training tto become eveni sibility. the Organic Lawx gives it a wvide range of powers and less able fiture teachiers). Yet ARNEM has university authorities over education in the Region. The Regional systems with the potential to help turn arotind the per- Government is responsible for existing schools, colleges, and formance of its beleaguered public schiool system, as universities wTithin its area of jurisdiction. It is supposed to well as to prodtuce the leaders, managers, and protes- make the Region's education system function as a subsystem sionals that the Region needs. of the national education system, i [ 'in' the same stricture * The Islamic eduIcation agenda implied in the ARIMM but with emphasis on the autonomv of the subsystem. It can Organic Lawv-for schools to be able to transmit ancl mandate that the Region's schools adopt the basic core cours- inculcate Islamic values to children as well as to es, minimum currictiltiim, and textbooks required by the offer basic knowledge and skills essential to their National Government, but it has the prerogative and responsi- ftiture-remains an tinftilfilled promnise of regional bilitv to add other courses and instructional materials that are autonoomy. How this is addressed couldC contrihute appropriate to the Region. Graduates from the Region's system not only to meeting the eduication challenges in the are expected to be able to transfer to schools outside ARNII Region but also to seeking solutions for the Region's with fLill accreditation. peace and development problems. Hlim .li q 1 " 1 11t' "itl ! > j'll 'l 'l 1 \10\1M 51 * Within ARM/IM itself, the powverful demand.s of the het- * Basic education should transmit and inculcate Islamic ter-off for an education system that is ahle to keep tIp values and culture as the unique heritage of the people with the hest in the country tentl to be heardl far more in the Region. One argument wvas that poor Miuslim than the needs of a muchi larger ancl worse-off seg- families may find investment in education for liveli- ment of the population for a hasic education sxystem hood purposes unattractive since economic opportuni- that is better ahle to deliver essential competencies. ties are so scarce anyway htut they may want to keep These competing pressures are often reflectetd in the their chiltlren in school longer if they regard such eclu- tension between attempts to concentrate resources in cation as advancing ancl preserning their Islamic faith a few centers of cxccllence antI efforts to spreatl out and values. limited resources to meet the hasic needs of all. * Basic etlucation should enable ARNINI citizens to par- * ARMMl's hasic edtIcation deliverv systemil has to perforill ticipate in national life, implying the neecl to transmit with much fewer opportunities for local resouIce nmohi- anti inculcate a common Philippine heritage. lization than most of the rest of the country since the * Ba,sic cclucation shoulcl prepare ARNIM resiclents for communities it serves are also generally poorer. Outsile their Itities and responsibilities ais citizens of their comi- ARINIM even't PHIPl of national government spencling munities anid aniong them, the future leaders of the on eclucation is ble to attract PHP'(116 of comciblu Colili1lumity should he veveloped and nurtured. 1" 111 tfrom local governments, while within ARNIM, * Basic etlucation shoultd provitle ARNIM citizens with the evenr PHPI of regional government spencling on edtu- essentiaLl capacity to pursue economic opportunities cation attracts a mere PHP0.003 of comparable spentling wvithin the Region as wvell as in the larger wzoril, hoth from local governments. The average non-ARMINI LGt' \yithin the countrn antI abroa.ti is not 53 times riccih than the averacge LGtT in ARMINI. Perceived 1iil hetw-een the goals of building a but it spencts 53 times more on edcationati uniqtue Islamic community and remaining fully integrateti in In the face of these challenges, the Regional Governient the larger Plhilippine nation has preoccupietl leadership in will ncecl to make wise choices-and then pursue those choic- ARMIMI ant, to a large extent, has prevented the Region from es relentlessly ancI efficiently. Tle rest of this sectioin attempts tackling the more muntlrane hut very real prohlem of saving to offer soime indicative solutions to these prohlems. Factors a regional CCluICtion systemi that has tleterioratecl over that pertain to ARMIMI's economic and conflict situations are decadtes of neglect anicl conflict. To ftilfill education's role in powerful deterimiinants of the tcemanti for ecltication in the builtling the Region antI its futire, the leadership of the edlu- Region, hut those are issULes that go hevond the reach of edtu- cation systemn in ARNIMM neetds to redirect its efforts tow-ard cation policv. However, there is hroatd scope for etlucational i 1. i 1d and huilding on the broadc areas of commonality reforms that could improve the Region's provision of ecluca- aniong these seemingly competing objectives-taking cues tion-among other things, the strategic directions of the from edLucation systemns in other Islamic countries like regional etlucation system kev mnianagemient antI operating Indonesia, for example-and then at once rebuiltling antI systems affecting the effectiveness of sclhool supervision ani tipgratling education institutions. In concrete termis, steps eventually the quality of school instriction. the level of fiscal must he taken immediately, perhaps through a series of con- resources available to etlucation, and the link hetween tertiarv ferences anti workshops, to resoilve the ongoing clebates on edLucation anti basic eltication. the goals antI institutional forms of the regional edtucation svstem, hioth pub lic anct private. 4.5.1. Articulate a clear and broadly shared agenda for Inevitably, the orrld of limited resources will require educational development hartid clioices and trade-offis to he matle in pursuing these pur- There is intense discussion amiong various political leald- poses simultaneously. For example, in the alloca.tion of ers antI educators in ARNIM about the principal objectives of teachier effort in instruction, a major commitmiient to Islamic hasic cclucation in the Region. Among the comiipeting priiorities etducltion, inclutling Arabhic language instrtction will have to *. I to the stulch teamii were: Ie harmonizetl with the - i i need to upgratLe the teach- 52 i I. ing iif English a,ndl 1'ilipino lhinguages. as well as mithlematics late tht regio nal plan quicklI ritO separate divisicti-le anld tIesciences, so that studenlIts haVe IsiCe Coh lli and life plins. withi torresponding buIdgets and I Iti, allhiations. skills that eCLuip thelmI for tileir futule. EcucIticin dlevelopmint Political interests can gct in the way of a rational pltnning and eCIl'ots niust concentrate on huilding an educat ion systemi that budgeting proicss-and wi irse, i hstrLuct implenlCetation-but offrs a stroug fioundation in these skills. However. strategic early puhliCe disCIOsur-e iof tlhe prOCess and its restilts migilt offer planning and thjective decision-miaking wvill reveal ciinsider- some defense against ca;pture. thly ImOI sce S fOt' irI pursuiing these goals jintintlv tIhn mnay he ILstriblis/i cI policy )'Igci/n ad madaris' tlicit is con/sitlent recogni/ed it the present timeI. nit/i) iiitioillc/ cdu/ciiCtionI s dtcinc/ircds. It has been arguld thlat Twio specific actions are needlvel to articulatte the edluCLa- the nattiona1l edLueition svstemi is irrelevant to MUslim Filipintios tio n agenda fohr the Region: in thia t it neithier- reflects the culttire in whichi thiey gruv tip nior Foi/ itll/cltc' ci iiii0il'ye I c,nii icdl clis;c c? clltction/ plcti /oi prepares theim ftoir the ecoi otitic eand social life in tilc Regioil as Ocr'teniine key( directions aind d(ecid'e onl mnic priorities. This a1n adult. Reptihlic Act No. Q(0I is an attempt to redress the is the first oircler of husiness for the Region's eclucation sys- shortecinings of puthlic edtdcation \itiin ARMINM. It explicitly tern-ancl inileedl there have heen serious effotrts at fo-rmulat- suites tilat NLusIlil ctilttire, Iores. tustotms, and traditions are ingayn ecluc ItiOunl clevelopmuent plan ftor ARNIN in the past. to he integrated nmd preserved in the CUrricultVim iof rCgtilar O(ne example is tIle Comnprehensive Minclanao Edlut ition public schools. In response sonie of AIRMMNI's public schlools Program (CIEPR) 1997-_2014. which ensciecl froiim the First are beginning to introciicue Arabic langtiJge instr-uetion into Mlinclanao Edluticttrs Congress in 1995 and StUbsequent thieir curriculuil, as a me1cans to give stticlelIts the skills needcedl Administrative Ordler No. 29(. CIFP1 \as scipposecl to 'lation- to read the Qtiran. Acenclring toi interviewNs hekl h1 the stutc' ilize. prioritize, integrate and coordinate all levels of ecluca - teami w-iti D)epEcd-ARNINI atout 20t perc'ent of public sclhools tiOInal devc1lopinenrt plais. proglraims and projects in Minclanaco have recruited Arabic languiage teachers. Public school teach- with the overal I go al of attalining a wholesotne quality of life'' ers and principal s are a,rware that teachlinig Arabic is a means to (CMlEP'-Programi Management COf'.. 1990). Its frnmtew-ork attrict more sttidents to the regulir school systemu. appears sensible and relevant to the conclitiotis of the Region, Nonetheless, tsl1amiC eduCation throLigh nicicinis -ill prolbabl but at the time of this study, local edlucation officials were remnain a relatively important part of the eclcteation systemn in unanimous in their view that the program hacl ftlterecd hefore AREMM, especialkl if public seCi00ls aie unable to meet local it was really implemilenited. Formulating anothier plan shouil ecultural neecs. review the reasons behind CMEP's failure to avoid the samre .cldcr/iis comiprise a diverse set of Islamilic schools. The pitfalls. In formulating any otither plan, the Regional common cic/drzcisci/m etirrictiluti across the wt-orld ineltides Government should conisult broadly with LGtUs and local edti- Islamic stuclies and the Islamic principles that are meant to cation officials steilh as division suiperintendents, district super- govern the daily life of iMuslimis, inelicling Islamic law, the visors, and schocil it. , and wvith communities thet-mselves. lrophet's sayings, the Plrophet's tratditions, and interpretation This would slowl down the process, but local edcliation o ffi- of the Quran-but in Bangladesh, Egypt, antd Indonesia. for cials are seeking greater participation in defining the Region's example. many mclcwiliris have tried to achieve a balance in edtdication agend.a and in determining the alloeation of teaching both religiotis and secular subjects (see bzox 4.1 for an resouirces for edutcation. Broald consciltation woutl help examilple from Incdonesia). Aceording to a 1998 survey (under- ensure that the diverse conditions, objectives, and needs with- taken tinder the CMIEP) AttMNI has 1,111 icdentificd mindic/c;is in the Region are Fully 1 ii . 1 in the plan-and w)ouldl help (inclucling traditional or orthocdox macdaris provicling purely mobilize scipport for the agendla frotm the LGUs, the private religious ancd Arabic instrcetictn, and develotpmental or graded sector, and eomitinities. In adclition, any plan will need deter- mucidc;n's), with only 45 being accredited. Many of these mined and trusmortilry leadership, adequate fiscal resourees, mnadrwis focus on teacihing the Quran and operatet only' on and realistic goals and standards. It is also imp)ortant to trans- weekends or part of the clay in order to supplement puihlic I N OJIJIIS tml' pltr.il of miltraahi) .Ire religimLI, rch,)lAs Hm [ ' 1tx. dtt'' ID, , "ion'; t cxw ". 1!1 In t it 53 5 education with religious teachings. Other madaris are private, are attempting to offer the national curriculum. religious schools that offer the national curriculum, augment- * In areas that are clearly underserved, that is, where ed by Arabic language teaching-but past studies show that children do not have a regular school within a reason- most of these madaris do not meet national accreditation stan- able distance, the options are to build a new public dards. Judging from these numbers, transforming madaris into school, to help transform the local traditional schools that offer a standard curriculum including the basic madrasab, if there is one, or to stimulate private provi- national curriculum-and with teachers who are able to teach sion. With only a few exceptions, after-school or week- that curriculum-is not only a costly proposition but also a end maadaris would not be easy to upgrade to a school long-term one. Are there sufficient fiscal resources in the that offers the national curriculum. In addition to signif- Region to undertake such a huge investment? Is it really more icant investments, such madaris should be required to effective, from the viewpoint of ARMM's educational develop- navigate the step-by-step rules of registration and ment goals, to use those scarce resources to transform madaris accreditation that apply to all private schools. than to upgrade the regular public schools so that they meet As a first step in implementing a policy on madaris, the the Region's needs? These are policy choices that confront Regional Government, perhaps with the national DepEd, regional leaders and managers. should obtain more information about the conditions and An important challenge in ARMM is to formulate a coher- needs of the macda ris in ARMM, keeping in mind the holistic ent regional policy of technical and financial oversight and education needs of communities. It might then consider estab- support for madaris that recognizes their role in ARMM's edu- lishing an initial investment program of assistance to upgrade cation system. Some guidelines for such a policy may be con- existing madaris that offer the national curriculum so that they sidered: meet minimum quality standards in teaching that curriculum. * Traditional madaris that do not offer the national cur- As mentioned above, public investment in niadaris will nec- riculum should be free to obtain support from the local essarily come at the price of investment in regular public community, but they would not receive public schools, so this program of assistance would need to be prior- resources. Many communities in ARMM are actively itized along with competing demands for fiscal and/or donor supporting Quranic schools by donating land and resources. Maclaris that receive assistance from this investment buildings, donating time to serve as a teacher, or con- program would be expected to achieve clear performance tributing toward the salary of the teacher. In many indicators, as would regular schools. cases, according to the study team interviewees, the contributions are very small, but in others, the contri- 4.5.2. Increase the efficiency of the education sector butions are sufficiently large to provide the teachers Addressing the education problems in ARMM requires with a viable secondary income. Children attend these appropriate management systems and adequate resources. mnadaris after regular school hours or on weekends. Traditional investments for expanding access or improving * If a mJadrasab already offers the national curriculum, quality, such as school construction and increasing school then it might be appropriate to provide a subsidy to supplies, are needed, but to extract the benefits from those upgrade it, provided that the mnadrasab can meet investments, the whole system must be better managed. national accreditation standards. Part of this process of This requires the ,11 - , transformation would be the willingness on the part of Establish a polici' of shared management anzcl accoit nt- madaris to employ teachers who meet professional ability in the system. Autonomy has increased ARMM's power standards to teach nonreligious subjects. This principle to manage its own education system, but accorcling to the key is consistent with a policy of having a unified regulato- education officials interviewed by the study team, the ry system for public, private, and religious schools. The Regional Government has been reluctant to share that country's "performance measurement system," aug- expanded authority with the system's local managers, the mented in the direction of outcome measurement, Region's division superintendents, and district supervisors. might be applied to keep track of those madaris that Superintendents felt excluded from information flows and n Indonesia, support to religious schools has been a long-standing commitment that began in 1946. Since then, government aid has flowed to these schools in the form of money, equipment, and personnel. There are three basic forms of madrasah schools in Indonesia. The first are madaris that incorporate general subjects into their curricula, the second are madrasah diniyahs that teach only Islam and Arabic, and the third are pesantrens, which can be either of the first two types but offer boarding for students who want to live under the guidance of kiais (instructors). This first type of madrasah has been formally recognized as part of the regular school system under a series of laws enacted between 1945 and 2000. Efforts have been made to equalize the quality of madaris with that of regular schools. Among ili-, ': this integration means that subject area contents taught in madaris have to be the same as those in the equivalent regular schools. At present, religious subjects constitute 30 percent of the curriculum, while the rest is for the standard curriculum subjects. This integration has been an outstanding achievement, since it ensures, at least in theory, that graduates of the primary-level madaris are able to enroll in reg- ular junior secondary schools, and so on. There are several reasons why enrollment in madaris in the last five years has grown faster than enrollment in regular public schools in Indonesia. Madaris are often found even in remote areas and so are very accessible. They tend to be less expensive than other types of schools, and so are preferred by,.:. fa,,imi-. They are flexible enough to hold classes at times that do not coincide with children's work schedules. And they are particularly attractive to parents who want their daughters to be "morally safe." The Indonesian Government is seriously considering the role that these schools could play in achieving the country's Education for All goals. But the challenge for madaris in Indonesia, as in the Autonomous Region in Muslim Mindanao, is to offer general education of adequate quality. There is a widespread perception in Indonesia that these schools are of the lowest quality. Average student test scores are lower in madaris than in regular public schools in 17 out of 26 provinces, although this difference is not large. Other evidence indicates that madaris lack adequate school facilities, teaching and learning materials, and trained teachers. But there is evidence too that madaris may, in fact, be more cost-effective, after one controls for cost and the socioeconomic background of students (Bedi and Garg 2001, Aziz 2002). Average cost per learner in these schools in Indonesia is only about 38 percent of the cost in public schools, while test scores indicate that these schools perform 91 percent as well as general public schools (Aziz 2002). To improve quality, however, would appear to be a more difficult challenge for madaris than for general schools. The madrasah curriculum is so overloaded that there is not enough time for teachers to master the contents of the mathematics and science they teach and for their students to understand them. To reinforce the message about raising the education quality of madaris, the Ministry of Religious Affairs has established a "model madrasah" which is a public madrasah that meets a required set of standards in terms of infrastructure and facilities, number and qualification of teachers, and selection of students. Making this model a reality for many more madaris is going to require significant financial investment and a firm commitment to good education. Sources: Adapted from Anzar, Uzma. 2003. "Islamic Education: A Brief History of Madrassas with Comments on Curricula and Current Pedagogical Practices; " and Aziz, H. Abdul. 2002. "Madrasah Education in Indonesia: Potential, Problems, and Issues." Symposium on Madrasah Education in the Context of a National Education System. Jakarta, Indonesia. 4 November, 2002. |' decision-mi.aking in the sectol reporting that, under regional Government needs to set good policy direction in this regard, autonomuyN, they had lost rather tha,n gained managerial con- and once it has clone this, shoull take steps to develop appro- trol. Neither were they consulted nor ill ..I to participate in priate systems that would provide the mechanisms for cnsur- the hasic allocaltive clecisions concerning their own cliisions. ing accountabilitv or responsihie stewardship of public At the very least, the superintendents expect the Regional resources. Government to discuss the strategic direction of the sector It pro'ev Pet' )oa;iatI e')t aund olpe/yltinig s't'Stet',S. mnd to make known its vision and plans eachi year: for their- Developing management subsystems is a detailedl and lahori- part, the division superinitendents indicated that they were ous task requiring leadership and sustained cotmmittment. prepared to implimcnt these plans. Specific areas that require improvement include the following: There are mlany good reasons for sharing managerial * Currenit and dcetiled information relevant for policy- powxers within an edication system. The key actors involved in manking tends to he scarce, a consequence of the the education sector and the relations that hind thcimi include Region's security situation. In order to raise the quality the parents and students, politicians and regional policyrmak- of both delivery and financial management in ARNlIM, a ers, and the service providers suchi as teachiers and school prin- b)etter information mechanism is neecded to m.eLsure cipals. When authority is not shalred, the principle of sharedc anldc record the resouirces. inputs, and outcoMes at the responsibility and accountability' has no imeaning, and services lexel of the school and sttidents. There is a neecl to are bound to fail. Althoughi a strongly centralist approach to de\elop clear regional standalrds for information han- management works well at fairly simple tasks, sucI as expand- dling and reporting, as well as mechanisms to ensure ing access to services, this command and control approach that thiy are followed, tends to fail at more complex and subtle tasks, suchi as improv- * Subsystems to deal with hudgeting, procuremilent, and ing the quality of instriction in schiools, and does so especial- financial management are needed at the dixision and IN in the unpredicwalec, conflict-ridden environment of ARNINI. schiool levels Systems are needed to address issues of Shared management, on the other hand, has the potential for schiool funding 'ia formulas and to simplify hudgeting strengthening the forces that could help improve services- formats. The main task would be to develop a set of bringing allocative authority closer to schools and the clients, accounting tools that can track expenclitures. both creating opportunities for co(mmunities anid schiools to supple- budgeted and realized, dow n to the school level and ment available resources where needed and to innovate, and that can aggregate all formis of expenditure for eaci enhancing local accountahility for the quality of provision, school. Experience in other cotintries suggests that increasing the * Arrangements for training, hiring, evaluating, and pay- pow\ er of parents in school management-for example, by' giv- ing teachers need to he assessel. If ARINIM'I is to suc- ing parents a say' in the hiring and promotion of teaichlers and ceed in its eclucation agenda, it vill have to adopt other school personnel, or by alloving them to monitor muchI more effective measures for mobilizing and uti- teaclher attendance-can improve teaclher attendance and per- lizing. to the best of their abilities, the thousands of formance and, ultimately, stuclent learning (jimenez and teachers already in the system. It will also he important Sa-wada 1999, King and Ozler 200w). Especially' in cases where to allocate sufficient supervision andl material support the tisual system of school supervision and managemient is for them, especially to the most disadvantaged and hampered hy sociopolitical crises, mtistering the self-interest worst-performing schools. of parents in their community schools miay provide the only * In hard-to-reach places. such as island provinces and reliable mechanism for improving schiool quality' municipalities, as xvell as conflict-affected areas, there There is a clear need-and opportunity-for the Regional may' he special needs requiring more innovative man- Government to clarify how it wants to muanage the education agerrment systems and pedagogical methods. The diver- system, ancl in particular, to define an El,, ii and clear func- sity wvithin ARINIM itself implies high diividends for local tion assignment betwx'een the region's central authority and the innovations and pilot-tests. And for as long as there is division and other local education officials. The Regional armeed conflict in ARMM11, it is necessary to find effective ind iffordabkl w;ays to minimiiize the imripact of this on pressing. However, when suLICh patterns haxve not been denmo- instruction and learning. It would he useful to review stratted. then the pressure is greater for the \National the extent to wvhich the relohcatio n to eVCuaLtion cen- GTov ernment to cxarmine its role - i m 2, sttndarcs of CLuatlity ters can he improved and to explore the use of altcr- of the Region's ohligatorv provision of edCaLICtion , - ii native delivery technologies, such as distance lieirning, the Naltiorial Government has coiimmitted itself' to international self-paced learning, atnd multigradle te.eaching, in order stalncldards of delivern (as in, for example. Edlucatio n for All). to redtice dlisruption to classes. * Several of the people inter-iewed hy the stutly teaivi 4.5.3. Ensure adequate resources for educational raised the problem of corrUption. ThIey- linkecl it to the development concentration of aluthoritr aindl to the lack of sharecd Regional aUtO1iniimV has given ARNMM's local clecision- information and transparency regartling personnel pol- muakers latitucle to iact upoin regional gi.lls with funds that are icy antl budget processes throighiout the sector. not restricted to one tise or another. It is the responsibility of Ciorrtiptioni impOses htige Ciosts on ARl\ll's develop- the Regional Governmillent ti aIlicate resources to ecaucLition hy ment b)e.tiRse it ta,ikes away resoitces from1 the sChools ftindling the opera.tion and maintenance of sclhools, paying and stutdents who most needl themil and it trocles the school personnel, and supporting ca.pital expenditures sutch is pullic's conificiencc in the edtucatiomn system. Niheln the the coinstrtLction of sclhools. This arraningemient issuimes thalt the implementation mechanisims of the regional autonoinov fuinds flov- to responsible local leaders, that there is sufficient are heing establishoedL it is timeily and strategic to i aCotUntability, and that it is neithei- necessary nor tlcsirahle to dlesign systems now for hn ,l, against and detecting intcrfere with regional government choices. Indeecld how- cori'tiptioin, and ptinishiing those responsihlel The puh- mtclh of the total regional reventies w-oUld he al1lo0C.ted to eclu- lic diselostire of infoiirmation regarding. imiong other cation tlepends on the II ,, - of the local governirments things. personnel actions, proCtLreilent. and disburse- within ARMINI to spendl on edtucation. The isstie of resource ment is a merans to btildl a culttire of transparency anI adeclitmacy, howvere' is not independenit of the level of per- accouintathilityv forirmince that the Regionial Governiment aispires to or that the Finall-. an important quiestion to aiddress is: NWho will National Gioivernment expects froiim the Region \ As letfiletl develop or i'edesign these mIanagemient systemns? IUndrtaking ihiive, resoturces allocated t( edcLuCation in ARNLNI are inatle- this task w-ill requilre sustainted political commilitment and a quatte to deliver c I 'I, equitably and at high qtUality. \-illingness to 11I . adeqtuate national finaincial resouirces It is temilptinig for policvmnakers to tise legislation tol man- aind national talent, )epEcl-ARMINI may neecl to create a time- dLate a level of spendting fur hasic edtucation. An alternative is hiounnd facilitv that will foctus on the tasks of getting the jol to base the bucdgeting antI financing process on a cleatr region- clone-to convene systems and mnanagemilenit experts: to w(ork al agencla for improving edlucation services that itself is the with administrative staff: to identify needls and criteria for svs- procltct of a process of broad consultation andl negotiation tems: to outsoutirce systemns developient to the hest talent in with stakeholders, Stich an agenda might incltide establishing the country (using proctiremilent imethods of open bidding and minimiiumii service stantlards for divisions and clistricts in ortler proposal testing); and to make systems available to all divi- to upgrade public schools; a reform programi of teacher (level- sions to test for a specified periocl of time. folloimed bv an evtl- opment ancl performance; school-basecl mnanegiment: a svs- U.ation. tem-vitle information network: and demand-side programs to An important issue about the governance and manage- reaich the poorest childlren, Sichi performance-hased resotirce ment of the education sector is the role of the Nationil allocation might attempt to go heyiond tht school edtiucation Government in the Region. In principle, with auitonomiy, ftinc provisions of the LGC of 1991 ancI define the levels aind ARMNI has broad freedolim of action to clefine and act upon its items of expenditures that couldl be assigned to ARNINI LGI's, intenclecl level of perforimiance, and when patterns of account- In severlal Countries, the amiot-nt of fundls allocated to educa- ability have been established and sustained, the isstie of what tion. ancl thus to schiools, is driven largely by the numiber of role the National Government plays in service delliverv is less stutdents who are expected to he enrollecd each yeaIr and bly an 'I: 5 presented earlier in this chiapter show that almost all of the -ecducational d'*.i 1 ii ,,' of ARNIM, wdhen comparedl vith other regions, is due to loN enrollment ratcs and high dropout rates in the Region's poorest comimiunities, Thlis fincling persists e-en when other factors have been considercd, underlining e 6 ' - - the importance of poverty as an ohstacle to eclucational dlevel- opment. For example, discussions wvith representatives from f.nded bY the 1asilan, Solo, anti Tawi-Tawi inclicate that these smaller, island XDPAf SOCIAL FUND pri inces needl speciall assistance. In aiddition, conflict sitult- _ , otpeace l:ee'ilI between tions in Basilan and Sulti halve maIdc regional supen-isioi i more PE ,*, goverrnment ai .II and have increased these provinces' isolation from the cn th MwNLF rest of the Region and the countrA, Targeted assistance to poorer atnd disaldvantaiged colimlilu- ~4 W , ^ nities in ARNIM might take the folim of dcanmd-sidc programs foEr scIlools as wvell as iMIusehOlds, For schiools, the first step -R X- -, Vould he to icdenitily needs, perhaps aigainst a set of millimiulLIl , f service standakrds, and to )iio)litor the level of allocated I -i ffi _ ' s resources that actually reaches these schiools, In poor commo-ili- nities \vhere demand for eclucation mix'v he weaker, it is all the - ji _ -Jo iore impoi-tant that scliools are attractiVe to studcents ancd that they are effective, as meatsured in term-ls of achieving certain ' . T5- '°. perforimiance indicators. Incomiie support that is aimecd to inlduce parents to send agreed-upon per student cost, Lsing a fuLniding formula that their clhildren to school is sometimces given as a direct subsidy depends on the numher of stuLdents rather than on the number to cover the cost of sclhooling or as cash support that is tied of schools encouLages a more efficient school size, Lurges somelhov to school enrollment of children in the household, under-subscribed schools to consolidate, and is potentially The experience of other countries showTs that this type of pro- more equitable in that every stuclenit is allocated equal, cost- gram succeeds in raising education outcomes, For example, in inclexed ftnds. It also means that sclhools ancl their commutni- 1997, the federal Government of MIexico introcluced the ties can predict the level of resources they are entitled to. Programja de Educaci6n, SalLid y Alimentaci6n (Progresa) as Equal resotirces for each sclhool, rather than eachi ptipil, wastes part of an effort to break the intergenerational transmission of fncds, provides no incentives for school consolidation to poverty. The program provides scholarships that are awarded achieve cost- .I - r pI i-i ,'-.r ratios, ancd is also highly monthly to eligible children who attend school at least 85 per- inequitahle among pupils and families NIoreover, to the extent cent of the time, plus the cost of a once-a-year book that the per student cost parameter is definecl on the basis of allowance, plus the per family, member share of a general sub- delivery of an acceptahle standard of service, the formula is sidy that Progresa provides to each eligible family on the basis likely to help schools make more effective use of resources of a poverty-level proxy means test (Behrman, Sengupta ancd available to themi Toddl 2002). Estimates of program impact on enrollment rates If LGLTs commit to a regional agenda of educational devel- at the secondary level, controlling for householdl and comrou- opment, they need to budget more resources for achieving the nity characteristics, range from four to six percentage points items on that agencla. But coimmunities are not equtal in their for boys and seven to nine percentage points for girls. In ability to mobilize local resources for their schools, so this Colombia. the Government created a voucher program for sec- argues that the Regional Government (and the National ondary school students in 1991 to enable poor children to Government) should assist poorer LGtls. The education data attend private schools using public Rinds (Angrist et al 2002). 58 jli': LU" ''f I x . i i I %i. 1 An evaluation of the program found that voucher recipients education. Efforts to upgrade quality at the lower education completed 0.1 more years of schooling (primarily due to levels depend on the potentially large benefits from investing lower repetition rates), were about 10 percentage points in the improvement of tertiary education in the Region. Such more likely to have completed grade 8, and scored 0.2 stan- investments could help break the cycle of poor quality in basic dard deviations higher on standardized tests. education. Lastly. current public spending on education ignores Second, higher education institutions are also the training the problem of the existing pool of illiterate and under- grounds for ARMM's technical and political leaders. This schooled adolescents and adults in ARMM wNho are victims argues for the ARMM Regional Government to develop a of past education disadvantage. A case might be made that strong research and development relationship with colleges this education burden is part of the responsibility of the andl universities in the Region so that the professional and National Government and that a separate transfer mecha- technical expertise available in these institutions can be put to nism, with a provision that it must end by a given date in a work in seeking solutions to key development issues. Such an few years, should therefore be created to enable the ARMM effort might be based on a rigorous review of current levels of Regional Government to eliminate this underserved popu- provision and the quality of existing higher education institu- lation over an agreed-upon period of time. Such a separate tions in the area. Then some policy actions by the National fund might then operate to support nonformal education Government and Regional Government might be taken to programs for out-of-school youths and adults. But this is improve the efficiency and quality of these institutions in also an area that can benefit from the participation of the responding to the needs of ARMM. private sector. Indeed, there appears to be a wide range of The majority of regional leaders are graduates of local uni- programs funded by business groups, such as those coordi- versities-and it is likely that future leaders will be too. Indeed, nated by the Mindanao Regional Office of Plhilippine these institutions appear to be strongly aware of the role that Business for Social Progress. The (I.illr5 is to coordinate they can play in engendering peaceful solutions to the such efforts effectively in order to maximize impact, reduce Region's troubled history and stalled development. Local uni- overlap, and ensure sustainability of these programs. versities, such as Notre Dame tJniversity and Mindanao State University, as well as Ateneo University in Zamboanga, have 4.5.4. Strengthen links between basic education developed curricula that are aimed at promoting an under- and tertiary education institutions standing of the issues of conflict within the Region and at In 2001, the Region had 12 public and 14 private insti- developing skills and programs to spread that understanding. tutions of higher education, with 86 percent of the total For example, Notre Dame UTniversity offers masters and doc- enrollment in the public institutions. Historically, ARMM toral training in peace and development education, and an took pride in the high quality of its universities, and stu- interreligious dialogue program that creates a forum for dents from the area were known for preferring to enter local Christian and Muslim students to discuss common issues. The universities. Ensuring that those universities maintain this Regional Government should consider adopting programs reputation is cricial because an increasing sense of social similar to these in the curriculum for basic education. and cultural isolation in the Region has intensified the need In 1998. ARMM accounted for a disproportionately low for local higher education institutions that understand 0.5 percent of the total enrollment rate at the tertiary level in ARMIM's unique history and yet that can provide their stu- the country, despite the fact that higher education institutions dents with ,d1 i11 relevant knowledge and skills. These in ARMM depend only minimally on student fees.r There are institutions are important to the Region in several ways. many ways to make higher education institutions more attrac- First, higher education institutions train teachers and tive, but one critical factor for raising demand for higher edu- supply those teachers with the pedagogical knowledge that cation in ARMM is increasing enrollment and survival rates at they need. Hence, the higher the quality of those institu- the lower levels and nurturing demand among those students tions, the higher the quality of the pool of teachers in basic for fturther education. This closes the feedback loop between basic education and higher education. F' r exampil. th' \lindarnao StMte i mversits dh.urgqs only l lli'Mis per stinester per stUdent, In C(otrtst t the Notre D)rtne Universits. whir h charg'es PFHP250 per Lnit per semester tl r'l'C''U'cffl i<' i. ui j ' i t 5S9 9 (PfA~~~~~~~~~~~~~~~~~~~~~~~~~P --- - - --------- s i < - - - ---X-I- i J- - - - -- - --- -' Xjn r a TA J ~ k A s ---- 5. The Health System in ARMM ringing the health of the peoplc ot ARNLM iup to the level of ' the rest of the ct'olitrf is a huIge clhallenge, given how ; poorly the Region stands today. This chapter will examrnine the health systemr in ARNIM with the aimn of hetter understand- ing the factors hehiiid this poor outcome i and of iclentifying ARMM, 2000 Philippines, 2000 71.6 66.3 opportunlities for accelerated health development in the Philippines, 1970 59 56 Region. It hlegins with a discussion of the pattern of mortalit- Philippines,1965 58 54 and the disease hurclen of the Region and rcturns to the twio key Madagascar, 1998 59 56 factors that explain the Region's exceptionally poor heal th Lesotho, 1998 57 54 outcoimes-extremeIc povertv and continuing i, 1 h1 It then Nepal, 1998 58 58 lookls at the health care system in the Region to examine the sys- Sources: temi's a1hilitv to lhelp compensate for the clisadvantages imposed FxARMMadthe Phpipnes, 20d:i202 lppnS Bka ear Baona tattialCoordination Board. - ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~For the Philippines, earlier years: World Bank, Live Database for the Philippines. 1wv thicsc tw(i factors. This analysis is f '11. I hv a pro)po sal fior For other countries World Development Report 2000/2001, World Bank. a long-ternm strategy to address the prohleris in the sector show cli irrhea, ina laria, and meiasles as major Causes of death 5.1. Health status and its determinants in onle or more of thesc provinces. 'Tiese tliseases nio longer appear in the list of top 10 I I f r . )r the CoLuntlr as of the Iatest The low life expectancies and higih levels of infant and av ailable nationwide clata for 1998. Otn the othel hland, clis- mtiternal mortality in ARIIMM indicate a Region that is far less eatses of the heart, the top killer nationwide since 1990 and in acvanced along the health transition curne' than the rest of the top thiee since 197, cloes not appear among the top five the coitntry. Life expectancy in ARNIM today is imiore akin to in thiee of the four provinces. In the foLurthl province, life expectancy in the Philippines as a whsole in the late 19(00s, Maguindlanao, hetart disease is not repottecl separately hut is hefore the ciountry benefitecl from the fruits of economiic combined with all cardliovasCullr diseases to rank thir,l development and adclv es in puhlic health programs. In fact. behind 'tiunkrnown senilityv and aeacidents."" As in the rest of the Region's heailth indicators are closer to those of pooretr the country. thotagi, hypertension is already arm(ong the top countries of Asia and Africa in the Ia te 19901s (tahle 5.1. thiee killers across the Region, prohahly pusIhed LIp 1hV the An examination of the nain causes of mortality in the high seafood content of thte cliet and conflict-incduced stress, Region furthel confirm this delayed health dlevelopment. Available data on the coi mmon key cleterinninits ot Available data on the 1() leading CAuses of mortlAity in the health outeomes in ARNISI I(tahle 5.2) suggest that poverty is 1 prosvinces of lanao dlel SoIt Sulou Nlaguindatn-ao, and 'lawi-Tarwi m ain driver of helaltlh outcome s in the Region A quick revi iew of I l iinkt vUsnkn ssis\ s 111 ', tkIn ir ts inkig rncl.iso i, ins-( )r lik cNt dic r-ul pt t 1, rcpt n tinh, tirn .iln thliing CeIS G-5-year-old children, 1998 Stunted 5.4 7.1 6.5 6.4 9.7 6.9 10.1 16 Wasted 7.2 8.2 5.0 6.1 6.0 5.2 8.2 12 Underweight 9.2 11.1 7.7 9.3 11.1 10.1 9.2 7 Prevalence of anemia, 6-month-5-yr-old children, 1998 31.8 42.4 19.8 27.5 33.8 25.6 50.6 16 Prevalence of iodine deficiency Disorder, 6-12-yr old children, 1998 65.3 79.6 85.3 68.3 65.5 79.0 48.8 2 Share of households with: Access to safe water supply, 2000 76.3 73.7 90.4 75.0 78.5 75.5 61.6 16 Sanitary toilet, 2000 69.3 68.6 59.9 72.8 66.6 68.4 42.8 16 Functional literacy, females 10-64 years, 1994 85.9 78.1 87.4 83.2 80.7 59.1 ib Total fertility rate, 2000 (number of children) 3.38 3.92 3.84 3.76 3.97 349 12b Population growth, 1995-2000 2.02 1.86 2.08 2.32 1.19 1.31 1.75 8 a. A rank of 1 indicates the most desirable outcome. b. Shows rank among t 5 regions: no data available for Region Xil. Sources: On malnutrition Philippine Nutrition: Facts and Figures (National Nutrition Survey t998), Food and Nutrition Research Institute (from FNRI web site ). On water and samtation: Field Health Semnce Information System 2000, Department of Health National Epidemioiogy Center (from Department of Health web site ). On literacy and fertility: 2000 Philippine Statistical Yearbook, National Statistical Coordination Board. the data on factors jttnxting health outcomiies indicates the betwecn ARNIM and the second-worst off regions f. ll -- ,,-. (seven and 17 percentage points, respectively). * Nutritionally, children in ARNIM show signs otf long- * Fertilitr rates in ARNIM are relatively high. although term mtalnutrition with rates of stunting at almost doubie population growth overall is lower than the national the countrywide level, and showing the highest pr-eva- averayne. This latter mnay be a function of emigration due lence among all regions. Short-term malnutrition, meas- to the conflict. It is notable that population growth is ured hy wasting, is somewhat less marked, bhut still .II' I ll,, 1 higher in Maguindanao and Tawi-Tawi higlher than national average. While the prevalence of (4.02 and 3.84) than in Lanao del Sur and Sulu (-0.58 unclenv-eight children appears to he about aveu-age, this and 0.14). These may reflect population movements can likely he explained hbY the fact that children are so either into vlaguincdanao anc Tawi-Tawvi (of displaced sttinted that their w,eight-for-height woulld appear to be Nluslims?) or out of Lanao del Sur and Sulu (of evacuees relatively good. Levels of anemia among children are and possibly Christians seeking "safer" communities?). miuch higher than national average, and again are the It is also possible that the conflict is raising death rates highiest in the country. On the other hand, levels of or pushing parts of the population into areas where iodine deficiency disorders are very low, most likely a they cannot be countecd during the census. result of high consumption of seafoocds in the Region. The impact of the conflict is apparent from the Region's * ARM, has the poorest indicators of access to safe water mortality statistics. "Trauma,'gunshot wounds" is the leading and sanitation and of wvvomen's literacy among all cause of mortality in SolL and the fifth highest in Lanao del Sur. regions. In fact, the region with the second lowest rate In NMaguindanao, where 'trauma" is reported together with of ftinctional literacy for women. Western Nlinclanao accidents, this cause ranked highest among the known causes (Region IX), is adjacent to ARIMM and probably has in the reported list, suggesting that the conflict is having a populations with similar literacy rates. Similar large direct impact on nmortalitv in Maguindanao as well. Only Tawi- gaps exist in levels of access to water and sanitation Tawi remains relativ'ely untouched by the conflict in this 62 :1 .' I:>: .i'' '('!i . ' ! ' l :! \ I regrd Nainie ciet' ak it sacue uf dceath These factors mnay mean that dtirect physica,l injuries to nmicoi i- hI ~t 'trairma' cl oes niiot appear in the ti p 1 I. hata,nt po puilatuions are minimiiiizedl. It is nevertheless impioirtant to D,it oninobidt\ esulting~ frixi the contlict (stress-related inve.stig"ite the incidcrnci.. if nijuneiS CuLI tO teCunflit. diison rders and diisabilitv ) are unava i abhle. andic nearly all hca Ith The cdisa,clva ntages if pi vertv-the hiighi rates (if' nia illnu-tri- WoI rkers inlteri'X'i CIX'elcUri'in fieldl visits said they had received thini, piii r wa,,ter and sanita,tion, and 1mw fiemale litcracv--are no cases Of traman and knew\ of nuo such otitcoi mes. Oni the inev\itahlV (2aC(2rhartcCl hV the COnlfliCt, theu result uf displace- (therl hand.C tUeaCh1eI's meIt hy the( stLicly team frequenlyC11 mien- meint iif affected populationms or of cornllict-relatecd stress and ti med thec effects oif the conflict (in children as a pruhlemn in traurmi. Even the hiighi fertilir\ I ra,tes Lmay partly relate t(o thle Sc'hoolis. IXltat fii0 i a SmallI stLCmcV (in psychologTical1 neecds inl co nflict, as tlhcm'e appears to he some1 heIiCIf amongI menCt. IPikit in the neiglhh ring pro vi nc'e of Noitirt Ciitahatio (1,o pez et pa rtiCL'u lvrX, that it is impiirta,nt to have( rannv children ti afl _ II_2) gives fuirther inclicatinon i f the psvchi ilogi ca,l trauma111, replace thioS lo ist to the coniifliict ( ir toi pro tect the numnhurs iOF that min'v he piesecnt aiming thiose affected hv the coinflict in this uiniiinritv po puilation . Althi mughi noii data were foiimunc ti AR\II Amnorg tIme 282 r-espondcents in the samtiple, nearly-1 all (lchticimnt the prevalence iif this belief, staff and clients in thec of thiemi experieincedl at least onec formi of tracimatic' event. wvith heallthl facilities X'isitecl hv thle stLCcV teamll rnenitii medi it several the Must coImmun01 fmmrm11 heingh evcuaItionl (94 peircent 1. ODther timeis Cicuring interv iews C0 mmmcii n t mini1s Oif traci malltiCc' xperience inicILiclecl looitinig (~9.IM percent). lack iif Shelter (~2. percent), and evacciation 5.2. Health care system CILICe to calamities 3 ,2.'> percent): 28 pei'ceint rep(irtecd deaths imingn relatives. 22. 1 percent iif w,Nhich Xvere violent traummi,tic Except for fertility rates, the ahiive proximate determinants in natcim(e. Among respioncents, there Xvais'a high inicidlence of of hea,lth outcomes are largecly inflciencecl hv factuirs external1 to hyperarioicsal I 2~;. percent t and i 4 intrcusive syiciptoi s the health secciir. Andt althoimugh the health secto r leaderCIship can 2 21.Q1)-prc'rnt 1,2 'l i- that a lam'gc P~~ipi pnrtii n i f the play an impo rtant ri le iif aclvo cacy and c3 x rdcinatioin. it can do SAmple)I piipcIlttion w,c're2 Still in the a,Cuite phseif theC stress little to dici'ctlv inflicinCC these factoirs. (Due factor that can have( response svcldroimc, deuspite the fact tha"t twu vear's had passed an impact on hecalth citc'omes and that lies wvithin the contro il i sinice thek cia or hattIe in IPikit. The Stuckcl team atttribcmtecd thecse the hecalth sectoiir is the perfiormance iif the hecalth care systemn concditions to the cunitinuintg fincident.S WhiCh, tIhoincig OImnl itself. Access to prev'entive a.nd ha,SiC CLI'cmrti\ve healthl Services, in spo raclic', piesent a Ciointinu-ing threat. par1tiCcilar. Ciiclcd iredccce ratcs of infleCtiusLiseae miernt-inctri- Thei'e- is niio infoirmatio n on phy'sica,l clisa hili tics tha,t may ent deficiencies, anld initernal inoirtal ity, aiming the pioirest fain- ha\ e rlsciUltecd froiii the coiinflict. it shmocmlct he niitecl that, cinilike in ilies. Access to family planning> services Cocilcl IeclCILCC fertility a ncitmtcr i f ctiher C(IIiCit c-atffcCtedC Cx UntrieS, thle cOtintliCt in rates aInd illegal ahi rtio ns. Ani I i. . andi aiccessihle hiealth McUslimi M'incdanao is nuot enmieshied with civilian en immcmnitie2s, caIre sy'stemn is therel'iOre an essenitial inigredfient fur accelerated hcUt rather takes place in enclaves, camps lhicatucl in jcungles or hcWmiT.n cdevelipiment in ARcNIM. ither m'eiciotir areas. When civilian cx mmc-11itiCiS are a.11. ALvailahle daita on heatlthl Sy-StemI OmtpUtS indicate tha"t the inicidlents are episidici' and increasingly in the r-ecenit pa,st, civil- leVels iif utilizaItiOn of hasic hecalth Services are verv lmiw in ia,n C01mmc1mnfitiCS ha,Ve receiVed Xvarning oif thie immiiinenit fire- ARMMN relative( to the rest iif thie couunti-Ny (tahlef .3 . For almimst fighit and hax ~e timec to ICa'eIV hefuire theC iiclthrCak (if cionflict. all coimmuin indicators. ARNvIM ranks lowecst ini Service ci% cvr- >[l111111 HII, ILICHi III ARI M'. i t L II , IIiliII tI.iCI th ', NodIic,i~L H~11 NII L,1Im' .L Ind L 1.P i j, iii 1 is'. 11 Iv'r if LIMIII _1 LInilc P,ikit iLplo iinh,d 211. n ifwv )ItiiA' , t ir -ii o I n 2.iLLao%\d Women with4 or 65D.3 66.8i 71.8 60.4 6t4.6 73.7 48.ri 14 more prenatal visits, 2001 Children 0-S months old protected against neonatal tetanus through mother's tetanus toxoid vaccination, 2001 55.6 46.8 64.5 65.5 67.8 55.7 35.3 16 Women who received postnatal 64.5 62.3 62.9 54.5 63.0 55.5 69.1 3 care, by postnatal care provider, 2001: Doctor 47.1 24.7 37.9 40.8 29.3 25.5 16.0 16 Nurse/midwife 39.9 43.8 48.0 40.3 51.4 53.0 36.4 13 Traditional Birth Attendant 12.8 30.7 14.2 18.9 19.3 21.5 47.6 1 Children 12-23 months fully immunized, 2001 61.3 46.1 64.3 63.7 53.2 65.5 21.3 16 Children under 5 years who received nutritional supplement during last six months, 2001: Vitamin A 75.6 74.4 73.1 78.5 67.5 78.6 37.2 16 Iodine capsule 57.8 60.6 54.0 60.6 51.6 58.3 30.7 16 Iron drops/syrup 68.2 66.8 69.5 67.0 57.6 69.1 40.5 16 a. A rank of 1 indicates the most desirable outcome. Source 2001 Maternal and Child Health Survey, Final Report, National Statistics Office. age (third lowest for women receiving a sufficient number of 10.5 percent in ARNLM, compared with 35.1 percent for the coun- prenatal visits). The one exception is the share of woomen try as a whole. Althougl cultuLal and religious factors reducing receiving postnatal care, which is higher in ARMM than in the clemand woultd explain at least part of this low contraceptive country overall. However, a larger percentage of women in prevalence rate in ARMIM, a lack of access to family planning ARMI receive postnatal care from traditional birth attendants, services is also playing a part, as indicated by the high unmet rather than from professional health personnel. Service statis- demand among married women of reproductive age in the tics from the )DOH ( Fieldl Health Sel7ce 11lJo/rm)1tiool SIysteml Region. This unmnet need seems p , ,11, desired for the pur- 2000) showv that 53.2 percent of deliveries in ARNMM wvere pose of spacing children rather than for limiting the total number attended by health professionals, 35. ' percent by trained hirthl of clhildren (table 5.4). None of the other regions in Mindanao attendants, and 10.4 percent by untrainecd birth attendants, shows levels of unmet need as substantial as that in ARNIM. compared with 69.0 percent, 26.6 percent. and 3.9 percent, Study team visits to health care facilities in Maguindanao respectively, for the country as a whole. Thouglh comparative province and discussions with health care managers of all five clata on place of delivery were unavailable for the study, one provinces indicate that the health care system is starved of could impute that more hirths take place at home, attended 1y resotirces. The most frequently cited prohlems were lack of traditional birth attendants, which may be an important con- drugs, staff shortages, and lack of funds to cover costs of travel tributing factor to the high maternal mortalitV ratio. to remllote areas. Deterioration of infrastructure and equipment Another measure of perforrmance of the healtlh care system was not mentioned as often, perhaps because upgrading of is the access to family planning services. Information fromll the healtlh infrastructure tends to he a popular form of SUppOlt national 2002 Familily Planning Survey shos ws that the total contra- among donors or even hy the Regional Government itself. ceptive prevalence rate among married xvotnen of reproductive In fact, the rexview of public sector expenditures on health age in 2002, alreadly low hy international stancdards for the coun- shows just how under-resourced the sector has been overall. try as a whole at 48.8 percent, was only one-third of this level in Per capita public expenditures on healtlh in ARNIMM including ARMMNI at 16.2 percent. Use of more effective, moclern methods expenditures by the National Government, the Regional of contraception among such wsomen was even lower at Government, and LGUs, add up to only -A percent of per Table 5.4 Unmet need for family planning, 2002 liospitals xvith ciapalcities of 10 to 25 heds per hospital (as is (percentofUnmmarried women ofamily reprodutive typical of rural hospitals in the rest of the country). It is impor- (percent of married women of reproductive age) tant to note, however, that the aht.ve statistics ao hospitals in mm m m ~ ~~~~~~~~~~~~ARNJIM, and prohahly on doctors and nurses as well, may ARMM 35.0 28.0 6.9 understate somewhat the levxl of access in the Region given IX 22.1 14.1 8.1 the fact that hospitals in Cotahato City, Nhich is loaeated Nithin X 16.3 9.0 7.3 the province of Mlaguindtanao hut is not administratively part Xi 17.2 6.9 10.3 of ARNIN, also serve the population of Maguindanao. Also, XII 14.8 7.6 7.1 MlaraN-i City, located within the province of La.nao del Stur, was XIII 21.1 10.3 10.3 inot part of ARMMI until 2001, and its hospitals were not inclucd- ed in the ahove statistics. Philippines 20.5 10.6 9.9 There are a relativelyT large numiher of rural health Unlits Source: 2002 Family Planning Survey, National Statistics Office (RHIUs) per capita in ARNIM, hut a very small numher of barai gC'y health stations, whicih taises the question of eoverage capita puhlic sector hcalth expenditures in non-ARNIMI areas, in the mIore remote areas in the Region. In addition, with only If, in addition, it is noted that (a) these figures do not include 7-4 doctors in the Region, it is clear that many of the 90( RHU's are expennditures hyI lPhilHealth on healthi care for its menmhers, not staffecl with a cloctor, assuming in parictular that many of the which in AR\IM are almost negligihle compared w-ith the rest dtctors woutld he hased in the Region's 11 hospitals. of the country, and (h) that there are few private sector facili- Finally, it is important to note that the geography of ties in the Region relative to the rest of the country, then the ARNIM-with large expanses of mountainous areas in the severity oftle Regions cl -1 il i,liy,. starts tol)hecttie evident. mainland protinces of Maguindanao and Lanao del SLr ancl A closer exam tination of health system resources in the particularly with the remote island provinces of SUlU and Taxvi- ! r i, shows a more nuanced situation, ho-wever (tahle 5.5). Taw-i (the bioat ricle fromil Tawi-Tawi to the closest mainland Consistent with earlier olhservations ahout the expendi- city of Zamhoanga takes 14 hours)-imposes especially tore Hias in fav-or of personnel, the ntLimhers of healthi person- onerous burdens on the Region's healthi systemi that are not felt nlel in government facilities in AR\IMI relative to the population served is not particularlI low comilpaLred with the rest of the C(Iuntrv\. No dlata are avn ailable otn hecalthi personnel in non- goxernment facilities, althlough there are likely to he fewer ofAR these in ARMNlMl than in the rest of the country given the small Numberofgovernmenthealth nuomher of private facilities. Complaints ahlout staff i i ni.., personnel per 100,000 population, 2000 ,were heard frequently hy the study teali, suggesting that Doctors 3.85 3.07 11 alhsenteeism, nonreporting of staff andior concentration of Dentists 2.54 2.20 7 staff in higger cities and larger facilities is taking place, at least Nurses 6.18 5.89 10 Midwives 21.50 24.00 7 in the m(ore rem)te areas,Numberofhospitalsper The nUmber of hiospitals per capita is significantly loNwer N,Of hpopulation, 2001 in ARNIOM than in the rest of the country (0.58 versus 2.23 per Government 0.84 0.46 16 1t0()() population). That is explained largely Ihy the very low Private 1.40 0.12 16 numlher of privatel hospitals in the Region (0.12 versus 14 per Total 2.33 0.58 16 100,000 poptilation ) althioughi the ratio of government hIospi- Number of rural health units per 3.14 3.73 5 tals to pOPUkltion is also relativ-lv low. These data indicate 100,000 population, 1997 Number of barangay health 18.84 13.39 15 that there is one hospital in ARMII per 172.000 population stations per 100,000 population, 1999 (comilpared with onle hospital per 45,000( poptlation in the Source Authors ca[culations based on data from 2002 Philippine Statistical Yearbook, country i . f The majority of hospitals in ARNIMI are sniall Natonal Statistical Coordination Board 1 w> -1 I : . 1' t' IX, 'i:i 1" 1 B lti 65 1 in other parts of the country. The existence of isolated poptila- (that is, very little of the variation in the dependent variable coulcl tions, either in mountainotis terrain or on islands, requires a be explained by variations in the factors measured on the right larger number of bcr1cngay ' health stations, staffed with well- sidle of the equation), and these other results are not reported. trained midwives and bttrengq)' health workers, with a goocd The regression results sho-w that a child living in ARNIM network of RH[Ts as hack-up. Access to hospittls is clifficult in was 25 percent less likely to have received any vaccination emergencies, in many cases simply impossible. It is also cliffi- than a clhildl in the NCR. No similar significant effect was shonvn cult to fill staff positions in remote facilitics-particularly for childlren resicling in other regions in Mindanao or in other doctors in small hospitals or in RHUs, or mid-wives in remote parts of the country. The i,gri 1' . of this ARMM effect is RHITs ancl b6ilrtngot' lhealth stations. eliminatecl, though, when household-specific variables are added into the equation. In the latter case, mother's education 5.3. Determinants of health system utilization was shown to have a smiiall but r i,n ll, II significant positive effect on vaccination of the child while hotiseholdl size and the As was done in the education section of this stuy, a series motlher's religion (whether or not she is Muslim) had small of multivariate regressions was rin to examine the relative effects negativc effu lt'[ on vaccination, even after accounting for the of demiiand and supply variables on the LIse of health services, possible effect that wealth and the other reportedl houselhold T,wo variables were used to measure health service utilization: factors miglht have had on the outtcome. The family's wealth whether a responclent's chiild agcd 1 y years had received any stmtus (measured by the wcalth quintile into * hich the fally vaccination at all: and whether the respondent herself (women is classified) also halld an impact on 'accination. A clhild aged 15-49 years) had visitecl a health facility in the last 12 mlontlhs belonging to a famili in the poorest wealth qtiintile was 9 Regressions were also nin on outcome variables merasurin- percenit less likely to have been vaccinated than one whose wh1ether the clhild had comilpleted the fuill set of vaccinations, as family belonged to the wealthiest quintile. Smaller and less sig- well as \vllether the child had had fever or cough. bhut these nificant negative effects 'were also observed for clhildren in regression results vielded R-squareds that were almost negligilble families in the seciond and third poorest quintiles. __~~~~E ARMM -0.25751** 0.0593-** 0.01049 0.10706** Other Mindanao -0.00671 0.0593** 0.017315 0.058439** LuzonandVisayas 0.000198 0.083281*** 0.00483 0.072392*** LowestQuintile -0.14062- 0.1015837** -0.09048*35 0.041555* 2nd Quintile -0.04761 *** 0.12034-* -0.03136* 0.067527*** 3rd Quintile -0.02769** 0.077671 * ** -0.02226* 0.0422720* 4th Quintile -0.00423 0.074136-* -0.00688 0.054945-* Age 0.090583-* 0.062373*** Age Squared -0.00135-* -0.00089-* Rural -0.02123 0.007426 -0.01 618 0.002234 Household Size 0.00702-- 0.00525** Child born 0.268061 ** Sick Child 0.202191*** Migrant 0.016264* 0.008488 Mother's Education 0.01 1097-t Muslim 0.020925*-* Pseudo-R squared 0.141912 0.077343 0.199919 0.126335 ***=significant at.001 level**= signifcant at.01 level:*= significant at.05 level. Note: These regressions have been corrected for region-level weighting and clustering. Source. Authors' calculations, based on data from the 1998 Demographic and Health Survey. The reference category for the residence variables is the NCR, meaning that the coefficients indicate the difference of residing elsewhere relative to residing in the NCR. The mother's reported use of a healthi facility was also physical isolation, poverty low literacy, anId poor i 11111 affected byL a number of these househioldl charac- housing conditions; teristics. Residence in ARNINI reduced the probability that a * comimiuitinities with living conditions marked by insecti- mothier usedl a healthi facility by 10 percent relative to mothiers rity. conflict, and lack of access to basic services: and in the NCR, e-en when variables on a varietv of houselhold * a health care system unnable to fullv compensate for characteristics wvere aedldc into the equation. This could imply these disadvantages at the houIsellold ancl commilunity that supply factors in ARINM, specifically the relative lack of levels. general health services. xvere having an impact on access to Much of this picture is catised by factors that lie outside woimens tise of services. The absence of this "ARMNI effect" on the healthi sector itself, inclucling the level of economic and vaccination, after houselhold-specific factors have been social development in the Region and the persistence of arilled accoulIteCd for (as mentioned above), is probably a tribute to 1. I Yet muchi can still be dotne within the reaches of the strength of the national Extencledl Program on health sector policy to improve the situation and bring better Imimitinization, inclucling its activities in ARMNI, vhicch has healthi ancl health care to the people in ARNIM l Plotting a clear been one of the best-performing public health programs in the strategy for the future svill be a cr-itical step. country. 'I'he fact thatt living in non-ARMIMI Mindanao or other Fortunately, the health sector in ARMINM enjoys the advan- regions of the country showed a larger probahility of use of a tages of a sector- that, natiomvide, has been introdLucinig heath facility compared xwith the NCR seems somewhat puz- improved measures in mnaternal and childl health and other pri- ling uLiless one considers that heialth facilities in the non-NCR ority public health programs for the past couple of decades, as regions, particularly for the first level of care, are likely to be w-cll as having undertaken a substantial drug reform program less expensive than those in the NCR. Houselholcl size again in the late 19XOs. Although implementation of these programs has a negative relationship wvith mother's use of a health facil- hals been only pai'tlV successfuflI and particularly less so in ity. implying that use of health services (whether for vaccina- ARALI, the technical knowv-how undlerpinning these reforimis is tion or other services) becomes imoe dciffictilt for larger availahle and has been proven effective through scattered pro- families either bLcause the m1othler has less time to access the gramis around the countrT. More recently, the national DOH service or the cost of services becomes more diffictilt to bear. has been leading an effort to institute a comprehensive Health It should zbe motedl that living in a rural area, as opposecl to an Sector Reforimi Agenda (HSRA) that addresses the SyStCemic urhan area, had no impact oni use of a health facility, eithier for issues of financing and service delivery that are expectecl to cihild 'vaccinationm or foir the niotier, whiclh seems to indiciate Bring 1ii1. l improvements in health care. DOH-ARMIM thait there is really little cliffer-eicee in demiand or supplI COtnldi- has participated in learning activ ities relatecd to I ISRA, and as a tions between urban and rural areas. 'his is not particularly ConseCLuen1Ce has been ahle to integrate many of HSRA's prin- SUtrprising given the inlforlmattion (in section_ 2.2 1) on relative- ciples into its strategic plans. In fact, the Regional Govern- lv loxv wealth staItUs in urbain a reas. imtent's health development program as presenited to the sttidV team lies very mIutichi along the lines recommended beo iw. This 5.4. Getting the health system to peak performance sttidvs recommendations will, it is hoped, servCe to validate the iclentifiecd pr-iorities, aind add dletail and bring fresh perspec- The, (, 111 ,-, to the heallth systemll in ARAIMI are sub- tives to that program, xvhich still remains in a sketchv forni. stantial. ARNINT receives a disproportionately smanll share of aTh health reforms recommended for AR\IM include bring- grav-ely dIepletedl ptihlic heallthl budiget. Its pi pulatioii has ing more funtis into the health systemn, establishing an efficient grealter health needs than the rest of the country, caused bv heth care delivery system.. F ii i 11 efient support sys- extreme poivety and chronic conflict. The conflict, in addition, tensfor managinghltiperations and promotingprograms conistrains health system activities. 'he Region's geography that respond to the special health neects of the Region. imposes special demarnrds on the system. The various indica- tOirs reviewed above tell of: 5.4.1. Bring more funds into the health system * househ1oldls unable to sectire for themselves average Section 5.2 showed the extreme dcegree to which the health outcomiies attained by other Filipinos dlie to health sector in ARMM has been deprivedl of public sector resources, -hen contrastecd wvith the health sector in the rest of Region. Estahlishment of local PhilHealth offices in ARMNIMI the country. Arimlecd with objective expeticlituLe analysis to sup- and provision of technical assistance to local health port their case, the Regional Government and D)OI--ARMNI can providers, hoth pulic ancl private, would , i ii accredi- he more forceful in deemanding a fairer share of rcsources for tation and maximize utilization of henefits. Payment of pre- the health sector in ARNIM. even in the midst o bluCIgetI2ay- con- miumiis for membership of poor families in the Indigent straints. The LGIUs in ARMINI are an . . ill promising Program of PhilHealth \ould he a natural vehicle for LGU source of funds. Ilaying heen spared the responsibility for financing of healthi care, given that the National Health financing healthi care while still enjoving the benefits of an IRA Insurance Law mandates that LGLis are responsible for such formitila tha,t -i i II covers local health services, the payment. The national 1'hilHealth can also he asked to assist LGLis can-and indeed should-he called upon to add to the in organizing consultations amirong local chief executives at health financing pool. In addition, greater than average heallthi provincial, city. and municipal levels in ARMNI to help themin neeis, the impact of the armed conflict, and the difficult geo- reach agreciment on who wvill finance premiums for the poor graphic conclitions, all make for proportionately greater as it has been cloing all around the coCUntry. Local chiief exec- requiremnents: arguing these points would strengthen the case utiVes can he reminclecd that LGII sponsorship of Indcigent for larger 11 iii from the National Government. Prograrm memberships will leverage counterpart funds from However, huiget resources are only one potential the National Government as requirecd by lawv further increas- source of funds. The Regional Government shotild lohby for ing resources for health. Those payments to PhilHealth a more rapidl expansion of PhilHealth operations in the return to the LG[' in the form of capitation benefits to par- ticipating RHLTs as .11 as the fu,ll package of PhilHealth benefits for 1 - n l l lil l _ Indigent Plrogram members. LGtTs in othecr parts of the country have fouind these tetrimls qtuite attractive. -- =r ~~~~~~~~~~~~~~~~~~~I ser chlarges represent;ote H > -~~~~~~~~~~~ source of flndis Lind are alruadev Mvidcl- #t * _ * 1X- ~~~~~~~~~~~~~~~~~~Nappliecl in the Regioii (as in the rest of the COUinLr. The small box for VOlintary ldonations' is now ubiqui- - ^ _ 6 _ - tous in RHits and a variety of fees is j-coimon in puhlic hospitals. Mlanv hospitals, in aLd dition, have private _rooms and other special perks avail- ahle to those willing to pay more. P F iTi - { t - I - These user chiarges are particularly popular among hospital managers who then have more resources to wvork wvith-to the extent they are Iable to retain earnings and are not required to remit thenil to the provin- cial treasury-hut they are also w-ide- 'N ) ly believed to he a dleterrent to timely and appropriate use of services by the poor. Althoughi iOst hospitals have a -_ .- a - system to idcntify indigents, who are 68 ii i then exempted from fees and inay even receive freec drugs (if is mainly foctised on public health services (miaternal and these are available), suchi systemis are time-consuming. sub- child care) pr-ovided mostly by midwkives and with many ject to political interferenlce, or arIc simiply ineffective at i(len- simall hospitals. It is clifferent from the rest of the countrl in tifying tile truly poor. Hospital managers also often claimn that that there are few private providers, almost nio large hospitals revenues from paying patients are used to subsidize serviccs (thier'e is only one 1()U-hed hospital) very low bed capacitv (or the poonr, -et it is often unclear how mucIh of those re-- ( -7 beds per 10())O) in the public sector compared with 3 2 enues cdo eventually reach the poor. In brief, user charges for the country as a whole, in both cases, excluding beds in shoiuld be applied wvith great care and only if solid assurance can be had that public resources meant to serve the popula- The first task for health planners in ARMM tion as a h Cole, and the poor in particultr are not siphoned off to the better-off who can afford to pay the additional is therefore to develop a good plan to charges. One final source off fuids, particularly relevant for ARMNM, rationalize the network of health facilities is the donor and NGO community. Over the last fex years, an increasing number ol' donor agencies, includinig the NWorld n the Region. Bank, hax'e expressed interest in offering assistance to ARMIMI. The Regional Gox-ernment wxill need to gixe highiest priority to retained hospitils). and xeCry few- specialist doctors. Like developing a systematic I ,rainework for dexelopment in thte miany healthi systems xorldwide, one problem xvith the sys- Region, and in tht healthi sectoCC specifically. to guiide donor tem is the self-referral to hospitals olf patients wvho coiuld be assistance and minimilize the very real risk that such assistance treated at an outpatient primtCrN care facility, resultinig in Will end up heing splintered. duplicatixe, inappropriate. or just underutilization of primary calre proxviders and, an unnieces- plaiin xVasteftCl-as so mCiCtl donor assistance has been in the sary ancd costly' burden to hospitals. The large number of 10- paSt. While it is true that miany donors co(iCe in xvith an aigen- and 25-bed hospitals means that mCost hospitals are too da of their oxn, it is also true that most xvill xxelcomie seeing small to mlaintain the minimitiCL required staff and infrastruc- their assistance contribute to a bigger schemile for development ture; equipment '(or efficient and high-quality operations. and will often shoxv greater flexibility if the bigger pictule is exen for a basic hospital. Yet, if all these hospitals were presented to thei. enlarged, they would be too expensive tom maintain and there w-ould he too manyI of them. Like the rest of the country, 5.4.2. Establish an efficient health care delivery system ARMMll has more hospitals than it needs and too many of No health system, however rich, will have ,'n, l C these hospitals are too sm.all. resources tom meet all the health needs of the population it The first task for health planners in ARMMI is therefore to serves. The managers or leaders of the health system there- develop a good plan to rationalize the network of health facil- fore need to seek a system that is as efficient and responsive ities in the Region. First, primary care must he enhanced. The as possible within the limits of the available resources. One Region's geographic configuration makes the role of the of the most important determinants of the overall cost-effec- baranzgavi. health stations especially critical, and concrete tiveness of the health system is the organization of the net- measures must be taken to ensure that there are sufficient work of health facilities. The number and types of facilities, numbers of these facilities and that they are appropriately their geographic distribution, the types of services offered in staffed. With only one doctor per 32,000 population, ARMM is each facility, the number of beds in inpatient facilities, the far from meeting national standards of one doctor per 20,000 numbers and skills of health personnel in each facility, the at the primary health care level. While efforts must be made to quality of care-all these factors together constitute the bring these doctors out to the RHUs (including offering incen- health delivery system. tives for accepting assignments in remote areas), these must be The health care system in ARMM is similar to that in the complemented with programs to empower nurses and mid- rest of the country in that it has a primary care provision that wives in RHUs to take up a greater range of tasks, including )-)uimj'mtmcCc!.)l&CC tor 1'MIIii d Plr'(mjclrih ill 11C (0INI 69 , ft (t'8' - i"t' 'S' t ' qtuality. In all cases, careful thoughit should be given to the appropriate service Imix, staffing Imix, bed capacity, internal ' \> -ttt4; i 1 , NM,^ organization, and level of specialization of the hospital, etc. 8 8 * ,*XC- tf i11t' '8 .- ;t - 1Hospitals not selecteed for Lipgracelino rrily b)e imergedl ademin- r 04w71ll|l Kit t; trs || 1- istr itively w-ith laLrger hospitals and converted into satellite rP - tcrir;j!/ Usfi8tJ facilities of these l.ager hospitaLls (e.g., diagnostic facilities, outp.ttient clinics) or convcrted into RHtTs. PreparaLtion of such leI,alth facility ration alization plan is strongly recon- imndecl as a precondlitioni for large-scale investments in _ I theulth fa cilities in ARMNI, vhether uLnider government or -- FaE ~t- - e c domior sponsorship (including the Wiorlcl Baink-funded ARNIM Social FuIndCI Project). It is inevitable that these proposecl changes will drawt fire t 7 fromil loc Il politicians, health care staff, or ex-en local popula- ' 5_ - E t _l U tions as iost people wNill not he happy about losing their local hospitalA Health sector leaders and loc.al chief executives in tfax or of change will find that manaiging the "politics" of health -reforiii nill be a major pa-rt of their joh. The more successftl health system reforms in other countries have shown thit, wxith gool communication, a transparent ancl participatory- process, ~~N - ~ one or imor,e "clIim aipions" arriong local politicians. and great reserves of patience (on the part of those trying to usher in chlnge). people (and even more, local politicians) ain even- be mnde to understand that a - r I high-qualitV providing basic curative services, that might normally he car- hospital some distance away is better than a low-cuiality hos- ried out bvy doctors. pital closer to homie. A goocl rationalization plan wiouil then take Lip the thorny issue of hospital care. To the extent that geographic 5.4.3. Establish efficient support systems for managing and demographic conditions permit, the ideal situation health operations xvoUld be to hlave fewer bLut larger hospitals vwell dispersed Health and development planners tend to forget that a among the population, with special arrangements made health facility cloes not consist of infrastructure and equipment where access is particulalrly difficult, as in the island alone. The proliferation of 'infrastructure" projects that call for provinces of Tawi-Tawi and Stulu. or the lake commiitinities of construction or repair of barnangav health stations, RHtTs, or Lanao del Sur. The first task Would be to identify wvhich of the hospitals butt remain silent on the staff who will work in the many small hospitals should he upgraded to larger, better new strictuLres or on the provision of drugs and other scipplies staffecl and better equipped facilities serving larger catch- is testament to that. At times, the unrealistic assumption is ment populations. Location, current patient flows, cuLrrent made that the new stricture will attract the necessary staff. It staffing. and existing infrastructure and equipment will all rarely does. Rationalizing the health care delivery system calls figure in the rationalization decisions. Taking into considera- for rational decision-inaking on staff deployment and drugs tion the Region's geography, it may he possible to justify con- and other supplies management, as much as on w,hich piece of tinued operation of a few relatively small (and therefore phyusical infrastructure will be repaired and equipped. The inefficiently sized) hospitals, but such decisions should be appropriate complement of staff, clnigs and other supplies. made with the aim of balancing conflicting objectives of mak- and effectivc management must combine xvith infrastructure ing health care ,,.. 'I while also maintaining standards of and equipment to complete the elements of wlhat economists 1 70 Ki.- Z , ' !(! [! . t ), , \ call the prodluction function" of heallthi ae.re If these elements puhlie fundls that are allocatecl for cIrug purclhase will are not hroughit togethier in the appropriate quality and pro- reduce leakages." Better systems for drrug procurement. portions, poor health care results. logistics, ancl financing have been known and applied Wlhen ftundls are limitecl, it hecomes even more impor- vorldwide-.and in some cases in some parts of the tant to manige health inputs responsibly. For dirugs, I'or Philippines-for almost tvvo decaides. Health sector leaders example, eoren)riois sav ings coulcl he macie bv introclting and local chief executives in ARNIMI with the waelfare of the mior-e efficienit procuremilelit methods. Pooling (Irug require- population at hearIt wVouldl clo - II to introduce such ments anioig different faicilities and even aiiong iutnici- systems in the Region as soon as possihle. palities. cities, and provinces would 11. hulk purchasing, Mlore diffiCult to aChieVe and yet more critical, the proper and in tutir improve prices. Transparent and competitive management of heailth human resources remains a hig chal- bidding proCedur es (as opposeCC to the opatque one-on-one lenige. The quality of stalff, and the need to upgrade and update negotiati ion processes cimmonlV usecd in the country to davy) I cil- l linical, managerial, ciommunications, and Can also lead to c,1, Ih ir, isavings. Together with improved person-to-pcison skills-are the most ohViOLIS issues. lut procurement. hetter- drug logistics systemis (stock manage- these are only the tip of the iceherg. l)eployment of staff needls melit, ordering, delivery. etc.) Nvill hring furthier gains to he reviewed- and appropriate redUeploymllelnt Clarefully Finm lI, tr nsp)lient mtn.gement of and IIeouiltb for p1a1ned inlI xccute2d Health mainagers sioutld he ible to col- !t'j; .-'-. 4~~~~~~~~~~~~~~~~~~~~~~~I ~~~~ ~~~~~ ,j,' I~~~~~~~~~...... !"M~~~~4 -0-APA.-~~~ lapse and create positions. Nlost importantly, it is important to suclh programns actively and to wvork closely \\ith their coi- 'break the cvcle of poor performance." This means correcting leagues in othcr sectors to ensuLe that other sectors' policies flaws in the recruitmiient and selection process and empower- and programns support health-promoting measures (e.g., ing health sector managers to reassign or even dismiss non- promotion of locally available healthy foods, edutcationl on performing staff, sanitary practices). As in the case of health facility rationalization, reforms to One example of a program response that is wvell suitecl to a cdrug system or to a health human resource system -Will sure- the Region's unique characteristics has been the effort to use ly meet political resistance, particularly among those vhose uloamasas advocates for reproductive health, including fami- personal interests are at stake. Thcse reforms wvill need to be Iv planning, tnder the Fifth Country Program of the United Nations Population Funcl (1tN FPA). Introduced in Maguin- The study on psychosocial needs in a dcanao and now expancding into other parts of the Region, this program draws lessons from successful programs in other conflict area shows the need for imumediate Islamic countries, (e.g., Egypt) that uinclerscore to the ,damtcis psychosocial intervention to strengthen the that reproductive health programs are consistent wvith, and even promote, Islamic teachings. coping skills and to enhance the psycho- While health managers and staff in ARMMtI are 11 versed in the rationale ancl methods underlying these tracli- logical resilience of individuals in conflict- tional public health programs, there is surprisingly little effort, or even awareness of the neecd, to respond to the health consequences of the armited conflict. The study on psychosocial neecds in a conflict area citecd above (Lopez et undertaken with firmness, fairness, and political savvy. Again. al t(202) indicating the viclespread presence of acute symp- strong technical analysis to underpin objective decisions, a toms of post-trautmatic stress clisorder (PTSD) shows the transparent process, open communication and consultation, needl for immecliate psychosocial intervention to strengthen and one or more influential champions will be necessary. the coping skills and to enhance the psychological resilience Finally, just as in the education sector, systems to improve of individuals in ''1M ir- F1'1'. .1 communities. Delaying information management and to strengthen budget and finan- intervention at this stage increases the risk that people go cial management will be needed to improve operational into the more chronic form of PTSD, which is both more dif- efficiency. ficult to detect and manage and wThich creates greater social clysfunction in the long term. Both health and social protec- 5.4.4. Promote programs that respond to the special tion agencies in the Region should take the lead in calling for health needs of the Region immediate psychosocial intervention, particularly among After being granted autonomy, ARMNI continuecl to communities directly affected by the conflict. If further implement the national programs aimecl at managing nmajor investigation shows a high incidence of physical injuries and public health concerns, including maternal and chilcd health, disabilities as a result of the conflict, it will also be necessarv reproductive health, family planning, tuberculosis, and to introduce rehabilitation programs. malaria control. Given the continued prominence of these public health concerns in the Region's disease burden, and 5.4.5. Autonomy: ARMM's version of devolution? given the impact that extreme poverty still has on the health Coming as it did several years after the creation of of the population, the Regional Government wvill need to ARMM, the nationwide devolution of the health system to continue giving full attention and support to these programs. LGITs in 1991 was not implemented in ARMM. Even when it In addition, although food supply, water, sanitation, and passed its own regional LGC in 1995, the Region chose to housing programs are not the direct responsibility of health retain the full functions of the pre-devolution national DOH sector managers, it should be in their mandate to promote at the regional level, with DOH-ARMM continuing to man- '!i 72 11:11 i l \', ' l'Iit !; ,' i.i':!l 011d p'lLid ; til e' IMM -~~~ ~r -A- IA _a. 4-~~~~~~~~~~~~~~~~~~~~~'t; ,> z~~~~~~~~~- --y - age all1 publicly owned healthi facilities along with the hudg- Autonomy hias given the Region a uiniqute opportuinity to ets and resotirces mneant for those facilities. This uniique Sit- stuidy the advantages and disadvantages of devolution as it hias f f~ ~~~~~~~n (lsdatgs unole in th ftecuty n Uation brings both advintiges addsdatgs In LnOCeIi h restoft curvan to adopt its own ver- principle. devolution can lead to responsive, flexible public sion of clevolution, one that does not necessarily have to lie at services, better adapted to local circumstances. This has eithier extreme of centralizedl management or fuill devoluition. indeed hiappened in parts of the countr-y where LGtU leaders At the very least, greater consultation and participation by have miade efforts to focuIS on improving health care for thleir local chiief executives anid othier local authorities in the process constituents. However, devolution can also generate ineffi- of healthi sector deveflopmient couild create at supportive con- ciencies in the health care systemi by leading to fragmenta- stituency for the sector. Local chief executives could, for exami- tion of services and to the breakdown of the referral systemi. ple, he asked to sit on a Regional Health Board to participate The imiportant exercise of planning a mior-e rational delivery in policymiaking. Greater participation would also increase systemi is particuilarly comiplex when the ca,tchment popuila- LOGts' ' ii', - . to contribute financially to hiealthi services, tion for- certain faci lities crosses administrative borders or wvhether in the formi of direct fuinding for publicly, provided whien neiglhboring LOGts miaintain duplicative facilitieS julSt services or sponsorship of premiumLiis for indigent popuIlations across th-ese borders. With management of the puiblic systemi in PhilHealth's Indigent Program. Alternatively, the Region still centralized at the r-egional level. ARMNtN may be spared could consider devolving all health serv-ices to the provincial snolw of the cross-LOtl co)mplications that are coimmiion (and level, preserving the advantages of size and scale while bring- seriouis) in the post-dlevolution health svstemi nationw~ide. ing services closer to the beneficiaries. The recent entry of On the othier hand, staff at DOH-ARMMTN are particularly Basilan and Marawi City into ARM4M will make it necessary for troubled by the seem-ing indifference of LGITs in the Region ARMIM (Fl,to rethink their policies on dlevolution very to the health needs of their popuilations, which is a shortly, given that these two LOGts are entering withi previouis- predlictable consequience. perhaps. of regional, centralized ly devolved healthi systems. It is an opportunity that shouild not management. be wvasted. ; t, i l4 * 73 - S r t ~~~~- - hi - r Il/ ,,. -- -_ -- --v.- -s,~~~~~~~I -w K~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 6. The Social Protection System in ARMM or over tliree decades since the 19-Ts, soicial stability haIs 6.1. The datu system in Muslim communities-The h been a hardlv reo(gniza,ible concept to thte average NMslim traditional safety net in times of peace houseChold in ConstLnt exposuLre to armedl conflict and vio- and of conflict lence. On the onet hand, trnmed ontlict and vh-ioence are not only eclical in oCCurrence hetw-een the mnigrant settlers (from TFlc maijor ethnic groups aimong Muslims in Minda;knao are Luzon and the Visavas ) aind the Niuslims. but also aimintg the Nlaguincdinanoanis in the old Cotabato province, the NMLuslim 'clans and familics clishing over unsettledl land Naranuios in Lanao, and the Tausugs in tIle Slo aIrchipelago. dlispuItes Cand over local rivalrics in the politieal atncl power Thrte Iare smaller ethinic groiups lik-e the Iranuns along the positions in government. On the other hand, the national horcler of the oldL Cotithabto ind Lamnmo the Yatkans in Basilan, gov-ernmienit forces invariablv take the sidel ol' the migrint the Sanias (also Saimals) in Tawi-Tawi, and the ladcljtais along settlers in the armed divide, transforining the conflict into an the coast of Basilan and the ZalmbO tnga Peninsula. All ethnic ideological ecluatioi nurturiedl on both sides hi geopolitics. groups atre governed lbasicallv hy the dhUlt system1, somne ol Thie cycles of armed citiflict have also been creating signili- xvhich federated into sultanates dating back centuLies. cant psychosoci al impacts that impede humian developiment The datit systemn ais a ba;Lsic unit of governance is ruIled 1w aind stunt thle forimltion of soicial cpital and, in the long haul, "nda faimilies or clans (ciimposed of interimarried families feedl on social institLitions thalt Wiould evenitually providel social with a e(IIii is the he.ad The elders aniong families or clans protection services. 'I'hroiugi lot all thiis. people in MluSlimH1 formii ito t Council thit helps the dantu in the governance of areas of Mindanaioi, particularly in ARMNINT, hlae had little more the whole clan aind the ethniic group. In the case of the fe\N thatn traditional family and cla n support netwolrks to fall hack sultanates, it is the sultan who serves as the head of thic ethnic on in times of psychosoicial crisis or suLdden incomeIi loss. griOIp. Thle governance of the dutii systei oir the sultinate is Organized government suppoit in the forim of relief and reha- highly 1Feudal in chara,icter and foriirn where the heads and hilitaition has existed hut this has been overburlened by thc ctiuncil of' eldlers are determined by roy-al blooil relationships, enoiiimois neeC. fainiy ties, and e\alth. Recently, lowever. a stritegic siift froim welfare to devel- Whether in time of peacie or ill i the (l(itil system opiment of self reliant Ci mi m unity netw orks ha;s started taking di minmates every social, political. ir ecoriolmic atspect of life. place uLnlere the ledlersship of DSNX'I)-ARNlN,L with suIpport The datti is expectedl to he the pro-ider of livelihood aind fromii the national 1)SWI). This shift is paving the way for emnplov iyment, ind issistance in time of needl. Becuisc the dhttil estaiblishment of a solid social protectioti systemn that is partic- svstemi aind the local goxernment meshed into One system ulalrly a1ppropiilta t' or a sitU;ltiOIm of COnltliCt and extlemlle during the last centtiry, the dttits and the leaders of the rovyal poivrtv. families Indcl ains of the ethnic groups h 1e atlso C bA hecoiim tthe local governencnt officials. Elections of local governmiient possible. This hals kept DSWD-ARMIMI almost - 1- 11, preoc- officials become token formalities of the clecisions of the cupie(l wvith providing suchi services to conflict-affccted coin- council of elders fromii the various clans. In somie instances mtinities since its establishment aftcr devolution to ARNIM, when decisions of the councils are divided, elections become especially cduring 2000 and recently, in renewed armed con- violent and conflicts are resolved once more in the couLicils ol' flict in and arounid the Buliok Complex in Liguaisan andI I'ikit the dnitu system ratlher than in the formal institutions of gov- (skirimlislhes are still being waged in mamny inlcrior bctr?YiigcilN ernment. In many instances, LG(is have hecome employment of Mlaguincldaiao, Lanao del Sutr, and Noirtih Cotalhato, agencies for membiers of the royal family, the clan, and the unknown to many and Linrepoited to the nedia) ethnic grotip, in that order. Nepotism ancd corrtiption are not ARNIM, through the devolved funictions of l)SNI), necessarily view-ed as negative practices becaLuset the tlitlt has made an internal assessmuenit of its performance over systemi is now superimilposed onto the system of local the period 1998 to 2002 ( )SWD-ARNI 2U()2a). The government. following paragraphsi highilighit some elements of its In times of major I,. -11h i suchi as the outbreak in 20)0,) perfoirmance. whole commiLunities displaced hy armed violence appear There are five major welfare service programis of DSWD- to he all accomimiilodated in the government evacuation centers. ARNIM being imiplemilenitecl that correspond to cdefinecl heniefi- But awavy froimi the attentio)n of the meiacli are the grealter nunt-> ciaries, namiely the progoiaims in FamilyI and Communuinity her of houselholds that are accommodated in resnttletimenit Wclfare (Ifor parents of disadvantagcd families anid econoiomi- areas within the lancds ol' the dtuits. In the resettii lemit areats, cally depriessecl comimiiiunities), Children antid (omth Welfare the internally displaced persons are provided with residential (for clhildlren and ylouth in disadvantaged and clifficult situa- land on w,hich they build their houses and a fractio)n of a tions), Women WVelfare (for the prevention and eradication oof hectare to be tilled as small ftarmis. These people are also hir-ecl women's exploitation), Disabled Persons -- II i (for the as seasonal farm helpers, thoughi labor standards may not be disabled anong the e2lerly, children, youths, and wvomen), observed. In Social Assessmzent of C I. A,- i 1 ./reas ill and Emeigency Assistance (for victims of natUral and hUtiman- Ilindanao (World Bank 2003), it was observed that generated disasters, mostly rooted in armed ..auIii I employmnent as farm helpers increasecl l,,i,i in the periocl A total of 200,767 fatmilies weere directly served by the five after the 2000 conflict, because the drit landowners hadl an major welfare programs of DSWD-ARMNI over the period, excess of farim laborers from among the displaced farrmers who compared with a target of only 175,410 families. However, the resettled on the daitu land. support system (and follow-up case work) to families that wxere seri-ed has been Iiau ill, disrnpted, largely because 6.2. Social protection-Traditional social DSWD-ARNIM has also been at the forefront in providing relief welfare services and rehabilitation to coIlmminities affected by the conflict. It is one of the few government agencies, and in some areas the Under the sustained and cyclical conditions of armied con- only one, offering relief services for families in these commu- flict and violence, social protection has been provided to nities. as well as resettlement sites and evacuation reception affected households and communitics to a limited extent in the centers, The spate of conflicts puts f)SW)D-ARNMM on a con- form of relief immediately after conflict ancd rebabilitaition stant emergency footing. This also means that its personnel in between episodes of ., 1h.il i usually until the next conflict the regular welfare programs are also regularlyv II I to work disrnpts the prior rehabilitation efforts that have 1,1111, taken in the conflict areas. root to prepare the ground for development. For the past The programs have a service presence in 864 bairangamws, or decade, the gap between episodes of conflict has become nar- 40 percent of ARMI baranrlgaols, most of wvhichi are the poorest rower, and the conflict itself has become wider and more vio- in ARMM (and in the coUntry). Service delivery is hampered by lent. In such conditions, the provision of relief services only is the inadequate road system in Maguindanao and Lanao del Sur, 76 . ,. f ,yqbp f. 1. .w, , Pu i , Thu and byv the isolation of comimillunities cdle to the arc1hipelagic aiddress the multiple facets of poverty and contlict at the local geography of Basilan. Solu, and Tawvi-Tawi. level. Themiaitic concerns being iddressecd have gone beyond Thle financial resources oLseCl in five vears amirounted to welfare and basic social services, into comimunitv- infrastructUre, 1P05,524218l at a cost of 131' per family served, or an annual livelihood, agriculture, and postharvest facilities). DSWVD-ARNI_NI cost of 1P03.09, which represents an efficient program in terimis is working toward the burangat' and municipal mIoltiagency of the cost belleficiary ratio, structures operating in a coordinated manner, though it is expe- In 2(02, the Malaysian Government deported Filipino riencinig a variety of diffictllties because of the respective w\orkers in Sabah. Altotighi not considerecl part of its regIular bureaucratic protocols ,and inability of some workers in partici- welfare and assistance services, DSWND-ARBMNM processecl the pating agencies to work li 1 with othier aigencies. Despite repatriation of 1S,T70 deportees in Tawi-TFavi, Basilan, and this, somecprojects remnain comimtinitv led and initial resotirCes Sulu (incltcling Zaimboanga). and provided relief sei-vices in are leveraged to attract moire ftinds for Commtinitv use receivino centers and transportation expenses for rettirn to (see hox , 1). their places of origin. Somile local goivernments contribute theil share to the coimunity-lec projects in various ways, b sho rlering the 6.3. Evolution toward development of community- costs, for example. of the sialar ol the CIDSS worker (sinice based social structures ioist wiorkers are proiject hired), the procliuction cquipiment- the constiriction of a day c are or mtultipurpose center, adcli- Despite the expostire to contlict situations. anct li tional pitcher wxater puitmps or the counterpart share of the maintaining the regular . 11i.- programs, DSWD-ARMM%I is commutnity project ftind. assisting in the development of the most economically Somiie hard lessons learnecl frolm the special projects depressed and conflict-affectecl commtunities througIl special have provi(led firm idleas for replication. Most of the projects projects that are not ftindled from regtular goivernment sotirces. iclentified are small and hecauSe of their community-led The tise of these projects to foCus on stIch commtunities has character, reqtire small ftinds that can he supported hy a been demonstrated in the implementation of the Countrv comihination of initial external financing ancl counterpart Program for Chiidren xvith ftunding assistance from tUNICEF, sharing (mostly in kind) from the community proposing the and the Comprehensive and Integrated Delivery of Social project. The tise of small ftincs that are readily accessible to Sernices (CIDSS) Program. the community contribtites to formation of social capital. Both these programs use a participatory approach in discoutrages elite-capture, and redtices (if not altogether generating the profile of the rninimuim basic needs of the coIll- eliminates) corrniption. It also helps local politicians builcl munity in foctis. This profile must be seen in the larger context closer links to their constituents because of the social capital of extrene poverty ancl conflict viewed throtigh the eyes of the formed by small community-led projects. community, and the specific context of problems ., 111 .i The implementation of the special projects has not been all ancl prioritizedl wvith the corresponding action plans formulat- that sticcessfu-l. In fact, some projects are outright failures. But ed into projects by the communitv. These community projects the main approaches have been developed and some important are led and managed b)y smaller units of the community organ- lessons have been learned. Today, special projects, especially ization, which serve as the commtunitv welfare and develop- tinder the CIDSS Program, are implemented in 382 of the poor- ment stricture engaged in a continuing stream of action est bcariangaws and in 79 of the poorest municipalities in ARNIM. planning to adclress the problems identified. Because of the promise of the special-projects approach as a In some areas, special projects are nov also serving as strategy for human development and formation of social capi- imiodels for a convergence program amoong some of the different nal, they should he fully assessed for their potential use as a reg- local governments, ARNIIM, and national line agencies sharing ular approach to the delivery of welfare services and counterpart financial and technical support w-ith communities to development by looking at the actual field results and impact. T he people of barangay Bulod (Sultan sa Barongis, Maguindanao) Through the Comprehensive and Integrated Delivery of Social Services used to be skeptical of any form of help promised by any government (CIDSS) Program and through the representation of the barangaychairperson, agency. The barangay is not only isolated because of the absence of a small fund was provided to the community for a water system. A project plan basic infrastructure connecting it to mainstream society, it has also was then prepared, and pumps were installed with labor and some materials long been a neglected community in which government basic social services provided as counterpart inputs from the community. Schemes were developed are a rarity. But community members had not realized that, even with help and implemented for user charges to be collected from the community for the from outside, they would, principally, have to help themselves by learning to required maintenance of the pumps and later for the eventual establishment work together. of more pumps. Suspicious community leaders needed a lot of persuading to take the The results achieved in community action planning spread to other initial steps of undertaking the minimum basic needs process to help iden- basic concerns, such as the need for solar driers among the farmers that tify issues that the community wanted to address first. All issues identified also served as a common sports area for the children of the community. appeared very basic, and all seemed a priority to be addressed considering Parallel action planning was also initiated by women to set up a day care the extreme poverty condition as reflected in the minimum basic needs center, which also served as a health center. benchmark results. There was a lot of "wait and see" and community mem- From the suspicious community that Bulod once was, it has become a bers expressed more doubts when for a while, the community failed to move coping and initially self-directing community encouraged by the strides of beyond deciding which of the needs requiring community action could be small projects, and aided by small funds. One community member quipped, undertaken, mainly by themselves, with the help of a few external resources. "we thought 'to-see-is-to-believe' was about the government extending Eventually, the need for a water system as a source of potable water for help to us. I realize that seeing and believing is more about us (the com- daily household use was eventually agreed on. munity) trying to work together solving our problems." ,Scl ire Adatcd)t f1-)io 17N,(l)sll)11)-it inteli-N exs NN itll M.IgLlinda, Dill)ISW;'I %N,I-k- \1i\1!1 79 '4 i~~~~s r* .. -. T _A , rt 1; l- . . Air, :2- L 4a ''N*f* s A j- rYs .-(tPt- _ _ St -4 i Vt ' I '' I , *pop qr, _ 4 r~~~~~~~~~~~~~~~~~~~~~~~0 7. Closing the Gap in Human Development Outcomes-A Strategic Framework for the Coming Decade revious chapters have lhighilighitel several imiajor facets of 7.1. Recommended strategy hnioan development in ARNINI, inicluding (a) that ARMINM stiuffers from serious deficits in human dlevelopment out- The full set of recoimmendlecl ictions for achieving huliman colimes compared with those in the rest of the country; (h) thatt development in A61MM is prescntecd in the Annex. Taken as a these dleficits have iOt heen mitigated 1b compensatory levels whole, the m;atrix suggests a package of strategic ictions-t of pullic spendling for this disadvantaged regionm c) that, in the political as, - JI as hureaucratic levels, in rcsource 1moli- fact. public spending on edtucation, heallthi, and social protec- lization as well as expenditure prioritizattion, in specific sec- tion in ARMNI is substantiAh lov(er than that in the rest of the toiral issues as i as hroad institutiona,l mrid minagemenlt country; and (cl) thalt a combinalition of sgli-n I,nt increases in mtatters-that are intenclel to reinforce each othel- in Lacilitat- puhlic spencling on hum-111an development ais well as internal ing and securing progress. Two key points ahout the maltrix reforimis in governince and deliver- systems for huma-i1.n devel- should he ephilphasized: opinent services couldl he importatit to closing the gaps in * There is ainmple justification for sulhstantinaillv increalsing huliian development outcomies. SucCess on this last point is the level of puhlic expenclitures for h umllan develop- g ing to hc a crucia.l coiimponent of any sustainahle peace and mcnt in ARPMM ind the case has heen made for realdiz- development prograim in Mindanao. This final chiptcr looiks at ing stichi an increase in future spendling to he fuinldle the concrete steps thit mighit he taken to carry ouit the recotin- especially 1y the National Government. LGUs, and miendecld ictions. donors. Yet the key stakeholders in ARMI governance. One note before proceeding: for ARN\lM no strategy for particularly the Regional Government, should also hutimin development would he comiiplete wNithout a call foir a demonstrate thalt there is incleecd a lroad-hasedc will to hurmane nid permanent resolution of the ongoing conflict in refor-mil internal governance and regional service per- the Region. The responsibility for this action lies wvith aill formance. which woauld greatly help sCcure increased parties, from the CoUintrv's leadership at the highiest levels to resoiurces. Increased resources atnd interrial retforim wvill the Regionil Government. the :trined factions, and furthier reinforce each other imiore effectivelyv hile the probhai- clown to the communities, famiilies, :tncl indiVicliulIs tesidenit hility of increalsecl resources would cLecline WithloUt evi- in the Rcgion, It is hoped that the depiction in this studLy of dlence of in-clepthi internal reforim. Henice, onze set ol/ the costs of the conflict in terms of losses to humran develop- recominmienidatitims (section I ?/ tl/ec Anniex) reivohocv menit. particularly for the childtren of the Region. ,11 serve (nOnn(1 a SerieS u/' . , 'slepivise uctiOnS to ibicicvse as one imiore remindler of why an end to the conflict in phlblic expelnditilres jor /iiinun; deelopme/npint (ilii Muslim Minclanao imuList he the overridling ohjective for all increa(se regtiNionll ai11toi10171)' in b/gi't b i anlagenett. co mcernecl. 1nbile/ increa.isn transa)(Irenc), (Iud a1ccilit(iilitt (Iand 81 denisonstratinlg biroCl-basedl Con.seusiis os keo polibcy which provides for moldels of service delivery. facilitv directions in binnanttii dlevelopment. investment policies, sources of funding, support sys- * There are a numbher of strategic actions in the individ- temis, ancl measures to meet special health needs. ual sectors-education, health, and social protec- 5 A social protection program policy centerecd on coIII- tion-that reinforce as well as articulate and amirplify munity-lecd development, which uses the exper-icnce the larger message of increasecl public spendling and from Successfful CIDSS projects ancd adopts community- improved governance for hurman development. based poverty-mapping instruments, such as the mini- Sectoral agencies in ARNMM, with the support of their mumiL basic needs, as its core targeting tool. cotinter-part agencies at the national level, have amnple If vigorous and positive movement along these five areas opportunity to pursue sectoral initiatives that can help of activities is seen, the cihances of eftfective and sustainecd the Region in moving oUt of its s'stemic constraints. action on the ground are increased considerably. Not onl will Sector-specific initiatives will bolster actions on gov- each action create favorahle conditions, hut the success of one ernance and public financing issues even as progress action will also make other actions more successfil. on the latter issues are likely to help aiccelerate and sustain sectoral improvements. Henzce, ai seconldI set O/ 7.2. Implementing the strategy recominenenttions (section1s 2 tO 4 Of the An111e.x) revolvcs tn'oundt sector-sJecific mneasures to clarifi The agendl is vast andi h11. ' - hut a logical secto1ralgoalls to it!service statlalrdEs, strenlgthen i1tra11- sequence and natural priority emerges from among the pro- aigelnelit anti(i operaJtionll(i Caplpicities, tinll(t! olertake posed package of actions. In broad termis, the human devel- selective investments in Iiic w'ith sector-specfiic opment strategic plan woukl unfold in two sequential but priorities. overlapping phases. The first phase will be a period of Given these two points, one can readily recoginize that consensus-l1m iil , and technical preparition. Engaging major implementation of the matrix of strategic actions is most likely to occtir in terns of simultaneously achieving five separate hut . - . interrelatecl coacrete develop))ments, namely: 1 A imediuim-termi public -1.--ii. franmework fori- ARMIM, xvIhich outlincs an indicative plan for targeted increases in pulblic spending on humaian (levelopi ient over a three- to five-year periol, fLndclecd fioi all m - so(urces. th 2. A regional policy agenda (Nacking the expenditure framiewvork), which establishes the framiework fo- human development spending and demonstrates broad-based political consensus on key huan (tevel- opment sector policy clirections and for greater trins- parency and accountabiility in management of staff tnd othtel- resouLi-ces. IL. - _ X 3. A regional hrasic educlation plan, wahichl outlines the hlzasic - goals, essential standards, critical improvements, po1icV on mnl(darisi key chianges in maniagemilent and operati" g - systems, funcling policies, cem.lnd-side progranms, and links beMeen teitiary institLitions and basic education. 2- i A rationalization plan for the regional health network, 4 ' ', 82 iV.i..1 ; i 0 \Ii partners to mobilize additional resources for human 7.3. Key actors development, preparing a plan for stepwvise transition to increased funding, greater budget autonomry and greater Sucib an ambitious program. intervening as it does in a ac)ountabilitv in humlailn development, cariving out a census of setting of sucb iimmense needl, can only be achieved with the government employees, resolving the lehbate on the appropri- involvement of the broadest possible array of partners. There ate goals and institutional forms of an edtucationi systemn serv- is a role for every major actor in the Region-national, region- ing ar minoritv Islamic CoMmunit-y and developing a health al. and local governments; eclueation, health, and social facilitv rationalization plan are amonig the actions that woultl welfare officials and staff; civil society and the commt-unities it fall unlider this category and that slyomild he initiated immedei- represents; and external dionors and fundling agencies. ately. This would also be the time to prepare technical studLies Althotigh all these actors have their respective parts. the lead on improved procurement and financial management systems, role in this pr-ocess belongs to the Regional Government, wlhiicl must motivate partners to take concerted action. Within One set of recommendations revolves around the Regional Gov-er-nmetnt, leadership mTIst ComIe froml the top, in the Office of the Regional Governor joinedl hv othtr parts of a series of parallel stepwise actions to increase thte Regional Government in , suppport to thie thilee key public expenditures for human development regional sector agencies. The maitrix of strategic actions in the Annex indicates the proposed leLd agency or agencies for and increase regional autonomy in budget ea1ich individual action in the strateg. management, while increasing transparency 7.3.1. Regional Government and accountability. Without - i i resources of its own, the Regional Government must nevertheless deliver on the promises ot regional autonomy onl the strengthi of its leadership and its manaTgemnent and inforimation systemns for heailth andl educa- mioral ascendancy. In exerting leadership. it must focus on tion serv-ices, anl an improved poverty mapping instrument proioting coherent mi ement along the above five areas of for ta-getin(g comimmunity-based projects. This initial phase activities. Along with its technical agencies, the Regiona would peak dlurin)g the first two years of tht strategic plan but Government lias specific responsibilities to: coIntirUc att a mi oderate pae as new issues emilerge dIurinig sub- 1. BItilt(Iel Clttiottl constittlt'uc) /r f /icositg tbe bum,an secluent vears. ClJel't'l/op t ,gaps. This StudI mllight he useftul as an The second phase Nvill consist of programis to undertake adRvocacy tol 'oiir building a national constituency for speCifiC poliCV Imea,suIres andI investments, is targeted and Closing the gaps in humnan development outcomes in framed hv the consultations and technical studlies. This phase ARNIM. Disseminantion( of the study might foctus on xvoulid Start to pick up in the second year of the imple- reaching meminers (f the Cabinet, Congress, melia, mientation periodl and grow in intensity as consensus is acaideme, minanagers and professionals of key national reached on priorities, as external funding becomnes available, agencies (DepEI, D)OH, and DSWD), national security aind ;is implementation capacity in the Region grows. agencies (sucIh as the Depatrtimient of National Defense), It should reach a peak 1w around the thirdl to fifth years and the dlonor cotmMunity. It might bet useftul to i highi- of the periodl, but shouldl continue at a higil level of light the fact that improvement of humnan development activity utitil the I I'<- 1li 1 -i gaps in serv-ice delivery outcomlles in ARMIM is a crucial aspect of peace and andl institutional capacity are bridged, likelv for another development in Mindainao, which in turn is a high cdecade, priority issue of national security and political I I T'he imatrix of strategic actions presented in the Annex 2. Exercise regiouziu politic(il lader,ship. The Regional gives an indication of timing and priority for each indlividual Government has shown an examiiple in exercising action proposel. rei(ional leadership in the imiplementation of national I!, I . ' 1 1 t 11. 1 E' , ,t' . - ',\ 83 government prograins and projects in ARJINI through the general populition. Leadership for these actions helping secure the issuance of such executive policies must comiie, as it already does, from the highiest levels in as Execuitive Order- 124 (implementing the ARNIMI the Government, at the Office of the President. Social Fund for Peacc and Development) and Executive However, in this regard, as in its other roles under this Orders 125 and 125-A (furthier devolving functions of agendal the National Government mtust show defer- national government agencies to the ARNIM Regional ence for the Region's 1, inmandated autonomy, and Government). Iolitical leadership of the Regional endeavor to form a partnership of equals wvith the Government will he crucial in securing colherent Regional Government progress in all the five areas of activities outlined 2. Increase national governinent tran;s/ebs to the r(egio)al1 alove, particularly in the first two itemis, namely the government nclzget and ensure that the humnan devel- mediumil-terimi public expendittire framnewvork for ARNIM opiment sectors receive a imore than proportionate and the policy agenda. share of those increases. In the facc of the evidence on 3. Ee'ercise sectoral techimical leadership. The regional discrepancies in per capita spending on huliman clevel- agencies for education (DepEd-ARMNIM), health (DOH- opment between ARMIMI and the rest of thle country, ARMIMTl), and social - 11iF (DSW'D- I ' I'! i will need to even the tight hudget sitiatior cannot excuse the provide the technical leadership in their respectiv e sec- National Government, and DBPI in particular, from tors, thouglh technical assistance from their counterpart sceking to J. F , all ,r, p l li . . for reallocation from national agencies w ould he constrluctive. Resources less urgent or low-er priority items in the national and opportunities provided hy existing foreign-assisted hudget. Defense of ARNIMI's budget position dur-ing projects in education, healti, or social 1 it mighit he Congressional budget hearings is an equally important usefuil for providing the technical 1,1, lIly, blocks for task. the basic plans of eaci sector. Existing projects Ii the 3. C¾olncecle increasinlg/v, greater budgetaty alnton1oni)' to ARMNII Social Fund Project or the Basic Education the kezional Gover'nmnent. True autonomy can only Assistance for Mindanao Project, anmong others, can come when the Regional Government has authlority provide the technical resources for regional agencies to over its budget, in the way that LGUs have autonomy develop the plans indicated in the matrix of strategic over thicir IRA shares. It is tirLe that the regional gov- actions. ernment bureaucracy is young, and lacking the experi- ence that LGIJs already enjoyed when the LGC came 7.3.2. National Government into effect. Nevertheless, only hands-on experience wvill The National Government has a strategic role to play. provide the opportunity to learn, and the National Representing the entire nation, it must sectire the peace and Government should gradually btut steadfastly yield prosperity that are critically needed to enhance the country's hutdget management authority to the Regional standing amiong potential international investors and partners. Governmnent, in the process providing the technical It must also provide all necessary stipport to the one among 16 support needecl to build capacity in the Regional regions in the country that has the poorest humnan develop- Government. ment outcomes, as a means to redticing disparities hetweel 4. Provide technical assistance to rcg,ionnl government rich and poor across the country. Ancd as the principal financier linle ((gencies. The national agencies for education of regional operations, it miust share accountability for the (DepEcl), health (DOTl), and social welfare (DSWD)) Region's performance. The National Government's specific possess know-how and experience gained fromn ] - l llI ldii' . are to: decades of implementing humran development 1. Act ais the Regions cbampion in the nlation(alaena, programs nationwide. With a vastly larger field of taking the lead in advocating to close the gap in humiLan operations on which to build its expertise, these development outcomes bet-een ARMNIM and the rest of national agencies have miuch to teach the ARMINI the country, with Congress. among donors, and amiong counterparts. Both the national DOH and the national 84 1 lu):], i ,It tQ i ! '. '1 . ,rI ! <', \R\i\I - '¶1(1 % 4,~~~~~~_7 4, AF - 4 3f~~~~~~~£ DSWI) have been providing substantial amounts of this, if necessary working to revise the regional LGC to man- technical assistance to ARMM counterparts, hot the datc such a role for LGt's and negotiating for appropriate national DepEd's assistance has been limited, sharing arrangements. Technical assistance to help lCGt's The urgent need to articulate a policy agenda for review their current uses of fLncls to identify possibilities for education in ARMM consistent with national educa- reallocation from lower priority items woLuld facilitate this tion standards provides a unique opportunity for con- change. Comparison with similar LGt.s in non-ARMMI areas structive cooperation hetween national and regional of the countrv could help set appropriate targets. In the agencies. longer run, LGLTs would benefit from support to help build local capacity in planning and managing human develop- 7.3.3. Local government units ment-sector programs. LGOJs are conspicuously absent from the human devel- opment sectors in the Region. And yet local chief executives 7.3.4. Donor agencies have much to gain politically from close identification with Substantial external assistance will be critical in the delivery of services that are so universally valued by political Region for the foreseeable future, given the gap between constituents. Furthermore, an IRA formula that assumes resource needs and availability, and many donor agencies devolved responsibility for health and social protection sew- are prepared to help fill that gap. A few are already active in ices and a Special Education Fund (20 percent of real prop- the Region. To facilitate donor assistance, the National ertv taxes) earmarked for education expenditures ensure that Government (specifically, DBM) will need to make appropri- LGOs have room in their budgets for human development ate adjustments in the Region's budget ceiling to ensure services. The LGtJs need to start sharing responsibility for that the assistance is in addition to the existing levels, not a human development activities in their communities. Other replacement. Counterpart funding, to complement key actors-from national and regional government leaders, donor support, will need to be accommodated within this to donors, to civil society-should combine to advocate for increased ceiling. Assistance from donors can take any of iLj tn, cX&¼ l '.W 't'i .1'i, :2,il ->>,~ i', ih, h'.T'iN 8S V the following forms, separately or in coibination, and is Ite intervention, particularly.1 in the earix' years of the intendled to: strategic plan. To enstire that systems are put in place 1. Faicilitaete theliailoge,liae mong kerprtileres to generate to enhance long-ron- efficiency and accountahility in broad consensus on the rmain pillars of accelerated the human development secto rs, this support should he humil.an development in the Regioin. It is of Valoalbhle condlitional on policy refoi-iris. suclh as those assistance to provide the occasion and setting for nego- recoinimlendedl in this stuiy. For example. this funding tiations and disCUssions aiuong the National instrumiLenlt Couldl be usedl to finance a stepxvise G overnment, Regional Government. and I,G[ts' aioong transition to increased fulndling at regional governienlit donors and, NGOs; and betwvcen i. 1' levels oi goi- level. greater budget autonomy, and greater accouita- erimillelit and the loitor anmd NGO comm111lun-ities. For hility in tIle human development sectors. ludlget support C01-1d also he proi-vided directly to LGLTS thalt LGUTs are conspicuously albsent fromi the agree to enhance thiril involkxeent in 1Iuliman develop- menit ( for exa,imple, by sponsorship olI'hilEFIealth meiil- humiian clevelopment sectors in the Region. hurs-llips for the pOOr). 4. IChvide/omuls/om' cal)(1Citt' 1)11ildo)mg amie establisbmoent Ancl vet local clhief executi-es have mtclC to 0/ 11t'1 .jS),tclils for Inana"in.g lclit .1lic 1 l I Jll gain politically from close identification with (e.g., hiFl,n reSOtrcS ml.inag-cmcrit systems. proculr- ientit. andl finla,ncial Inallglemteint systemlls) s). Donor deliverv of services that are so universally fulnIds Could cover tle CoSt of coml puLter-ized informa,,- tiotl .alldl z1o06c111 C011111-iCtiaitioniS WS-tlInS. valued by political constituLents. tion and m der mtiIcatii ins systems. lti l',&l-OO Sll)I)iff/fi)1 1Mryei'-SCim/e iulVeStoMeiiIS iln the UU atioll, 11iCA th, a1nd soCia l piteCttioll (s2eetitos illClUdiug example. suppiort foir dlisLissiorins on fo rolat ii inig th1e Li pgl-adilng tIlese sctitors ho11mlanl resoiurees. ifilfrastruc- 1e(dituI ro terIll ptulic ex`\penlditLue '1-oi2ravi i\-Ork \x\l-1i 1de to- II.Ian eqtIlipinrineot. TI is is thic tiad itional role of door ol' immecdiate value. Also, spoi nsoirship ()f a series (f p T('tikiIs.I'hien1sure that plreeitLis re>oLtrCes are used effi- woIlrshklops on1 the Ppr Oipria,t1e r leCs of po li mc ad pri- CieltlV, in aCCOciCl.iI With seC1 )I-SpeCifiC` dCex'l( ipICOet Na;te religious edIuLaItiOn andl CorrespoindOling priotities pl:ains. the Regiond m io;vernment antld it's technical agen- for public fulnling w \ou1ld Ihelp speedl up imlplenInta- ties will need to actively coordinate with the d onors. antd til m of badly needecl imiproiVeICiltS ortI 1le Regmi('ls I(l(d)1os will aIIsi nleel to 11i(I l dregu(lar ci isti-ltatii(0l. education systemn. 2. (ivte i7ical assistancetO Iorocr extensive inalysis or 7.3.5. Civil society technical development of key elements of the Region's \N'hem2e a governm11elnt and its institutilins are -ouIng, as humi-1an development strategy. Donor agencies couill vith the ARNIM Regional Government. and particullarly whe facilitate the flow of ideas froiim other areas of the cooLn- a society is emeiginy i'ltomi a period of conflict and instahility, try or even other parts of the wvorld vhere relevant les- acti'e participation by civil society in the I,1 Ihi,,, effforts is sons have heen learned. The experience wvith Islamnic especially valuable. The NGOs of the Region can contribute education in other countries wotuld be valuable, for specifically, if they: example, as woviulc expertise on health facility rational- 1. Ad1vocaite /br better huma6in dlevelopment ser^vices (lldI ization. Expertise to help with systems development moore resoices on belialf of the comniunities they rep- and other aspects of planning and policy development resent. NGOs can advocate for increased hudgetary is also tirgently needed. allocations for human development from LGUts by, for 3. Proovile budget supp)ort codclitional oilu olicy rwjbrnms. examnple, helping local chlief executives recognize the Given the serious funding 1 I, , ,II in human develop- value of humian development serv'ices for their con- ment in ARMM, btindget support would he an appropri- stituencies and byl helping the people recognize their rights to hetter serices. Similir advocacy can take i .'ill tc' Service gaps 'here ov'ernmienit wel,licis are place at the national level. iIIable to delivice. NGOs can themselves contribute to 2. Mloitor ' ' ti - ll levels i/ ,gol enOieot,(l1t the provision of hLumal[n development services vhere e/1(11 111(1Cll developmentt sector aIgen'ci ill 01 )(tiCit- go)vernment reaich is limitedl Comnmunitv-led activi- 1(ii. Civil soeietx canitoring *tn a pplv to all aspects ties, I in remote areas are particularly stuit- of the human developiment strategic plan, inCludling, aIble for NG() support. A critical part ol' NGO for example. monitoring of funding levels for hum1111an inVlVilvement NVOuld be creating the s(ocial strtuctures development or of compliance with transparency for self-help that W OUld a oioiw ci imLullities to andl atecounotahility staIndatrdis (e.g. for procuremlenit beezotie mel self-reliant in the long ruin , and te aching and finalnciatl manao igemenlt reforms). or ensurinyg c1i 1lnunit\ memibe ers o1 assert their rights a> well as thlat educat. ion and healthtl persImoIIC ;re in regulIaL- fulfill their i ThIigatttiins Vist-is -the a t ri ius leviels of attendnice at their place of wiirk. gi Mve1rnm1ent. A ~ F~~~~~~~~~P r- I = 4 e ^!Iw *k",. - ' x~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~6 irx iI i >e\si i t I,i1:i i,ii' j S '> e X;i871 References Abinales. Patricio N. 2000. M1akin4g AMindanac . Cotabato (ClllC DvaIo in the Formation of the PbilippinleIVatio,i State. Quezon City, Ateneo de Manila Universitv Press. Philippines. Anderson, Kathrvn, Elizabeth M. 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Office of the ARNINM Rcgional Governor, Cotahato City. Republic Act No. 673-1. Organic Act for the Autonomous Region in Muslim Mlindanao, Signed lune 8, 1989. Manila. Repuhlic Act No. 90S4. Strengthening ancl Expanding the Organic Act for the Autonootious Region in Muslim Mindanao. Signed Februaly 7', 2001. 1 iii Santos, Solimaina ir. 2)000. 7he L1'or(o Islamic C : . . .Constitutional Rethinking for the Mindanao Peace P1)rocess. University of the Philippines Press, Quezon City, Philippines, p. 208. Tanggol, SuLikarno D). 1990. "Regional Autonomy and Social Development: Some Notes on the Case of NLuslim . Mindanao." hbilippine J1ourud oljP(f Puilic Administration 3.()1): 1-1zT. Itnitecd Nations Development Programmlie. 2001. 2001 Haumoan Dezvelopmoenmt Repolt. New York. I Tni'ersity of the Philippines Planning and Development Resource Foundation, Inc, (IUP). 2())02. Social ,Assessment Report fur BRasian and Shinl1. (Report submitted to the World Bank.) AuguLst. Wo rld Bank. 2002. CoLuntry Assistance Strategy, Philippines. Inpr'l Ot'i11g the Liv es o/f the Poor throughb Gronth an id Emupowermuent. April 3(. Nlanila. World Bank. 2003. Sociail As.sessmlent ofA( e. ..'..'.. I Aas ini Atlindaio. Nlay 3. MIanila. Ligava Fernando Amilhangsa. photos on cover, pp. 6, 40, 73, and 90. il 89 AL j ! . w Z - SW L 4'~~~~~~~~~~~~~~~~~~~~~~~~r 1Y~~~~~2 F," 90 G. = '?, 'l '- ;' . :-' . .-.t Annex 1. Governance and Financing Strategy: Negotiate and implement a medium-term governance and financing framework that would increase public expenditures for human development (HD) and strengthen regional autonomy in budget management. In parallel stepwise fashion, take a series of confidence-building measures to increase transparency and accountability in management of staff and other resources, and demonstrate political consensus on key policy directions in HD. Involve civil society in monitoring actions of all governments. P'LfposCISCoure of Aclion - riming Ease of Delivery Poiential impaci Resources Needed Lead Agenr A. Increase public expenditures for human development, financed by a mix of sources including the National Govemment, local govemments, and donors. Use increased funding to increase shares of nonpersonnel expenditures, i.e., maintenance and other operating expenses and capital outlays A.1 Formulate proposed medium-term ' Immediate Technically difficult and politically Multiyear guide to prospective budget Modest, for Political leader- financing and expenditure plan for HD complicated envelope available for HD actions and technical ship of Regional based on principles of (i) substantially reforms assistance (TA) Government increased overall funding from Important to provide policy basis and (RG) with National Government (NG), local justification for proposals Provides baseline proposals for support from government uvits (LGUs) and official negotiations with financing sources Autonomous development aid (ODA); and (ii) more ODA funding likely to concentrate on Region in than proportionate share of increases CO. Hence governments must ensure Muslim reserved for maintenance and other sustainable recurrent cost funding Mindanao operating expenses (MOOE) and (ARMM) HD capital outlays (CO) agencies Civil society to monitor implementation A.2 Negotiate indicative levels of Immediate Subject to political uncertainties in Crucial catalyst for moving forward on Modest, for TA Political leader- future NG transfers to RG for HD; 2004; might be clearer with new other sources of financing since this is to RG and NG ship of RG and these should be substantially higher administration after 2004. Start with currently the main source for HD key support from than current levels 2005 budget expenditures in ARMM Substantial NG leaders, increases in NG Department of NG must recognize that greater needs allocations Budget and in ARMM and HD contribution to Management country-wide "peace dividend" justify (DBM) increased NG funding levels 91 A.3 Formulate a negotiated formula Immediate to Requires study on current uses of LGU LGUs have steady income source Modest, for TA Political leader- for LGU cofinancing of HD as part of medium term funds to identify possibilities for (Internal Revenue Allotment-IRA) to RG and LGUs ship of RG and revised regional devolution policy; reallocation from less urgent or lower that could provide sustainable LGUs this should be substantially higher priority items source of funding Substantial than current levels increases in LGU Civil society must LGUs must be persuaded or mandated Based on comparison with LGUs in allocations participate in to share responsibility for HD other parts of the country, ARMM advocacy with LGUs could make potentially large LGUs Subject to political agreement between contributions to HD services RG and LGUs Could be mobilized immediately, Requires legislative action to revise with strong political leadership devolution policy from region A.4 Negotiate with donors for Immediate to Crucial to obtain overall budget Could provide early response to Modest, for TA Political leader- indicative portion of expenditures medium term ceiling within which ODA projects can resource mobilization; offers greater to RG line ship of RG with likely to be covered by ODA be identified and prepared financing stability despite uncertain agencies and key support from projects in HD fiscal position of NG LGUs NG leaders Once budget envelope clear, project pipeline can be established ODA assistance generally, though not Substantial Technical leader- always, restricted to CO (infrastructure, increases in ODA ship from HD Requires donor coordination within equipment) and other investment costs allocations agencies in a common HD framework (training, seed money for revolving ARMM to funds, etc.) develop common Project preparation and strategic implementation capacities Government sources must provide the framework will be essential corresponding sustainable recurrent cost financing A.S Negotiate indicative levels of RG Immediate Subject to future levels of RG local Amounts minimal, but important signal Modest, for TA Political leader- local funds for HD expenditures funds and political agreement between of RG commitment to HD from to RG and RLA ship of RG with Regional Executive and Regional resources within its control support from HD Legislative Assembly (RLA) agencies and RLA B. Increase autonomy in budget allocation and management for the Regional Government B.1 Negotiate with NG and Congress Stepwise Can start with 2005 budget. RG should Regional initiatives to improve HD No additional RG leadership for less itemization of its budgetary transition over demonstrate efforts to increase outcomes supported by informed resources to negotiate appropriation to ARMM immediate to accountability (see points D decision-makers in RG needed with NG/DBM and medium term and E below) with Congress Need monitoring system, initially Civil society moni- toring B.2 Define part or all of NG transfers Medium term Same conditions of accountability as Would provide more stable funding TA to develop RG leadership toARMM under IRA-type formula B.1 source than annually negotiated appropriate to negotiate budget allocation with NG and formula with Congress B.3 Expand local revenues of RG and Long term Limited prospects for expanding tax Would reduce dependence on NG No additional RG LGUs base, except in long term allocations resources in immediate future health, and social protection in this matrix) D. Conduct organizational and staffing review and develop human resources development plan for human development agencies in ARMM D.1 Conduct a census of RG Immediate Technically complex and politically Eliminate most egregious abuses in Moderate for TA RG leadership employees to update the staff rolls difficult public sector employment and costs of and managers of and identify nonexistent, absentee, census HD agencies or unqualified employees Savings from elimination of "ghost employees" can be used to (a) hire Substantial, if "real" service providers, especially in incentives for remote areas; (b) increase salaries; voluntary andlor (c) finance MOOE and CO separation or early retirement needed D.2 Clarify and enforce standards and Immediate Policies must be transparent and Oblective criteria set for human Modest, for TA RG leadership for processes for hiring and firing of RG widely disseminated resources (HR) actions policy employees Sanctions for nonperformers Top and middle managers in HD for enforcement D.3 Develop staff deployment plans Immediate, part Crucial to obtain early decisions on More efficient use of HD resources Modest, for TA Top and middle for HD agencies consistent with of HD sector policy directions (e.g., decentralization, (should be HD HR but sounds/looks managers of HD strategic directions in each sector master plans devolution, priorities) to guide funny) Substantial, if agencies organization and staffing incentives for Better coverage of underserved areas redeployment needed D.4 Identify priorities for capacity Immediate to Part of HD sector master plans Improve the match between staff Modest, for TA Top and middle building, training, retooling; and long term members and their job descriptions to HD agencies managers of HD implement staff development agencies programs Staff productivity and morale crucial Substantial to to goals implement training programs D.5 Proceed with planned reorganiza- Immediate to Technically complex and politically Rationalize the regional bureaucracy Modest, for TA RG leadership tion and restructuring of agencies to medium term difficult rationalize the regional bureaucracy D.6 Define andlor update job Medium to long Initial effort to define job descriptions Objective criteria set for HR actions TA to HD Initially, RG lead- descriptions for all positions in term for job will be difficult; standard job agencies ership and man- government; define results agree- descriptions descriptions should be used agers of HD ments for each staff member on the wherever possible agencies basis of these job descriptions; insti- Annually over tute regular performance evaluations the long term Key is to sustain attention and Over the long based on these results agreements; for others effort over a long period as effects term, top and and define region-wide policies for are cumulative middle managers rewards and sanctions linked to of HD agencies performance evaluations Can be done for HD agencies only or all government agencies E. Adopt meIasure oircpove teur oansaecyll andu accuntailaity in Ireources allocated anduse foru hv lumian development/, startn wxyvith proureeturlr andu financial mlaniagemenit E.1 Implement the new National Immediate for Key is to sutain attention and effort Demonstrates RG's commitment to Modest, for TA RG through its Procurement Law (RA9184) and its adoption of Law for enforcement transparency to minimize if not to RG and HD Regional Implementing Rules and Regulations and IRR eliminate corruption agencies Procurement (IRRs) Will require extensive capacity-building Monitoring Unit Immediate to in competitive electronic procurement Considerable savings in costs of goods Advocacy TA long term for procedures, planning, and monitoring and services purchased for civil society Procurement capacity building participation units in HD Will require establishment of a Just-in-time procurement agencies regional procurement coordinating and monitoring unit Civil society to monitor Civil society participation in monitoring public procurement activities needed E.2 Implement an automated Immediate Key is to sustain attention and effort Signals RG's credibility and trustwor- Modest, for TA RG leadership accounting information system for enforcement thiness by demonstrating prudent use to RG and managers of its resources Link up with national Commission on Audit (COA) to use [COA owns Reduce financial mismanagement and software & needs to give permission corruption to ARMM] simplified bookkeeping software, and TA if needed 94 1 \ !1 . l 2. Education Strategy: Bring to rapid conclusion the ongoing debates on the goals and institutional forms of the Regional education system-both public and private-to enable the system to proceed with the challenge of rebuilding and upgrading quality with the limited resources available. Institute a participatory management style and introduce improved manage- ment and operating systems. Improve the links between basic and tertiary education institutions. ~~~~~~~~~~~~~~~~~ - -----I m - -- |- ------ Purpose/Cours of Act=o Timing Eas 01 Defver otentiaf bkpac Resourc Needed LeadApny A. Articulate a clear and broadly shared agenda for educational development in ARMM A.1 Formulate a multiyear regional Immediate Broadly consultative process to prepare Strengthen links between RG and Modest, for RG to initiate basic education plan for ARMM that agenda; public disclosure about LGUs leadership, and other education preparing plan but need to (a) clearly articulates broadly shared process important officials Substantial, for involve LGU and goals and acceptable service implementing Department of standards; and (b) defines a concrete Realistic implementation plan Persuade NG to allocate more plan Education program for increasing availability necessary but may be more difficult, resources for education in ARMM (DepEd); donor of schools in remote areas and given many needs in region assistance may upgrading the quality of the public Persuade LGUs to mobilize more be needed school system Agree on allocation of responsibilities of own resources between RG and LGUs Achieve coordinated effort toward education goals and reduce wastage in sector A.2 Formulate policy on madaris, Immediate Need survey to assess condition of By upgrading quality of madaris, Modest, for RG, LGUs, and reserving option of public support madaris relative to national increase enrollment and continuation policy DepEd, with for madaris willing and able to meet accreditation standards; information rates, especially among the poor development possible donor national accreditation standards, is not good now assistance; particularly in areas not served by Substantial, community public schools Consultative process is important; depending on groups keeping political agenda separate the agreed from education agenda will be a public role of challenge madaris B. Increase efficiency of the education sector by improving key management and operating systems B.1 Establish policy of shared Immediate Response to division superintendents Improve initiative and effort by local Modest; needs RG with support management and accountability in and other local managers; political education managers political from LGUs system; devolve clear functions to will and support for democracy by RG commitment local education managers with Improve sector decision-making to shared corresponding resource transfers Accountability mechanisms needed; management TA may be needed to experiment on what would work; performance may be difficult to measure B.2 Improve regular information Medium term TA needed to design system; need Improve resource planning and Substantial RG with collection and distribution system collaboration of local education budgeting assistance of down to schools and students to managers DepEd map out needs and track performance Improve sector decision-making B3 Improve budgeting, procurement, Immediate Assess existing systems; design and Increase operational efficiency Moderate RG and LGUs and financial management systems pilot new system; train and implement with assistance at division and school levels Improve transparency, reduce of DepEd Related to current DepEd project corruption Meet school needs better 1 ; .: t '' : I ' ! I' : l , ; ' 'ii ; 95 especially for hard-to-reach places system design and training of local to-reach areas with assistance (such as conflict-affected areas and managers and school personnel of DepEd island provinces) B.S Improve teacher development Medium term Assess quality and deployment of Improve teacher attendance, Substantial RG with and management systems teachers with respect to education instruction methods, and student assistance of agenda learning DepEd Improve teacher development Better deploy good teachers where programs, as well as compensation, they are needed evaluation, and promotion systems C Ensure adequate resources for educational development in ARMM C.1 Amend school funding formula Immediate Formula to be underpinned by Upgrade public school standards and Modest, lor RG with to reflect education agenda and quality and service standards for improve school performance change in assistance needs public schools funding formula from DepEd Reduce wastage by allocating Identify and target under-resourced resources where they are needed Substantial, if public schools implemented to address needs of under-resourced schools C.2 Mobilize NG, LGU and donor Immediate to Implement public school upgrading Improve school performance and Substantial NG, LGUs, donors resources for education long term plan in A. 1 (b) above achieve educational goals for funding RD takes lead on LGUs need to take responsibility for Reduce out-of-pocket spending by poor implementation specific education goals (See point A under Governance and Financing section) C,3 Design demand-side program for Immediate Ensure that these special support Reduce out-of-pocket spending by Moderate to RG and LGUs, the poorest and disadvantaged areas, programs imply additional funds poor, linked to education behavior substantial, with NGO and especially in conflict-affected areas depending on donor assistance Monitor accuracy of targeting Improve disadvantaged-school level of support outcomes May need coordinated nongovernmental organization (NGO) and donor assistance CA Set and implement policy for Immediate Assess size of problem in region, Improve educational development Moderate RG and LGUs outstanding pool of illiterate and and set performance goals for all under-schooled adolescents and adults | 9)6 li , .E .!( ' s ! D.1 Develop close R&D relationship Immediate to Find technical solutions to improve Improve quality of basic education Moderate RG with between schools and tertiary long term education in hard-to-reach and assistance of education institutions; especially conflict-affected areas; distance- Reduce dropout rates of students, and Commission on for developing pedagogical methods learning methods may help evacuees improve learning Higher Education for students in conflict-affected areas and others where schools are (CHED) and and in remote islands disrupted or too remote Increase relevance of tertiary education DepEd D.2 Use university capacity to train Medium term Regional universities already have Include peace and conflict resolution in Moderate RG with education personnel and political and existing inter-faith dialogue programs, education process assistance of business leaders to find and promote but these need to be used in teacher CHED and DepEd solutions for peace and prosperity development D.3 Upgrade quality of tertiary Long term Determine public and private roles Improve returns to basic education Substantial RG with education, especially in relation to for this assistance of teacher development Improve quality of teacher supply to CHED and donors May need coordinated NGO and basic education donor assistance ,A ,ja 2 ! , L *1 S ; 1* * *i 3. Health Strategy: Immediately correct the serious under-funding through a mix of funding sources (National Government, local government units, PhilHealth, donors, user charges). Develop a master plan to guide strategic upgrading of primary and secondary facilities, ensuring that qualified staff are present before undertaking infrastructure projects. Increase support for priority public health programs and programs to reduce conflict-related trauma. PuposeICourseofAtAon ,-in- Ewe of Del_v _- tendalmpactRoure Needed Lead Agen_ A. Bring more funds into the health system I~~ , I__ _ _ _ _ A.1 Increase share of health in Immediate Health sector should receive more Increase resources to improve quality Substantial RG and NG/DBM ARMM budget than proportionate share of any and reach of care increases in RG budget. (See point A Civil society to under Governance and Financing section) Reduce out-of-pocket costs for poor advocate for increased Meanwhile, RG and NG to identify resources possibilities for reallocation from less urgent or lower priority items within the existing RG budget. A.2 Increase LGU financing of health Immediate Local chief executives (LCEs) must be Same as A.t above Substantial RG to initiate care through: (a) direct funding of persuaded or mandated to allocate dialogue with health services; and (b) LGU greater share of IRA for health. LGU LGUs, lead devo- sponsorship of indigents in PhilHealth share in health financing would be an lution discussions Indigent Program (IP) essential provision of the proposed revised version of the ARMM Local LGUs to allocate Government Code (LGC) funds for health RG and LGUs could cosponsor IP Civil society to memberships advocate for increased _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _--_ _ _ _ _ _ _ - _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ rreso urce A.3 Increase PhilHealth activity Immediate for PhilHealth is already planning to do Same as A,1 above; especially, reduce Substantial National in the Region through: (a) opening (a) and (b) (a) and (b). Need to accelerate action out-of-pocket costs for poor If covered PhilHealth for of PhilHealth office(s) in ARMM; under IP (a) and (hi (b) expanding IP coverage; Medium to long (c) and (d) will require substantial (c) upgrading providers to meet' term for investment funds (see also B.2 below) Improve physical and financial access National and accreditation standards; (c) and (d) to health providers local PhilHealth, (d) encouraging private sector RG, LGUs, and providers donors for l l l l | | ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~(c) and (d) l A.4 Mobilize donor and NGO Immediate ! Donor coordination required, preferably Same as A.1 above Substantial RG and/or LGUs funding for the health sector within systematic framework for health Modest to subs- lead coordination system development Donor coordination required to tantial (depends efforts maximize impact on donor) A.S Institute user charges but only Immediate Difficult to assure conditions Increase resources to improve quality Modest to Health facility with assurance that: (a) poor are (a) and (b) and reach of care moderate (from managers with exempted from fees and receive equal health system guidance from quality care; and (b) revenues are Community monitoring advisable Increase out-of-pocket costs with risk clients) ARMM retained by facility. Preferably apply for (a) of excluding poor Department of only for nonessential aspects of care Health (DOH) (private rooms, etc.) Public investments in "private wings" divert funds from priority public services |GUs to permit retention of revenues ' ;. __~~~~~~~~~~~~~~~~~~~~~~~~ __ _ :, O. px NV __g B. Establish an efficient health care delivery system B.1 Develop a plan to rationalize the Immediate Requires TA on health network Provide blueprint to enhance access 1 Moderate ARMM-DOH, in Region's health network, especially at (must precede planning to primary and secondary care of consultation with primary and secondary care levels step B.3) good quality, reduce unnecessary RG, LCEs, provin- Political consultation process is as hospitalization, and reduce cial health offi- (The plan should consider staffing important as technical analysis inefficiency/wastage in health cers, municipal and funding realities) investments and operating costs health officers, private providers and community representatives B.2 As part of B.1, develop cost- Immediate to Challenging task requiring inputs Expand the reach of the health system Modest ARMM DOH, in effective and sustainable service medium term from experts in field operations to the poorest families consultation with models for remote areas LCEs, MHOs Will require active community involvement B.3 Invest extensively in primary Medium to Will require substantial investment Enhance access to primary and Substantial ARMM-DOH, facilities; invest selectively ix long term funds secondary care of good quality, LGUs, donors secondary facilities in line with reduce unnecessary hospitalization, rationalization plan Lack of qualified staff is a prime and reduce inefficiencylwastage in constraint health investments and operating costs (All infrastructure projects must have ensured staffing and operating cost Political consensus must be Potential for enormous wastage if funding) maintained in support of facilities are without qualified staff ___ ___ __ ___ __ ___ __ ___ _ -rationalization plan C. Establish efficient support systems for managing health operations C.1 Introduce systems to improve Immediate to Requires TA on HHR planning Health personnel more productive Moderate to G for region- health human resources (HHR) medium term Substantial, wide civil service management, including (a) staff Involve communities in HR planning, Health system able to produce more depending on reform; ARMM- deployment in line with especially for remote areas and better services without increasing conditions of DOH for HHR rationalization plan; (b) reformtof ! costs. civil service reform if HHR management system (part of Strong political leadership required reform centralized civil service reform); and (c) skills to pursue HHR (civil service) reform system; ARMM- |upgrading |,||DOH and/or l upgrading LGUs if devolved; community representatives C.2 Introduce systems to improve Immediate for Requires TA on drug systems Less frequent drug stock-outs in health I Moderate ARMM-DOH in drug management, including (a); medium management facilities consultation with (a) pooled procurement, using term for (b) local health transparent competitive bidding; and (c) Easier to do for centralized system; Lower prices for drugs managers if (b) improved drug logistics systems; requires LGU agreement to pool centralized and (c) transparent and accountable procurement Reduce out-of-pocket costs for poor system; ARMM- management of public funds for DOH and/or drugs Reduce leakages/corruption LGUs in consultation with local health managers if devolved - I - r~~~~; 991 C.3 Introduce systems to improve Medium term Requires TA on information system and Health system able to produce more Moderate ARMM-DOH in (a) health information management financial management system designs and better services without increasing consultation with and (b) budget and financial costs local health man- management Will require moderate investment agers if central- funds for software and hardware Reduce leakages/corruption ized system; ARMM-DOH Better monitoring of health inputs, and/or LGUs in outputs, outcomes consultation with local health managers if devolved D. Promote programs that respond to special health needs in the Region D.1 Increase support for priority Immediate and Existing programs require increased Direct impact on health outcomes Substantial ARMM-DOH public health programs including medium term resources with local health maternal and child, nutrition, and managers reproductive health, family planning, Programs should be culturally sensitive tuberculosis, and malaria programs (e.g., involving ulamas in reproductive health, family planning program) Increase integration in program delivery to fit broader health system reforms D.2 Undertake multisectoral health- Immediate to Requires interagency coordination Improve general health status; prevent Substantial ARMM-DOH in -:., c l nrt. .:1 . food supply, long term illness coordination water, sanitation, housing) with concerned Substantial long-term impact on health agencies; local health managers D.3 Expand psychosocial Immediate Pilot community-based program Reduce immediate and long-term Modest ARMM-DOH interventions to reduce post- exists in Pikit, North Cotabato consequences of conflict-related and ARMM traumatic stress disorder (PTSD) psychological trauma Department Needs modest resources to expand of Social Contribute to peace effort Welfare and Health staff not trained in PTSD Development management (DSWD) D.4 Set and implement policy for Immediate Assess size of problem in region, Improve educational development Moderate RG and LGUs outstanding pool of illiterate and and set performance goals for all under-schooled adolescents and adults ioo~~~~ A. Selec successful community-led best pramices from Comprehensive and Integrated Delivery of Social Services (CIDSS) projets in poorest barangays to serve as demonstration and leaming sites A.1 Assess and profile community-led Immediate High degree of cooperation needed Community-led best practices in SP Moderate. First ARMM-DSWD (DSWD or NGO guided) best practices among ARMM-DSWD, LGUs, and some provide concrete and doable people- year resource and LGUs in social protectio n activ ARMM NGOs to support both the host and to-people solutions to SP needs in the requirements visiting communities real environment of post-conflict and drawn from A.2 Prepare selected communities Immediate extreme poverty situations regular fund as models and hosts for immersion and sustained RG and LGUs to work out operational sources of both and exposure for other visiting activity onward coordination and resource sharing sup- They also demonstrate powerful SP ARMM-DSWD communities port system outcomes that rely on people-centered and LGUs utilization of resources merely combined with A.3 Manage replication activities by Medium term Community exchanges only possible in complemented by limited external counterpart visiting communities in priority target (second year relatively violence-free communities assistance. fund from barangays onward national DSWD Desirable self-help values become manifested which replace dependence, Second-year post-conflict depression, helplessness, resource and social exclusion requirements similar to first year but with more NG transfers Substantial. Third year onward needs even bigger NG transfers and donor assis- tance, in antici- pation of increased project-driven demand B. Improve community-based poverty mapping instrument to be more user-friendly to poor communities B.1 Review poverty mapping Immediate Strong resistance from some LGUs Its use is also the first funda- Collaboration of instrument, make its use more are expected, especially in making mental step in community-led ARMM and participatory as a basis for prioritizing community-led profiling mandatory processes and a clear indicator LGUs in the poorest communities for the for all barangays for community participation resource shar- combined assistance of LGUs, ARMM, before any financial assistance ing should be and NG Its use is also the first fundamental takes place the basis for step in community-led processes and a further assis- B.2 Pass a law requiring all Medium term clear indicator for community partici- tance from NG barangays to use the improved MBN pation before any financial assistance and donors mapping tool as basis for community takes place profiling of basic SP needs; can be expanded to other community needs profiling i W 1 'i ! 'ii F\W\I 101 profile all barangays as part of basis (second year planning rest on this fundamental step for release of IRA share to complying onward) (from SP needs identification all the barangays including other forms of .way to project development and imple- assistance from RG and NG mentation) B.4 Train barangay officials, workers Medium term and facilitators on the use of the (second year improved MBN mapping tool onward) C Develop the policy basis for social protection program coordination and resource sharing to support scaling-up of community-led projects C.1 ARMM-DSWD to consult with Immediate Besides the ARMM Governor as Resource sharing that contribates Modest. All ARMM LGUs on program coordination and champion of this revision to the ARMM concretely to development of activities in the Legislative resource sharing LGC, other champions per province in communities starting with community- first year are Assembly with the ARMM area should be recruited to led processes in SP should provide funded from ARMM Governor C,2 Formulate draft bill for further Immediate gain support in law making and in new ideas in constituency building regular sources as champion, consultations with LGUs (this may be actual resource sharing in SP projects. anchored on development of people with some ARMM-DSWD, a component of the proposed revised Local champions will reduce resistance rather than on patronage and budget items LGUs version of the ARM M LGC) to resource sharing dependency politics realigned for the purpose. C.3 ARMM Legislative Assembly Medium term passes draft bill into law Budget realign- ment should be C.4 ARMM-DSWD and LGUs adopt Medium term done at the CIDSS-like and community-led social (second year current period protection projects as a regular onward so that realigned program (rather than sa special budget can be program implemented by national ised in time for DSWD through ARMM- DSWD) the first and subsequent periods D. Update the ARMM DSWD Strategic Plan D.1 Consultations on SP program Immediate oversight body constituting NG, The interdependence of LGUs, ARMM, Modest. To ARMM Governor, framework made coherent with ARMM, and LGUs created for the and NG should work as a unified speed up the NG, and donors overall HD strategy in ARMM purpose and to reduce and manage governance system for SP and HD in review process, resistance at all levels of government the Region. This is reflected primarily donors, with D,2 In parallel, review recent ARMM- Immediate in any written plan, such as the ARMM and NG, DSWD Strategic Plan for 2003-2005 strategic plan can initiate and for coherence and rationalization in carry the cost of resource sharing among LGUs, start-up ARMM, and NG activities D.3 Review budget specifically on Immediate and items for resource sharing among sustained LGUs, ARMM, and NG to anticipate regular activity needed medium-and long-term onward resource requirements of ARMM SP plan (including budget requirements ofARMM-SF Project and other ARMM focused aid/loan funds) Note:ARMM = Autonomous Region in Muslim Mindanao, CIDSS = Compeehensive and Integrated Delivery of Social = Local chief executive; LGC = Local Government Code; LGU Local government unit, MOOE Maintenance and Services; CHED = Commission on Higher Education; COA = Commission on Audit; DBM = Department of Budget and other operating expenses; NGO = Nongovemmental organization; ODA = Official development aid; PhilHealth = Management; DepEd = Department of Education; DOH = Department of Health; DSWD = Department of social Philippine Health Insurance Corporation, R&D = Resarch and development; Regional LegislativeAssembly; RG t Welfare and Development HD = Human development; HHR = Health human resources; HR = human resources; IP = Regional Government; SP = Social protection; TA = Technical assistance. 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Emerald Avenue, Ortigas Center Washington, D.C. 20433 Pasig City, Philippines USA Tel: (63 2) 637-5855 Tel: (202) 477-1234 Fax: (63 2) 917-3050 (202) 477-6391