Pidsbk02 Urbanization1 PDF

ManagingUrbanization
Undera Decentralized
Governance
Framework
Volume1
ManagingUrbanization
Undera Decentralized
GovernanceFramework
Volume 1
Edited by Rosario G. Manasan
Raul S. Anlocotan
Casimira V, Balandra
Jazmin D. Berido
Rosemarie O. Buan
Carmel P, Chammag
Clark Y. Clarete
Aurora M. Joson
Johnny T. Lira .
Ma. Lourdes D. Lira
Rosario G. Manasan
Ruben G. Mercado
Virginia S. Pineda
Ross Q. Quisao
Anicia C. Sayos
Victor B. Ubaldo
Demographic Researchand Development Foundation, Inc.
pAs
Philippine Institute for Development Studies
Copyright 2002
• by Demographic Research and Development
Foundation (DRDF), Inc.
c/o Population Institute, University of the Philippines
2/F Palma Hall, Diliman, Quezon City 1101
Philippines
and
Philippine Institute for Development Studies

4/F NEDA sa Makati Building
106 Amorsolo St., Legaspi Village
1229 Makati City
Philippines
Printed in the Philippines. All rights reserved.
The findings, interpretations and conclusions in this volume are

those of the authors and do not necessarily reflect those of DRDF
and PIDS.
Please address all inquiries to:
PHILIPPINEINSTITUTE FOR DEVELOPMENTSTUDIES

NEDA sa Makati Building
106 Amorsolo St., Legaspi Village
1229 Makati City
Philippines
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ISBN 971-564-047-8
RP 06-02-500
Table
ofContents
Foreword .......................................................................... xix
Part I ANALYSES
Chapter I Financing and Delivery of Urban Services

in the Philippines: An Overview ............................................. 3
by Rosario G. Manasan
Urbanization vis-_t-visExpenditures and Revenues ..................... 5

Revenues and Expenditure Structures of Cities .......................... 7
The Urban Fiscal Problem ............................................................ 11
Closing the Urban Fiscal Gap ....................................................... 24
Issues for Further Research .......................................................... 30
References ...................................................................................... 31
Chapter 2 Metropolitan Arrangements in the Philippines:

Passing Fancy or the Future Megatrend? ..................................... 33
by Ruben G. Mercado and Rosario G. Manasan
Context of Inquiry. ......................................................................... 34

Purpose and Scope of Study. ......................................................... 38
Demographic and Geographic Features of Current
and Emerging Metropolitan Arrangements ......................... 39
Genesis of Metropolitan Arrangements ....................................... 40
Organization, Financing and Activities of
Metropolitan Arrangements: Variations
and Commonalities ................................................................... 45
Policy Issues and Implications ...................................................... 52
Sustaining and Enhancing the Metropolitan
Arrangements ............................................................................ 58
Alternative Metropolitan Structures ............................................. 61
Conclusions and Agenda for National Policy Action .................. 68
References ....................................................................................... 72
Chapter 3 Environment and Natural Resources Management:

Lessons from City Program Innovations ............................................. 75
bynen Mer,ao
Selected City Environmental Programs ........................................ 76
Lessons Learned: Key Elements for Program Success ................ 97
V
Conclusion ...................................................................................... 102
References ....................................................................................... 103
Chapter 4 Health Management: Strategies

from Selected Cities ............................................................................. 105
by Virginia S. Pineda
Health Services Provided by Cities

and DOH Under the Devolution ............................................ 107
Comparison of Population, Health Expenditures
and Health Performance of Selected Cities .......................... 108
Health Concerns and Strategies ............................ . ...................... 109
Strategies Related to Systems Administration ............................. 119
Applicabili W and Suggested Improvements ................................ 123
Conclusion ...................................................................................... 124
References ...................................................................................... 126
Chapter 5 Local Efforts in Housing Provision ............................... 127

by Anicia C. Sayos, Ross Q. Quisao and Rosario G. Manasan
Introduction ............................................... :................................... 127

Objectives ............................................. ........................................... 128
Urbanization and Housing Needs ................................................ 129
Local Efforts in Housing Provision ............................................... 131
Cost Recovery. ..................................................................... ............ 140
Key Concerns .................................................................................. 146
References ...................................................................................... 149
Appendix ........................................................................................ 150
PART II CASE STUDIES
Chapter 1 Closing the Urban Fiscal Gap: An Overview ................. 155

by Rosario G. Manasan
Introduction ................................................................................... 155

The Heart of the Problem ............................................................. 155
Dissecting the Urban Fiscal Problem ........................................... 157
The Unfortunate Consequence .................................................... 158
Recommendations: Interventions to Close
the Urban Fiscal Gap ................................................................ 158
Reference ........................................................................................ 161
vi
Chapter 2 Metropolitan Arrangements
in the Philippines: An Overview ........................................................... 163
by Ruben G. Mercado and Rosario G. Manasan
Metropolitan Arrangements vs. Decentralization ....................... 163
Metropolitan Arrangements in the Philippines .......................... 164
Activities That Metro Arrangements Do Best .............................. 164
Policy Issues ..................................................................................... 165
Sustaining Metropolitan Arrangements ....................................... 166
Agenda for National Policy. ........................................................... 167
Choosing the Appropriate Metro Structure ................................ 168
C . mdie of_Metropo
Owning the Metropolitan Vision: The Case of BLIST ...................... 173
by Ruben G. Mercado and Carmel P. Chammag
Development Trends in Metro BLIST.......................................... 174

The BLIST Master (Structure) Plan ............................................. 174
Potentials for Cooperation ............................................................ 176
Managing Metro BLIST. ................................................................. 180
Existing BLIST Structure ............................................................... 181
Points for Consideration in Handling Metro BLIST ................... 184
Conclusion ....................................................................................... 190
References ....................................................................................... 191
Setting an Institutional Framework for Metropolitan

Management: Metro Cebu ................................................................... 193
byRuben G. Mercado
Composition and Management of Metro Cebu .......................... 193

Metro Cebu Population and Land Characteristics ..................... 194
Current Activities in Metro Cebu ................................................. 195
Potentials for Cooperation ........................................................... 196
Institutional Structure for Managing Metro Cebu ..................... 199
Conclusion ..................................................................................... 201
References ...................................................................................... 202
Providing a Metropolitan Perspective to Development

Planning: Cagayan de Oro .................................................................. 203
by Ruben G. Merrado and Casimira V. Balandra
Metro CDO Current Development and Prospects ...................... 204

Approaches to Metro CDO Development ................................... 211
vii
Metropolitan Concerns in the CDO Area .................................... 214
Metro CDO Planning and Governance ........................................ 215
LGU Preferences on the Sharing Pattern of
Urban-Related Activities and Service Delivery. ...................... 216
Conclusion ....................................................................................... 219
References ....................................................................................... 220
Metro Naga: A Continuing Challenge of Local

Autonomy and Sustainability ............................................................... 221
by Ruben G. Mercado and V/ctor B. Uba/do
Management of the Metropolis .................................................... 221

Demographic andLand Characteristics ....................................... 222
Historical Antecedents/The Metro Naga Development
Program (MNDP) ..................................................................... 223
Programs/Accomplishments ......................................................... 226
Future Plans .................................................................................... 231
Key Features of Success .................................................................. 232
Furore Challenges .......................................................................... 233
References ...................................................................................... 234
Melro Iloilo: A Struggle for Acceptance and Organization .............. 235

by Ruben G. Men:ado and Rau/S. An/ocotan
\.
Demographic and Land Characteristics ............................ i......... 237

Identified Areas for Cooperation ................................................. 238
Possible Next Steps ............. ,.......................................................... 244
Conclusion ...................................................................................... 245
References ...................................................................................... 245
Metro Davao: In Search of Metropolitan Def'mitions ....................... 247

by Ruben G. Mercado
The Three Definitional Models of Metro Davao ......................... 248

Conclusion ...................................................................................... 253
References ....................................................................................... 254
Governance and Urban Development: Case Study

of Metro Manila ..................................................................................... 255
by Ruben G. Mercado
Introduction .................................................................................... 255

Metropolitan Governace ................................................................ 263
Major Metropolitan Governance Challenges ....................... ........ 281
ell
VIII
Future Challenges and Directions ................................................ 293
References ....................................................................................... 295
Chapter 3 Health Management Strategies of Selected Cities .......... 299

by Virginia S. Pineda
Pros and Cons ................................................................................. 299
Passing the Buck to Local Governments ...................................... 300
Eight Who Made the Grade ........................................................... 300
Coping with Insufficient Health Stations ..................................... 301
When Health Workers Are Scarce ................................................. 302
Meeting Medical Emergencies ...................................................... 304
Augmenting Finances .................................................................... 305
Identifying Health Needs: Knowing the Problems
Gets You Half the Way There ................................................. 306
Integrated Approach: The Sum Is Greater Than Its Parts .......... 307
Clustering of Barangays: A New Meaning for Hamletting .......... 307
Planning, Monitoring and Evaluation:
Don't Expect WhatYou Don't Inspect .................................. 307
The Best and the Worst: Appealing to the Filipino Ego ............. 308
More Improvements in the Current Setup .................................. 309
Health in the Hands of the People: In Conclusion ..................... 310
C_e Studies_of Health Management Strate_es
Reaching Out: Gingoog City's Total Integrated

Development Approach (G-TIDA) ...................................................... 315
by Virginia S. Pineda and Clark Y. Clarete
Health Facilities and Expenditure/Budget ................................. 315

Health Performance ........ ;............................................................. 316
The G-TIDA Approach .................................................................. 316
Key Elements for Success .............................................................. 322
Areas for Improvement ................................................................. 323
Applicability and Replication ........................................................ 324
Conclusion ...................................................................................... 325
References ...................................................................................... 326
Puerto Princesa City's Satellite Clinics:

A Curative Rural Network .................................................................... 327
byvirginias. Pinega

Health Performance ...................................................................... 328
The Satellite Clinic Projects .......................................................... 329
ix
Impact of the Project ............................................. ........................ 331
Key Elements for Success ............................................................. : 332
Strategies That Can Be Replicated ............................................... 332
Other Recommendations .............................................................. 334
Conclusion ..................................................................................... 335
Emergency Rescue Naga: An LGU-Managed Emergency

Rescue Project ....................................................................................... 337
by Virginia S. Pineda and Rosemarie O. Buan
Health Facilities, Welfare and Expenditures ................................ 337

Emergency Rescue Naga (ERN) ............................ :...................... 338
ERN Structure, Functions and Responsibilities ............................ 339
Key Elements for Success ............................................................... 342
Applicability and Replication ......................................................... 343
Conclusion ...................................................................................... 345
People Power at Work: The Case of Surigao City's Primary

Health Care (PHC) Federated Women's Club ................................... 347
by Virginia S. Pineda and Johnny T. Lira
Health Facilities and Expenditures ............................................... 347

Health Performance ....................................................................... 348
The PHC-City Government Partnership ...................................... 349
PHC Health Activities ..................................................................... 351
PHC Health Initiatives .................................................................... 353
Key Elements for PHC Success ...................................................... 354
How to Replicate ............................................................................. 359
Conclusion ...................................................................................... 361
References ....................................................................................... 362
Financing and Delivery of Health and Sanitation Services:

A Case Study of Cotabato City............................................................. 363
by Virginia S. Pineda and Ma. Lourdes D. Lira
Vital Facts and Figures .................................................................... 363

Problems/Constraints to Effective Health Service Delivery. ...... 364
The Special Project on Health and Sanitation ............................ 366
Key Contributors to the Project's Success .................................... 372
Strategies That Can Be Replicated by Other Cities ..................... 374
Conclusion ...................................................................................... 376
X
Lapu-lapu City's Partnership for Health ............................................ 377
by VirgniaS. Pineda
Health Facilities .............................................................................. 377
Health Expenditures/Budget ....................................................... 377
Strategies to Promote Health ........................................................ 379
Key Elements for Success .............................................................. 382
Conclusion ...................................................................................... 384
Olongapo: A Health City ...................................................................... 387

by Virginia S. Pineda and Aurora M.Joson

Health Performance ....................................................................... 388
Strategies to Promote Health ........................................................ 388
Conclusion ...................................................................................... 392
Butuan City: A Consistent Regional W_nner in Nutrition ................. 393

by Virginia S. Pineda anJazmin D. Berido

Nutrition Activities ......................................................................... 395
Strategies to Overcome Malnutrition ........................................... 397
Conclusion ...................................................................................... 402
About the Authors .............................................................................. 403
xi
ListofFigures
PART I
Chapter 1
Figure I Share of CLGUs in Total General Government

Revenue ............................................................................. 7
Figure 2 Share of Externally Sourced Income in
Total Receipts of LGUs .................................................... 8
Figure 3 Revenue Performance of CLGUs ................................... 8
Figure 4 Share of CLGUs in Total General Expenditure ............ 9
Figure 5 Importance of CLGUs in Total Expenditure,
Total Population and Total Land Area ........................... 10
Figure 6 Growth Rate of Real Per Capita Expenditure
and Real Capita Local Source Revenue ......................... 10
Figure 7 Distribution of CLGU Expenditures by
Service Category. .............................................................. 11
Chapter 2
Figure 1 City, Non-city and Total Metropolitan Land Area ......... 40

Figure 2 Comparative Structure of Local Government
System With and Without a Metropolitan Body. ........... 56
Figure 3 Metropolitan Governance Framework ........................... 59
Chapter 3
Figure 1 Structure of the Clean Effort ............................... :........... 85

Figure 2 Structure of the Green Effort .......................................... 86
Figure 3 Eco-Walk Program Essentials ........................................... 87
Chapter 5
Figure 1 Organizational Chart of the Lote Para sa

Mahirap Program .............................................................. 145
xii
PART lI
Case Studies of Melropolitan Arrangements
BLIST
Figure 1 Proposed Organization for Metro BLIST

Under the Structure Plan ....................... ......................... 182
Figure 2 BLIST Area Task Force Under the NWLGQ. ................. 185
Metro Manila
Figure 1 Major Road Network of Metro Manila ........................... 262

Figure 2 Organizational Structure: Metropolitan Manila
Development Authority .................................................. 278
Case Studies of Health Management Su'atet_ies
Emergency Rescue Naga
Figure ] Organizational Structure of the Emergency

Rescue Naga ...................................................................... 340
Surigao City's PHC Federated Women's Club
Figure ] The Community Dam Board ....................................... ....356
ListofTables
PARTI
Chapter 1
Table ] Linear Regression of Per Capita Tax Revenue

of CLGUs ............................................................................. 14
Table 2 Ratio of Revenue to Expenditure from LGU Business
Enterprises, 1991-1995 ...................................................... 17
Table 3 Ratio of Revenue to Expenditure from LGU Business
Enterprises of Selected CLGUs, 1995 ..................... ;..._.... 18
Table 4 Total Cost Recovery of Hospitals, 1995 ............................ 19
Table 5 Linear Regression of Per Capita Expenditure
of CLGUs ............................................................................ 23
t0*
xnl
Chapter 2
Table 1 Urbanization in Selected Asian Countries, 1990 ............... 33

Table 2 Metropolitan Arrangements: Composition, Land Area
and Population .................................................................... 39
Table g Metropolitan Composition, Geographic and
Demographic Characteristics, by Metropolitan
Arrangement ........................................................ _............... 42
Table 4 Organizational Types and Financing of Metropolitan
Arrangements ..... _................................................................ 46
Table 5 Development Activities Under the Metropolitan
Arrangements ........................................... :.......................... 48
Table 6 Past and Future Traffic Demand in Metro Cebu,
1979-2010 .............................................................................. 50
Table 7 Urban BLIST: Water Demand, 1994-2020 .......................... 51
Table 8 CAMADA: Landfill Site Requirements ............................... 51
Chapter 3
Table 1 Basic Features ofOplan Linis Program .............................. 77

Table 2 General Information on Bantay Puerto Program
Components .......................................................................... 79
Table 3 Baguio City Clean and Green Program Components ....... 82
Table 4 Clean and Green Program Budget and Sources, 1996..._. 85
Table 5 Olongapo City Solid Waste Management Program,
1989-present .......................................................................... 89
Table 6 Environmental Sanitation and Management Office
Income and Expenditure, 1990-1996
(in thousands of pesos) ........................................................ 91
Chapter 4
Table 1 Population of Selected Cities .............................................. 108

Table 2 Population Density and Land Area of Selected Cities ...... 110
Table 3 Infant Mortality Rates ........................................................... 110
Table 4 Child Mortality Rates ............................................................ 110
Table 5 Maternal Mortality Rates ...................................................... 111
Table 6 Health Expenditures and Ratio to Total City
Expenditures ......................................................................... 111
Table 7 Rado of Basic Health and Hospital Expenditures
to Total Health Expenditures .............................................. 111
Table 8 Health Expenditures Per Capita, 1991 and 1994 .............. 112
Table 9 Basic Health Expenditures Per Capita, 1991 and 1994 .... 112
Table 10 Hospital Expenditures Per Capita, 1991 and 1994 ........... 112
xlv
Chapter 5
Tablc._"'Stat_ of Urbanization ......................................................... 131

Table 2 Income of Local Government Units .................................. 139
Table 3 Participants and Their Respective Roles in the
Kaantabay sa Kauswagan Program ...................................... 143
Appendix
Table 1 Cities' State of Urbanization ............................................... 150
PART II
Case_Studies of Metmp_olitanArrangements
Metro BLIST
Table 1 Metro BLIST: Demographic and Land Characteristics .....174

Table 2 Metro BLIST: Land Use (in percent) ................................. 175
Table 3 Metro BLIST: Water Demand, 1994-2020 .......................... 177
Table 4 Expected Benefits From and Share in the BLIST
Cooperation .......................................................................... 187
Metro Cebu
Table 1 Metro Cebu: Demographic Characteristics ........................ 195

Table 2 Urbanization Projections for Metro Cebu ......................... 195
Table 3 QuantityofSolidWaste in Cebu City.................................. 197
Table 4 Past and Future Traffic Demand in Metro Cebu,
1979-2010 ............................................................................... 198
Table 5 Water Balance in Metro Cebu (in cu.m/day) .................... 199
Metro Cagayan de Oro
Table 1 Metro Cagayan de Oro: Demographic Characteristics ..... 205

Table 2 Existing Land Uses ............................................................... 207
Table 3 Passenger and CargoTraffic at the CDO-PMO
and Airport ........................................................................... .207
Table 4 Types of Business Establishments ....................................... .208
Table 5 Telephone Situation in Metro Cagayan de Oro .......... ...... 212
Table 6 Water Supply Facilities, 1996 ............................................... 216
Metro Naga
Table 1 Metro Naga: Demographic and Land Characteristics ...... 223

XV
Table 2 Area-Specific Roles in Metro Naga ........ ...................... :..._i. 2_i-i
Table 3 Financial Sources of the MNDC .............. :..,_z...._x: .......... 226
Metro lloilo
Table 1 Metro Iloilo: Population and Land Characteristics .......... 237
Metro Davao
Table 1 Davao City: Basic Demographic and Land

Characteristics ...................................................................... 248
Table 2 General Land Use, 1994 ..................................................... 249
Table 3 Population Distribution, Land Area and Density, 1990... 249
Table 4 General Information on Davao City, Sta. Cruz
and Panabo ........................................................................... 250
Table 5 General Information on Davao Integrated
Development Program ........................................................ 253
Metro Manila
Table 1 Demographic Facts About Metro Manila ........................... 257

Table 2 Gross Domestic Production Structure ............................... 258
Table 3 Regional GDP Per Capita .................................................... 260
Table 4 Poverty Incidence of Families, by Region
and Urbanity, 1985-1997 ...................................................... 261
Table 5 Comparative Overview of Metro Manila
Commission (PD 824), Metro Manila Authority
(EO 392) and Metro Manila Development Authority
(RA 7924) ...................................................................... . ....... 265
Table 6 Comparative Revenue Structure of Metropolitan
Organization .......................................................................... 268
Table 7 Expenditure Pattern of Metropolitan Body. ...................... 274
Table 8 Total General Government Expenditures in
Metro Manila, 1989-1997 ..................................................... 276
Table 9 Traffic Volume on Major Roads, 1980 and 1995
(vehicles/day) ................. ,.................................................... 283
Table 10 Number of Registered Vehicles in Metro Manila,
1980, 1990 and 1995 ............................................................ 283
Table 11 Car Ownership Structure, 1980 and 1996 ......................... 284
Table 12 Public Transportation Supply, Estimated No.
of Operating Units, 1983 and 1996 .................................... 285
Table 13 Transport and Traffic Management in Metro Manila ....... 286
Table 14 Land Use Classification in Metro Manila ........................... 290
xvi
.Case Studies._of_Health ManagemenLS1rategies
Gingoog City's Total Integrated Development Approach (G-TIDA)
Table 1 Mortality and Nutdfion Indicators, 1990 and 1995 .......... 317
Puerto Princesa City's Satellite Clinics
Table 1 Budget for the CHO and Satellite Clinics,

1995-1997 (P million) .......................................................... 328
Table 2 Mortality and Nutrition Indicators, 1990 and 1995 .......... 329
Table 3 Satellite Clinics and Catchment Areas ............................... .330
Table 4 Satellite Clinics' Services and Number of Patients ........... 2,31
Emergency Rescue Naga
Surigao City's PHC Federated Women's Club
Table 1 Mortality and Nmrition Indicators, 1990 and 1995 .......... 348
lVmancing and Delivery of Health

and Sanitation Services in Cotabato City
Table 1 Comparative Mortality Rates, 1990 and 1995 .................... 372
Lapu-lapu City's Partnership for Health
Table 1 Catchment Areas of Hospitals and Barangay

Health Stations in I_apu-lapu City. ..................................... =.378
Table 2 Mortality and Nutrition Indicators, 1990 and 199.5......... 1380
Olongapo: A Health City
Butuan City: A Consistent Regional Outstanding Winner

in Nutrition
Table 1 M0rtalityand Nutrition Indicators, 1990 and 1995 .......... 394

Table 2 Composition of the Butuan City Nutrition Committee....395
Table 3 Malnutrition in Butuan City and in the Philippines ......... 397
xvii
Foreword
ing of the Local Government Code in 1991. This single Act of

ne of the landmark
granting legislations
more autonomy in Philippine history
and responsibilities to our islocal
the pass-
gov-
ernment units has had tremendous impacts on the way governance takes
place at the local level. Perhaps the most significant has been in the
challenge that the Code had incited among local officials and citizens in
coming up with innovative ways to address issues and shortcomings in
their respective spheres.
Of course, the Code--and the accompanying decentralization pro-
cess as a whole--is not without problems, to say the least. The decen-
tralization process was rendered even more complicated by the rapidly
growing urbanization phenomenon that has taken place in the past few
decades and which has impinged heavily on the fiscal condition of the
various localities.
This first volume of a 2-volume publication documents these phe-
nomena-urbanization taking place against the framework of a decen-
tralized environment for governance. The overall picture is a bit bleak
and shows the urgency of resolving the fiscal situation first and fore-
most. But the accompanying snapshots to the bigger picture are encour-
aging. They show that in coping with such situation, the innovativeness
and determination to succeed of a number of local communities shine
through.
This book is about them. In coming up with this volume, there-
fore, I sincerely hope that the winning case illustrations will serve as an
inspiration to more local government units and communities to put their
acts together and aspire to be among the best in their endeavors.
Finally, I wish to thank the Demographic Research and Develop-
ment Foundation (DRDF) through its director, Dr. Corazon P. Raymundo,
for its support of the research project as well as of this two-volume pub-
lication. The writing of the case studies for this volume would also not
have been possible without the assistance provided by the following in-
dividuals and offices in the regions: Ms. Madelyn Escandor of NEDA
Region VII (Central Visayas); the Primary Health Care and Barangay
Environmental and Sanitation Implementation Group (BESIG) mem-
bers of Surigao City; the staff of NEDA Region IV (Southern Tagalog)
and Puerto Princesa City Planning and Development Office and satel-
xix
lite clinic; the staff of the Olongapo City Health Office; Dr. Victor Borja
and the Emergency Rescue Naga/Naga City Hospital staff; the Macro
Division of NEDA Region V (Bicol Region); Dr. Berame, health officer•
• of Lapu-lapu City; and the Cotabato City Office of Health Services.
MARIO B_LAMBERTE, Ph. D.

President, PIDS
xx
Part I. Analyses
Chapter
Fin'lancingand Deliveryof Urban

Services in the Philippines:
An Overview
Rosario G. Manasan
rbanization has certain advantages. Agglomeration economies

esult inhigher productivity than in the rest of the economy.
urbanization proceeds, cities are better able to capture
the benefits from economies of scale, which may bring about
reductions in unit cost of delivering certain types of services. Scale
economies are more likely in public utilities such as sewerage
treatment plants, public transportation, and the like. Urbanization
also induces increases in the taxable capacity of cities such that more
revenues can be mobilized from the same jurisdiction.
However, urbanization also tends to be associated with a good
number of problems. Congestion, which tends to increase with city
size, leads to agglomeration diseconomies that may offset the positive
effects of technological economies of scale on input costs. These
diseconomies may take the form of air and water pollution, increased
need for disease control and fire/police protection, and slum
settlements. Moreover, one observes that basic services such as potable
water supply, solid waste collection, telephones, health and education
facilities are critically inadequate in many large cides.
Worldwide, there have been two types of responses to these
problems. One way is to impose controls on rural-urban migration
and rapid population growth. The other way is to find efficient ways
to manage and finance the urban sector.
This paper takes the accomodationist view and focuses on the
question of how to finance and deliver adequate public services in
urban areas. This question then becomes, in large part, a fiscal
question. However, it cannot be denied that improvements in resource
allocation and in service delivery mechanisms/arrangements at the
local government level are also extremely important.
4 Managing UrbanizationUnder a DecentralizedGovernance Framework
The immediate cause of the shortage and, sometimes near

absence, of basic public services in large cities is the inability of
governments to fund the delivery of the right quantity and quality of
these services. At the national level, central governments may be so
preoccupied with stabilization issues and the need to deal with the
problem of large central government fiscal deficits to have enough
time and resources to address unmet needs in the urban sector.
Moreover, central governments may not be in the best position to
levy and/or collect taxes and user charges that are suitable at
mobilizing public resources from the growth in urban fiscal capacity.
At the local level, the growth of local government revenues may be
dampened by centrally imposed constraints on their revenue-raising
powers, and limited by low revenue effort and inappropriate
intergovernmental fiscal relations.
How can cities and other urban areas capture the fiscal benefits
of urbanization so that they can then increase supply of public services
in their respective jurisdiction? For this to happen, cities should be
empowered to levy and collect taxes and fees that can better exploit
thei r gains from urbanization. There should be no disincentives arising
from the grant system against improvements of local government
revenue effort. Also, there should be appropriate credit institutions
and mechanisms that will enable subnational governments to finance
investments of a relatively large scale.
In the conduct of any study on urban management, one is always
confronted with the difficulties of delineating which are "urban areas."
This study tried to resolve this issue by defining its coverage to include
all cities plus non-city regional growth centers? This decision was borne
more out of convenience than out of rigorous analysis. Admittedly,
some cities will not qualify as "urban" under most definitions. However,
this option is a a convenient way of categorizing most urban areas
without getting bogged down by the definition problem. Also, the
focus on city local government units (CLGUs) is motivated by a desire
to study urbanization in the context of the more decentralized
governance framework that is engendered with the passage of the
Local Government Code (LGC) of 1991. Note that the fiscal gap (the
di_rence between expenditure requirements/needs and revenues)
of urban LGUs tend to be magnified by the recent devolution of
fianctions from national government agencies.
1The municipal regional g_ovcth centers included in this study ate Santiago in Isabela, San Feriaando
in La Un_-on, _ad S',m P'e_nando in Pampanga,
Financingand Deliveryof Urban Services S
In the next section, the conceptual framework that defines the

urban fiscal gap problem is presented. Meanwhile, the section
"Revenue Structure of Cities" presents an overview of the expenditure
and revenue structure of CLGUs in the Philippines. It provides some
overall perspective on the size of the urban sector. The section "The
Urban Fiscal Problem" looks at the determinants of CLGU revenue
performance and expenditure behavior in an attempt to validate the
existence of the urban fiscal gap in the Philippines while "Closing the
Urban Fiscal Gap" presents some ways to close the said gap.
Urbanization vi_-vis Expenditures and Revenues 2

Local government units (LGUs) in urban areas typically tace a
financing problem. The problem may be defined by the existence of
a "fiscal gap," a gap between perceived service needs and available
financial resources. It should be notedthat the fiscal gap is different
from the actual fiscal deficit that reflects the shortfall of actual revenue
collections relative to actual LGU expenditure. This distinction is very
important in the Philippine context where LGUs are not allowed to
engage in deficit financing of recurrent expenditures.
To gain some understanding of how urbanization impacts on
the fiscal gap, it helps to look at how urbanization and population
growth affect the expenditure requirements as well as the revenue
collections of urban LGUs. On the one hand, the growth in the
demand for public services is most often driven by the growth in
population. The growth in population may arise from its natural
growth and from migration. Some would argue that LGU expenditures
have to increase at a rate that is at least proportional to the rate of
population growth so as to sustain a given level of service. In cases
where service provision entails increasing marginal cost, the response
of expenditure needs to population growth is even more pronounced.
This may be relevant, for instance, when rapid rural-urban migration
tends to lead migrants to settle in hard-to-service (and, therefore,
cosily-to-service) areas like shorelines, mountainsides and floodplains.
The strong and positive correlation between urbanization and
per capita personal income in developing countries is well
documented. At the same time, higher per capita income tends to be
associated with higher per capita demand for public services (which
implies that most types of public services are normal goods). The
2This section draws heavily from the work of Bahl and Lima (1992).
6 ManagingUrbanizationUnder a DecentralizedGovernanceFramework
increment in service requirements would be larger as the income

elasticity of demand for public services goes up. Positive income
elasticities have been observed for water/power supply, telephone
services, and for solid waste disposal and also urban highway
infrastructure (because the demand for motor vehicles is highly
income-elastic). Similarly, the demands for educational services and
health care are positively linked with rising incomes.
While it is clear that urbanization exerts an upward pressure on
local government budgets, it is unclear ifLGU revenues will respond
as quickly and as strongly to rapid population growth. Undoubtedly,
population growth, urbanization and the associated growth in per
capita income all tend to expand the revenue capacity of urban
governments. However, the growth in LGU revenue is held back by
the fimited taxing authority of LGUs and their lagging revenue efforts.
For instance, while property values tend to rise with urbanization,
this is not immediately reflected in the statutory tax base unless
assessment values are automatically indexed.
Also, inflation is usually higher in larger cities. However,
government expenditures are more automatically responsive to
inflation than government revenues. Inflation will drive up
government spending requirements almost instantaneously because
of a hike inthe cost of materials and supplies and of the pressure to"
increase government employees' salaries following the associated
escalation in the cost of living. The LGU revenues are not as responsive
to inflation. This is because in many places, there is no automatic
indexation of the assessed values of real property for real property
tax purposes. Moreover, many local taxes are imposed on a specific
rather than on an ad valorem basis.
The evidence on the relation between city size and cost recovery
is mixed. On the one hand, some large cities (especially those which
operate public business enterprises) are able to fully recover the cost
of service delivery and they may sometimes even generate a surplus.
Some countries like South Korea and Colombia impose betterment
levies (or special assessment) in order to charge alt_cted landowners
for the benefits they get from certain improvements in infrastructure.
On the other hand, it may be difficult to genei_tte enough revenue
from user charges to cover full costs from services like transportation,
housing, health and education, which have a large social component.
Lastly, the relationship between intergovernmental grants and
urbanization can either be inverse or direct. "If grants are distributed
on a straight per capita basis then urbanization may generate an
Financingand Deliveryof Urban Services 7
increased inflow of"external resources. The same will hold if grants

are made on a cost reimbursement basis. External resource flows may
increase or decrease in responseto increases in per capita personal
income in the city depending on the structure of the grant system. A
tax-sharing scheme will channel more funds to local governments as
urbanization proceeds, whereas formula-equalizing grants may have
just the opposite effect" (Bahl and Linn 1992).
Revenue and Expenditure Structures of Cities
Revenue structure
All LGUs, in the aggregate, accounted for 4.9 percent of total
general government revenue in 1985-1991 and 5.7 percent in 1992-
1996 (Figure 1). Thus, the degree of fiscal decentralization when
measured in terms of revenue decentralization has not been altered
significantly by the passage of the LGC.
In comparison, the share of CLGUs in the country's total general
government revenue rose significantly from 2.1 percent in 1985-1991
to 2.9 percent in 1992-1996. In a sense, the increment in the share of
all LGUs in total general government revenues is due solely to the
increase in the share of CLGUs. Moreover, CLGUs' share in the total
local source revenue of all subnational governments has expanded
from 43.0 percent to 50.2 percent during the period under study.
Nonetheless, there appears to be a trend toward increasing
reliance on external sources of finance among CLGUs. The
contribution of externally Sourced income to the total receipts of
CLGUs was magnified, reaching 52.0 percent in 1992-1996 from 38.6
Figure 1. Share of CLGUs in Total General Government Revenue
ALL LGUs CLGUs ALL LGUs CLGUs

4.9% 2.1% 5.7% 2.9%
1985;_1991 1992-1996
8 Managing Urbanization Under a DecentralizedGovernance Framework
Figure 2. Share of Externally Sourced Income in Total Receipts of LGUs

externally
sourced externally
income sourced
38.6% income
52%
1985-1991 1992-1996
ALL LGUs
externally
externally Sourced
sourced
64,7%
62%
1985-I 991 I gg2-1996
Figure 3. Revenue Performance of CLGUs

TOTA,,oc._
sou_l. P_ o_ 0.25.................................
GNP
0.2
0.16
_ 0,1
I 1935-1991 1992-1996 1985-1991 1992.1996
percent in 1985-1991. However, CLGUs continue to be less reliant

on external sources of finance relative to the average LGU, where
the share of externally sourced income to total receipts rose from
52.0 percent to 64.7 percent (Figure 2).
Despite these developments, the overall revenue performance
of CLGUs was noteworthy during the period under study. Total local
source revenue rose from 0.34 percent of gross national product
(GNP) in 1985-1991 to 0.55 percent of GNP in 1992-1996 (Figure 3).
Thus, per capita local source revenue of CLGUs grew at a decent
pace of 11.4 percent in 1991-1996 compared with the 8.9 percent
Financingand Delivery of Urban Services 9
growth of local source revenues of the average LGU during the same
period and the 2.4 percent growth in CLGU local source revenue in
1985-1991.
The biggest increase was posted by local business taxes, which
doubled from 0.11 percent of GNP to 0.22 percent of GNE This was
followed by real property taxes, which increased from 0.14 percent
of GNP to 0.21 percent of GNE However, operating income of CLGUs
remained steady at about 0.1 percent of GNE Consequently, the local
business tax came to dominate the real property tax after the
implementation of the LGC.
F__enditure structure
In the Philippines, the LGUs as a whole contributed 7.0 percent
of total general government expenditure in 1985-1991 and 14.0
percent in 1992-1996 (Figure 4). This implies that the degree of fiscal
decentralization, when measured in terms of expenditure
decentralization, has doubled in the post-LGC era. The latter figure
is roughly equal to the 15 percent share of subnational governments
in general government expenditure in a sample of less developed
countries (Bahl and Nath 1986).
Figure 4. Share of CLGUs in Total General Expenditure

ALl. LGU CLGU
N.I. _ 7,0 3.5 CLGU 14,01 7.4
19_5-1SSl lSg2-1_6
In like manner, the share of CLGUs in total general government

expenditures in the country doubled from 3.5 percent in 1985-1991
to 7.4 percent in 1992-1996 (Figure 4). Thus, CLGUs' share in the
total expenditure of all subnational governments has remained fairly
stable at approximately 50 percent throughout the period under study
even as their jurisdictions include 25.5 percent of total population
and 6.0 percent of total land area (Figure 5).
12 Managing UrbanizationUnder a DecentralizedGovernanceFramework
growth and/or urbanization, the urban fiscal gap still exists (find is
manifested in reduced levels of public service delivery). This may have
arisen because other sources of CLGU finance (which account for
some 75 percent of total CLGU receipts) do not exhibit a similar
relationship with either population growth or degree of urbanization.
It is also worrisome that the present IRA distribution formula
tends to have a disincentive effect on local business tax effort. Also,
CLGUs have an apparent disregard for cost recovery practices.
Ironically, the experience elsewhere in the world suggests that this is
in fact one area where urban governments are better able to generate
additional revenue as urbanization proceeds.
On the expenditure side, we found that relative gainers in the
devolution process allocated higher IRA at the margin on education
and economic services but not on health services. This implies that
the provision of health services is not a priority sector for most CLGUs.
Determinants of revenue performance of CLGUs

This study assessed the determinants of CLGUs revenue
performance in 1991-1995. The LGUs' revcnuc performance was
measured in terms of per capita total LGU income and two
components of per capita locally generated revenues: per capita local
business tax revenue (PCLBT) and per capita real property tax
revenue (PCRPT). Per capita LGU revenue is then regressed against
the variables listed below for each of the years 1991, 1993, 1994 and
1995.
1. Per capita personal income (PCPY) is used as a proxy for the

taxable base of the CLGU.
2. Per capita IRA (PCIRA) is included as one of the major
determinants of CLGU tax effort to assess whether central
government transfers to CLGUs suhstitute for locally
generated taxes. On the one hand, there is concern among
some policy analysts that intergovernmental grants may
provide a disincentive to local resource mobilization efforts.
On the other hand, others argue that central government
transfers may stimulate LGUs to increase local revenue
generation because such grants allow LGUs to breach the
threshold income associated with the provision of more and
higher quafity services, in this case, higher allotments from
the central government may encourage LGUs to generate
Financingand Delivery of Urban Services ] 3
more revenues locally to complement what they receive from

the center.
3. Degree of urbanization (URB). Earlier studies have shown that
LGU revenue performance is determined by the economic
base as well as other economic variables that indicate the
overall level of development like the degree of urbanization
(Bahl and Schroeder 1983). In these studies, a high degree
of urbanization is hypothesized to allow LGUs to derive more
revenue from agiven economic base because tax collection is
less difficult when the informal sector is relatively smaller in
more urbanized areas. Relatedly, urbanization is associated
with the expansion of market-based activities that are easier
to reach tax-wise.
4. Population growth rate.(POPGR) is yet another proxy for changes
in the economic base.
Two alternative functional specifications were tried: linear and

double logarithmic. The results of the double logarithmic equations
are largely consistent with those of the linear equations in terms of
the signs of coefficients and their statistical significance but the linear
form was found to have a better fit.
White's (1980) test was used to detect heteroscedasticity. This
test is deemed to be important considering that the regressions were
run using cross-section data. The test is based on the regression of
the squared residuals from the original regression on the original set
of explanatory variables plus the squares of said variables. Where
heteroscedasticity was present, the procedure suggested by White was
used to correct the standard errors and t-statistics.
Per capita local business tax revenue

The results presented in Table 1 show that per capita local
business tax revenue is, as expected, positively related with per capita
personal income. The relationship is not statistically significant for
all years under study except in 1995. Moreover, the relationship is
weak because the increase in PCLBT is estimated to be P0.26 at the
maximum for every P100 increase in PCPZ. This may be indicative of
the LGCs' inability to fully capture the revenue potential of their
economic base.
At the same time, PCLBT is found to be negatively related with
PCIRA. Unlike in 1991 and 1993, the relationship was found to be
14 Managing Urbanization Under a Decentralized Governance Framework
Table 1. Linear Regression of Per Capita Tax ]Revenue of CLGUs

INDEPENDENT VARIABLE
DEPENDENT Constant PCPY PCIRA URB POPGR R2 White
VARIABLE Chi-Square
PCLBT
1991 -4.143 0.001 -0.040 0.620 0.619 0.522 2.483"

(-0.293) (1.004) (-1.449) (4.162)" (0.310)
1993 q.030 0.001 -0.148 0.760 2.339 0.441 2.394"

(-0.059) (1.013) (-1.532) (2.896)- (0.657)
1994 14.898 0.002 -0.030 0.609 5.833 0.459 1.986"

(0.604) (1.610) (-3.055) °" (2.271)" (1.446)
1995 15.172 0.003 -0.034 0,748 7.418 0.477 2.596"

(0.515) (1_664)* (-2.765)'" (2.343)'" (1,552)
PCRPT
1991 -1.480 0.006 _).039 0.032 7.269 0.247 2.147"
(-0,048) (2.123)* (-0.742) (0.068) (1.108)
1993 7.606 0.005 0.020 0.078 0.876 0.098 0.257

(0.149) (1.952)* (0.794) (0.170) (0.106)
1994 -23.915 0.005 0.045 -0.111 18.830 0.120 2.646"

(-0.326) (1.332) (1.198) (-0.140) (1.709)"
1995 -17,000 0.005 0.007 0.076 21.458 0.142 2.740""

(-0.200) (1.741)" (0.163) (0.089) (1,936)"
PCLGUY
1991 1802.223 0.003 1.172 1.465 -1740.106 0.429 1.575
(1.330) (1.220) (6.549) "" (1.796)" (-1.295)
1993 630.444 0.009 1.134 2.987 -731.572 0.851 3.406""

(0.461) (1.633)* (20.288)" (2.954)*" (-0.539)
1,994 20.638 0.026 0.859 1.197 88.274 0.625 8.082'*

(0.008) (2.112)' (8.765)'" (0.077) (0.035)
1995-2241.926 0.021 0.935 2.583 2320.627 0.432 8.068"

(-0.667) (1.068) (7.185)" (0.866) (0.695)
"Statistically significant at 5%.

*"Statistically significant at 1%,
Note: Numbers in parenthesis refer to t-values. When the White ehi-square is significant, the
t-values are derived from White chi-square heteroskedastieity-consistent covarianee matrix.
Financingand Deliveryof Urban Services |5
statistically significant for 1994 and 1995. The coefficients for PCIRA
indicate that an increase of PI00 in PCIRA results in a P3.01-P3.36
reduction in PCLBT, other things being equal. These suggest that
while intergovernmental transfers had a neutral effect on local
business tax effort prior to the implementation of the LGC, CLGUs
tended to substitute central government grants for local business taxes
with the LGC's implementation.
Lastly, the PCLBT of CLGUs exhibits a positive and significant
relationship with the degree of urbanization in all years under study.
In contrast, the coefficients for population growth rate yield negadve
signs but are not statistically significant. These suggest that CLGUs
are able to capture part of the fiscal benefits of urbanizadon and
population growth.
Per capita real proper_ tax revenue

In contrast, PCIRA appears to have a neutral effect on per capita
real property tax revenue in all years under study. While the
coefficients for PCIRA are positive, they are not statistically significant.
Again, PCPY has a positive and significant link with PCRPT (except
in 1994). The relationship is slightly stronger than that of the PCLBT.
A P100 increase in PCPY results in a P0.48-P0.55 increase in PCRPT.
The coefficients for population growth rate have positive signs
and they are significant in 1994 and 1995. However, while the
coefficients for degree of urbanization are also positive, they are not
significant. Apparendy, CLGUs' real property tax systems have not
been able to fully capture the positive effects on land values that
urbanization usually entail.
Per capita CLGU total income

Per capita LGU total income (PCLGUY) is found to be largely
driven by increases in per capita IRA. This is expected given that the
IRA accounts for approximately half of the total CLGU income during
the period. The regression results also confirm expectations that
PCLGUY is positively and significantly associated with per capita
personal income. This was the case in 1993 and 1994. However, on
the whole, both the urbanization and the population growth rate
variables are not found to be statistically significant explanatory
variables for PCLGUY (with the exception of the 1991 and 1993
equations, where the coefficient for degree of urbanization is found
to be positive and statisticaUy significant).
This study also assessed the performance of CLGUs in

recovering the costs of provision of certain types of service through
user charges. Specifically, cost recovery in the provision of public
utilities (like waterworks, power supply, and telephone services) and
of general urban services like markets and slaughterhouses was
studied.
Table 2 indicates that, in the aggregate, CLGUs' cost recovery
ratios (i.e., revenue-to-expenditure ratio) in the activities enumerated
above were consistently below unity in 1991-1995.3 Moreover, contrary
to the experience in other countries, the cost recovery ratios of
CLGUs are even lower than those of the average LGU.
For instance, the 1995 data showed that none of the 20 CLGUs
providing water supply services had a cost recovery ratio greater than
unity. Moreover, it appears that only four of these CLGUs were
charging for water (Table 3).
The CLGU cost recovery performance in markets and slaugh-
terhouses was relatively better but still problematic. Only nine out of
42 CLGUs were able to fully recover the recurrent operating cost of
their public markets while only five out of 24 CLGUs (or 21 percent)
were similarly situated with regard to slaughterhouses (Table 3).
Lastly, the hospital revenue-to-hospital expenditure ratio of
CLGUs in 1995 varies from a low of 0 to a high of 36 percent (for
Olongapo City). Moreover, seven out of 17 CLGUs in the sample
posted ratios higher than the 11 percent average for all CLGUs. This
result is not quite expected because many LGUs regard hospital care
services as a public good that should be given free of charge (Table
4).
Determinants of CLGU expenditures

To study the determinants of the expenditures of CLGUs, total
per capita I, GU expenditures (PCTLGUEXP) and per capita
expenditures on economic services (PCECON), health services
(PCHE) and education (PCED) were regressed against the variables
listed below.
1. LGU Income. Obviously, LGU expenditure will be limited by

LGU income because of the budget constraint. By tradition,
sI-Iere, we limited our analysis to recovery of recurrent costs only because of data
inaccessibility for capital costs.
FinancinganODeliveryof Urban Services !7
Table 2. Ratio of Revenue to Expenditure from LGU Business

Enterprises, 1991-1995
All LGUs CITIES
1991 |992 1993 1994 1995 1991 1992 1995 1994 1995
Total Pubfic 53,66 97.33 90.55 78.61 68.02 49,71 90.01 78,86 77,00 68.06
Enterprise
Waterworks System 72.95 48.18 55.69 54.72 72.06 83.00 42.59 36.f_
Electric Light 69,28 84.56 78.27 86.76 18.42 92.59 93,75 94,01
& Power
Telephone System 94,72 98,55 227.04 151.84 37.78 0.27
Transportation 16.02 10,70 59.77 $.66 6.87 0,84 3.06 1.48

system
Operation of Market 119.09 109.23 106.71 75150 66.12 118.12 92.19 97.07 76.94 71.73
Opelation of
Slaughterhous_ 197.61 165.69111A2 83.97 227.39 156.28 85,31 77._
Operations of Toll
Roads,Bridges&
Ferries 1.76 14.25 _9._ 38,02 32.47 2.52 11_,83 3,380.90 425,02 534.59
Operation of 184.10 94.75 177.00 126.12 90._ 453,26 299.79 263.40 404.87 180.37
Cemeteries
Source of data: AFR 1991-1996,
Philippine LGUs do not finance recurrent expenditures by

issuing debt. In the analysis that was done for this study, two
major components of LGU income (per capita IRA [PCIRA]
and per capita local source revenue [PCLSR]) were considered
as distinct explanatory variables. Itis important to distinguish
between these two variables so as to evaluate the impact of
intergovernmental transfers on CLGU spending.
2. Net Resource Transfer as a Result of the LGC While the increase
in the IRA (as a result of the implementation of the 1991 Local
Government Code) is sufficient to cover the cost of devolved
functions in the aggregate, it cannot be denied that there is a
mismatch, between the financial resources and the
expenditure responsibilities that were transferred to LGUs.
Thus, the increase in the IRA share of some LGUs is not
enough to finance the functions devolved to them. 4 Although
only a few CLGUs had negative per capita net resource transfer
in 1993 and 1994, there is considerable variation in said
erhc IRA increment in 1991 is defined as the difference between the 1993 IRA and the
1992 IRA. The IRA increment in 1994 is analogously computed.
18 Managing Urbanization Under a Decentralized Governance Framework -. -
Table 3.Ratio of Revenue to Expenditure from LGU'Business Enterprises

of Selected CLGUs, 1995
RATIOOF INCOMETO EXPENDITUI_(%)
N_a_ae of Cities Water Markets Slaughterhouse Transport
Laoag, Ilocos Norte 93,31 116.42

Dagupan, Pangasinan 96.26 336.68
San Carlos, Pangasinan
Baguio, Benguit
Santiago, Isabela 99.32 12.75
Cabanatuan, Nueva Ecija 65.70 46.69 0.00
Palayan, Nueva Ecija
San Jose, Ecija 150.38
Angeles, Pampanga 54.68 120.77 0.0O
Olongapo, Zambales 14.68
Batangas, Batangas 106.98 0.00
Lipa, Batangas 114,03
Gavite, Cavite 201.82
Tagaytay, Cavite 99.92 216.71
San Pablo, Laguna 149.96 38.05
Lucena, Quezon 270.25 81.17 0.00
Legazpi, Albay 59.96
Iriga, Camarines Sur 98.27 84.22
Nag'a, Camarines Sur 0.00 100.66 84.10
Roxas, Capiz 77.94 30.46
Uoilo, Iloilo 0.00 96.29
Baeolod, Negros 0.00 40A7
Bago, Negros Oct. 8.55
Cadiz, Negros Oct. 0.00 77.06
La Carlota, Negros 58_35
San Carlos, Negros Oce.
Silay, Negros Occ. 0.00 18.41
Tagbilaran, Bohol
Danao, Cebu 27.60 69.41 97.41
Lapulapu, Cebu 0.00 44.65
Mandaue, Cebu 0.00 63.01 72.90 155.42
Toledo, Cebu 21.54 37.04 3._.46
Bais, Negros Oriental
Dumaguete, Negros Oriental
Ormoe, Leyte 38,24 65.66
Tacloban, Leyte 0.00 19.43 0.00 0.00
Calbayog, Western Samar 0.00 21.95
Dapitan, ?_amb_Del Norte 0.00 17.96 30.26 0.00
Dipolog, Zamb. Del Norte O.00 0.00 O.00 0.00
Pagadian, Zamb. Del Sur
Zamboanga, Zam. Del Sur 0.00 55.88 53.27
Ozamis, Misamis Occ.
Tangub, Misamis Occ. 214.10
Cagayan de Oro, Misamis Or. 0.00 38.44
Surigao, Surigao Del Norte 0.00 68.66 98.81 0.00
Davao, Davao Del Sur 29.26 15.17 0.00
General Santos, S. Cotabato 0.00 93.51 136.73 384.13
Iligan, Lanao Del Notre 30.97 63.48 2.03
Marawi, North Cotabato 28.16
Cotabato, N. Cotabato 0.00 34.49 15.89 0.0O
C_oocar_
Pasay 131.83
Q_ezon 2.42
No. of dries w/ratio > 100 0 out of 20 9 out of 42 5 out of 24 2 out of 12
Percentage to Total No. 0 21.43 20.83 16.67
Financingand Deliveryof UrbanServices 19
Table 4. Total Cost Recovery of Hospitals, 1995

..... Hospitals
ul ir Name dCilies ulli Income Ex/_ndit_..,.
Ratio
(%)
Laoag, Ilocos Norm 156,828.00 2,6'29,419.25 5.96

Cahanatuan,Nueva Ecija 1,332,862.00 17,023,515.28 7.83
Angeles,Pampanga 5,19'2,2_8.95 21,294,692.23 24.38
Olongapo'/am_cs 6,650,576.88 18,439,639.32 36.07
Cavite,C__ite 0.00 904,259.40 0.00
San Patio, Laguna 0.00 3,000,000.00 0.00
Naga, CamarinesSur 1,554,701.98 7,828,976._2 19.86
Bag_ NeglOSOct. 994,943.60 5,262,267.73 18.91
Toledo, Cebu 626,989.21 9,700,013.91 6.46
Onnoc, Leyte 0.00 989,567.05 0.00
Tadohan, Leyte 1,425,510.81 6,507,776.27 21.90
Pagadian, 7_rnK Del Sur 46,380.27 1,581,451.01 2.55
Ommis, Misamis Occ. 1,165,910.83 7,868,676.15 14.82
Cagayande Oro"Misanfis Or. 2,805,178.40 26,728,446.48 10.50
lligan, Lanao DelNorm 2,865,949.62 21,650,876.09 13.24
Caio(rm_ 652,647.16 12,298,011.2'2 5.31
Pasay 1,915,413.85 18,103,726.19 10.58
All Oties 71,219,000.00 623,173,000.00 11.43
All LGUs i
L_31,986,000.00 2,783,245,000.00 10.46
variable across individual CLGUs. s A dummy variable, D1,

(which takes on the value of 1 when the per capita net resource
transfer to the CLGU is above the median and 0 otherwise)
was thus includedas one of the explanatory variables in the
regression analysis. This variable was induded to verify whether
the budget allocation behavior of the relative gainers from
the devolution program differ significantly from that of the
relative losers.
3. Human Development Index. The analysis also tested whether or
not lagged (or contemporaneous) values of the composite
human development index (HDI) and its various components
(life expectancy [LE] and functional literacy rate [FLR])
influence the budget allocation of CLGUs for the social sectors
in the current year. This is an attempt to determine if CLGUs'
5 The net resource transfer is defined as the difference between, the IRA increment and
the cost of devol_d functions.
spending on the social sectors is responsive to objective

indicators of need. In the 1993 equations, 1990 HDI values
were used while 1994 HDI values were used in the 1994 and
1995 regressions.
4. Population Growth Bate (POPGR). The growth in the demand
for public services is most often associated with population
growth. A prior/, it is expected that LGU expenditures grow
more or less proportionately with respect to population so as
to maintain a constant level of service.
5. Degree of Urbanization (URB). A strong and positive relation
between urbanization and per capita personal income is well
established (Bahl and Linn 1992). At the same time, rising
per capita personal income would tend to lead to an increase
in the demand for public services if such demand is income-
elastic.
6. Dummy Variables for the Presence of CityProvincialRegional
Hospital Within CLGU Jurisdicfion. Three additional dummy
variables were introduced. D2 takes on the value of 1 if the
CLGU operates its own hospital and is set at zero otherwise.
On the other hand, D3 is given a value of 1 if there is a
provincial government-operated hospital while D4 takes on
the value of 1 if there is a Department of Health (DOH)-
operated hospital within the city.
Given the high cost of operating hospitals, the presence
of city-operated hospitals is expected to impact significantly
on per capita CLGU health expenditures. On the other hand,
since most of the patients of province-operated and DOH-
operated hospitals located within a given city are typically
residents of the said city, their presence usually implies an
effective subsidy to the city in the form of lower health
spending requirements (Capuno and Solon 1996).
Again, two alternative functions specifications were tried: linear

and double logarithmic. The results of double logarithmic equations
are largely consistent with those of the linear equations in terms of
signs and significance of the coefficients. Generally, the linear
specifications werefound to have better fit. White's (1980) test was
again used to detect heteroscedasticity and White's correction was
implemented where needed.
Per capita total LGU expenditure

In all years, a strong,positive and significant link is established
between per capita LGU total expenditure and per Capita IRA.
However, while there appears to be some evidence that relative net
•gainers from the devolution process tend to have different marginal
propensities to spend out of the IRA comparedwith relative net losers,
the coefficient of the Dl*PCIRAvariable switches sign from negative
in 1994 to positive in 1995. 8
The results of the expenditure regressions presented in Table
5 show that the degree of urbanization and PCLGUEXP are negatively
and significantly related in 1995. In the other years, the sign of the
coefficient of the urbanization variable is positive but not significant
(except in 1994). These results tend to show that while CLGUs were
able to adjust their aggregate expenditure level in line with the
increasing demands of urbanization in 1991-1994 (when the IRA share
of LGUs increased substandaUy following the implementation of the
Local Government Code, they were largely unable to do the same in
1995 (when the increase in IRA share of LGUs have started to taper).
In contrast, the population growth rate variable did not turn
out to be a good explanatory variable for all years under the study.
Per capita health expenditures

The analysis reveals that the population growth rate is negatively
and significantly associated with per capita health expenditures
(PCHE) for all years except 1991. Similarly, the coefficients of the
urbanization variable are also negative and statistically significant in
1994 and 1995.
The negative sign of the POPGR and URB variables is contrary
to initial expectations. However, it is possible that actual CLGU per
capita health expenditures (as opposed to required level) will decline
with higher population growth rates and higher degree of
urbanization as their revenues do not increase accordingly. This is so
because Philippine LGUs are generally unable to go into deficit
finance. Consequently, these results might be an indication of the
urban fiscal gap problem.
However, CLGUs that operate their own hospitals tend, as
expected, to spend more on health on a per capita basis compared
with other CLGUs. This is manifested by the positive and highly
°Note that IRA share of LGUs of BIR revenues rose from 11 percent in 1991 to 20 percent in
1992, 25 percent in 1993 and 40 percent from 1994 onward.
significant relationship between D2 and PCHE. However, our results

do not suggest that the presence of province-operated or DOH-
operated hospitals within city premises leads to a reduction in per
capita health expenditures of the host cities.
The coefficients for PCIRA have the expected signs but are not
significant in 1994 and 1995. Moreover, while the coefficients of the
DI*PCIRA variable are negative in the PCHE regressions 7, they are
not significant except in 1993. This is in sharp contrast with the results
of similar regressions made for provincial governments. The
difference may be because only one of the CLGUs was a net loser in
the devolution process in an absolute sense.
Similarly, there is no strong link between per capita local source
revenue and PCHE. While the coeffÉcients of the PCLSR variable are
positive, they are not significant except in 1995.
It is noted that while CLGU allocations on the health sector are
consistent with health need indicators like life expectancy (i.e., with
high life expectancy-CLGUs budgeting less for health services), the
relationship between these variables is not statistically significant
except in 1994.
The coefficients of POPGRin the PCED equations have negative

signs as in the PCHE equations. However, these coefficients are not
statistically significant. The same result holds for the URB variable.
All these lend some support to the existence of an urban fiscal gap.
The DI*PCIRA and the PCIRA are the only statistically
significant explanatory variable in the PCED regressions, s The sign
of the coefficient of the Dl*PCIRAvariable is positive indicating that
relative net gainers in the devolution process tend to allocate their
windfall resources to the education sector. However, the negative sign
of the coefficient of the PCIRA variable suggests that on the whole,
per capita education expenditure of CLGUs tend to fall with higher
per capita IRA.
Per capita local source revenue does not appear to be a good
explanatory variable for PCED; Its coefficients in the PCED regressions
are not significant except in 1991.
_'he negative relationship between D I*PCIRA and PCHE indicates that relative net gainers in
the devolution process tend to spend less on health at the margin compared with the relative
net losers.
SThe D I*PCIRA is significant in 1993 and 1995 while the PCIRA is significant in 1991 and 1994,
Table 5. l.lnear Regression of Per Capita Expenditure of ClaUs
D_ C__mnm¢ Per Cq_a DI* Per Per Capita POPGR URB FLR LE D2 D3 D4 R2 W_te 5'
vARiam _. IRA C_mA _ Sam_me " _ mI
=
_re O.
Tolal Eeenemic
1991 -730.049 .0.0_5 4).o80 277.4_ 006.139 .0,039 i_ =_

(.o.8c_) (.0.._1) (.1.2os) (o.sso) (.0.8oa)" Q-
199,$ -1184,642 (0.0131 0,254 0.014 1454.827 .0.018 0.269 0.620
(-o.421) -0.105 (2.7a0) "" (o.o66) (.529) (-2.100)
19o_ 1007.693 -0.0a4 0.188 -0.1,,8 -`513.475 .0.005 0.270 0.4s4 --
(0.,1401 (-0.._0) 0.1591 "" (-1._531 (-0.2251 (.o.cm) _"
1995 1250.176 .0.028 0.170 -0.020 -789A13 .0.005 0,256 0.523 ,_
(0.5311 (-0.474) (3.082) "" (-0.259) (-0.:_t8} (.0.fi34}
1991 188.804 0.941 0.075 -169.439 0.096 .0.196 25.707" -8.072 -2A06 0.573 0.815 Q_
(1.073) (1.7111" (3.,................._0)"
(-1.0751 (1.0801 (.0.2121 (4.6101 (-1.374) (-.0.580) _.
1993 858.$92 0.052 -0.040 0.030 -779.080 .0.257 -0.320 21.113" 3.188 s.3880,300 0.514 m
(i.84_) (1.900)" (-2.310)" (1._51 (-2.2¢81" (-l._Jo) (-0.1_) (2.sos) (o._<Jo) (o.275) -_
1094 1081.007 0.012 0,006 0.034 -1188.585 -0.0`51 -5.314 49.690"- -'26.586 -0.288 0.631 0.460
1995 (2_8_) (0000700

_ (.0,_$21
.0.014 (IA59)
0.073 (-2.936)"(-2,2591"
.1959,870 .0.735 (-I.826)
.2.689 (3.920)
25.445 (-1.810)"
8.692 (.0.369)
12.738 0.313 1,195 0')
(2.430) (0.220) (-0,5611 (1.9021 (-2.6041'(.I,7251 (-0,509)(1.148) (0.528) (0.495) _-
_n E_acndiem,
e
1901 300.593 0.0_ 0.071 -348,517 0.674" 0,_09 2.655
°°
(1 .g_o) • (1.7¢s) (3.41_)" (-2.o_)" (2._21
1995 492.210 .0.076 0.087 0.008 .172.7t7 -2.02_ 0.370 0.359
(0.749) (-0.759) (2.094)" (0.177) (-0312) (-1.054)
1994 -20.821 .0.044 0.023 0.0_ 39.411 0.726 0,109 2.486"
(-0.046) (-2.065)" (1,113) (.855) (0.09,5) (0.424)
1995 792.943 -0.033 0.175 -0.009 -518,690 -1.609 0513 0.115
(0.783) (-o.913) (2.9211 "" (.0.1`57) (.0.565) (.0._631
LI;U_
1991 1771.253 1.0_5 0._03 -t696.750 1.113 0.199 0.$01
(0.763) (3.319) "" (1.2701 (.0.73_) (0.768)
1995 -1181.542 0.842 0.044 0.686 1006.102 2._¢/ 0.615 1.123
(.0.37S) (7.345) "" (0.404-) (2.7'20)" (OAV2_) (1.157)"
199_ _17.025 i.o37 .0.1o_ .0,068 -s_4._4 5.45o o,7_5 2.7_'.
(1..5021 (10.2801 "" (-1.6531" (-1.OOO) (-1Ar_) (1.o._71=
199_ -s4.soo -o._3 o.._1 .o.o4o 2162._4 -lo.9o3 o.3os 2.sa_-,
(-0.o17) (-2._8o)" (2.7o2) "" (-o.101) (o.4_) (-3.oo_)
•Statistically significant at 5%,
"Statistically s_gr_icant at 1%,
Note: Numbers in pa_nthesis refer to t-values. When the White chi-square is significant, the t-values are derived from White chi-squarc heteroskedaslicity
consistertt to covariance matrix, UJ
" " on economic services

The DI*PCIRA variable is the only variable that is consistently
significant in the PCECON regressions. Similar to the PCED equations,
the sign of the DI*PCIRA coefficients is positive, suggesting that
relative net gainers in the devolution process tend to allocate a larger
portion of their IRA on economic services compared with relative
losers.
The coefficients of the POPGR and the URB variables are both
negative tending to support the urban fiscal gap hypothesis. However,
they are not statistically significant.
At the same time, both the PCIRA and the PCLSR do not register
statistically significant relationships with PCECON.
Closing the Urban Fiscal Gap

The problem of the urban fiscal gap can, in principle, be
addressed in four different ways: (1) increased local revenue effort
with unchanged revenue authority; (2) increased LGU revenue
authority; (3) increased transfers from central government; and (4)
more efficient use of existing financial resources in service delivery.
Increa_ng _ revenue effort

One of the more important findings of this Study is the
substitutive effect of the IRA distribution formula on local source
revenue. To counteract this tendency, tax effort may be taken into
account explicitly in the IRA allocation formula. Alternatively, the
IRA distribution formula may also be allocated to the different LGUs
so as to equalize net fiscal capacitieis, i.e., revenue capacity net of
expenditure needs (Shah 1994).
At the same time, the results outlined in the subsection "Per
Capita Real Property Tax" indicate that CLGUs' real property tax
systems have apparently not been able to fully capture the positive
effects on land values that urbanization usually entails. In this regard,
the amendment of the Local Government Code in favor of an
automatic indexation of the schedule of fair market value in between
general revisions will greatly help to compensate for this weakness in
the system. Such a move will protect the real property tax base from
being eroded by inflation during the years when no general revision
is undertaken. By avoiding the need to make substantial adjustments
in the schedule, it will also be easier to narrow the gap between the
"official" fair market values and the true marketvalues of real property
in the medium term. Moreover, to counter local assessors' tendency

to value real property below its true market value, the use of the zonal
values of real property (on which the BIR bases its assessment of
transfer taxes) should be considered. Tan (1993) found from a sample
of areas in Metro Manila that the local assessors' estimate of the fair
market value was at best 30 percent of the true fair market value of
real properties.
On the collection side of RPT, Fisher (1996) recommends that
current collecdbles should be monitored separately from delinquent
accounts. He further recommends that a more aggressive collection/
enforcement stance be taken such that at the close of each quarter,
each account is issued notices of delinquencies; at the end of the
second quarter when an account becomes delinquent, warrants of
levy should be issued; and at the end of the third quarter when an
account becomes delinquent, auction notice should be issued.
In comparison, the biggest problem with regard to the local
business tax is the underreporting of gross receipts of establishments.
Requiring taxpayers to submit income tax returns (ITRs) filed with
the Bureau of Internal Revenue is perhaps the most direct way of
obtaining information. Given the present tax calendar, this implies
that local business tax is initially assessed on the basis of previous
year's ITRwhich is subject to final adjustment later in the year as the
current ITR becomes available. In addition to the ITRs, local treasurers
may require large establishments to submit supplementary accounting
records. In large/urban areas, local treasurers should be trained in
the conduct of field examination to check veracity of reported gross
receipts. The use of presumptive income levels, particularly for small
establishments, should be explored. Anecdotal evidence suggests that
this worked very well in Naga in the late 1980s and early 1990s.
To improve collection/enforcement of the non-RPT, ARD
(1992) noted that the requirements are simple. They only need
consistency in practice. It includes: (1) the establishment of a tax roll
for each type of tax (the conduct of a tax census and the development
of a revenue data bank are key steps in this regard); (2) maintenance
of systematic and organized records where payments of all taxpayers
are automatically entered as they occur;, (3) the sending of tax bills;
(4) conscientious monitoring of payments of taxpayers and
identification and collection of tax delinquencies; and (5) strict
implementation of sanctions and penalties on erring taxpayers.
26 ManagingUrbanizationUndera DecentralizedGovernanceFramework
A number of LGUs, particularly provincialgovernments, have

•adopted cost-based pricing of hospital services. Moreover, a good
number ofdties are already sourcing a substantial part of their hospital
expenditures from user charges. In addition to this innovation on
the technical side, local sanggunians (councils) need to pass legislation
that will remove restrictions on the retention of income generated
by these hospitals. It has been found that said restrictions discourage
hospital personnel from collecting user fees.
In contrast, the poor financial performance of CLGU business
enterprises is worrisome. Again, a move to cost-based pricing is one
way of addressing this problem. Still another wayis through the award
of management contracts to the private sector.
Lastly, a good number of CLGUs have large cash balances.
However, the Commission on Audit has put in place certain
regulations that limit the CLGUs' ability to maximize the returns on
these funds. Some LGU officials (e.g., Bacolod officials) were
questioned when they invested in Treasury bills.
increasing LGU taxing authority

in the medium term, the assignment of taxing powers to various
levels of government must be reviewed. Existing theoretical guidance
on tax assignments suggests that residence-based taxes and taxes on
immobile factors like the RPT are appropriate for local taxation. At
the same time, motor vehicle ownership and use is also a suitable tax
base for CLGUs. "The number of vehiclesAn any given city usually
grows faster than its population. The growing number of vehicles
requires more expenditures to maintain roads and imposes the cost
of congestion and pollution on the urban environmenC (Bahl and
Linn 1992).
The imposition of betterment levies (or a tax aimed at recouping
from beneficiaries the public costs of providing urban infrastructure
from the beneficiaries) should also be explored. Such charges have
been tried with positive effects in Korea and Colombia.
,, ng and inse,- e li,y

Case studies of best practices in LGU service delivery suggest
that upgrading of LGU planning and fiscal management capacity,
greater emphasis on participatory process, more effective
coordination with other government agencies including other LGUs,
ability to catalyze private sector and NGOs, use of appropriate low-
cost technologies, contracting with the private sector, and elimination
Financingand Deliveryof Urban Services 27
of corruption will all contribute to improving the efficiency of public

service provision. These highlight the need to disseminate and
encourage replication of such practices.
In this project, eight case studies ill health service delivery
(Butuan, Cotabato, Gingoog, Lapu-lapu, Naga, Olongapo, Puerto
Princesa, Surigao), five in environmental and natural resource
management (Baguio, General Santos, Olongapo, Puerto Princesa,
Las Pifias), and three in housing (Naga, Puerto Princesa, San Carlos)
were reviewed. The objective of this exercise is to document innovative
programs and highlight the key elements that have made them
successful and sustainable. Many of these programs have already
received awards from various bodies like the Galing Pook Awards,
HAMIS (Health Management Information System), and Clean and
Green Program. The added benefit of this project is not so much the
identification of previously unrecognized innovations but the
decomposition of so-called best practices into their principal
components which, in turn, enhances their replication in other cities.
These case studies share several features that cut across sectors.
First, greater participation of various stakeholders (local institutions
and people) in the financing as well as in the implementation process
ensures efficient and effective program results and helps sustain the
program itself. This is best exemplified by the mobilization of women's
groups in the delivery of health services (as in Surigao City's Primary
Health Care Federated Women's Club, Lapu-lapu City's mothers
support groups); Naga City's reliance on the community organizations
in identifying the beneficiaries of the housing program and in putting
together the share of the beneficiaries in the financial requirements
of the project; and the widespread participation in Puerto Princesa's
Oplan Linis and reforestation program.
Second, the LGUs involved in these best practice cases have
somehow been able to break free from the financial constraints that
most urban LGUs face. The concerned LGUs took different routes
in addressing the fiscal gap. Some have introduced user fees (as in
Olongapo City's Solid Waste Management Program) while others have
spent time and effort in designing a well-thought-out cost recovery
Scheme (as in San Carlos City's LoteParasa Mahirap). Still other LGUs
have focused on mechanisms/techniques that reduce the cost of
service production/delivery. This is true of Cotabato City's use of
barangay halls and even private homes in the absence of barangay
health stations (BHSs) and the mobilization of health volunteers in
Cotabato City, Olongapo City and Naga City. Some LGUs have also
mobilized additional funds from other levels of goyernment as well

as from the private sector. For instance, Olongapo City requires its
barangays to allocate 5 percent of their IRA to health and welfare.
Surigao City obtained P1.5 million for the construction of a training
center for its PHC Women's Club from the Countrywide Development
Fund (CDF) of a senator. In Lapu-lapu City, partnerships with the
private sector were established, wherein 10 private companies and
five educational institutions support eight barangays in the conduct
ofamonthlyfree clinic and donated facilities and supplies. Similarly,
in General Santos City's Adopt-an-Island Program, business
establishments, academic institutions and NGOs develop and maintain
parks and road islands in the city. Other LGUs have maximized the
use of their own resources to finance development expenditures. San
Carlos City, for example, set aside 30 percent of its IRA (instead of
the mandated 20 percent) for their Local Development Fund.
Third, the better programs are those that are integrated,
intersectoral and undertaken within a development strategy that
attempts to capture the synergy from program interdependencies.
For example, Puerto Princesa's Low-Cost Housing Project is in reality
just one component of the city's Bantay Dagat Program. In like
manner, Olongapo City strengthened the link between health and
sanitation by integrating its environment program with health
activities.
On the other hand, the case studies also highlight a number of

sector-specific concerns. In the housing sector, both Naga's Kaantabay
sa Kauswagan Housing Program and San Carlos' Lore Para sa Mahirap
focus on the provision of lot and settlement upgrading in contrast to
Puerto Princesa's Low-Cost Housing Project, which involves the
provision of a house and lot package. Experiences elsewhere in the
world tend to indicate that the role of government in the housing
supply is best limited to land development and investment in on- and
off-site infrastructure. "Given the heterogeneity of people's
preferences for a kind of shelter and the speed at which they can or
want to improve its quality, it is not surprising that public housing
projects often do notfit the housing preferences of the poor." In this
case, public resources alloted for housing construction are better
placed in complementary inputs into housing like tenure and services
(Bahl and Linn 1992).
FinancingandDeliveryof UrbanServices 29
The experience in all three housing cases is consistent with the

experience in many countries that subsidize housing consumption
either through the underpricing of land or the implicit subsidy on
interest. Often, land is valued at its acquisition cost to government.
_While a first project may be able to draw on financially cheap public
land, follow-up projects may have to purchase land at commercial
prices from private owners. In that case, the replicability of the first
project--if it relies on subsidized land costs--is in doubt." At the same
time, experience in other countries suggests that subsidies on housing
tend to result in the overconsumption of housing relative to other
goods and services and in overly ambitious expectations for housing
standards because full cost is not borne by beneficiaries (Bahl and
Linn 1992). This lesson is most relevant in the case of Puerto Princess
where the project did not Charge an interest and which provides
homelots of 99 square meters (almost double the size of lots in
commercial low-cost housing projects) but beneficiaries still complain
about the smallness of the lot. Although San Carlos and Naga provide
some implicit subsidies in their programs, these subsidies are not as
substantial.
In all three cases, the success of the programs was helped by the
LGUs' ability to play a catalytic role in terms of coordinating with
national shelter and shelter-financing agencies. Moreover, in Nags,
the City Council passed ordinances pertaining to land conversion and
gave the mayor authority to negotiate the purchase of land. Aside
from the traditional way of acquiring land which is through direct
purchase, the LGU negotiated for land sharing and land swapping
schemes.
All three cities used census listing of the claimants in monitoring
the legality of the latter's claims as future beneficiaries. But most
noteworthy is the local initiative in strictly implementing the ban on
illegal construction in Puerto Princesa.
Environment and natural resource management

The types of environmental programs that cities can undertake
may vary depending on the overall development goals of the city as
well as the features and priorities of the city environment that is to be
managed. For natm_ resources-rich cities like Puerto Princesa and
Baguio, environment and natural resource management activities
(such as the Bantay Gubat and Bantay Dagat in Puerto Princesa and
Eco-Walk Program in Baguio) serve as the city's main programs. For
30 ManagingUrbanizationUnder a DecentralizedGovernanceFramewOrk
highly urbanized cities where environment problems are associated

with growth in economic activities such as in Olongapo City, solid
waste management program deserves greater emphasis.
Environmental programs can also be nonconventional as in the case
of Las Pifias and General Santos where the focus is more on the
aesthetics and tourism aspects and goals of the program.
In environmental and natural resource management where
there is a need to change people's behavior and attitudes, a good
information, education and communication program is essential.
While each LGU may craft its own program for the environment,
inter-LGU cooperation has to be made in many instances in view of
the economies of scale and externalities involved (e.g., sanitary landfill
site management and maintenance). Lastly, when market-based
instruments are used in tandem with regulatory instruments, LGUs
may be able to raise revenues while minimizing further environmental
damage.
Health
Puerta Princesa's Satellite Clinic Project and Naga's Emergency
Rescue Naga are aimed at providing emergency medical assistance.
Naga's scheme makes use of an extensive radio network and the
availability of ambulances to improve the access of residents in rural
barangays to medical care in emergency situations. Making the
program available metro-wide enabled the sharing of limited facilities
and magnified benefits.
In contrast, Puerta Princesa (by staffing the satellite clinic with
trained medical personnel on a part-time basis) not only provided
emergency medical care but also improved the access of rural
barangays to basic health care. The satellite clinics enabled early
treatment of diseases before they go t worse and decreased the number
of patients going to hospitals. Thus, the projects highlights the
importance of looking at curative and preventive health care in a
more integrated manner.
Issues for Further Research

This study also attempted to collect some input/output
indicators of the service delivery levels of CLGUs. The results are
rather disappointing. Input/output indicators were not available (or
at the very least, not easily accessible even if they are available) at the
local level for most services with the exception of education and health
care services. The absence of this information may indicate that
Financingand Delivery of Urban Services 31
CLGUs do not make use of this kind of data in planning and

budgeting. Moreover, simple correlation analysis between input/
output indicators (when they are available), on the one hand, and
per capita CLGU expenditure, on the other, suggest there is a weak
relationship between them.
References
ARD (Associates in Rural Development). 1992. Essential Actions for

LGU Revenue Mobilization. Local Develoment Assistance
Program (LDAP) Project Document.
Bahl, R. andJ. Linn. 1992. Urban Public Finance in Developing Countries.

New York: Oxford University Press.
Bahl, R. and L. Schroeder. 1983. The Business License Tax. In Local

Government Finance in the Third World: The Case of the Philippines,
edited by Roy Bahl and Barbara Miller. NewYork: Praeger.
Bahl, R. and S. Nath 1986. Public Expenditure Decentralization in

Developing Countries. Government and Policy 4:405-418.
Capuno,J.J. and O. Solon. 1996. The Impact of Devolution on Local

Health Expenditures: Anecdotes and Preliminary Estimates
from the Philippines. Unpublished.
Fisher, R. 1996. Assessment of Real Property Tax System in the

Philippines. Report submitted to ARD-Gold Project.
Shah, A. 1994. The Reform of Intergovernmental Fiscal Relations in

Developing and Emerging Market Economies. Policy and
Research Series No. 23. Washington, D.C.: World Bank.
Tan, E. 1993. Real Property Taxation and Its Potential as a Major

Source of Local Revenue. In Poverty Growth and the Fiscal Crisis,
edited by Emmanuel de Dios and Associates. Makati City:
Philippine Institute for Development Studies and Ottawa:
International Development Research Centre.
White, H. 1980. A Heteroskedasticity-Consistent Covariance Esdrnator

and A Direct Test for Heteroskedasticity. Econometrica 48:817-
838.
Chapter
2
Metropolitan Arrangements
in the Philippines: Passing
Fancy or the Future.Megatrend?
Ruben G. Mewado, and Rosario G. Manasan
In the next century, human progress will hinge on the

metropolitanization of the majority of the world's population,
transformation of the old models of metropolitan development and
planning, and the elimination of urban inequality... What is needed
is a new wa_ of thinking about the metropolis and urban planning
based on the idea that the metropolis is progressive and desirable and
not aplague to the humanity... The new way of thinking should pmject
the current trends of metropolitan development into the twent_frrst
century, not as fantastical futuristic visions but as sane scientific
assessments of the laws that govern metropolitan development, and
that permit us to consciously guide that development.
- Thomas Angotti (1993) in Metropolis 2000
economy and the continued pursuit of the national dispersion

he country's
policy through drive towardconcentration
regional becoming a have
globally competitive
revitalized and
eventually stirred large cities to expand their physical area for planning
as well as their service area for urban service delivery. Noteworthy in
recent years is the emergence of new "metropolises" in almost every
region of the country. A local traveler may be surprised to hear that a
city he has always known now has the word "metro" preceding its
name. A tour in these new metropolises will reveal, however, that they
do not show yet the metropolitan complexion, i.e., population and
built structures, that the term "metro" usually connotes.
Angotti (1993), in writing a modern day perspective on metro-
politanization in the world, has suggested a general rule-of-thumb in
defining a metropolis by referring to it as a large urban settlement
with at least. 1 million population, t. A city is different from a metropolis

as the former is only a medium-sized settlement with a population
between 100,000 and 1 million. Also a unique feature of a metropolis
is that its geographical area usually extends across several local
government boundaries.
If the above definition is to be used, only Metro Manila, Metro
Cebu and Metro Davao will qualify. Metropolitan arrangement in this
paper defines or classifies other metropolises that do not pass the
theoretical standards of population nor the urban criteria of a
metropolis but functionally behave as such. Operationally defined, a
metropolitan arrangement is where a highly urbanized city and the
local government units (LGUs) contiguous with it enter into a
cooperative venture in planning and implementing urban
development activities.
The formation of metropolitan arrangements emerged mostly
in the 1990s. But is this just a fleeting phenomenon considering the
recent emphasis placed worldwide on mega-cities? Or, is this a prelude
to future trend in the management of the urban environment in the
21'_century Philippines? If there are significant benefits to this form
of geopolitical cooperation, how can these be strengthened and
enhanced as an alternative mechanism for effective and efficient urban
service delivery?
Context of Inquiry
Interwoven in this study is an examination of the issues
surrounding the evolution, appropriateness, effectiveness and
sustainability of these metropolitan arrangements. It may be
worthwhile to consider these issues in the light of current
socioeconomic and political development in the national and global
scene.
There is no strict universal definition of a metropolitan area such that metropolises in the
world vary in terms of population and area size. Neither is there a formal definition in the
Philippines. More recently, however, with the emergence of relatively big metropolis worldwide,
the United Nations has defined some metropofis as megalopolises, which pertain to big cities or
metropolises having a population of 8 million and over (UN Unive_gsity 1994).
MetropolitanArrangementsin the Philippines 35
Table 1. Urbanization in Selected Asian Countries, 1990

Urban, Population
Ave. Annual
Population Area
Country (in millions) (sq. km) Density GrowthRate
1980-1990 As%of
Total Growth
Rate
1980-1990
Philippines 61 300 203 2.4 49 5.1

Thailand 56 513 109 1.8 23 4.6
Indonesia 178 1905 93 1.8 31 5.1
Malaysia 18 330 54 2.6 43 4.9
Vietnam 66 330 200 2.1 "_2 3.4
South Korea 43 99 434 1.1 72 3.5
Japan 124 378 328 0.6 77 0.7
Source of basic data: WorMDe_/opment Report 1992.
Rap/d urban/zat/on
The rate of urban growth in the Philippines, which posted 5.1
percent for the intercensal years 1980 to 1990, is considered one of
the highest in the developing economies of Asia (Table 1). As it is
true for its ASEAN neighbors, its urbanization rate is more than double
the national population growth rates. The source of this growth has
been recognized to be influenced by a mixture of factors, including
history, geography, sectoral, macroeconomic and explicit spatial
policies (NEDA 1996).
The 1990 Census of Population and Housing revealed that the
Philippines is 48.4 percent urban. Projection for 1995 showed the
share of population in the urban areas to be 54.1 percent or about 38
million out of the 69 million total population (Gonzales 1997). This
represents a high growth rate of 4.6 percent--almost double the
national growth rate of 2.45 for the period 1990-1995. The proportion
of urban population over the national population is expected to
increase its share as the country's economic production will be
generated mostly in the urban areas following the anticipated
increasing shares of the industry and services sectors.
Ttw advent of metropolises and meg_bolises

The rise of metropolises and the emergence of megalopolises
are contemporary urbanization phenomena taking place in many
countries. The former refers to the process whereby a city expands
its influence to surrounding cities and towns, forming an urban region
or conurbation 2 more commonly known as a metropolis or

metropolitan area. The latter phenomenon is when a metropolis grows
further in terms of population and creates an expanded metropolis
forming a megalopolis, a term first used byJean Gottman for a spatial
system consisting of several metropolitan areas (Serote 1994).
In the Philippines, the occurrence of these phenomena is very
much pronounced in recent years. Metro Manila is now part of the
world map of current megalopolises or mega-cities (ADB 1994).
Having reached more than 8 million population in 1990, it has
graduated from a metropolitan status. Lately, some of the highly
urbanized cities have been gradually taking on a metropolitan
character in terms of increasing population and the presence of
relatively complex urban systems, including modern transport and
communication infrastructure, expanding residential areas resulting
in an intricate daily commuting pattern and sophisticated commercial
and trading activities. Other cities, while still far from being considered
a metropolis, are gradually following suit by shaping either a formal
or an informal metropolitan arrangement among the concerned
LGUs. The transformation of these cities into metropolises finds basis
in the expectation of their likely metropolitan destiny aside from the
perceived benefits that can be derived from such aggrupation.
Metropolitan arrangements: decentraliza6on or

re-centralizaaon ?
Article X Section 13 of the 1986 Constitution provides the prime
basis for any inter-governmental or metropolitan arrangement. It
states:
Local government units may group themselves,

consolidate or coordinate their efforts, services and
resources for purposes commonly beneficial to them in
accordance with law.
=Serote (1.994) quotes the Dictionary of Social Sciences in defining "conurbation" as a

"large geographical area, extending across several local government boundaries, forming
in socioeconomic terms a single continuous urban region." He further explains that
the term metropolis comes from two Greek words: metro meaning "mother" and polls
meaning "city." It is descriptive of a "mother city giving birth as it were to daughter cities
and together forming a large city that is several times bigger than the original one in
terms of land area and population."
MetropolitanArrangementsinthe Philippines 37
The 1991 Local Government Code further strengthened the

concept of metropolitan arrangements under Chapter 3, Section 33:
Local government units may, through appropriate

ordinances, group themselves, consolidate or coordinate
their efforts, services, and resources for purposes
commonly beneficial to them. In support of such
undertakings, the local government units involved may,
upon approval by the sanggunian concerned after a public
hearing conducted for the purpose, contribute funds, real
estate, equipment, and other kinds of property and
appoint or assign personnel under such terms and
conditions as may be agreed upon by the participating
local units through Memoranda of Agreement.
While these provisions form the legal basis for some

intergovernmental structures that can then be applied to a
metropolitan arrangement, the creation of such a structure is feared
by some as a form of re-centralization or, at the very least, a threat to
the autonomy of LGUs. Metropolitanization would, in effect, make
LGUs give up some of the greater and broader powers and functions
they have been accorded under the new Local Government Code. In
addition, smaller LGUs might consider such metropolis formation as
a form of annexation and fear that they will lose their identity as a
distinct local entity.
Still, some believe that metropolitan arrangements strengthen
decentralization rather than encourage re-centralization when its
formation is caused primarily by the LGUs themselves. Such
metropolitan formation allows for a subnational-level government (as
oppose to a central government) provision of services characterized
by economies of scale and externalities. Thus, metropolitan
arrangements can be viewed not as a re-centralization movement but
rather, a refinement of the decentralization thrust.
Me_llam arrm_me_ _ poetical preferences

From the standpoint of a more integrative development
planning, the support behind metropolitan arrangements emanates
from the benefits that could be derived from scale economies and
the spillovers of service between administrative or political
jurisdictions. This is true particularly of urban services such as traffic
management, water supply, treatment and storage, solid waste
management and land use planning that can be provided more

effectively and efficiently if they are jointly planned and delivered by
moreJ than one LGU. While this is arguably a justifiable option, the
choice of the type of organizational structure may be difficult to
determine considering that LGUs have equal political legitimacy.
Thus, competition and antagonism may sometimes hinder a workable
and sustainable working relationship or moreso, a more formal
metropofitan arrangement.
Purpose and Scope of Study

This study provides a broad inquiry into the evolution and
dynamics of metropolitan arrangements in the Philippines.
Specifically, the objectives are:
1)To document the evolution of the various metropolitan

arrangements in the country and evaluate their future
prospects;
2) To determine the various functional areas where metropolitan
arrangements have been or can be effective and efficient in
the delivery of urban services;
3) To identify and analyze problems confronting these groupings
in the area of institutional strengthening and coordination,
finance, management operations and local autonomy; and
4) To propose policy reforms regarding these arrangements, both
metropolis-specific and metropolises in general.
Eight metropolitan arrangements are considered in this study:

Metro Manila, Metro Naga, Metro BLIST (formerly Metro Baguio),
CAMADA (formerly Metro Dagupan), Metro Cebu, Metro Iloilo,
Metro Cagayan de Oro (CDO) and Metro Davao. While there are
other metropolitan arrangements that are known to be emerging
(e.g., Metro Urdaneta, Metro General Santos, Metro Iligan), the study
limits itself only on those that already have a formal institutional
arrangement or are in an advanced stage of evolving one. The insights
and perspectives put forward in this study benefited very much from
formal and informal discussions with regional government officials
and local executives in these areas.
Table 2. Metropolitan Arrangements: Composition, Land Area and

Population
Population
Composition Land Area 1995
blvb-o City Municil_dity Province (_l. kin) I_wel Growth
(Total) Rate
1990-95
Manila 10 7 17 633.21 9,454,040 3.52
CAMADA 1 2 3 147.50 269,093 1.38
BLIST 1 4 5 973.34 386,512 2.49
Naga 1 14 15 1257.67 560,322 2.19
Cebu 3 7 10 922,98 1,435,903 2.39
Iloilo 1 3 4 207,80 437,351 1.59
CDO 1 15 16 3841 _71 861,588 3.63
Davao 1" 1 1 2211.30 1,006,840 3.39
2** 1 2 3 2724.61 1,039,721 2.66
3*** 1 4 20817.86 4,480,267 2.29
* Davao City only,
** Total of Davao City, Panabo and Sta. Cruz.
*** Total of Davao City, Davao del Norte, Davao del Sur and Davao Oriental.
Sources: 1990 Population and Landarea Data from National Statistics Office; 1995 Census of
Population and Housing.
Demographic and Geographic Features of Current

and Emerging Metropolitan Arrangements
Table 2 provides a general picture of the eight metropolitan
arrangements as to their demography and geography.
Expectedly, a metro arrangement is generally composed of a
city plus the neighboring municipalities. Variations, however, exist in
the number of geopolitical units involved in the arrangement (Table
2). The number of cooperating LGUs ranges from 3 to 17. Metro
Davao is a special case where there are at least three definitions that
have evolved: (1) a Metro Davao that is synonymous to Davao City;
(2) a Metro Davao that encompasses Davao City and the neighboring
municipalities of Panabo and Sta. Cruz; and (3) a Metro Davao
referring to Davao City and the three surrounding provinces, namely,
Davao del Norte, Davao del Sur and Davao Oriental.
There is a close association between the largeness of the
metropolitan areas under study and the area contributed by the non-
city LGUs in the metropolitan composition. These non-city LGUs
account for a sizeable share (i.e., about more than half) of the total
metropolitan area in this study (Figure 1). Conversely, the same graph
shows that the share of the city area to the overall size of the
metropolitan area is relatively small. Except for Metro Manila, Metro
Cebu, Metro Davao 1 and Metro Davao 2, the share of the mother
city comprises only less than a third of the total metropolitan area.
Figure 1. City, Non-city and Total Metropolitan Land Area
25000--
I
z_oo, I=N°_Y I
,
NXlO.
_- MANILA BUST _M_ *CO,' ,L01LO CES0 C_- 1 OAVAO

3
Source: Basic data from Table 2_
The demographic and geographic differentiation between city

and non-city areas can be seen as creating a development balance.
For instance, the geographically large non-city area can be a potential
expansion area for the geographically limited capital city while the
demographically large city can be seen as a big potential market for
non-city products and services. Such symbiosis and development
complementarities would, of course, prove workable, depending
largely on how well the metropolitan arrangements are effected.
Genesis of Metropolitan Arrangements

With the exception of Metro Manila, the formation of
metropolitan arrangements are events of the 1990s. One can glean
from their unique experiences a variety of factors that cause their
formation. These arrangements can be generalized based on four
major precursors,
Common pressing local concern

The formation of Metro BLIST, CAMADA and Metro Naga was
preceded by pressing concerns. The damage left by the strong quake
that hit the regions of Northern Luzon in 1990 has paved the way for
LGUs to interact more closely and view future developments in a more
integrated fashion. The disaster has facilitated the development plan
of Metro Baguio, which eventually, upon consultation with the

surrounding municipalities of Benguet Province, became the
foundation of the Metro BLIST (Baguio, La Trinidadl Itogon, Sablan
and Tuba) area. The same experience holds true for Dagupan City,
Calasiao and Mangaldan in the province of Pangasinan. Originally
called Metro Dagupan, the new name CAMADA was eventually agreed
on by the mayors of the area. In the case of Metro Naga, the shortage
of oil products during the Gulf War led Naga City and surrounding
municipalities to work together in resolving gas sourcing and
allocation issue.
Metro Cebu, Metro CDO and Metro Davao find their origin
from regional or area development strategies and spatial studies.
Initially, the Regional Cities Development Project targeted Cebu,
Davao and Cagayan de Oro. In view of the important infrastructure
projects undertaken in these major cities, strategies for regional
development gave them key roles for the growth and development
of their respective regions. The influence of these cities have
expanded beyond their boundaries and development planning has
led these cities to take on a new status as metropolitan centers
integrating themselves with the nearby cities and provinces. The
Central Visayas Regional Program (CVRP) first defined Metro Cebu
as a planning area. Under the CVRP, the Metro Cebu Development
Project (MCDP) is the CVRP's infrastructure component,
implementing road projects in the areas defined as Metro Cebu by
CVRP. Metro Cagayan de Oro, on the other hand, was a product of
the integrated area development (IAD) approach, which was a
development planning strategy fashionable during the Aquino
Administration. While the National Council on Integrated Area
Development (NACIAD) was abolished during this period, IAD as a
planning tool has been carried over and reinvented through the
Special Development Programs (SDPs). The Metro CDO was
packaged as an SDP, of which the Cagayan de Oro-Iligan Corridor
(CIC) Project is a major component. Efforts in the implementation
of the SDP were focused more on the development of infrastructure
links between Metro CDO and Iligan. Such realization has given
impetus recendy in considering the needs of the defined metropolitan
area hand in hand with the development of the CIC region. While
originally a Davao City initiative, the Metro Davao now has
metamorphosed into a subregional growth area as defined by the
Table 3. Metropolitan Composition, Geographic and Demographic

Characteristics, by Metropolitan Arrangement
Population
Metro Level Growth Rate Land Area
1990 1995 1990-1995 (sq. kin)
Metro Manila 7,928,867 9,454,040 3.52 633.21
Manila 1,598,918 1,654,761 0.62 24.98
Mandaluyong 244,538 286,870 2.75 9.29
Marikina 310,010 357,231 2.68 21.52
Pasig 397,309 471,075 3.22 48.46
Quezon City 1,666,766 1,989,419 3.34 171.71
Sat*Juan 126,708 124,187 -0.40 5.95
Kalookan 761,011 1,023,159 5.64 55.80
Malabon 278,380 947,484 4.13 32.64
Navotas 186,799 229,039 3.82 8.94
Valenzuela 340,050 437,165 4.81 47.02
La_ Pinas 296,851 413,086 6.37 32.69
Makati 452,734 484,176 1.25 18.31
Muntinlupa 276,972 399,846 7.02 39.75
Parafiaque 307,717 391,296 4,57 46.57
Pasay 366,623 408,610 1.96 13.97
Pat;eros 51,401 55,286 1.37 10.40
Taguig 266,080 381,350 6.93 45.21
Metro BLIST 341,202 386,512 2.49 973.34
Buguio City 183,102 226,883 4.09 57.51
La Trinidad 48,252 63,089 5.04 80.78
Itogon 61,773 47,781 4.70 423_70
Sablan 8,440 9,170 1.57 96_95
Tuba 39,635 39,589 -0.02 314.40
CAMADA 251,160 269,093 1.38 147.50
Calasiao 62,966 69,528 1.87 53.40
Mangaldan 65,947 73,351 2.01 56.87
Dagupan City 122,247 126,214 0.60 37.23
Metro Naga 502,299 560,322 2.19 1,257.67
Naga City 115,329 126,972 1.82 84.48
Bombon 10,874 11,739 1.44 44.20
Calabanga 54,261 59,164 1.63 163.80
Camaligan 15,436 17,411 2.28 4.68
Canaman 20,298 22,732 2.14 43.27
Gainza 7,095 7,743 1.65 14.75
Magarao 16,623 18,264 1.78 44.97
Milaor 18,199 21,213 2.91 33.64
Minalabac 35,922 37,574 0.85 126.10
Pamplona 24,097 26,176 1,56 80.60
Pasacao 31,960 36,070 2.29 149.54
Pill 52,481 61,520 3.02 126.25
San Fernando 20,608 24,196 3.05 71.76
Bula 48,240 54,650 2.37 151.30
Ocampo 30,876 34,898 2.32 118.33
Metro l]oil0 403,949 437,351 1.59 207.80
Iloilo City 309,505 334,539 1.47 56.00
Leganes 18,505 19,235 0.73 32.20
Pavia 23,814 26,756 2.21 35.00
Oton 52,125 .56,821 _. 1.63 84.60
Table 3 (continued)
Population
MeU'o Level Growth Rate Land Area
1990 1995 1990-1995 (sq. km)
Metro Cebu 1,274,345 1,435,903 2.39 922.98

Cebu City 610,417 662,299 1.54 315.00
Lapu-Lapu City 146,194 173,744 3.29 58.06
Mandaue City 180,285 194,745 "1.46 25.18
Cordova 22,331 26,613 3.34 17.15
Concolacion 41,270 49,205 3.35 147.20
Lfloasl 42,587 50,973 3.43 52.10
Compostela 22,006 26,499 3.54 53.90
Tali_ay 97,955 120,292 3.92 86.45
MinglaniUa 50,875 62,523 3.94 65.60
Naga 60,425 69,010 2.52 102.34
Metro C,DO 718,699 861,588 3.63 3,841.71
CDO City 339,598 428,314 4.44 412.80
Jasaan 29,146 33,598 2.70 77.02
Villanueva 17,122 21,310 4.19 48.80
Tagoloan 33,919 40,929 3.58 117.73
Claveria 31,130 39,020 4.32 894.90
Opol 20,473 23,958 2.99 80.85
El Salvador 26,721 31,500 3.13 87.13
Alubijid 19,531 21,765 2.05 103.45
Laguindingan 15,503 16,521 1.20 16.74
Gitagum 10,994 11,327 0.56 43.40
Libona 29,652 31,897 1.38 343.20
Manolo Fortich 61,329 67,400 1.78 405.19
Talakag 35,379 39,378 2.03 186.40
Baungon 19,774 22,617 2.55 245.30
Malitbog 14,934 16,414 1.79 581.85
Sumilao 13,494 15,640 2_80 196.95
Metro Davao 849,947 1,006,840 3.39 2,211.30
Davao City 849,947 1,006,840 3.39 2,211.30
Metro Davao2 1,016,070 1,196,564 2.66 2,724.61
Davao City 849,947 1,006,840 3.39 2,211.30
Sta. Cruz 55,951 59,139 1.11 319.91
Panabo 110,172 130,585 3.40 193.40
Metro Dav'ao3 2,932,361 3,288,824 2.29 20,817.86
Davao City 849,947 1,006,840 2.28 2,211.30
Davao del Sur 632,701 677,069 2.41 4,541.05
Davao Oriental 394,697 413,472 0.87 5,700.61
Davao del Norte 1,055,016 1,191,443 2.28 8,364.90
Sources: Basic data from National Statistics Office 1990; 1995 Census of Population and
Housing.
Davao Integrated Development Program (DIDP). Metro Davao is a

product of the joint undertakings by the city and the three provinces
whose aim was to develop the whole of Davao as a tourist and
investment area. Such undertakings includes big tourism projects as
well as the area's major role in the East ASEAN Growth Polygon.
The beginnings of Metro BLIST and CAMADA (though actual

development was facilitated more by the effects of the 1990
earthquake) can also be traced to its being first identified as major
components of the North West Luzon Growth Quadrangle (NWLGQ).
The NWLGQ is an interregional development strategy envisioned
for Region I and CAR. Metro BLIST and CAMADA constitute the
East Quad and South Quad (CAMADA-Sual-Bolinao Growth
Corridor), respectively.
Deliberate national policy and constituency approval

Metro Manila is the only metropolis that came about as a result
of a conscious policy decision at the national level. Metro Manila is
not only a metropolis but is also the National Capital Region (NCR).
Such title carries with it a distinction of being the economic, social,
cultural, educational and political center of the nation. The needs of
metropolitan Manila is a priority concern of the national leadership
because of two major considerations. First is how to improve public
services in the areas geographically embracing the center of
government. Problems of inefficient and uncoordinated services as
well as future challenges in the face of rapid urbanization have caught
the attention of the national leadership. The second consideration is
the need to develop a region that will serve as the showcase for the
country's drive for modernization consistent with its exp0rt-oriented
national development strategy. These concerns brought the Marcos
leadership to issue Memorandum Order No. 314 dated November
10, 1972, creating an Inter-Agency Committee on Metro Manila to
"study the systems of municipal/city government in metropolitan
Manila and to recommend whatever measures of coordination and
integration are deemed appropriate" and to "study the functions and
responsibilities of the National Government in the metropolitan area,
and to recommend whatever changes in structure and interrelation
with municipal governments are deemed appropriate." The
committee proposed for the creation of a Metropolitan Manila
Authority under the Office of the President through a presidential
decree. A referendum was called for to get the people's support to
legalize the compositional definition of Metro Manila and to give the
President the authority to create a new administrative structure for
the NCR. Eventually, with the positive response by the people, a
presidential decree (PD 824) was issued in 1975, which defined the
composition of Metro Manila and created the Metro Manila
Metropolitan Arrangements in the Philippines 45
Commission (MMC). Executive Order 392 was issued by President

Corazon Aquino in 1990, replacing MMC with the Metropolitan
Manila Authority (MMA). Then in March 1995, Congress enacted a
law creating the Metropolitan Manila Development Authority
(MMDA), replacing MMA and clothed with more powers and
authorities than the previous metro body.
Lozalmittazi_
Metro Iloilo and Metro Naga are examples of local or
subregional initiatives. The germ for the creation of Metro Iloilo came
from influential city locales and was eventually supported by some
local officials of Iloilo City and the three surrounding municipalities
that have a stake in a metropolitan arrangement.
In the case of Metro Naga, the establishment of the metro
arrangement was principally bolstered by the leadership of the mayor
of Naga City. Under Naga City's leadership, the initial discussion on
the gas shortage as a result of the Gulf War eventually led to broader
concerns and identified the potentials for future cooperation, which
paved the way for the creation of the Metro Naga Development
Council.
Organization, Financing and Activities of Metropolitan

Arrangements: Variations and Commonalities
Table 4 outlines the various organizational structures and
sources of financing of the eight metropolitan arrangements in the
country. Only three of the eight metropolitan areas under
investigation already have their respective policy and management
structures in place. These include Manila, Naga and Davao. Metro
Manila and Metro Naga are supported by a congressional law and
presidential decree, respectively, while Metro Davao was established
through a memorandum of agreement by and among local
government officials. Majority are still in the process of forming their
metro bodies and are biased for an authority type of management
leadership although local leadership is emphasized particularly in the
chairmanship and composition of the executing council. The Metro
Cebu Development Council is one of the most recent organizations
formed. A lot still have to be done to internally organize as well as
clarify linkages with the regional and local structures, and institutions.
Except for Metro Manila, all metropolitan arrangements are
largely locally led. The provincial governors and mayors of the cities
and municipalities of the cooperating area comprise the highest

decisionmaking group in the organizational hierarchy. Although it
has been shown in the preceding discussions that while many of the
existing metropolitan arrangements were not mostly local initiatives,
the management and sustainability of the arrangement depend largely
on the zeal and full cooperation of the LGUs. This does not only
pertain to their crucial role in steering the development of their area
but similarly important is their commitment to sustain the established
arrangement through their agreed financial contribution. All
metropolitan arrangements have fixed local contribution, which is
Table 4. Organizational Types and F'mancingof Metropolitan Arrangements

Existing Proposed Source(s)
Metro Organization Organization Basis / Support Participants of Financing
Manila Metro Manila Republic Act National / National Allocation/

Development Local Local Fixed
Authority Contribution/
Fees/Fines Collection
CAMADA Under Study CAMADA Master Under Under Study

(Structure) Plan Study
BLIST Short Term: BLIST Master Local Under Study

Consultative (Structure) Plan
Forum
Long Term:
a "Metro"
Authority
Naga Metro Naga Executive Order Local National Allocation/

Development Local Fixed
Council Contribution
Cebu Metro Cebu RDC Resolution Regional MCDP Proiect Funds/

Development To be determined
Council
Iloilo Metro lloilo Memorandum of Local Local Fixed

Development Agreement Contribution
Council
CDO Under Study Metro CDO Under Under Study

Master Plan (on- Study
going)
Davao DIDP Board/ Memorandum of Local Local Fixed

Committee/ Agreement Contribution
Management
Office
MetropolitanArrangements in the Philippines 47
usually a certain percentage of the LGU's internal revenue allotment.

For Metro Davao3, LGUs provide an equal share of P300,000 as initial
funding for the program and the operation of the management
structure. However, Metro Manila and Metro Naga are provided
annual appropriations from the national government budget, on top
of the fixed local contribution.
Table 5 lists the areas of concern considered or proposed to be
undertaken by the established and the soon-to-be-instituted
metropolitan arrangements. There are some disparities in the activities
undertaken by each metropolitan arrangement. This is expected
considering the diversity in the conditions and priority for coordinated
effort of each area. For ins "tance, only Metro Davao and Metro Baguio
have included tourism as part of their major concern because of its
significant role in these areas' development goals. Interestingly, the
concerns of Metro Manila and Metro Cebu are exactly the same
because Cebu views its present and future needs for integrated
planning and service delivery as one that is or would be similar to
those of Manila [at least t_om the point of view of the proponent of
the congressional bill creating the Metro Cebu Development Council
(MCDA)].
In general, however, there are concerns that seem to be common
to all metropolises. These are in the areas of development planning,
solid waste management, and transport and traffic management.
MMDA considers these areas as its biggest challenge at present. It is
worthy to note that the other emerging metropolises have included
these concerns either because they are confronted with these issues
at present or because they want to be more prepared for these
challenges in the future.
In Metro Cebu, transport and traffic management is one of the
priority concerns. Although the traffic situation may not be as severe
as in Metro Manila, Metro Cebu is confronted with traffic congestion
in some of its major sections. If existing road situations are not
improved (i.e., unless new road constructions and/or road expansions
are undertaken in the future), all of these road sections will be totally
clogged with increasing traffic demand by the year 2000. Table 6 shows
past and future traffic demand and how this translates in selected
road sections of Metro Cebu. The tmttic demand will continually grow
at over 3 percent toward the next century. By then, its major road
sections have reached beyond their full capacity as revealed by the
computed congestion ratios.
Table 5. Development Activities Under the Metropolitan Arrangements

Metro ConcernActivityProgram
Manila Development Planning
Transport and Traffic Management
Solid Waste Disposal and Management
Flood Control and Sewerage Management
Urban Renewal, Zoning and Land Use Planning and Shelter Services
Health and Sanitation, Urban Protection and Pollution Control
Public Safety
CAMADA Development Planning (socioeconomic, land use and environment)

Flood Control and Drainage Improvement
Solid Waste Management
City/Town Centers Upgrading
Housing/Resettlement
Education
Health
Telecommunications
Water Supply
BLIST Solid Waste Management

Tourism
Water Supply
Naga Development Planning

Equipment Pool Program
Elderly Service
Emergency Rescue
Enterprise Development
Manpower Development and Employment
Water Supply
Health Services Support
Cebu Development Planning

Transport and Tr'_c Management
Flood Control and Sewerage Management
Urban Renewal, Zoning and Land Use Planning and Shelter Services
Health and Sanitation, Urban Protection and Pollution Control
Public Safety
Iloilo Development Planning

Transport, Traffic Engineering and Management
Environmental Sanitation, Waste Management and Disposal System
Flood Control and Sewerage Mmlagement
Urban Renewal, Land Use and Zoning and Shelter Services
Networking of"Economic Support Infrastructure
Public Safety, Maintenance of Peace and Order, Disaster Management
Trade and Investment Promotion
CDO Traffic Management

Water Supply
Table 6. Past and Future Traffic Demand in Metro Cebu, 1979-2010

1979 1992 2000 2010
Person Trips (000)
Private 111 347 583 901
Public 1029 1846 1728 2309
Total 1139 1093 2311 3210
Annual Growth Rate 8.05 g_89 $.29

Selected Sections
(person t.rips, in 000)
Talisay-Ce bu 35 61 85
Cebu-Mandaue 51 110 159
Mandaue-Consolacion 25 55 82
Mactart-MaJ.nla_d 17 36 58
Road Congestion Ratio
Talisay-Gebu 1.18 2.03 2.83
Cebu-Mandaue 0.64 1.38 1.99
Mandau e-Consolation 1.25 2.75 4.10
Macta_,-Mainland 0.86 1.80 2.90
ASSUMPTIONS
Population (000) 1,274 1,712 2,301
Trip Maker (000) 956 1,284 1,726
Trip Rate per Trip Maker 1.68 1.8 1.86
Private Vehicles (000) 65 110 170
Basic source: Cebu Integrated Area Development Master Plan Study (1994).
well-operated landfill or composting site. Dagupan, Calasiao and

Mangaldan have dump sites that are generally below international
health standards. Land area estimates for landfill sites ior the
CAMADA are shown in Table 8 based on the indicated assumptions.
Potential areas have been proposed in the Master Plan for CAMADA
and are still awaiting actual implementation.
The above cases of metropolitan arrangements underline the
difference of tackling local concerns toward a more integrative
planning and program implementation and the need to clefine the
roles of each involved LGU. The basis for such arrangements vary in
legal forms such as laws, executive orders or memoranda of
agreement, depending on the political culture of these areas.
Generally, such legal forms delineate each locality's functions and
roles in the given arrangement, in practice, however, formal
arrangements and systems are not yet installed for many of the metros
under study despite their awareness of their respective urban
problems.
Note that the functions commonly identified for metropolitan
cooperation are largely consistent with those one might expect a prior/
Table 7. Urban BLIST: WaterDemand, 1994-2020
Year Population % Served Average Water Production Requirements

LPCD Ave. (cu. m/day) Peak (cu. in/day)
1994 312,000 58 190 34,400 48,135
2000 358,000 70 210 54,600 73,700
2010 421,000 80 220 74,100 103,700
2020 473,000 90 220 93,700 131,100
Source: BDUPP (1994a).
Table 8. CAMADA:Landf'dlSite Requirements

LandAreaRequired
Period Initial Population Final Population (ha)
1996-2000 301,000 334,000 9.2
2000-2010 334,000 417,000 27.3
20102020 417,000 500,000 33.4
TOTAL 69.9
Assumptions:
Average daily waste generation: 0.75 kg/capita/day
Percent of population serviced by collection system: 95%
Average solid waste density (as collected): 375 kg/cu.m
Final landfill volume: 50% of collected volume
Average landfill depth: 5 m
Additional site area required for services: 5%
Basic source: BDUPP (1994b).
on the basis of the theory on expenditure assignment under fiscal

decentralization. That is, functions that are characterized by
economies of scale and externalities are generally deemed to be more
appropriate for higher level governments. Thus, services that require
areas larger than a local jurisdiction for cost-effective provisioning
like water supply, sewage disposal and solid waste management are
generally assigned to metropolitan governments worldwide. Similarly,
the same is true for services like public health whose benefits and
costs accrue to nonresidents of a Iocaljurisdiction (i.e., services that
give rise to spadal externalities).
On the other hand, Metro Naga's identification of "elderly
service" as a metropolitan service appears to be surprising at first
considering that it is largely a quasi-private good with minimal
economies of scale and benefit/cost spillout. However, if one
considers that this service is likely to have a large redistributive
component, then one sees why the proponents of Metro Naga would
rather assign this to the metropolitan unit rather than to the individual
LGUs.
Metropolitan Arrangements in the Philippines ,53
the formation of a stronger and more coordinated structure to

implement the Plan.
Metros Cebu and CDO have yet to show any concrete evidence
that their cities and municipalities concurs with the need for a formal
metropolitan arrangement. One may argue that in the case of the
former, the problem of acceptability may not be so alarming
considering that the area has already experienced many metro
projects in the past. However, one must consider that the dynamics
of a policy and the management structure differ a lot between a project
office and a metro body. Metro CDO, which is currently formulating
a master plan for itself, may have to find out how the LGUs envisioned
to comprise it would like to view the plan's institutional management
structure. The failure of Metro BLIST and CAMADA to instill among
the LGUs involved a deep appreciation of the arrangement and their
inability to work outan acceptable structure for the master plan should
serve as a lesson to others.
Leadership is crucial to the adoption of an acceptable

metropolitan structure. There are two points in this leadership issue.
The first concerns the question of who should initiate to get everyone
to agree on a structure. The second is the determination of an
agreeable mode of metro leadership.
The first facet of the issue is a serious reality. Generally, the
initiative is expected to come from the dominant city. There are at
least three reasons for this. First, most often than not, the dominant
city has the greatest stake in the arrangement. Second, the city is
usually recognized as a "big brother" to the other LGUs. Third, the
component cities and municipalities are constrained ethically to make
the first move considering thz, t they are structurally under the
provincial government.
While these reasons may be valid, the dominant city still hesitates
to initiate. There are two reasons. First, dominant city fears that some
LGUs may misconstrue the former's initiative as a move to expand its
political power and authority. Second, the dominant city encounters
some difficulty over the provincial government's sensitivities. The
result is a political stalemate. This whole initiative issue is very real in
the case of Metro BLIST and C_IKDA. Higher authorities (i.e.,
regional or national leaders) are opined by the local officials to be
more effective arbiters in such a case.
The second facet of the leadership issue is equally challenging,

i.e., the choice of leadership type for the adopted structure. Metro
Manila provides a good example of experiments !n metropolitan
leadership. The MMC had a powerful governor at its helm. The MMA
shared the powers by adopting a rotating leadership among the
members of its council. The MMDA has a presidential appointee as
chairperson with a Cabinet rank while giving the council a big
decisionmaking authority. Given Metro Manila's rich experience on
various modes of leadership, it is not surprising that many of the
emerging metropolises refer back to these tried structures in
formulating their own. Reaching a decision on an acceptable formula
is still in process for a lot of these emerging metropolises•
• " ed_body
An effective structure is where roles and functions are clearly
delineated and understood. In the experience of the MMDA, this
factor is lacking. One of the criticisms on the functions and
responsibilities OfMMDA under Republic Act 7295 is the use of the
word "coordinate," which finds weakness in practice. For instance,
MMDA's function in coordinating land use classification and zoning
means almost nothing because it is the LGUs that have the authority
anyway to reclassify land by virtue of the Local Government Code.
Coordination in this case has often reduced the MMDA into a mere
center of information on any changes in land classification by the
LGU. An integrated physical planning for Metro Manila, which is the
whole rationale for such task, becomes difficult for MMDA to
effectively carry out because the function as written in the law does
not warrant full responsibility and authority.
e an " •
When a metropolitan arrangement graduates into a formal

metropolitan structure, it inevitably requires a full-time organization
to handle its growing technical and administrative needs. Metro Naga,
which has gradually evolved from an informal metropolitan setup to
an established institution, now finds itself needing to build up its
secretariat support to the Metro Naga Development Council (MNDC)
as development challenges and activities in the area mount. At present,
such support is lodged with a Project Officer of Naga City. While this
one-man support setup is still workable, an expansion of management
support may eventually become a big necessity.
Finandal mstainabillty
One of the key factors for a metropolitan body to be sustainable
is a stable financial source. Different modes of financing and various
strategies have been employed by existing metropolitan organizations.
It can be said that the different convictions and perspectives on
metropolitan structures are reflected in their choice of financing.
Metro Davao believes on local self-reliance and, therefore, deliberately
ruled out their dependence on national support to finance its
organizational machinery. Thus, each member-LGU commits
P300,000 as its annual contribution. Metro Naga, on the other hand,
is more practical in its approach. While it too believes in local self-
reliance, it takes into account the financial condition of the LGUs in
the arrangement. The uniform 2 percent of the 20 percent
development fund set aside by the municipality from their annual
budget as contribution to MNDC addresses the varying financial ability
of its members. In view of the limitation of the total local contribution,
the MNDC has to source funds from other sources. The issuance of
Executive Order (EO) 102 creating the MNDC was a means employed
by Metro Naga to entitle itself funds from the national budget. The
original proposal was to get funding from such institutions as the
Philippine Amusement and Gaming Corporation (PAGCOR). The
executive order, however, provided for funds under the Office of the
President. While the NMDA receives an appropriation of P1 million
annually, the appropriated item has changed its funding source.
Currently, the budget is part of that of the National Economic and
Development Authority (NEDA)under its Integrated Area
Development activities, the item where the fund of the Regional
Development Council (RDC) is also sourced.
Metro Manila is a special case. Being a nationally initiated
metropolis backed by a congressional law, it gets a regular
appropriation, on top of fixed local contribution, from member-cities
and municipalities sufficient enough to manage its day-to-day
operations.
laenaCyand "toyatty"erise,of
and munidpalities
The introduction of a metropolitan structure--be it
metropolitan arrangement or a formal metropolitan body--chang.
significantly the relationships of political units in the local governme
system. Figure 2 shows graphically these changes. Prominent in t"
Figure 2. Comparative Structures of Local Government System With

and Without a Metropolitan Body
Philippine Local •Government System
WithoutMetro Structure WithMetro Structure
Metropolit_ ] [ Provinoe
comparison is the way component cities and municipalities of the

arrangement can be cross-related with the province and the
metropolitan body. Quite many believe, though, that the identity and
loyalty issue may not necessarily present problems in the legal-
administrative perspective but may do so in the political realm. The
issue becomes sensitive especially when the historical evolution of
Metro Manila is brought to the fore. It may be recalled that the original
composition of Metro Manila prior to the establishment of the MMC
includes the cities of Manila, Quezon City, Pasay and Caloocan--all
units that are not under any provincial jurisdiction. When the MMC
was installed after a pleb!scite was undertaken, the 12 municipalities
that were under the province of Rizal and one municipality under
the province of Bulacan formed part of a special province now called
Metropolitan Manila Area or the National Capital Region (NCR).
Many believe that the eventual late of many municipalities and
component cities upon joining any metropolitan arrangement is to
be detached from the province and become part of a new political
jurisdiction. The experience of Metro Naga, however, shows that it is
possible for municipalities to maintain their identity as a political unit
under the province and still be an active member of the metropolitan
arrangement as well as contribute religiously in all its endeavors while
• doing its responsibilities as part of the larger i_rovince. It should be
mentioned, though, that the MNDC leadership particularly of Naga
City consulted the province regarding the formation of the council

and sought its support and cooperation.
The existence of a municipal identity and loyalty despite its
metropolitan arrangement in the traditional local government system
may, thus, depend on the political dynamics in the regional area. Such
dynamics will determine the destiny of subprovincial units involved
in the arrangements.
Resolution of conflicts: compromise and sacrifice

Taking heed of tradeoffs between metropolitan and local
concerns is one of the more difficult issues in metropolitan
governance. The basic problem arises when local executives give
priority to the interest of their respective constituents over that of
the whole metropolis. The problem of solid waste management best
illustrates this dilemma.
Many LGUs have improved garbage collection system by
adopting more systematic methods and have successfully rallied the
cooperation of their constituencies in promoting a clean environment.
However, the reality remains that the final disposal of collected
garbage has not reached a level of modernity and strict environmental
acceptability. Open dumping is still the standard practice. The two
major technologies available in this regard are incineration and the
establishment of a sanitary landfill. The former is regarded by the
Department of Environment and Natural Resources (DENR) as an
expensive option considering the quality of waste generated, which
is largely putrescible materials. The use of landfills is what the agency
is encouraging local governments to adopt instead (Ganapin 1997).
There are two big constraints to the establishment of sanitary
landfills, which is why these cannot gain much support from local
governments. First and foremost is the huge cost of developing the
facility and the similarly expensive maintenance requirement. This
problem could be mitigated through inter-LGU cooperation as
economies of scale are achieved. Metropolitan arrangements show a
lot of promise in this regard. In case financing can be handled jointly
by the LGUs concerned, a second hindrance comes to the fore--the
NIMB (short for Not In My Backyard) attitude. The problem of site
identification is such a perplexing issue and no amount of technical
exegesis can convince a local government of the economic, geological
and environmental feasibility of an area under its jurisdiction as the
best place to build the sanitary landfill.
For a lot of the emerging metropolises under study, the garbage

issue is one of the sources of nonsupport for a metropolitan
arrangement. Often, municipalities, especially those that have large
tracts of land with big potential as a landfill site, perceive such
arrangement as a means for them to be co-opted to be the site of
refuse of the dominant city or the other municipalities in the
metropolitan area.
Metro Manila's experience in this issue was one that required
presidential intervention. What complicated the problem is that the
identified landfill sites are in Carmona and San Mateo---both in Rizal
and municipalities outside of Metro Manila's jurisdiction. The issue
could not have reached a fast resolution had Malacafiang not
intervened for the MMDA.
For many cities, especially those having limited land for final
disposal, the garbage problem pose both a serious and an urgent
issue. For instance, Baguio City projects that its current dump site
will reach full capacity in a year's time. Negotiations are being tried
for a possible site in La Trinidad, among others, but with much
difficulty.
If metropolitan arrangements will not prove workable for cities
beset with metropolitan-wide problems, how can these be resolved?
Should Metro Manila's experience of Presidential mediation be always
used or should a national policy be formulated in cases of conflicts
requiring compromise or sacrifice?
Sustaining and Enhancing the Metropolitan Arrangements

Addressing the issues just described necessitates a clear
understanding of the elements essential for the successful planning
and management of the metropolis. An understanding of these basic
prerequisites would help identify the necessary policy intervention
instruments that will solve the issues confronting the existing and
emerging metropolises in the country.
The identification of the key elements of metropolitan planning
and management finds basis on the documented experiences of other
countries and from the unique lessons derived from the existing
metropolitan arrangements in the Philippines under study.
There are three key elements or conditions necessary for an
effective and efficient metropolitan planning and development. First,
a common vision of preservation and development of the region is
crucial. Second, there ought to be a unified ecooomic and political
base to implement the vision. Third, an appropriate metropolitan
structure that will provide an institutional framework for successful

planning and implementation is inevitable. These three conditions
essentially constitute what we shall refer hereon as the metropolitan
governance framework (Figure 3).
At the apex of the triad is the adoption of a vision to preserve
and develop the region or the constituted metropolitan area. The
vision may either be an elaborately framed goal or a simple recogni-
tion of the benefits that the members of the constituted metropolis
may derive from the arrangement or cooperation. Similarly impor-
tant is the process of framing and adopting the vision or the identi-
fied benefits. The ownership of the vision can be better accepted as
well as produce an impact if the vision itself is derived through a pro-
cess of community debate and decisionmaking.
A universal experience in metropolitan planning is that many
of the formal master plans that embodied the vision for the metropolis
suffer from non-implementation to mere uselessness (Angotti 1993).
This is one of the biggest frustrations of metropolitan arrangements
such as in the cases of Metro BLIST and CAMADA.
There is no question on the technical merits of these master
plans. What is lacking perhaps is the fuller involvement and coopera-
tion of member-municipalities in promoting a metropolitan-wide vi-
sion that reflects the collective interests of the major stakeholders in
the area. Cooperation is better assured and the organizational mecha-
nism for implementing the vision will be less difficult to install if local
ownership of the metropolitan arrangement is secured early on.
A contrasting example is Metro Naga, which took its root from
a desire of the leaders of the city and member-municipalities to pur-
sue development via the principle of resource sharing, role identifi-
cation and integrated area development. A number of achievements
Figure 3. Metropolitan Governance Framework

Common Vis/onfor the Reg/on
and Po//t/m/Base M_erope//ta_

have been made so far without the existence of a formal master plan.
Only recently did the leaders realize the need for one.
Metro Davao3 is also treading toward a more sustainable arrange-
ment. Its vision of nine key result areas for socioeconomic coopera-
tion and development under its Davao Integrated Development Pro-
gram shall form the basis for the soon-to-be-completed master plan.
The Memorandum of Agreement adopting the strategy and the com-
mitment to financially assist indicates a commitment to a unified pur-
pose and vision for the region.
At the base of a triad is a unified political and economic mecha-
nism to implement the vision. Ideally, to be effective and efficient,
the metropolitan area should have a unified political jurisdiction and
a well-coordinated and well-managed economic agencies and authori-
ties. Metropolitan planning and management differ from city or
municipal planning in that the former has to contend with disjointed
political jurisdictions. Unified planning is thwarted especially when
these political jurisdictions retain and exercise substantial functions
and powers under existing laws. A similarly formidable challenge is
how to harmonize or rationalize the various sectoral and specialized
agencies providing urban development services. These agencies and
authorities often develop independently of elected government and
may resist participation in metropolitan-wide planning if not handled
carefully and systematically.
Metropolitan Tokyo is a distinct political unit with 23 special
wards, 26 cities, 7 towns and 8 villages. The development of the whole
area is contained in a single plan, which is backed up by a national
legislation and has the national agencies providing for its regional
infrastructure needs. In Calcutta, effective delivery of services and
infrastructure needs of the metropolitan area was carried out only by
rationalizing the existence of about 570 public institutions, "a veri-
table maze of jurisdictions and authorities that were often in conflict
andin noway coordinated regionwide" (Sivaramakrishnan and Green
1986). In Metropolitan Toronto, a division for urban services was
devised so that the six area municipal governments and the regional
agencies, boards and commissions have clearly defined responsibili-
ties and accountabilities.
On the other hand, the case of Metro Manila best illustrates the
presence of multiple government agencies operating, in most cases,
independendy of the metropolitan authority. Almost all the metro-
politan services are handled outside of the MMDA without a clear
line of authority between these agencies and the metropolitan sixuc-

ture. For instance, in the transport sector, the Light Rail Transit Au-
thority (LRTA) is under the Department of Transportation and Com-
munication (DOTC), Traffic Engineering and Management Team is
under the Department of Public Works and Highways (DPWH), road
construction and operations are under DPWH and local governments,
vehicle registration and licensing are with the Land Transportation
Office (LTO) and the Land Transport Franchising Regulatory Board
(LTFRB), flood control and drainage is with DPWH, environmental
management and services are with the Department of Environment
and Natural Resources (DENR) and the Laguna Lake Development
Authority (LLDA).
The problem of coordination especially in urban iniiastructure
was not evident during the MMC regime as it was during the MMA
establishment, when it suffered not only financial and manpower
constraints but also powerlessness in coordinating metro-wide ser-
vices. While greater powers have been given to the present MMDA,
problems still exist in the area of vertical and horizontal coordina-
tion among national sectoral agencies as well as local governments.
The last element of the triad is the choice of metropolitan struc-
ture. Existing and emerging metropolises in the country may choose
one or a combination of the following models of governance struc-
ture acceptable to its members: (1) a metropolitan city, under which
a single LGU has responsibility for all local functions; (2) jurisdic-
tional fragmentation, under which the responsibility for the same
local functions lies with the various LGUs operating in the metropoli-
tan area; and (3) functional fragmentation, under which the provi-
sion of services is area-wide but divided along functional lines among
the LGUs and one or more autonomous agencies or corporations
(Bahl and Linn 1992). However, each of these metropolises will have
to craft its own structure considering the multiplicity and variety of
political and socioeconomic challenges.
Alternative Metropolitan Structures

Given the issues raised in the preceding section, the task of
choosing from among the variety of metropolitan structures would
definitely not be easy. This section now discusses some of these alter-
native structures for metropolitan management and how they can
address the particular needs of the present and rising metropolitan
arrangements.
New city or metropolitan city

The metropolitan area may be structured as a metropolitan city
where the provision of most basic services is provided by a Single LGU
and where no other LGU operates in the area. A metropolitan city
may occur naturally by virtue of the prior existence of a political juris-
diction whose land area is large enough to contain its urban sprawl
within its boundaries. Alternatively, a metropolitan city may result from
the annexation or amalgamation of a number of existing political
jurisdictions or LGUs into a single political administrative unit. Met-
ropolitan Bangkok is actually a merger of former municipalities of
Bangkok and Thonburi. The result was the creation of the Bangkok
Metropolitan Administration (BMA), an autonomous metropolitan
city government. The BMA charter provided for a metropolitan as-
sembly consisting of both elected and appointed members, each rep-
resenting a constituency of about 100,000 people, the equivalent of a
district. Aside from Bangkok, metropolitan cities in other countries
include Seoul, Kuala Lumpur, Surabaya and Jakarta.
The metropolitan city structure provides some ease in coordi-
nating activities and implementing plans. The duplication of services
is less likely and the new city tends to be large enough to enjoy econo-
mies of scale (Bahl and Linn 1992). The formation of a new citycan
provide a resolution to the legal administrative ties between the prov-
ince and the municipality/ies that are involved in the metropolitan
arrangement. Their legal identity in the local government system is,
thus, clearer and more defined. However, the weakness of the metro
city's structure lies in its general inability to account for intra-city or
neighborhood differences in the demand for the services.
For metropolitan arrangements that involve only a relatively few
local entities and where political and cultural forces are less problem-
atic, a plebiscite can be held for a new city charter. The CAMADA
may be an eligible candidate. Interviews conducted with high offi-
cials of Dagupan City and the municipalities of Calasiao and
Mangaldan indicated no strong opposition to this option. However,
since the two municipalities thought that because Dagupan City has
twice their population, they may have to field one candidate for may-
orship or governorship for the newly formed political unit to com-
pete with Dagupan City.
Jurisd'wtional frabomentation with a second-tier government

The second approach to metropolitan governance is to allow
for jurisdictional fragmentation, i.e., the existence of several LGUs
side by side with a second-tier governance structure within the met-

ropolitan area. This structure is very common in the United States
but examples in developing countries do exist, notably Metro Ma-
nila, Sao Paulo, Lima, Rio deJaneiro and metropolitan areas in South
Asia.
Geographic or jurisdictional fragmentation is usually a sponta-
neous phenomenon stemming from the expansion of the metropo-
lis beyond the primate or core city. This model promotes economic
efficiency by bringing the government closer to the people and, con-
sequendy, making it more responsive to local preferences. However,
it has the disadvantage of being less able to capture the benefits from
economies of scale and to address problems associated with spillover
effects of certain types of services. The creation of the second-tier
governance structure in this model is precisely aimed at counteract-
ing this inherent weakness in jurisdictional fragmentation.
The upper-tier structure takes various forms in different places
around the globe. One may have a metropolitan development coun-
cil, metropolitan development authority or a metropolitan govern-
ment. The difference among these three options lies in how power is
shared among the LGUs in the metropolitan area and the leadership
structure in the second-tier.
Metropolitan development council (MZK2)

A common and less complex form of metropolitan structure is
a metropolitan development council (MDC). In this structure, the
powers of LGUs composing the council are maintained. Metropoli-
tan leadership rests on the council composed of mayors represent-
ing the cities and municipalities and whose chairmanship is appointed
from among the members.
A similar model can be found in most large U.S. metropolises
such as the Metropolitan Washington Council of Governments
(WASHCOG), which is an association of federal, state and local gov-
ernments concerned with the Washington metropolitan area. The
metropolis covers a land area of 4,000 square miles located in three
states (Maryland, Virginia and District of Columbia) with a popula-
tion of about 4 million people.
The MMA is a form of MDC. Metro Naga's adopted structure is
one vari_/nt that follows the RDC type of organization, minus the
agency representations. Instead, it has purely local government com-
position. The Metro Davao3 model also has semblance to this struc-
ture. The difference between these existing models is their respec-
tive technical and administrative support. Metro Naga relies on

secondment of technical personnel from the member LGUs to serve
in the MNDC Secretariat. Metro Davao3, on the other hand, estab-
lished a full-time Project Management Office to manage the affairs
of the regional program. Meanwhile, the MMA has full-time person-
nel with plantilla positions, owing to its being an interim metropoli-
tan structure after the abolition of the MMC.
One advantage of this metropolitan structure is its relative ease
in obtaining national support mainly because it is backed by constitu-
tional provisions. An executive order from the president will suffice
to sustain its legal identity and financial backing. However, because
of the limited budget of the executive, financial sustainability of the
MDC is always at risk. In the case of Metro Naga, its appropriation is
taken from an agency budget. However, such could prove disadvanta-
geous to the agency? Local self-reliance in financing the council can
hold some promise, as in the case of Metro Davao3--that is, if LGUs
sustain their commitment to the arrangement. The MMA's regime
suffered because the LGUs refused to contribute their Internal Rev-
enue Allotment (IRA) shares to maintain the authority.
Metropolitan development authority

An attractive form of metropolitan structure is the metropoli-
tan development authority (MDA). This is in view of its relative insti-
tutional permanence, greater corporate powers and functions and
fiscal advantage. Also, since it is more of a technocratic organization
than a political body, it de-politicizes decisionmaking especially on
issues that are controversial or difficult to be raised by an elected
leader as they involve political risks.
In the Philippines, the creation of an MDA lies with the legisla-
tive branch by virtue of a congressional law enacted for that purpose.
The metropolitan authority is typically headed by a chief executive
officer who is appointed by either the central government or the state
government.
What easily comes to mind when referring to this model is the
MMD& Based on interviews conducted in the regions, Metros Cebu,
* The NEDA, from which the MNDC's appropriation is lodged, had to defend its
recommendation to increase its budget ceiling following the addition of MNDC as a
new item in the agency budgeL
BLIST, lloilo and CDO tend to prefer the MMDA structure but it is
difficult to determine whether such structure would fit in the socio-
economic and political milieu of these emerging metropolises. Issues
on political jurisdiction would have to be resolved and may require a
regional plebiscite to determine the people's willingness to conform
to a new administrative unit. Also, their coordinative relationships
with the regional institutions (e.g., RDC) should be clearly spelled
out.
Metro Manila is unique because it is a region in itself but func-
tioning as the RDC of the national capital region. Therefore, when
adopting its model on other regions, adjustments may have to be
made, especially on those that compose a significant geographic and
political part of a region. Moreover, these are questions raised with
respect to the strength of the authority because it displayed weak
leadership and ineffective coordination of activities with local gov-
ernments and national agencies. Caution, therefore, must be taken
so that the faulty features of the model are avoided if it is to be adopted.
A lot of cities or metropofises in South Asia, including New Delhi,
Bombay, and Colombo, have adopted this model. Experience has also
shown that, as has been the case in Karachi, metropolitan-wide au-
thorities have not been able to resolve conflicts in project implemen-
tation and that central and provincial governments have to intervene
(Cheema, in ADB 1987). Moreover, Bahl and Linn (1992) noted that:
MDAs need to have executive functions and fiscal autonomy

(resources) if they are able to coordinate the delivery of ser-
vices within metropolitan areas and provide certain services
with area-wide benefits. A planning agency with only advisory
powers cannot effectively play this integrative role. Typically,
MDAs have not been given such powers and as a consequence
their effectiveness has suffered .... MDAs often fail to com-
bine development (investment) and operating responsibility
and thus create the typical turnkey problem: the agency re-
sponsible for capital ouday and planning does not allow suffi-
ciently for the preferences and the technical, managerial, and
financial capacity of the operating agency. The result is that
local facilities deteriorate for lack of adequate maintenance. 4
These weaknesses are shared by the two other models ofjurisdicational fragmentation
discussed in this section.
Meixo4_lilaJa government
The establishment of a me tropolitan government is one of the
more controversial options. Metropolitan government differs from
authorities or development councils in that the LGUs composing the
metropolitan area are subjected to a higher jurisdictional authority
or government whose leadership is usually elected. The metropolises
of Tokyo and Toronto adopt this model.
In a metropolitan government setup, the body is usually headed
by an elected governor. There is a single-tier council and the city and
municipal mayors also act as area managers. The governor coordi-
nates the sectoral departments of the national government. In the
Philippines, the establishment of this kind of metropolitan setup will
only be possible with the amendment of the present Constitution. As
discussed in the earlier section, LGUs have been safeguarded by the
Constitution against any form of disempowerment that may result
from the establishment of metropolitan authorities or similar bodies.
It should be recalled that the new charter was framed in preparation
for the abolition of centrist governance (under the Marcos adminis-
tration) in favor of a more democratic regime and local autonomy.
A compromise metropolitan government can be set up whereby
the local governments retain their powers and function but surren-
der to the metropolitan government those functions and activities
that are metropolitan in character or those that transcend political
boundaries. The leadership shall be through an elected governor,
who shall therefore command the respect of both the people and
the local executives in the metropolitan area.
Functlonal_
With functional fragmentation, LGUs in the metropolitan area
have limited responsibilities for service delivery, but autonomous lo-
cal bodies with corporate powers are given the authority to under-
take specific functions and services on a metro-wide basis. Special
metropolitan corporations can be established to perform services such
as water supply and sewerage, electricity, transportation and solidwaste
management. The metropolitan corporation model is suitable in ad-
dressing economies of scale in capital-intensive services like public
utilities and transportationmareas where smaller LGUs would nor-
really have difficulty financing. The "corporatization" of service deliv-
ery has the advantage of energizing the management of service deliv-
ery activities by professionals (vs. politicians) whQse decisions tend to
be shielded from political interventions. Moreover, this mode pro-
motes greater cost recovery; thus, assures the availability of funds for
the expansion and maintenance of a particular service. However, this
model makes cross-sectoral coordination more difficult and may lead
to either over or underinvestment in certain sectors because of the
earmarking of user charges to the activities. In Metro Manila, the
Metropolitan Waterworks and Sewerage System (MWSS) and the Light
Rail Transit Authority (LRTA) are examples of the functional frag-
mentation2
There are other laudable models of these metropolitan corpo-
rations outside the country. For instance, the Metropolitan Toronto
Corporation, with its agencies, boards and commissions, provides
specialized urban service functions such as licensing, zoo maintenance,
performing arts center administration, police services, transportadon,
family and child service. The Karachi Metropolitan Corporation in
Pakistan takes care of development projects through its subsidiaries,
the Karachi Development Authority dealing with land and infrastruc-
ture projects and the Karachi Water Supply and Sewerage Board. In
Metropolitan Madras, development projects and operation of urban
services are executed by governmental, parastatal and municipal or-
ganizations, one of which is the Madras Corporation that is governed
by a council of 120 elected members and administered with a state-
appointed special officer. The commissioner, who is the executive
head of the corporation, is also appointed by the state government.
In Cartagena, Colombia, the Municipal Public Service Company
(EPM) provides the majority with local public services including wa-
ter supply, sewerage, fire protection, administration of public mar-
kets and slaughterhouses.
Public corporations have been tried in the Philippines with some
degree of failure and success but the experience has been largely
limited at the national level. Metropolitan organizations may, how-
ever, adopt this model based on the success features in other metro-
politan bodies abroad. However, a more basic issue has to be resolved.
That is, whether the metropolitan body has the legal or corporate
personality to undertake this form of service provision. In the case of
Metro Manila, Presidential Decree 824 issued in 1975 created Metro-
politan Manila as a public corporation but Republic Act 7924, which
created MMDA in 1995, redefined the metropolis as a special devel-
5Operationally, however, these are government-owned and controlled corporations

(GOCCs) and, therefore, outside the coverage of the metropolitan unit.
opment and administrative region. Meanwhile, RA 7924, which is the

existing legal framework for Metro Manila, no longer recognizes its
corporate personality (unlike PD 824) nor allows for MMDA to cre-
ate corporations.
There are three notable reasons why it is advantageous for a
m_tropolis to have a corporate personality. First, it will be able to
advance economic interest should it require resources that are be-
yond what it can immediately provide; for instance, via capital market
or through other financial arrangements with private institutions.
Second, a metropolitan corporation may address the issue of decen-
tralization versus re-centralization. For instance, acting as stockhold-
ers, LGUs can more forcibly advance their own interests as well as
determine the functions of the organization and the manner by which
these capacities will be carried out. Third, a corporate structure gives
continuity to programs despite the limited tenure of local govern-
ment leaders.
Conclusions and Agenda for National Policy Action

The metropolitan area is the ultimate form of urban transfor-
mation. Once an area reaches this stage, it becomes imperative that
the area should not be constrained to evolve an identity as a new
political and administrative unit. This will facilitate the formation of
an organizational machinery that is appropriate, effective and effi-
cient.
This paper has shown concrete examples of this urban transfor-
mation and how the emergence of this phenomenon in many urban
areas of the Philippines has necessitated new forms of administrative
structures. The metropolis is not a province, municipality or city. It is
rather a collection of all these and therefore requires unique plan-
ning models and distinct legal laws.
Metropolitan planning and development is fast becoming a new
feature of local governance in the Philippines. While most of the
groundwork is undertaken largely by local governments themselves,
the national government plays a critical role, especially in providing
the legal framework and environment conducive to such undertak-
ings. The following is a list of some of the short-term and long-term
agenda for action in support of metropolitan development.
Review of basic laws supporting metropolitan devekrpnwnt

While the present Constitution has authorized the creation of
special metropolitan political subdivisions," it has delimited the ex-
tent to which metropolitan management will proceed. This is because

of the provision that says higher jurisdictional body such as metro-
politan authorities can only be established through a congressional
act and that "cities and municipalities shall retain their basic autonomy
and shall be entided to their own local executives and legislative as-
semblies." Thus, there are no laws that allow a desirable metropoli-
tan mechanism with sufficient powers and authority when the situa-
tion calls for its establishment. One of the immediate tasks of
policyrnakers, therefore, is to make appropriate amendments to the
Philippine Charter that will strengthen the metropolitan structure
and promote the objectives of metropolitanization. Some of the prom-
ising provisions can be the inclusion of metropolitan areas as a recog-
nized territorial and political subdivision of" the country. With such
recognition, it would be easier to accord the structure with enough
powers and functions inherent in such political subdivision. This can
provide [br a stronger constitutional authority and flexibility for any
legislation pertaining to metropolitan organizations.
Rad, ao/inelnde provisions in the Philippine Local Government

Code
The Local Government Code has overlooked local governance
relative to the current and future dynamics of urbanization. Rapid
urbanization as a result of greater industrialization and agricultural
modernization, however, has compelled local government units to
expand their political and administrative linkages with neighboring
cities and municipalities.
Should changes be made in the Local Government Code, its
amendments should be in line with the proposed changes in the
Constitution. This will allow for the eventual changes in the way shar-
ing of powers and functions between LGUs and the constituted met-
ropolitan organizations are to be effected. The current Local Gov-
ernment Code has further strengthened LGUs' powers and respon-
sibilities while overlooking the fact that a number of them are attain-
ing the metropolitan character. No provision, however, has been made
to vest appropriate powers and responsibilities best suited to deal
with the unique requirements of metropolitan management and de-
velopment. In fact, serious problems still exist in so far as sharing of
powers and responsibilities between the capital city and the surround-
ing municipalities is concerned as well as in the lack of appreciation
to give up some of their powers and functions to a higher jurisdic-
tional body.
There are at least two areas where amendments can be explored.

First, the assignment of urban functions or services to a metropoli-
tan unit ought to be consistent with and complement that of other
LGUs or other government agencies. At the very least, the functions
can take into account those that are metropolitan in character. Po-
tential services for metropolitan units to assume include land use plan-
ning, traffic management, solid waste management, water and sewer-
age services, transport services, flood control and management. Sec-
ond, the functional relationship of the metropolitan unit with other
government entities must be clear and well-thought for better coor-
dination and maximized benefits. For instance, in the area of budget
review, the absence of an institutionalized development planning for
Metro Manila was weakened when the Code passed on the review of
the LGU budget to the DBM rather than to the MMDA (then MMA).
This has institutionalized the disjointedand uncoordinated program-
ming and budgeting process in the metropolis and prevented maxi-
mum use of Metro Manila's resources. Had the line of responsibility
between the metropolitan unit or organization and the LGUs regard-
ing plailning, programming and budgeting faanctions been recognized
and made clear, then key problems and needs arising from the grow-
ing urban service and infrastructure requirements in the metropolis
could have been strategically formulated. The same lack of institu-
tional linkage with the sectoral line agencies makes it difficult for the
MMDA to influence these agencies' priority thrusts.
Recognize roles of _litan planning and institutions in the

present and future urban managenwnt
Urbanization and the rise of new metropolises are inevitable
and the challenge of sustainable development in the next century
lies in their effective and efficient management. National and regional
planners' perspectives must seriously recognize the implications of
metropolitanization in their medium- and long-term development
planning efforts.
The RDC as a nonpolitical entity can be a catalyst for interlocal
or metropolitan undertakings in the region. As the development
planning and policymaking body in the region, it can support and
provide impetus to efforts where local governments are politically
constrained to initiate.
Promote researchand deve/opm_ on metwpol/tan p/ann/rig

and management modds
Literature relating to city or metropolitan planning and
management are not that many. In the Philippines, rigorous policy
studies are rare and if there are any, most are focused on Metro Manila
only. Given the myriad and increasing number of issues and problems
of the city and metropolises, studies should be made on a more
sustained basis to ably assist leaders in making appropriate policy
interventions.
Offhand, there are at least three related issues that have to be
tackled in the short term. One is the need to look at what a metropolis
or a metropolitan unit can or cannot do under the existing legal
framework. A clear understanding of this aspect will reveal important
issues for intervention by the legislature. Two is the need for a deeper
study on the issues brought about by the changes in the institutional
dynamics between regional and subregional governments following
the emergence of a metropolitan arrangement. The policy study can
identify how a metropolitan cooperation can enhance rather than
obstruct regional development coordination. Third, financial
mobilization under a metropolitan setup or similar inter-LGU
arrangement is an important area for research since financial
sustainability is the lifeblood of any metropolitan arrangement.
Long-term issues can be identified in the areas of financial
structure and management, improvement in the administrative
capacity to meet the increasing demand for shelter and basic services,
improvement of urban information systems, development of urban
institutional capacities and issues pertaining to urban environmental
management.
Finally, the study has also explained that metropolitan planning
goes beyond technical development planning, it is often political
planning, a relational and prudent approach that sets it into reality
and fruition. Sivaramakrishnan and Green (1986) has an interesting
description of this:
"In reality, metropolitan management is an unglamorous

interagency process; its accent is on consensus rather than on
command; its quality is a product of perseverance and team
effort; and its success in the long-run is directly dependent

on the degree to which that effort can continue to be
maintained in the rapidly changing kaleidoscope of
metropolitan life,"
A metropolitan arrangement is a crucial beginning of

metropolitan development. It can be a passing fancy if the members
of the arrangement who hold the key to its full development lose
their enthusiasm and zeal to make it work and if the national
government fails to open its mind to new avenues and ways of thinking
about decentralization and local governance.
References
ADB (Asian Development Bank). 1987. Urban Policy Issues.

Proceedings of the Regional Seminar on Major National
Urban Policy Issues, February 3-7. Manila.
_. 1994. MegacityManagement in the Asian and Pacifw Region, edited

byJeffrey Stubbs and Giles Clarke. Vols. 1 and 2. Mandaluyong
City, Philippines: ADB.
Angotti, T. 1993. Metropolis 2000: Planning, Poverty and Politics. New

York.
Bahl, R.W. and J,E Linn. 1992. Urban Public Finance in Developing
Countries New York: Oxford University Press.
BDUPP (Baguio and Dagupan Urban Planning Project). 1994a.

BLIST. Manila.
_. 1994b. CAMADA. Manila.
Ganapin, D.J. 1997. Prospects for Greater Public-Private Sector

Partnerships. Paper presented at the Conference on Solid
Waste Management Capability Building, Cebu City, June 26.
Gonzales, E. 1997. Settlements, Growth Zones and Urbanization.

Paper presented at the Technical Workshop on Population
and Urbanization, PIDS, Makati City, 22 September.
Housing and Urban Development Coordinating Council / Local

Government Development Foundation, Inc. 1998.
Metropolitan Manila Management Study. Manila.
Japan International Cooperation Agency. 1994. The Study on the

Cebu Integrated Area Development Master Plan. Final Report,
Vol. 2. Cebu.
National Land Use Committee NEDA. 1992. National Physical

Framework Plan.
NEDA (National Economic and Development Authority). 1996.

National Urban Policy Agenda.
NEDA Regional Office XI. n.d. Profile of the Davao Integrated

Development Program.
Republic of the Philippines. 1991. The Local Government Code of 1991.

Congress of the Republic of the Philippines of 1987-1992,
Manila.
Serote, E. 1994. Toward a Nadonal Urban Development Policy: A

Conceptual Framework. Pasig: National Land Use Committee.
Sivaramakrishnan, K.C. and Leslie Green. 1986. Metropolitan

Managcnumt: The Asian Expoqence. NewYork: Oxford University
Press.
United Nations University. 1994. Mega-City Growth and theFuture. Tokyo:

UNU Press.
Chapter
3
Environment and Natural
ResourcesManagement:
Lessonsfrom City Program
Innovations
he enactment of the 1991 Local Government Code brought

local government units (LGUs) greater responsibilities to
manage their natural resources and the environment. In
particular, the following environment-related mandates have been
given to the city:
Solid waste disposal system or environmental management

system and services or facilities related to general hygiene
and sanitation (Sec. 17.b.2.vl).
Pursuant to national policies and subject to supervision,

control and review of the Department of Environment and
Natural Resources (DENR), enforcement of forestry laws
limited to community-based forestry projects, pollution
control law, small-scale mining law, and other laws on the
protection of the environment; and mini-hydroelectric
projects for local purposes (Sec. 17.b.3.iii).
Tourism development and promotion (Sec. 17.b.3.xii);

tourism facilities and other tourist attractions, including the
acquisition of equipment, regulation and supervision of
business concessions and security services for such facilities
(Sec. 17.b.2.xi).
For some Philippine cities, the enormous responsibilities placed

on them have brought more opportunities for greater dynamism and
innovation. Strategies employed and programs undertaken vary in
focus and form depending on the city's stage of development and,

relatedly, on the features of the city environmenL For instance, natural
resource-rich cities have made the environment the focus of their
overall development strategy, particularly in relation to resource
conservation and tourism development. Within the same focus,
variations are evident in both program content and the institutional
dynamics that were involved. Fo r largely urban cities, environmental
problems are associated with growth of economic activity and for most
of these cities, special attention is given to the maintenance of air
quality, cleanliness and managing solid waste. Although strategies
adopted differ, all the cities achieved a relatively similar degree of
success. A number of these successful programs have features and
implementation process that can be considered unique or innovative.
While these programs were crafted under the socioeconomic and
political milieu of their respective areas, they nevertheless provide
valuable insights to other LGUs wanting to better their program design
and execution.
This paper aims to draw lessons from some selected cities that
have undertaken innovative environment programs and to highlight
the key elements that have made their programs successful and
sustainable. It concludes with a brief account of other environmental
management concerns that have not been given significant emphasis
and attention or where performance has been short of expectations,
and suggests measures to address the same.
Selected City Environmental Programs
Puerto Princesa City: Oplan Linis and Bantay Puerto Programs

There are two major environment programs that Puerto
Princesa City has undertaken: Oplan Linis and Bantay Puerto. These
have been successfully implemented, bringing national and
international recognition to the city. The city has become a source of
inspiration to many local governments not only in the area of
environmental management but also in the area of local governance.
Puerto Princesa's secret for being the cleanest and greenest
city in the Philippines-is the sustained implementation of the Oplan
Linis Program. The program has significantly remade the image of
the city from the haven of prisoners and malaria-causing mosquitoes
that it was to what is now the most envied city for its estimable
cleanliness and for its reputation as one of the major tourist
destinations in the country.
Environment and Natural Resources Management 77
Table 1. Basic Features of Oplan _ Program

Component Obiectives Activities
Cleanliness Maintain - Street sweeping
cleanliness in all - Cleanliness contest in barangays and schools
public places (local version of Clean and Green Award)
- Award for Cleanest and Dirtiest Barangay
-_Monthly general cleanin G
Sagip-Dagat;, Maintain coastal - Operation of redemption centers in coastal
Operation areas clean barangays for wastes dumped in coastal areas
Basura - Low-cost housing program for _luatters
living near the coastal area
Beautification Beautify the city - Painting of sidewalks
- Planting of ornamental plants and trees
- Nursery for continuous supply of planting
materials (Program buys from children 5 tetra
packs for P1.00. They are used to grow
seedlings/cutting of plants_)
Sanitation Promote sanitary - Installation of garbage receptacles (donated by
practices the business community) along main streets and
other conspicuous places"
- Putting-up of comfort rooms in coastal and rural
barangays
Information Disseminate - Organization of information team composed of
and Education information about representatives from city government and civic
the program organizations
- Tapping government and private entities to assist
ill all information-related activities
- Airing of a rive-minute local TV program to tackle
issues on cleanliness
- Formation of Oplan Linis Families (OLF) in each
school composed of a minimum of 50 students
providing cleanliness awareness in their
immediate neighborhood. Each OLF is required
to submit a regular accomplishment report.
Operation Improve air - Strict enforcement of the following ordinances:
Sagip-Hangin quality in the city Anti-Littering, No-Smoking and Anti Pollution.
- Violators are imposed fines and their names are
flashed on TV and aired over the radio_
Solid Waste Improve garbage -Daily collection of garbage in the marketplaces
Management collection and and scheduled zone collection in residential areas
disposal - Program introduced to produce organic
Iertilizex_ fi'om wastes disposed through IRREN
Foundation (an NGO). Fox"this purpose,
classification of garbage at the household level is
slowly being introduced. Target collection in
residential areas is once a week.
Source: Oplan Linis Story: The Puerto Prineesa City F_, Puerto Princesa City Government,
1996.
Puerto Princesa City now claims to be larger than Davao City in

terms of land area (253,982 hectares) and, therefore, boasts of being
the largest city in the world. Despite its huge size, the city has
successfully managed to make the task of cleaning, greening and
beautifying itself a not-so-difficult undertaking.
The Oplan Linis Program aims to sustain cleanliness and beauty
in the city through program institutionalization and community
participation. Table 1 presents a summary of the basic features of the
program.
The program is being managed by a full-time staff headed by a
project manager (who, incidentally, is the wife of the mayor), two
assistant project managers and a program supervisor for each of the
program components, i.e., Cleanliness, Sanitation, SagipDagat (Save
the Seas), Beautification, Sagip Hangin (Air Improvement Program),
Dog Pound and Information and Edfication. At the lower level of the
organization are 50 grass cutters, 70 street sweepers and gardeners,
50 garbage collectors and various workers and volunteers.
Program cost at the start of the program in 1993 was P2.1 million.
This increased to P6.1 million in 1995, representing amere 1.3 percent
of the total budget. Initial program cost was spent on information
and education campaign (e.g., media hour, printed materials,
consultations, etc.), which were considered essential to make the
program effective and successful. In later years, cost for personnel
services, mainly for street sweepers, exceeded the cost for operations
following the expansion of the program's coverage area.
Palawan is considered the Philippines' "Last Frontier." As the
capital, Puerto Princesa City considers its critical role as a "steward of
(its) biodiverse resources and as the active promoter of the balance
of its total ecology" (Puerto Princesa City Government 1997). Faced
with illegal activities existing both in the forests and in the seas [e.g.,
illegal logging, kaingin (slash-and-burn) method of farming,
destructive forms of fishing such as use of dynamite and cyanide, muro-
ami], the city has responded to the call of conserving, preserving,
rehabilitating and sustaining the development of"its forest and water
ecosystem through the Bantay Puerto Program.
The Bantay Puerto Program originally had four components:
City Forest Protection Project or the Bantay C-4zbat,City Coastal Areas
Protection Project or the Ba,ntay Dagat (Bay-watch), Special Task Force
Unit and the Special Monitoring Unit. Lately, another component
was added, i.e., the operation of the Cyanide Detection Laboratory.
Environmentand Natural ResourcesManagement 79
Table 2 provides a general description of the Bantay Gubat and Bantay

Dagat projects and their accomplishments.
The Special Task Force Unit (STFU) and the Special Monitoring
Unit (SMU) lend support to both the Bantay Gubat and Bantay Dagat
projects. The STFU evaluates and disseminates intelligence
information, prepares plan of action relative to illegal activities and
performs apprehension or arrest of violators. The unit is a 21-person
body headed by a task force leader from the PNP, a civilian task force
Table 2. General Information on Bantay Puerto Program Components

Program Objectives Strategies / Activities Highlights of Major
component Accoml_sh_ems
Bantny To address the Intensify information During the first 100 days of the
Gubat alarming dissemination campaign program, confiscated
(City Forest reduction of regarding preservation and 33,302.17 board feet of
Protection forest cover in conservation of the city's illegally cut logs, 2,749 pieces
Project) Palawan that forests_ of round poles, 3 chain saws
reportedly and 50 illegally caught wildlife.
decreased from Strengthen partnership and
75 percent in cooperation of the city with Instilled in the community that
1976 to 50 DENR, DA, DILG-PNP, NGOs the government is serious in
percent in 1992. and PVOs in the enforcement enforcing and carrying out
of forest-related laws_ forest protection laws.
To conserve,
preserve and Organize and train 24 Increased awareness and
rehabilitate the community-based forest importance of forest
forest areas of protectors serving as project conservation and
the city, managers in the identified rehabilitation by instituting
particularly in critical areas, the "Pista Y ang Cageban"
the identified 24 (Feast of the Forest) held every
environmentally Establish four checkpoints (2 June 7 to reforest the denuded
critical rural in the north and 2 in the watershed of Irawan.
barangays, south) equipped with radio
communication system and DENR devolved to the city the
motorcycles, management of the Irawan
Watershed and the St. Paul
Plan and conduct operations/ Subterranean National Park
raids against illegal activities. (Nagkan Tribe of Palawan,
Haribon Foundation and
Seize illegally caught marine Ulugan Bay Foundation sit as
products and equipment used Board Members).
in the commission of the
crime and apprehends its
violator/s.
Endorse to authorities
concerned any confiscated
property for proper custody.
Organize/create a foot patrol

group in most critical areas.
Table 2 (continued)
Bantay To lessen, if not Daily (average of S hours) In the initial months of the
D_at eliminate, the patrolling of the fbur strategic program, the city government
(Baywatch) depletion of bays of the City. passed an ordinance banning
marine resources the shipment of all live fish
due to illegal Intensify information and lobster out of the city_
fishing activities dissemination campaign
regarding preservation and Daily patrolling of the bays
conservation of the city's resulted in the confiscation of
coastal areas, a total of 482 seacrafts as of
end of 1994_
Strengthen partnership and
cooperation of the city with Seized 13 pump boats engaged
government agencies in illegal fishing activities; 184
especially the Philippine pump boats without
Coast Guard and NGOs. license/permit from
Philippine Coast Guard and
Maintain six outposts placed BFAR; collection of P309,000
strategically in the different from one fishing vessel for
bays of the city. muro-ami fishing within 7-kin
boundary of the city and for
Plan and conduct vessel overload; and from one
operations/raids against fishing vessel loaded with live
illegal activities, fish without permit and
manned by British nationals
Seize illegally caught marine without passport or working
products and equipment used permit_
in the commission of the
crime and apprehends its
violator(s).
Endorse to authorities
concerned any confiscated
property for proper custody.
Source: Puerto Princesa City Government Documents (4th City Sharing Workshop paper and
Galing Pook Award application materials).
Note: The Gaiing Pook Program is a national program that aims to recognize local governance
or best practices in the areas of health services, environmental management, public
finance, peace initiatives, integrated approach to development, sociocultural
development, employment generation/livelihood and productivity improvement.
leader, 10 PNP personnel and nine civilians. The SMU is composed

of 10 monitoring officers tasked to monitor problems in the
implementation of the program and gather information on specific
areas of concern as directed by the program manager. The added
feature in the program is the establishment of the Cyanide Detection
Laboratory, which has been accredited by the NBI to assist in legal
cases involving cyanide fishing.
The whole Bantay Puerto Program is being managed by the city
mayor with the assistance of the project managers of each of the major
program components. The Bantay Gubat project manager is assisted

by two project assistants, 24 community forest patrol officers, 24
checkpoint sentries and a project recording secretary. The Bantay
Dagat project manager is assisted by two project assistants, seven banca
(boat) operators , seven deputy marine guards and a project recording
secretary.
Bagnio City: Clean and Green, and Eco-Walk Programs

The active and substantial involvement of Baguio City's
community and the civil society in the affairs of the city government
are more than exemplified in many of the cleanliness programs and
forest preservation projects of the city. While Baguio City is known by
various rifles such as "The Summer Capital of the Philippines," "The
City of Pines," "The Garden City," "The Education Center of the
North," and "The Regional Center of the Cordillera," the successful
implementation of its cleanliness and preservation programs has also
given it the title of "The Cleanest and the Greenest City."
Maintaining the city clean and green has been a great challenge
considering the multiple roles of Baguio City. The city serves as the
regional administrative center of the Cordillera region, the
commercial and retail trade center for agricultural products of
Benguet province, the center for higher learning in the north, and
one of the favorite tourist destinations in the country. These roles
carry with them a wide array of development activities that invariably
put a strain on the city's environment. To lessen the difficulty in
carrying out its task, the city government forged strong partnerships
with active nongovernmental organizations (NGOs), the media,
business sector and the community residents themselves. The Clean
and Green Program of the city of Baguio has seven components. Table
3 lists these components and their respective activities and
accomplishments.
The entire program would not be possible if not for the
partnership of the city government, the NGOs (particularly the Baguio
Re-greening Movement and the Alay sa Kalinisan) and the national
government agencies operating in the city. The organizational
structure of the Clean and Green Program shows graphically the
extent to which it has involved everyone. Separate structures were
established for the Clean effort and for the Green effort (Figures 1
and 2). Barangay/Baguio residents' inclusion in the organizational
structure is a recognition of their important role in the success of the
.program and its sustainability.
Table 3, Baguio City Clean and Green Program Components

lh-ogram Activities -- Major accomplishments
component
Sofid Waste Dally garbage collection 117 out of 129 barangays are served with
Management the city's collection system (90 percent)
Orgmaization of Quick
Response Team on call for
emergency garbage
collection especially during
peak seasons of summer
and Christmas
Advocacy campaign 20 barangays have attended as of 1996

through training of
barangay residents on the
3Rs of Solid Waste
Management (Re-use,
Reduce and Recycle)
Local Clean and Green Contests held every year in schools, public
Contest buildings, barangays, local departments of
the city govemmeaat, includingjeepney
Annual purchase of one terminals.
g-,u'bage ffuck
Liquid Waste Installation of more latex_ 10 sewerage projects completed in 1995

Management and secondary sewer lines (e.g., installation of 2422.1 lineal meters
of sewer pipes, 25 manholes and one
communal septic tank, repair and
rehabilitation of 70 linear meters of old
sewer lines and 256 manholes in various
parts of the city).
Intensified monitoring of City Ordinance provides for mandatory

pollution levels in creeks connection to the public sewer system.
and natural and man-made City government undertakes regular
waterways within the city sampling and testing to determine the
bio-oxygen demand and carbon oxygen
demand levels of different tributaries in
the city_
Environmental Conduct of regular Organized a special task force that

Sanitation and inspections of food centers, conducts on-the-spot checks on
Management recreational facilities, night compliance.
spots and u_,msient housing
facilities, including Conducted regular mad compulsory
dormitories and boarding health testing and training of food
houses in terms of handlers.
compliance to health and
sanitation standards
Abattoir Establishment and strict New/acility established, which is

Operations maintenance of a cleml and provided with rails where animals are
sanitary environment of the hanged and slaughtered. This way, floor
new abattoir facility_ dressing and carc'asses are avoided, thus
Table 3 (continued)
ensuring utmost sanitation in the area

and fresh and disease-free meat.
Liquid wastes and other effluents

generated by the abattoir are disposed
of through the Sewerage Treatment
Plant while solid wastes are collected
regularly by garbage trucks for disposal
in the city dumpsite-. Part of solid waste
is composted for use as fertilizer.
Perimeter fencing of the City Abattoir to

discourage further squatting in its
vicinity.
Anti-Smoke Intensified compulsory Acquired new smoke-testing machine.

Belching testing of all motored Intensified testing generated P796,:190
vehicles especially diesel- worth of income from fees and fines and
fed vehicles more importantly, raised awareness of
the city's serious drive against smoke
belching and proper maintenance of
vehicles.
City's inter-agency Traffic and

Transportation Management Committee
conducted an "Anti-Smoke Belching
Contest," a search tot model driver and
model uansport association with big
cash prizes donated by the private
sector,
Pat'ks Regular maintenance of Collection and propagation of seeds of

Maintenance city parks and street islands ornamental plants and tree seedlings as
and a continuing activity.
Reforestation
Reforestation Evaluated success of the city's 57
reforested areas (10 reforested by the
city government and 47 by various
private organizations). Results showed
about 70 percent survival rate
representing 27,698 total surviving trees-
Apprehension of 55 persons violating

forestry laws and effecting the
confiscation of various tools and
equipment as well as forest products
valued at P46, 322.28 in 1995.
Table 3 (continued)
Program
cmnimmmt
Activities Major
Advocacy Tri-media advocacy Public Information Office of the City
campaign to generate Government spearheaded the campaign
people participation and, that also led to the implementation of
enthusiasm the Eco-Walk Program.
DECS launched in the different

elementary and secondary schools in the
city the "War Against Waste" project-
Office of City Social Welihrc and

Development and Public Employment
Services Offices incorporate clean and
green agenda in their respective
prosa-ams.
Source: Office of City Planning and Development Coordinator (OCPDC), Baguio City, 1997,
"Always Clean, Ever Green_"
Financing the program is not solely the responsibility of the

city government. Although mainly funded by the city government
(17 percent of its annual budget in 1996), barangays and NGOs share
a relatively large amount to sustain the program. Table 4 shows a
summary of contributions to the program from the various groups in
1996.
Baguio City was a Galing Pook Awardee in 1995 for its program
called "Eco-Walk: An Environmental Awareness Program for
Children." This program is actually a revival of a similar program in
1992. The 1992 project was started by the Baguio Regreening
Movement but not sustained due to lack of volunteer tour/hiking
guides. In 1993, an NGO called Timpuyog Ti Iit, whose members were
mainly barangay captains, pledged support to the program and
assigned its members as lifetime volunteers. They complement the
existing volunteers from other NGOs and government agencies that
believe in the program's rationale and objectives. Figure 3 shows
graphically the process involved and the activities undertaken as part
of the Eco-Walk Program.
The basic objective of the program is value-formation, which is
considered the foundation for the protection, conservation and
rehabilitation of the city's environment. In particular, the program
Table 4. Clean and Green Program Budget and Sources, 1996

Sources Amount (P)
City Government 45,000,000
Office of City Mayor 2,000,000

General Servii:es 16,000,000
Public Utilities and Services 5,000,000
City Architect and Parks Superintendent 12,000,000
City Veterinarian 2,000,000
City Health Officer 4,000,000
Other Departments* 4,000,000
Barangays ** 645,000
.Association of Barangay Councils (ABC) *** 12,080
Baguio Regreening Movement 1,680,000
* All other departments share at least 1 percent of their respective budget to the program,
which is then used at least once a month for the massive cleanup of creeks and main
thoroughfares.
** The 129 barangays allocate at least P5,000 of their respective budget for the beautification
and cleanliness campaign
*** The ABC launched "Piso-Piso para sa Kalirlisan," which they turned over to the Alay sa
Kalinisan, an NGO leading the clean effort.
Source of basic data: OCPDC (1997).
F'_gure 1. Structure of the Clean Effort
Scctore [ NGA
LGU [ NGO/erivate 5
(ASK)
?day sa Kalikasan
[
ASKThrusts
I I 1
Qeanliness Drive Propagation of Medicinal Plants
I
Figure 2. Structure of the Green Effort
[ LGU ] [ NGO ] _ NG-A ]

I ] t _ [
] Baguio Re-_gr¢_ningMovement (BRM) I
I
I Executive Committee ]
Technical [ Re=greening [ I_oxma.tion

Committee 'AJ
[ I Committ¢_
I ,1 ] [/ C_c_tW_u, °n:-
umcauon
[ I Ways&Memls [ ] [ Community [ [
[ [ Committee [Service Com_nitteeJ
I Barmlgay / B_ttio
-/
Re;idents _]"
Source: OCPDC (1997).
hopes to make children aware of the importance of trees and forest

and learn how they contribute to the supply of water in the city. Busol
watershed was chosen as the site of the eco-tour walk since it is the
city's major source of water. However, due to denudation, it barely
produces 250 to 300 gallons per minute (gpm) from its original
generating capacity of 4,000 gpm.
The seven-member staff of the Public Information Office of the
City Mayor's Office serves as the coordinator and overseer of the Eco-
Walk Program. Volunteers who serve as guides of the children in their
hikes come from the Timpuyog Ti lit, the Baguio Re-greening
Movement (BRM), media practitioners, the Department of
Environment and Natural Resources (DENR) and the Baguio Water
District.
The program started with very minimal funding but as it
progressed, there were activities and projects that required bigger
funding. A fund drive was launched fbr the construction of a picnic
shed, wherein about P50,O00 was raised.
The city government now ha_sa regular budget of"P20,000 for
the purchase of reforestation tools. The BRM and the Timpuyog Ti lit
shelled out PIO,O00 and P30,O00 for the program, respectively. In
the future, more funds would be needed for the establishment of a
tree nursery, audiovisual equipment for lectures, documentation
requirements, office and salaries for a regular staff, and regular forest
guards to help protect the children's seedlings and the watershed as
a whole.
Environmentand Natural ResourcesManagement 87
Figure 3. Eco-WalkProgram Essentials
urrl u Dr
Source: Various Galing Pook documents (1995).
The active participation of school children (about 15,000 grade

schoolers as of 1995) has reforestated the Busol watershed with about
25,000 tree seedlings. It has reaped socioeconomic benefits. It
minimized squatting, logging and forest fires. Because the children
initiated the maintenance of the watershed, there were no forest
guards needed. This spelt considerable savings to the government in
terms of maintenance and security expenses. Most important is the
unquantifiable benefits of the eco-walk experience to the children,
especially on their present and future regard for the environment.
Olongapo City: Solid Waste Management

Olongapo City is one of the pioneer innovators in local
governance, particularly with regard to solid waste management
(SWM). As in most cities, Olongapo has faced garbage management
problems--i.e., irresponsible disposal of waste and a disorganized
collection system. Part of the problem was the lack of financial
resources to put up an efficient system since the cost of available
technology and system was beyond the city's financial capacity.
Given its meager resources, the city government introduced an
innovative program on garbage management. Tile program rests on
the principle that solid waste management is not the sole responsibility
of the local government but is rather a shared obligation with the
community. This involved user fees and was therefore initially met
strong opposition. However, because the city government showed its
sincerity in pushing forth this program, the people were convinced
and themselves took the program seriously. In the removal of the US
bases in 1991 and the eruption of Mt. Pinatubo, the city took on an
even greater challenge of maintaining and improving the city's
environmental condition as a major strategy in attracting investors.
Table 5 summarizes the innovative features of the program.
The city's solid waste management program has been financially
serf-sustaining in the first two years of the program through income
derived from garbage fees. As shown in Table 6, the city has a net
income of about P1.4 million during the first year of the program
and more than P500,000 during the second year. From 1992 until
1996, the city incurred more expen-ses than income derived from
garbage fees, reaching about P5.7 million in net loss in 1996. The
expenditure increase over these years was due to the provision of
benefits under the Salary Standardization Law and the hiring of more
SWM personnel as demand for services grew with increased
population. One will note that garbage fee collection dwindled in
1991 to 1993 because of population loss brought by outmigration
from the city following the eruption of Mt. Pinatubo and the removal
of the US bases. Thereafter, population grew again (attributed to
returning residents and migration from areas displaced by the
calamity) side by side with the flurry of development activities and
projects in the city with the installation under the Subic Bay
Metropolitan Authority.
The increasing expenditure of the city for solid waste
management and the relatively small hike in the income derived from
garbage fees gave the SWM program budget a deficit since 1.992 and
contributed to the total city budget deficit since 1995. To raise
revenues, new ordinances to amend the 1989 program of fees for
garbage collection and use of landfill site were issued in 1997. The
mayor consulted the people with these new rates: from P10-20 to
P30-40 for households and from P30-P300 to P50-P500 for business
establishments.
Table 5. Olongapo City Solid Waste Management Program, 1989-present

Component Activities/Innovations
Collection and Residents required to put garbage in plastic bags or else they will not be
Monitoring collected. They are encouraged to use the prescribed plastic bags as
follows:
Yellow plastic bags (dry recyclable wastes) to be collected on the
following schedule:
Zone 1 - Mondays
Zone 2 - Tuesdays
Zone 3 - Wednesdays
Green plastic bags (wet biodegradable wastes)
Zone 1 - Thursdays
Zone 2 - Fridays
Zone 3 - Saturdays
Orange plastic bags (hazardous wastes such as hospital and clinical
wastes) to be collected on a designated day and to be disposed of
through incineration
Collection schedule is strictly followed (twice a week in residential area_s

and daily in commercial zones and markets).
Garbage collectors (called Garbage Teehniciam) and truck drivers wear

uniforms and IDs (to mark professionalism in the service).
Sanitary inspectors from City Health Office regularly inspect the

assigned areas. Citation tickets are issued to residents as_d establishment
owners violating the sanitation ordinances.
Junk dealers, scavengers, pushcart boys, ambulant and sidewalk vendors

organized and integrated in the program; children stAcfly kept out of
the dumpsites.
Information and Garbage trucks have public address system broadcasting jingles and
Value Education reminders for people to guard their health, keep surrom_dings clean
and dispose of garbage properly.
Garbage trucks are emblazoned with slogans like "Keep Olongapo

Clean" and YBawal ang Tamad sa Olongapo."
Essay-writing and poster-making contests conducted though the

Department of Education, Culture and Sports (DECS).
City Tourism Council organized cleanliness competitions among 17

barangays that facilitated the adoption of the program by the
barangays.
Organization Environmental Sanitation axld Management Office (ESMO) headed by

the Public Service Officer oversees the entire program. The ESMO is
divided into three sections: garbage collection, street cleaning and
raotorpool.
City Planning and Development Office (CPDO) provides technical

assistance through program documentation, interagency negotiation
and sharing of the city's experience with visitors and researchers_
Table 5 (continued)
Component Acfivifie_/Innovafiom
City Health Department provides support through its sanitary

inspectors, who issue citation tickets to violators_
Financing Garbage fees collected.
To make collection easier and efficient, garbage fees are included in

the electricity bill:
- P10 to P20 for households depending on floor area of
housing structure; and
- P30 to P300 for business estabhshments depending on the
type of business
Garbage trucks finzaaced through donations.
Legal Orders Ordinance No. 31, Series of 1988 (Use of the Material Recovery Plant at
New Cabalan) amended by Ordinance No. 13, Series of 1997.
Ordinance No. 34, Series of 1988 (Schedule of Fees t_or the Use of
Sanitary Landfill Area at New Cabalan) amended by Ordinance No. 7,
Series of 1997.
Ordinance No. 1 Series of 1989 (Schedule of Garbage Fees and Other

Requirements for Proper Waste Disposal) amended by Ordinance Nos.
6, 8, and 33, SeiSes of 1997.
Ordinance No- 56 Series of 1995 (An Ordinance Adopting an

Environment and Sanitation Code of Olongapo City), embodying the
city residents' goals, aspirations, efforts and discipline with respect fo
environment and sanitation management.
Source: Various Olongapo Citygovemment documents asld personal interviews with city officials
Marikina City: River Park Managtmwnt

The success of the Marikina River Development Program, or
what has been more popularly known as the Save the Marikina River
Project, provides fresh perspective and valuable lessons on river
rehabilitation and river park management in the metropolis. The
program, which started in 1992, has received numerous citations and
awards from regional and national bodies and has been an inspiration
to the current efforts to rehabilitate the Pasig River, of which the
Marikina River is a tributary. The city's project increased in popularity
when the Philippine Earth Day Festival in April 1996 and the World
Earth Day Festival in April 1997 where held at the river park.
The current features of the river park are far better than what
were originally conceived. The initial objective of the city leadership
Table 6. Environmental Sanitation and Management Office Income and

Expenditure, 19901996 (in thousands of pesos)
Pmtkadam 1990 1991 1992 199S 1994 1995 1996
(C,arbagcFees) S,755.621 5,713.556 5239.960 4_12.435 5,126.496 5,590.840 5,721.217

Espemilmm 4,384.815 5,0725.625 6,031.195 6,050.045 6,992.013 10,193.57811,377.07S
Salaries and
Other Personal 2,976.495 3,737.870 4,149.577 4,283.927 5,572.468 8,327.621 9,345.924
Services
Gasoline/ 1,408.320 1,335.755 1,881.618 1,766.717 1,419.544 1,865.956 2,031.749
Maintenance
and Other
ExpenSes
Net I_ome/ 1,570.805 659.930 (69,234) (1,2$8.210) (1,865.516) (4,8@2.737) (5,656,455)
Source: City of Olongapo, comparative income statement (1997).
was just to revive the river and its traditional use as a people's park
the way it had been prior to the 1970s--before the squatters settled
along the river banks. The task was to simply relocate the squatters
and to clean the 22-kilometer stretch, plant shade trees, carve out
jogging, biking and walking paths along both banks, set up park
benches and install park lights. Today, however, the 12-kilometer
stretch has been installed with the following features: a skating rink,
picnic and tamping grounds, water fountains, a Roman garden,
gazebos, a floadng restaurant (a small ship turned into a restaurant)
and a floating stage (used for public performances). The fountains
and the ship are lighted to enhance the view at nighttime.
The river park project is one of the city's major programs meant
to address a broader concern--to improve the living environment
and conditions of the Marikina residents. It should be mentioned
that about a third of the people are living in depressed areas, many of
them settling in disaster-prone places such as those along the
riverbanks. Flooding is one of its biggest problems because it is situated
on a valley. The overflow from the Marikina river is not only caused
by heavy rains. It is exacerbated by the garbage dumped mainly by
factories and squatter shandes along the river.
A successful resettlement program would be a prerequisite to a
more focused river rehabilitation and park development. While in-
city resettlement was favored by officials over relocation of people
outside the city, resetdement efforts were not as easy as it was thought
it would be. After a yea r of discussion that necessitated the help of
community development experts and sociologists, the squatter-

families were finally convinced to resettle in the Malanday and Tumana
areas. Because the land is privately owned, the city government helped
the families organize themselves and facilitated their enrollment in
the Community Mortgage Program so that they could eventually own
the land and house they occupy. One of the major factors that led
people to cooperate was the city government's effort to ensure that
the resettlement sites have the basic facilities such as water, electricity
and sewerage.
After the successful resettlement of families, the city government
issued an ordinance that penalized garbage dumping into the river.
A fine of P2,000 was set for violators. The ordinance was strictly
enforced and those who could not pay the fine had the option to pay
the equivalent amount in the form of community service.
The construction of the five-kilometer biking, jogging and
walking lanes passing through 11 of the town's 14 barangays was
henceforth pursued. Electric lights were installed and park benches
placed along the river stretch. In cooperation with the Department
of Environment and Natural Resources (DENR), 800 ornamental trees
were initially planted along the riverbanks. Fish seeding (carp, plapla
and tilapia) was also undertaken. Marikina river prides itseff as the,
only biologically living river in the whole Metro Manila. The rise of
numerous structures along the river followed. Included here are the
playgrounds, picnic groves, camping grounds, basketball courts,
skating rink, floating restaurant and water fountains. From 1993 to
1997, the city government spent about P34.7 million or an average of
P6.9 million per year on this project. Among its financial sources are
national government entities and about P1.6 million from the
Countryside Development Fund of two senators. Donations in kind
were given by the city's private sector. For instance, the Chinese
Chamber of Commerce built a Chinese pagoda while the Marikina
Zonta Club (a people's organization) designed a Roman garden.
The Marikina River Park Authority (MRPA) under the Office
of the Mayor was created to oversee the whole river park program. It
is presently an attached agency of the city government and manned
by about 50 personnel. The MRPA coordinates with the City
Engineering Office, City Settlements Office, City Health Office and
City Public Safety and Security Office and the barangays. The city's
radio broadcast facility, DZBE also supports the project through its
public service programs aired daily from 6:00 a.m. to 7:30 p.m.
Marikina City is the only LGU in Metro Manila adopting this form of
communication service to reach its constituents. The whole program
has achieved more than its basic objective. It caused the recovery of
valuable land for public use. It helped restore the people's confidence
in the local government. Dredging activities currently being
undertaken to alleviate the effects ofLa Nifia can now be undertaken
with less difficulty as big equipment can easily navigate around the
river park. Lastly, Marikina City's experience provided hope and a
tested model for rehabilitating waterways in the other parts of the
metropolis.
General Santos City: "Adopt, an-Island" Program

There are numerous creative ways to beautify the city aside from
effective garbage management and the conventional activity of
maintaining ornamental plants and trees around the city. General
Santos City's simple but creative project provides such example.
Historically, General Santos City experienced the same fate as
Central Luzon with the eruption of a volcano 90 years ago. Although
years have passed, the sight of lahar ashes is still evident especially
along the uncemented roads of the city, making the place dusty.
Planting and maintaining trees around the city help screen dust from
the air. Thus, as early as 1959, tree planting has been part of the major
programs of the city.
Given the city's economic boom following the implementation
of major infrastructure projects and its vision to attract more
investments as well as make a mark in the international trade scene,
the task of cleaning and greening the city has gone beyond the level
of aesthetics. With the support of the city mayor, the City Environment
and Natural Resources Office (CENRO) embarked on a program that
called for the development and maintenance of parks and road islands
in the city. The city has two major parks and seven road islands needing
to be developed and maintained. Because of the meager resources
of the city and the need for the people to accept the responsibility of
managing the environment, a program was launched based on a
concept called "Adopt-an-Island."
The program enjoins business establishments, academic
institutions and NGOs to adopt (i.e., develop and maintain) a park
or a road island. The city government formulated a landscape design
of the parks and road islands. Then it forged an agreement with any
of these said groups wherein the latter would be required to execute
the plan and sustain the project. The city's only role is to provide
planting materials/seedlings and to assist in daily watering activities.
To date, agreements with the following groups have been forged:
Cutflower Vendors Association, Plaza Photographers Association,
Coca-Cola Bottling Philippines, Inc., Rotary Club of Dadiangas, RFM
Corporation, Notre Dame Dadiangas College, Mindanao State
University-CETD, and the General Santos City Garden Club, among
others. A mark bearing the name of a group or association is placed
in each island for people to know the original developer and the one
responsible for maintaining the island. The city government has also
solicited the cooperation of the media, particularly Bombo Radio, to
either publicly praise or air the people's complaints regarding this
groups' performance. Recendy, Bombo Radio has also ,joined the
program and adopted its own road island to develop and continuously
maintain.
The city government spent at least about P25,000 for each road
island as initial funding for landscape design and purchase of planting
materials. Thereafter, the government spends only a small amount
for watering assistance as the major maintenance cost is shouldered
by the adopter or partner group. Other maintenance activities include
weeding of the island's peripheries, pruning or trimming, insect
spraying and painting of island fences.
The presence of road islands in the inner core of the city and
the city parks has not only improved the city but has also provided
the people with an opportunity to substantially contribute to the city
government's program.
Las Pifias City: Historical Corridor Project

Another creative way to improve the city's environment is to
introduce changes in the built structures of the city so as to project a
unified architectural theme. This strategy, which is aligned with the
city's tourism master plan, is exemplified by the Las Pifias City's
Historical Corridor project.
Las Pifias is one of the cleanest and greenest places in Metro
Manila. It is home to the Las Pifias (St.Joseph's Parish) Church and
Bamboo Organ, which gained worldwide fame and regularly draw
local and foreign tourists in the area. This led the city to realize its
need to further develop its tourism potential by restoring its historical
and cultural sites and artifacts.
importantly to its quality based on clearly defined roles in the entire

program framework. The case studies have amply illustrated the tact
that local government programs relating to the environment extend
beyond normal bureaucratic responsibility, as they demand greater
coordination and collaboration of various institutions. The setting
up of a framework and organization to effect a properly planned
participation and some kind of a machinery to resolve conflicts are
therefore important. As have been shown by the city experiences
presented, bringing together the various actors and stakeholders in
an organized fashion has lessened the cost of implementing the
program, helped sustain its implementation (even with change in
political leaderships) and impressed on the people that environmental
management is a shared responsibility with the city government.
Surely, "better participation" is more important than "more
participation."
Communication: improving knowledge and understanding

Effective communication is necessary in soliciting meaningful
participation in a program. The cases presented have recognized the
crucial role of a well-informed citizenry. A change in the behavior of
people through information and greater understanding of the general
intents of the program can bring about unfettered acceptance of the
responsibilities, costs and inconveniences of any environmental policy
or program.
The identification of target beneficiaries and communicators
of the program was important in designing the communication
strategy of Puerto Princesa's Oplan Linis Program and Olongapo's
SWM Program. Oplan Linis targets the children as both beneficiaries
and disseminators of program information in their respective
households and communities. Thus, the Project Team covered all
elementary and high schools to discuss the value of cleanliness and
oriented them on the program. In each orientation, the team then
measured how successful they were able to communicate the
program's concept. To do this, children were given biscuits and juice
drinks and were then observed if they would find a trashcan for their
garbage. If they do so, then the orientation was considered to have
achieved its objective. For Oplan Linis, every resident knew about
tile program. School children and tricycle drivers were in fact the
most active program campaigners and overseers. In Oiongapo, since
the major component of the program required some instilled
discipline and financial sharing by households, the city mayor, along

with the city officials, held meetings in each barangay to discuss and
elicit suggestions and/or confirmation on the program. Regular
barangay meetings allowed discussions and resolution of conflicts.
The importance of including information, education and
advocacy as an integrated component of an environmental program
cannot be overemphasized. In the case studies presented, programs
extensively used government and private entities, and especially the
media, both in program dissemination and monitoring. For instance,
local media was tapped to report violators of the program, as in the
case of Puerto Princesa and General Santos. This illustrates that
program advocacy and program awareness can be done in more
creative ways than one.
Leadership: vision, popular support, clout and managerial

_nls?l
From the five city program innovations presented, four

leadership themes are underscored: vision, popular support, clout
and managerial acumen. The leader referred to here is not necessarily
only the city mayor. These leadership themes may be present among
other leaders or groups in the city.
Visionary leadership refers to the ability to see the big picture of
what to achieve and how to get there. "Without vision, people perish"
may be a trite expression but the articulation of a vision for the city
has propelled the five program innovations to move and get things
done. For instance, Puerto Princesa's Oplan Linis and Bantay Puerto
programs were formulated based on the city's vision of "Kalinisan,
Katahimikan and Kaunlaran" (Cleanliness, Peace and Order and
Development). Baguio City's Clean and Green Program and how it is
implemented anchor on the city's vision of a "...progressive, peaceful,
clean and green Baguit>---a center for education, trade and family-
oriented tourism--managed by God-loving and strong-willed leaders
in partnership with self-reliant and disciplined citizenry." Olongapo's
simple vision--to clean the city and create a better image of itself as a
city and people---drove the organization and sustainability of the
program. Improving the external environment of General Santos City
as a means to attract people and investors and contribute toward
becoming a competitive city in the international trade market
illustrates than an environmental program can be linked to the city's
overall development framework. The shared visirn of the city of Las
Pifias and the Congressional Office "to bring back the old charms of
Las Pifias while at the same time raise the quality of life of its people
in a way they can be truly proud of" has led the city to implement its
Historical Corridor project. Meanwhile, Marikina City's vision of
letting people "touch and smell the water" has driven efforts to
rehabilitate a dying and unsightly river.
Popular support derives itself from the leader's ability to
communicate the vision to the people and rally them behind that
vision. Credibility and trust on the leader is more important than the
leader's personal charisma and proficiency in public speaking.
Credibility is gained through consistency in public utterances and
actions, in the case programs presented, all of the local leaders in
their respective cities have established some form of credibility and
trust among its people. While people's belief on the program per se
and the benefits that may be derived are important, the leader's
credibility is critical in ensuring that the people fully embrace the
program and take on a positive attitude toward its success. This is
exemplified, for instance, in Puerto Princesa's Oplan Linis Program.
Although this was a mere remake of past programs, local leaders
showed more political will to see through its implementation by
organizing better, issuing ordinances and strictly enforcing them, and
appropriating sufficient funds.
Clout refers to the leader's capacity to influence critical
institutions and individuals to support a program. The ability to
influence the City Council is important so that critical legislations or
ordinances are passed and budget appropriations are approved. Clout
also includes the skill to encourage government agencies, business
groups, NGOs and the media to take part in the program in terms of
funding and technical services. In this study's cases, city leaders
displayed political and administrative clout in undertaking their
respective programs. Such allowed the timely passage of needed laws
or ordinances, sufficient funding for the program operations as well
as enabled the active participation of various groups both in imple-
menting the programs' activities and in providing grants and
donations.
Managerial acumen refers to corporate and administrative
capacity to lead or to intelligenfly choose people who will oversee the
program's implementation. From among the case studies presented,
Puerto Princesa's mayor personally steered the Bantay Puerto
Program. On the other hand, the other programs in this study relied
Environmentand Natural Resources Management 101
upon the leadership of mayoral appointees. It is interesting to point

out that program managers do not necessarily come from the city
environment office. Puerto Princesa's Oplan Linis program had the
First Lady at the helm; Baguio City has the Public Information Officer
as coordinator of the Eco-Walk Program; and Das Pinas has the Office
of Tourism and Cultural Affairs playing a major role. General Santos,
though, had the City Environmental and Natural Resources Officer
as program overseer. In O!ongapo, the program overseer was the
Environmental Sanitation and Management Office, a unit especially
created for the program in coordination with the City Planning and
Development Office and the City Health Office. In Marikina City, a
parks authority was created to oversee the fiver park program.
In general, the management of the programs proceeded under
a formal organizational setup within the city government and clear
organizational lines with other agencies and institutions.
Program design: creative adoption of local culture, values

and beliefs
The adoption of local values, beliefs and practices can become
a creative tool in designing effective and culture-based programs. In
Puerto Princesa, for instance, the transformation of the yearly Irawan
Town Fiesta into a Pista Y Ang Cageban (Feast of the Forest)
incorporated environmental awareness and concern on the need to
reforest Irawan into this annual religious festival. In Baguio City, the
Eco-walk program has adopted the concept of muyong, an Ifugao term
for manmade forests that serve as sources of water for the Banawe
Rice Terraces. The term was adopted fbr the planting area in the
Busol Watershed designated for the reforestation project of a group
of children. As part of the tradition, no one could enter any muyong
without the permission of its "owners." Because of the sacredness of
this concept, the reforested area gained respect from outsiders and
led to the high survival rates of tree seedlings planted.
Fund _" funding sources not limited to city govermnent
One of the big lessons that can be derived from the five programs
presented is that the limited financial resources of the local
government should never pose a constraint to environmental
programs. No matter how costly the program, there are creative means
.of fund sourcing and there are alternative programs that can still
achieve the same ends. If the people realize the worthiness of the
program, then they can share resources, even voluntarily. The
programs presented have shown the creative use of Countrywide
Development Fund (CDF), user fees, and donations in kind, and fund
drives initiated by various groups and NGOs.
Program regularity and institutionalization

Successful programs usually stand the test of time. Except that
of Las Pifias, the other programs have more than three years of
sustained implementation. The secret lies not only in leadership but,
more importantly, in undertaking regular activities that can
institutionalize the program in the city. For example, Oplan Linis has
a regular Saturday cleanup in a designated area, Eco-walk is a
continuous program, Olongapo's garbage services follow a regular
schedule according to zones, and the General Santos Road Island
Program is regularly checked and maintained by the city and the
partner institution.
National support
The support and involvement of the national government in
the city programs, though admittely limited, come in various forms.
For one, the devolved powers and increased internal revenue
allotment (IRA) give cities more clout and resources to undertake
the program. This is especially true for those whose annual budget
relies mosdv on the IRA. Other forms of support by the national
government are the awards and recognition given to program
innovators.
Conclusion
This study identified the elements and the preconditions that
make programs successful in terms of goal achievement as well as
program sustainability. Also underscored here is the collective or the
participative nature of environmental management programs as all
sectors of the society can play a dual role: as implementors and as
beneficiaries of the program.
Managing the environment is a huge task that local governments
have to deal with not only because they are mandated by the Local
Government Code to do so but more importantly, because failure to
address environmental concerns would undermine the entire city's
development efforts and affect people's welfare. While each city or
any LGU is expected to craft its own program for the environment,
there are instances that interlocal programs have to be made because
of the resulting program interdependencies and economies of scale.
This is MOSt especially true in solid waste disposal managemenL While
many cities have been successful in cleaning their surroundings, the
final disposal of wastes has not achieved the same degree of
sophistication _s waste collection. Huge costs required in establishing
a sanitary landfill and the similarly expensive maintenance
requirement pose a constraint on the LGUs to undertake the more
environmentally sound waste disposal activities as an alternative to
providing areas as dumpsites. Interlocal arrangements show some
promise in this regard in terms of joint financing and maintenance.
On a long-term view, the management of environment and
natural resources would entail the scientific accounting of
environmental damages and use of natural resources. It will not only
ensure sustainable management of resources and the environment
but will also provide revenues for the LGUs when it is used as basis
for the implementation of regulatory instruments or other more
effective instruments meant to minimize further environmental
damage and natural resource depletion. At present, a number of LGUs
are already adopting regulatory schemes (e.g., anti-smoke belching,
etc.) to avert activities damaging the environment and are also
imposing fines and penalties for violators. However, these fines do
not reflect the full cost of the environmental damage because these
were not based on sound scientific costing. In some developed
countries, full cost accounting of environment and natural resources
is being used as basis for managing forest resources, minimizing
vehicular emissions, reducing industrial effluents, and installing waste
treatment plants and facilities, among others. In the Philippines, a
number of efforts are being undertaken (e.g., Environment and
Natural Resources Accounting Project [ENRAP], Metropolitan
Environmental Improvement Program [MEIP] ) which, in the future,
can help LGUs improve the management of their respective
environment and natural resources in a sustainable fashion.
References
Baguio City Government. 1997. Baguio City: Always Clean, Ever Green.
Office of City Planning and Development Coordinator, Baguio
City.
. n.d. Baguio City Profile• Office of the City Planning and

Development Coordinator, Baguio City.
Campbell, T.EJ. 1997. Innovations and Risk Taking: The Engine of

Reform in Local Government in Latin America and the
Carribean. World Bank Discussion Paper No. 357. Washington,
D.C.
General Santos City Government. 1997. City Environment and Natural

Resources Office Operational Framework• CENRO, General
Santos City.
Local Government Academy 1996. Eco-Walk: Environmental

Awareness for Children. In renovations. LGA-AIM, Manila.
Marikina City Government. 1992. Program of Government, 1992-1997,

Major Thrusts/Programs.
Office of Congressional Representative (Las Pifias). n.d. Las Pifias

Historical Corridor• Briefing Materials•
Olongapo City Government. 1997. Oiongapo City Solid Waste

Management Program. Paper presented during the DENR-
World Bank Conference on Local Governance and Private Sector
Participation in Solid Waste Management. Asian Institute of
Management, Makati City.
Puerto Princesa City Government• 1996. Oplan Linis Story. Puerto

Princesa City, Province of Palawan.
• 1997. City of Puerto Princesa: Profile, Development Vision

And Strategies. Puerto Princesa City, Province of Palawan.
• n.d. Bantay Puerto Documentation Enhancement Project. A

project proposal submitted to Gantimpalang Pang-Lingkod
Pook, Puerto Princesa City, Province of Palawan.
n.d. City of Puerto Princesa Ecological Environmental Pro-

gram: A Case Study. Paper presented during the 4d_City Shar-
ing Workshop. League of Philippine Cities, Puerto Princesa City.
Republic of the Philippines. 1991. Local Government Code of 1991.
World Bank. 1992. World Development Report 1992: Development

and the Environment. New York: Oxford University Press.
Chapter
4
Health Management:
Strategiesfrom SelectedCities
Virginia S. Pineda
ities are facing the challenges of urbanization and devolution.

Urbanization increases the demand for basic services and
sanitation facilities. Devolution, on the other hand, gives cities
and other local government units (LGUs) autonomy in the
mobilization, allocation and utilization of resources. It involves the
transfer of power, functions, responsibilities, programs and projects,
personnel and assets as well as their corresponding appropriations,
from the national government to the LGUs. If LGUs fail to mobilize,
allocate, and utilize resources wisely to meet the increasing demand
tor health services, the health of the population would deteriorate.
Devolution has been met with perhaps the strongest resistance
in the health sector. There were fears concerning the health workers'
security of tenure, the financial and management capability of the
LGUs to sustain the devolved facilities and functions, and the
politicization of health services. Consequently, there have been moves
for recentralization or suspension of devolution.
On the positive side, devolution can facilitate and improve health
service delivery. With health workers under the jurisdiction of the
LGUs, decisionmaking is faster, which allows immediate action on
health needs and problems. Greater accountability to and closer
association of local officials with the people put them in the best
position to underake health programs that are locally responsive,
relevant and innovative (Borlagdan et al. 1993).
As devolution proceeded, many local officials complained that
the internal revenue allotment (IRA) had been inadequate to cover
for the devolved functions and responsibilities. The net transfer of
resources (incremental IRA less cost of devolved functions) was
negative in 26 out of 76 provinces and in some 20 percent of the
1,500 municipalities in 1993. Although provinces and cities received
the same IRA, provinces shoulder 60 percent of the total cost of
devolution of health services while cities shoulder only 2.5 percent
(Manasan 1995). Insufficiency and delay in releases of funds adversely

affected the implementation of health programs and benefits of health
personnel as well as the maintenance and operation of hospitals and
other health facilities. Demoralization among devolved personnel,
lack of medicines and supplies, and deterioration of services in many
of the hospitals turned over to provinces have been reported. Budget
allocation for health was also eroded in LGUs where health was not a
priority of the chief executives. While there are unmet needs in the
health sector, total local government expenditures on health, on the
aggregate, have been lower than what the government used to spend
before the devolution.
On the other hand, the Department of Health's Local Govern-
ment Assistance and Monitoring Service (LGAMS) reported that in
each of the many places where the health sector and the LGU have
succeeded in forging a working relationship, there has been a marked
improvement in community participation, closer coordination among
the various agencies involved in health and health-related programs,
more flexibility in program implementation, and better primary health
care management. The LGAMS was able to document I.GU success
stories under the devolution, specifically, selected municipalities and
provinces with innovative responses to devolution's transition prob-
lems.
This study focuses on model cities--those that have exemplary
health strategies that could help other cities cope with the demands
of devolution and urbanization. Based on the recommendations of
the NEDA Regional Offices, eight cities were selected for the case
studies on the health sector. The cities have been winners in compe-
titions for best-practice, such as the GalingPook and Health and Man-
agement Information System (HAMIS) Awards (see Asis 1994 and
Queta 1994).
The next section specifies the type of health services devolved
to cities and those retained by the Department of Health (DOH).
This is followed by a comparison of population, health expenditures
and health performance of the selected cities before and after
devolution. The study then presents the cities' various approaches in
overcoming common constraints to health financing and service
delivery as well as their strategies related to systems/administration.
Finally, it provides an evaluation of the applicability of the strategies
and suggested improvements.
Health Management: Strategies from Selected Cities 107
-Iealth Services Provided by Cities and DOH

Ynder the Devolution
With decentralization, city governments will be responsible for
the implementation of primary health care and other field health
services, aid to puericulture centers, and provision of medical, hospital
and other support services (which include primary, secondary and
terdary health care services) in the following health facilities:
• Barangay (village) health stations;

* Rural health units;
• City health offices; and
• City hospitals in highly urbanized cities (excluding those in
the National Capital Region).
Primary health care includes health education; control oflocaUy

endemic diseases (such as malaria, dengue, and schistosomiasis);
expanded program of immunization (against tuberculosis, polio,
measles, diphtheria, whooping cough and tetanus); maternal and
child health and family planning; environmental sanitation and
provision of safe water supply; nutrition; treatment of common
diseases; and supply of essential drugs. It is usually provided by
midwives and barangay health workers in barangay health stations
(BHS) or rural health units. Secondary health care is given by
physicians with basic health training. It is usually done in infirmaries,
clinics or hospitals. Secondary level facilities can perform minor
surgery and some simple laboratory examinations. Tertiary care is
rendered by specialists in hospitals. Tertiary hospitals have staff and
facilities to handle complicated cases, intensive and rehabilitative care,
diagnosis, treatment, research and training activities.
The DOH retains the following functions, services, facilities,
programs, personnel and assets:
• components of national programs that are funded from

foreign sources;
• nationally funded programs that are in the process of being
pilot-tested or are in the process of being developed;
• health services and disease control programs covered by
international agreements such as disease eradication programs
and quarantinable diseases;
° regtflatory, licensing and accreditation functions in accordance

with existing laws such as Food, Drugs and Cosmetics Law and
hospital licensing; and
* regional hospitals, medical centers and specialized health
facilities.
Comparison of Population, Health Expenditures and Health

Performance of Selected Cities
Poputat/on
The population of the cities ranged from about 88,000 persons
to 247,000 persons in 1995, with Gingoog having the lowest and
Butuan having the highest population (Table 1).
Table 1. Population of Selected Cities

Population
City 1990 1995 % Change
Puerto Princesa 92,147 129,577 40.62
Lapu-lapu 146,194 173,744 18.84
Cotabato 127,065 146,779 15.51
Naga 115,329 126,972 10.10
Butuan 227,829 247,074 8_45
Gingoog 82,582 87,530 5.99
Surigao 100,379 104,909 4.51
Olongapo 193,327 179,754 -7.02
Philippines 60,703,206 68,616,536 13.04
Source: 1997Phili1_ine Statistical Yearbook, National Statistical Coordination Board.
Puerto Princesa City had the highest increase in population

between 1990 and 1995 at 41 percent. In contrast, Olongapo City's
population declined by 7 percent for the same period. This may be
due to out-migration after the withdrawal of the US Navy from Subic
and the eruption of Mr. Pinatubo. For the rest of the cities, the rise in
population ranged from 5 to 19 percent between 1990 and 1995.
Lapu-lapu City was the most densely populated among the cities
under study, with almost 3,000 persons per square kilometer in 1995
(Table 2): It is followed by Olongapo and Naga, each with over 1,500
persons per square kilometer. Puerto Princesa and Gingoog had the
lowest density, with population per square kilometer of 62 persons
and 216 persons, respectively, in 1995.
Health expenditures and mortality rates

All the eight cities have lower infant and children mortality
rates than the average for the Philippines in 1990 and 1995 (Tables 3
and 4). However, Surigao, Butuan and Puerto Princesa have higher
maternal mortality rates than the national average for the same years.
Nevertheless, they showed a greater decline in maternal mortality
rates than the national average from 1990 to 1995 (Table 5).
The data on health expenditures and mortality rates (Tables 3-
10) indicate a positive relationship between these two variables. The
magnitude of the cities' expenditures depends on the extent of the
health problem. Cities that have the highest (lowest) mortality rates
also have the highest (lowest) health expenditures.
Puerto Princesa had the most substantial increase as well as the
biggest h_alth expenditure per capita in 1991 and 1994. The city
aimed to reduce its mortality rates, which were the highest among
the selected cities in 1990 and 1995.
In Olongapo City, the share of health expenditures to total
expenditures dropped significantly from 26 percent in 1991 to 8
percent in 1994. The city had the smallest increase in health
expenditure per capita between 1991 and 1994. Although it had the
highest health expenditure pcr capita in 1991, it ranked fifth only in
1994. It minimized its health expenditures considering that it had
the lowest infant and child mortality rates in 1990 and 1995 and ranked
third lowest in maternal mortality rate in 1995.
Likewise, Lapu-lapu City's low health expenditures may be
associated with its having low mortality rates. The city had the second
smallest increase as well as the lowest health expenditure per capita
in 1991 and 1994. It had the second lowest infant, child and maternal
mortality rates in 1990 and 1995.
These cities may be deemed as good examples since they have
been adjusting their expenditures to the severity of the problem--
pending more when the problem is greatest and spending less when
the health problem has been minimized.
Health Concerns and Strategies
st sfor /th
In several cases, the cities confronted the same constraints to
health service delivery. These problems and the corresponding dif-
ferent approaches used by the cities in resolving them are as follows:
Table 2. Population Density and Land Area of Selected Cities

Density (persons/sq. kin) Land Area
City 1990 1995 (sq. kin)
Lapu-lapu 2,516 2,990 58_1

Olongapo 1,872 1,740 103.3
Naga 1,488 1,638 77.5
Cotabato 722 834 176.0
Butuan 433 470 526-3
Surigao 409 428 245.5
Gingoog 204 216 404.6
Puerto Princesa 44 62 2,106.7
Philippines 202.3 228.7 300,000
Source: 1997 Phili_ine .Statistical Yearbook, National Statistical Coordination Board_
Table 3. Infant Mortality* Rates

Infant Mortality Rates
City Rank
1990 1995 % chan_e ]990 1995
Olongapo 41.2 30_9 -25.0 ]. 1
Lapu-lapu 42.0 32.8 -21.9 2 2
Cotabato 45.0 36.1 -19.8 5 3
Surigao 44.3 36.3 -18.1 3 4
Butuan 45-9 36.7 -20.0 6 5
Gingoog 44.7 36:7 -17.9 4 6
Naga 49.6 42.2 -14-9 7 7
Puerto Princesa 52.7 44.8 -15.0 8 8
Philippines 56.7 48.9 -13.8
* Infant mortality: infant deaths per 1,000 live births.

Sources: Herrin (1998) ; National Statistical Coordination Board.
Table 4. Child Mortality* Rates

Child Mortality Rates
City Rank
1990 1995 % change 1990 1995
Olongapo 54.0 40.2 -25.6 1 1
Lapu-lapu 55. I 43-0 -22.0 2 2
Cotabato 60.9 50_0 -17.9 3 3
Gingoog 61.1 50.2 -17_8 4 4
Surigao 61.8 50.8 -17.8 5 5
Butuan 65.0 52.2 -19.7 6 6
Naga 66.6 56_2 -15.6 7 7
Puerto Princesa 71.8 61.2 -14.8 8 8
Philippines 79.6 66.8 -16.1
* Child mortality: number of deaths among children less than 5 years of age per 1,000
children of the same age range_
Sources: Herrin (1998); National Statistical Coordination Board.
Table 5. Maternal Mortality* Rates

Maternal Mortality Rates
City Rank
1990 1995 % chan_e 1990 1995
Naga 150_7 128.1 -15.0 1 1
Lapu-lapu 157.7 130_8 -22,0 2 2
Olongapo 184.0 138.0 -25,0 4 3
Cotabato 182.8 149.9 -18.0 3 4
Gmgoog 190_3 156.1 -18.0 5 5
Sufigao 237.7 194_9 -18.0 6 6
Butuan 251.3 201.0 -20_0 7 7
Puerto Princesa 253.1 215.1 -15.0 8 8
Philippines 209.0 179.7 -14.0
* Maternal mortality: number of materrxal deaths per 100,000 live birtl_s.

Sources: Herrin (1998); National Statistical Coordination Board
Table 6. Health Expenditures and Ratio to Total City Expenditures

Health Expenditures (_)/
City Health Expenditures (]_) Total Expenditures
1991 1994 1991 1994
Gingoog 2,295,264 10,774,523 0_06 0.09
Butuan 12,262,330 27,512,850 0.11 0.10
Cotabato 3,016,387 8,470,312 0-07 0.05
Naga 3,594,597 10,456,201 0.07 0.06
Puerto Princesa 6,512,001 20,119,268 0.07 0.05
Surigao 3,888,840 12,066,714 0.09 0.06
Lapudapu 2,821,137 6,099,927 0-07 0.04
Olongapo 18,764,434. 23,586,670 0.26 0.08
Table 7. Ratio of Basic Health and Hospital Expenditures to Total Health

F_.xpenditures
1991 1994
Basic Health Hospital Exp,/ Basic Health Hospital Exp./
City Exp,/Total Total Health Foxp./Total Total Health
Health Exp. Exp. Health Exp. F_xp.
Naga 0.48 0_51 0.41 0.59
Olongapo 0.44 0.56 0-41 0.58
Butuan 0.34 0.66 0.43 0.55
Puerto Princesa 0.96 0.00 0.74 0.17
Gingoog 0.97 O-00 0.61 0.05
Cotabato 0.75 0.24 0,95 0.00
Surigao 1.00 0.00 0.77 0.00
Lapu-lapu 0_65 0.00 0.88 0,00
Source: Local Government Audit Office (LGAO).
Table 8. Health Expenditures Per Capita, 1991 and 1994

Health Expenditures Amount of
City Per Capita (_) Increase (_) Rank

1991 1994 1.991 1994
Puerto Princesa 61.51 160.21 99 2 1
Gingoog 27.46 124.54 97 6 2
Surigao 38.31 115-98 78 4 3
Butuan 52-96 113.20 60 3 4
Olongapo 95.01 111.99 17 1 5
Naga 30.58 83.96 53 5 6
Cotabato 22.86 56.46 34 7 7
Lapu-lapu 18.65 36.28 18 8 8
Table 9. Basic Health Expenditures Per Capita, 1991 and 1994

Basic Health Expenditures Amount of Rank
City Per Capita Increase (_)
1991 1994 1991 1994
Puerto Princesa 59.25 118.66 59 1 1
Sufigao 38.31 88.98 51 3 2
Gingoog 26.65 76_15 49 4 3
Cotabato 17.25 53.59 36 5 4
Butuan 18.05 48.78 31 6 5
Olongapo 41.88 46.03 4 2 6
Naga 14,68 34.68 20 7 7
.Lapu-lapu 12.04 31.76 20 8 8
Table 10. Hospital Expenditures Per Capita, 1991 and 1994

Hospital Expenditures
City Per Capita Amount of Rank
1991 1994 Increase (P) 1991 1994
Olongapo 53.13 65.12 12 1 1
Butuan 34.91 61.97 27 2 2
Naga 15.55 49.27 34 3 3
Puerto Princesa 0.00 27.38 27 - 4
Gingoog 0.00 5,82 6 5
Cotabato 5.43 0.00 (5) 4
Surigao 0.00 0.00 0
Lapudapu 0.00 0.00 0
• _.r__ofbarangay health stations

Conducting outreach activities in rural barangays. To deliver basic
services to people who live far from government facilities, Gingoog
City implemented the Gingoog Total Integrated Development
Approach (G-TIDA) in December 1988. The G-TIDA is an outreach
program to rural barangays. It is integrated since it provides health
medical, infrastructure and other services.
A G-TIDA core group, organized by the mayor, is responsible

for planning, identifying the target barangays, and implementing the
outreach program. The core group is composed of the G-TIDA
coordinator, the G-TIDA Secretariat, transportation coordinator,
lo_sdcs coordinator, and specific service coordinators represented
by the department heads of the concerned agencies.
The city conducts G-TIDA outreach activities usually once or
twice a month. During the G-TIDA Day, members of the team meet
with the people and their leaders to discuss the needs and problems
of the barangvay, if problems cannot be solved immediately, they are
referred to the appropriate agency. The G-TIDA team informs the
people about the functions and services provided by each agency in
the city so everyone would know which to approach for specific needs.
The G-TIDA approach contributed to the building of people's
capabilities and participation in local governance. Encouraged and
guided by the G-TIDA team, people in some of the far-flung barangays
were able to install water pipes connected to a spring using their own
local resources and relying on the ba_anihan (mutual assistance and
exchange of labor) system.
Gingoog's outreach program is now on its tenth year of
implementation. It has provided a means for delivering health care
services in areas without BHSs. During the early implementation of
the program, the G-TIDA team stays for two days and one night in
the barangay. However, as requests for outreach activities increased,
the conduct of G-TIDA outreach activities is now limited to about
one day per barangay. Presently, all the 50 rural barangays have BHSs
manned by at least a barangay health midwife and volunteer health
workers.
The expenses incurred by the various agencies in providing
services during the G-TIDA outreach are taken from the regular
agency budgets. No new appropriations are provided except for the
budget for overhead expenses like gasoline, transportation and food.
In 1996, the city government appropriated P189,400 for G-TIDA.
Use of barangay halls and rooms of private homesfor BHS. Cotabato
City aimed to provide a BHS for every barangay so that the people
could have ready access to basic health care services and facilities.
However, the city's Office of Health Services (OHS) had very limited
financial resources. Its regular budget was just enough to cover
personal services and maintenance and operating expenses. In the
city's experience, building cost for a concrete BHS was about P100,000.
At most, the city could construct only three concrete BHS structures
per year. Despite such constraint, the number of BHSs increased from
nine in 1990 to 35 in 1991.
The OHS overcame the lack of permanent BHS structures by
using (free of charge) barangay halls and rooms or spaces in homes
of concerned citizens as health stations. This strategy enabled the
provision of a BHS for each of the city's 37 barangays. At present,
Cotabato City has 37 BliSs and seven BHS extensions. Of these, 23
are permanent structures constxucted by the city while the rest are
temporarily placed in barangay halls or private homes.
Inadequ_umber of health pexs_nnel

Mobilization of health volunteers. The common approach to
augment manpower is to mobilize volunteers. Cotabato City activated
100 volunteer health workers, mostly trained hilots (traditional
midwives), to assist midwives in the BHSs ..... nilarly, Olongapo has
about 300 health vohmteers. For its rescue and emergency medical
assistance program, Naga City has 400 trained first responders and
emergency medical technician volunteers. The volunteers render free
services so the cities save on salary expenses. As token of appreciation,
Cotabato City gives each volunteer P500 cash gift during December;
Olongapo entitles them to hospitalization benefits; and Naga provides
them with uniforms, group insurance, and free fbod while on duty.
Organization of women's gnmps. Women proved to be valuable
partners of the city governments in the health sector. Olongapo has
its Balikatan Ladies of Olongapo Movement (BLOOM). The group
has 6,000 members, most of whom are housewives in the community.
Its members participate in the city's cleanliness drive and undertake
various barangay projects. Members who also serve as health
volunteers work without pay as nursing aides in the city hospital and
also assist the health workers in the immunization drive, and in the
organization and conduct of health classes.
Similarly, Lapu-lapu City has its mothers' support groups,
composed of 410 members. Health personnel ask help from the
mothers during advocacy activities such as feeding the children during
nutrition month.
Surigao City mobilized the largest number of women for health
care. its Primary Health Care Federated Women's Club (PHC) has
over 12,000 members as of 1996. This represents about 63.2 percent
of the 20,240 households in the city at that time.
The PHC is a people's organization initiated in 1986 by a City

Health Office (CHO) midwife who conducted three-day seminars on
health matters and thereafter formed PHC Clubs. The CHO adopted
and expanded this strategy all over the city. It appointed a coordinator
whose task is to launch PHC clubs. In addition, it provides the training
package and resource persons for the PHC classes. Upon completing
the course, the participants form a PHC chapter at the pur0k I level
and elect a set of officers.
As health volunteers, the PHC members are involved in the
operation and maintenance of BHS and feeding centers. They record
immunization, bring the pregnant women for prenatal checkup, assist
in feeding the children, conduct health education activities,
encourage and teach plant propagation to those who do not have
herbal or vegetable garden, and do the necessary follow-ups, such as
on children who have not been immunized. They have also learned
to treat common illnesses and make herbal cough preparations and
liniments. Since the PHC members work on a voluntary basis, this
brought the CHO considerable savings on salaries while having
thousands of health workers on call.
Involvement of private companies/medical practitioners. Lapu-lapu
City asked private companies and institutions to adopt barangays that
they could assist in terms of health care needs. These entities help by
engaging the services of their own doctors (retainers) to conduct
regular monthly free clinic in the adopted barangays and by donating
facilities or supplies. One company even handled fogging activities in
the entire Lapu-lapu City. At present, 10 private companies and 5
educational institutions have adopted 8 barangays.
The Lapu-lapu City CHO also involved private medical
practitioners from the Mactan Doctors' Organization and nurse-
volunteers from the Mactan Community Hospital in the immunization
program. It provides vaccines for the group during such collaborated
• program. Moreover, it also requested the doctors and nurse-volunteers
to render free services to the barangays. Currently, 50 doctors and
about 100 nurse-volunteers give their services for free for such a cause.
A small district within a barangay (village) ; subvillage.

Hiring of temporarypart-time health personngl. To reach more

people and serve them better, Cotabato City OHS's target was to have
one midwife stationed in every barangay. However, the regular budget
could not finance the employment of additional permanent midwives.
To solve this problem, the OHS hired casual midwives and funded
the salaries from the 20-percent Development Fund. Thus, the city
was able to employ 37 casual midwives for its 37 barangays and other
casual personnel for the Main Health Center starting 1993_ Salary
expenses for these personnel totalled P2.5 million yearly.
For its Satellite Clinics Project, which was also financed from
the 20-percent Development Fund, Puerto Princesa City hired five
doctors on contractual and part-time basis. At present, it has five
strategically located satellite clinics. Each doctor ys for two days a
week in his/her assigned satellite clinic. For the rest of the week, he/
she is free to work in hospitals or engage in private practice. The city
government pays each doctor a monthly salary of P10,000.
The schedules of the doctors in the satellite clinics are
synchronized to maximize their availability. For example, in one
satellite clinic, the doctor's schedule is Monday and Tuesday. In the
nearest satellite clinic, the doctor's schedule is Thursday and Friday.
During the days when the doctor assigned to a satellite clinic is not,
scheduled to come, tile patient can go to the other satellite clinic and
avail of another doctor's services.
Lack of emergencyJl3_]igal2_s_
Emergency Rescue Naga (ERN). In April 1991, the Naga City
government initiated the establishment of the Emergency Rescue
Naga (ERN) under its Disaster Preparedness Program. The ERN is a
quick response unit led by the Naga City Hospital personnel. It
provides emergency medical assistance, rescue services, and transport
to a hospital. It also gives medical backup assistance to events and
conducts regular training on Disaster Preparedness and Management
to ERN volunteers and various groups.
The ERN has two telephone hotlines and two VHF controls. Its
volunteers are equipped with beepers. Average ERN response time is
3-5 minutes within the city proper and 30 minutes for the farthest
mountail_ barangays some 17 kilometers away. As the ERN has become
metrowide, calls come not only from Naga City but from neighboring
municipalities as well. Within Metro Naga, an extensive radio network
links all offices of the mayor, the ambulances, and the police and fire
stations. Handheld radios were also distributed to key personnel of

each LGU. Of the 14 LGUs comprising Metro Naga, only four have
fire protection bureaus and five have ambulances. Making the ERN
metrowide enabled sharing of these limited facilities and magnified
their benefits.
The ERN's core staff includes a paramedic, a driver, and
volunteers. Regular hospital staff, numbering 40, are on call. It has
400 trained First Responders.and Emergency Medical Technician
volunteers. Its participating partners include the Philippine National
Police, Bureau of Fire Protection, City Disaster Coordinating Council,
Task Force COMET (for calls involving peace and order problems),
and other civic organizations equally prepared to serve when disaster
strikes.
The ERN started with only one ambulance. At present, its
facilities consist of three ambulances, one all-terrain rescue vehicle
and one rubber boat stationed at its base at the Naga City Hospital,
and a trauma van posted at the Naga City Bureau of Fire Protection.
All ambulances are on call 24 hours a day and manned by a crew of
three per vehicle. The city government spent a total of P150,000 for
ERN for 1997.
For 1996, the ERN responded to 2,257 emergency and transport
cases or an average of 6.2 trips per day. It has provided valuable rescue
services during calamities. For example, when Super Typhoon Rosing
struck Naga in 1996 and floods rose to more than five feet, ERN
rescued and evacuated about 310 families or more than 1,700 persons.
In recognition of its exemplary performance, the ERN was honored
with several awards. These include the Galing Pook Award (Top
Twenty) in 1994, Disaster Management Award (Regional Level 1995
and 1996, National Level 1995) and Alay Buhay Award (given by thc
Department of Health in 1996).
Puerto Princesa City's satellite clinics. The city has five strategically
located satellite clinics to serve far-flung rural barangays that do not
have access to health services. These clinics handle emergency cases
and simple illnesses. For more serious or complicated cases, the clinics
have ambulances ready to bring the patients to hospitals.
In the absence of telephones, the satellite clinics use radio
communication equipment. Each barangay and tribal community is
provided with hand-held radio (VHF transceivers). Emergencies are
reported to the barangay chairperson who then calls the nearest
satellite clinic for an ambulance and health personnel. If patients
require hospitalization, radio communication enables the clinic to

make an advance call to the receiving hospital. This gives the hospital
time to prepare and have a team of medical personnel ready for the
arrival of the patient from the rural barangay.
Each satellite clinic is manned by two midwives, a radio operator,
a driver and a utility man. A doctor stays two days a week and a dentist
comes every two weeks. To accommodate patients who are too weak
to move or are in need of further observation or awaiting transport,
each clinic is equipped with four to five beds, These patients are
confined in the clinics for about one to three days.
From 1993 to 1997, the clinics have served an average of 47,000
patients per year. Most cases attended to were respiratory infections
and other simple illnesses. The clinics serve as a vital link to the city's
referral system. They resulted in an increase in the reported
emergency cases and a decline in the number of patients with simple
illnesses going to the hospitals. The satellite clinics project was one of
the top 20 Galing Pook winners in 1996, For 1997, the budget fbr this
project was P6.2 million.
__int an daaagmen/afiaQ
Barangay funds for health. Olongapo requires its barangays to
allocate 5 percent of their IRA to health and welfare. Drug allocation
to the barangays are sourced from this fund. In Cotabato City, the
barangays also finance the medicines. In the case of Lapu-lapu City,
the barangays provide the allowance for barangay health workers.
Depending onthe budget, the allowance ranges from P400 to P1,500
per month. Sourcing funds from the barangays reduces the financial
burden on the cities and encourages greater involvement of barangay
officials in health matters and in monitoring the activities of the
barangay health workers.
20percent Development Fund. Cotabato City and Puerto Pfincesa
City used the 20-percent Development Fund to be able to hire
temporary health personnel and set up satellite clinics, respectively,
which otherwise could not be financed from their regular budget.
Contributions. Financial constraints were somehow alleviated by
contributions. In Surigao City, the Barangay Environmental and
Sanitation Implementation Group (BESIG) members contribute labor
services while the government provides fimds for small infrastructure
projects, such as construction of health stations and feeding centers.
The city's PHC Federated Women's Club obtained P1.5 million for
the construction of its training center from a senator's Countrywide

Development Fund.
Under the share-food project of a Butuan City barangay, well-
to-do families sponsor malnourished children for three months.
During this period, the sponsoring family feeds a child every mealtime.
In Lapu-lapu City, private companies and congressmen
contribute for the milk feeding of preschoolers and Grade 1 pupils
while a food manufacturer regularly provides noodles for children's
feeding. They also donate facilities or supplies to barangays.
Strategies Related to Systems Administration
Regular visitatlon/interaction with the barangay residents

To identify the people's needs and ways of improving the delivery
of health care services, the Lapu-lapu city health officer toured all
barangays for one month. He traced the city's low performance in
the Expanded Program of Immunization (EPI) and the peoples'
limited access to health care services to the absence of a specific
schedule for immunization, the doctors' unavailability, and the
people's lack of interest. The CHO therefore set a permanent
schedule for the immunization and the doctors' visits and encouraged
people to go to the BHS and avail of health care services. As a result,
Lapu-lapu was awarded the Most Accelerated City in EPI in 1991. At
present, the city health officer still goes to the barangays three to
four times a week to check on the status of programs being
implemented. The mayor also accompanies the CHO to the barangays
about three to four times a month.
The Lapu-lapu City health officer also conducts a barangay
assembly meeting every quarter. He presents the current health
programs and projects initiated by the government and solicits from
the community their health problems and priorities. Through the
assembly, the community participates in coming up with solutions to
address its own problems.
In the case of Olongapo City, the mayor goes to the barangays,
together with all the department heads, to personally see the people's
situation and needs. All the 17 barang, ays are visited within one quarter.
During barangay consultations, the people inform the mayor of their
problems and needs. The department head concerned is then tasked
to act on these matters the following day. The people report to the
mayor any problems that remain unsolved.
.Integrated approach
Gingoog City opted fbr an integrated approach to its outreach
program to rural barangays. Its officials recognize that there are
problems that can only be solved by several agencies working together.
One example is the malnutrition problem. The City Health and Social
Welfare personnel address this problem by feeding malnourished
children, teaching mothers proper nutrition, and educating people
about thmily planning. Stafffrom the agriculture department are also
needed to teach people how to plant and grow nutritious food.
Infrastructure services are required to construct health centers and
water systems.
Olongapo City, on the other hand, strengthened the linkage
between health and sanitation by integrating its environmental
management program with health activities. The CHO plays a major
role in the city's solid waste management project. Its sanitary inspectors
regularly check their assigned areas and issue citation tickets (fines)
to residents and owners of business establishments who violate
sanitation ordinances (such as having unclean premises and putting
out garbage outside of the scheduled collection time). The
combination of health and environmental management resulted in
the reduction of sanitation-related diseases such as l_¢phoid fever and
paratyphoid infections from 75 percent in 1988 to 9 percent in 1995
per 100,000 population.
Chtstering, of barangays
For more effective supervision and monitoring, the Cotabato
OHS grouped its 37 barangays into seven clusters. Each duster is
headed by a coordinator who supervises and monitors the activities
of his/her BHS, and barangay midwives. Dividing the work of
supervising and monitoring the 37 barangays among seven
coordinators i_tcilitated these tasks. Because each is now focused on
only a few barangays, coordinators can immediately respond to the
problems and needs of the barangays within their respective clusters.
Planning, monitoring and evaluation of programs

and activities
_..minats / wo r_ksh_o_ps
Butuan City Nutrition personnel and Department of interior
and Local Government (DILG) staff conduct nutrition program
planning seminars with barangay leaders. They compare the

nutritional status of the puroks in the barangay and guide the leaders
in making local plans for each quarter. I.ocal leaders are asked to
identify problems, think of solutions, identi_ funding if needed, assign
people to handle the problems, and make a timetable.
The Cotabato OHS conducts semi-annual and annual reviews
of its programs, activities and performance. Through the workshops,
the OHS staff and health workers learn of better methods as they
listen to lectures, interact with "each other, share their experiences,
problems and solutions. The workshops therefore serve as an effective
monitoring and management tool.
Regtttar_mee gs
In Surigao City, the PHC chapter's monthly meetings serve as a
venue to identify and discuss community needs and problems,
solutions, development projects, and plans at the puroklevel. To ensure
prompt action and accountability in implementation, the PHC uses a
monitoring chart specifying the problems or needs, the steps required,
the persons responsible for each step, the target completion date,
and the plans that have been accomplished.
Monthly staff meetings, in addition to report submission, are
also conducted in Olongapo City to monitor, compare and evaluate
performance in the barangays. Likewise, health personnel and workers
in each of Lapu-lapu's eight districts and nutrition workers in each of
Butuan's 10 barangay clusters also hold monthly meetings for the
same purpose. Accordingly, causes of low accomplishments are
identified and appropriate actions are undertaken, resulting in a
better performance.
Surigao City's sustained implementation of the community data

board enables it to know the health status of each household and
identify their needs. Each household is represented in the data board
by a small hut. The hut shows the house number, the name of the
family head, the health concerns, and the quarterly period covered.
For comparison, the previous year's quarterly performance is included
as baseline data.
The community data board is updated every quarter through a
survey of all households. The survey covers health concerns such as
pregnancies (pre/post-natal), immunization and nutritional status
of children, garbage disposal, water source, occurrence of diseases,

PHC health insurance membership, and availability of toilet, herbal
and vegetable garden.
For each health concern, the health worker and the assisting
mothers assign a colored circle to indicate health status. The color
codes, their meanings and some examples of their application in
different health concerns, are as follows:
Color Meaning Example

Blue Not Applicable Nobodyis pregnant in the household
Yellow Improving Degreeof Malnutritionchangedt_omsevereto mild
Green Safe Childrenare fully immunized
Red Danger No PHChealth insurance
By looking at the red circles, the health personnel are alerted

on the needs of each household. The concerns of the purok can also
be prioritized according to the number of red circles. The health
concern with the most number of red circles is considered as the top
problem. Comparison with the previous quarter will also show where
performance has improved or deteriorated.
Recognition of outstanding and worst performers

In Surig_ao City, outstanding perfbrmances are recognized based
on how the PHC chapters or members conduct health-related
programs, projects and activities such as the most number of babies
immunized and the most number of sanitary toilets constructed.
Awards are given to the Ten Outstanding PHC Chapters, Five
Outstanding Workers, and Outstanding Couple during the PHC
annual convention. The awardees receive prizes in cash and in kind.
Butuan City conducts an annual contest for the most
outstanding barangay, known as the Search for Bulawanong (Golden)
Barangay. Every quarter, the performances of the barangays are
evaluated using various criteria such as prhnary health care activities,
food production and livelihood programs. Prizes for the winning
barangays range from P50,000 to P100,000. The city also ranks
barangays in terms of rate of malnutrition and announces the poor
performers during the barangay captains' meetings. The problems
of these barangays and appropriate action plans are further discussed
accordingly.
Recognition of the outstanding and worst performers motivates

barangay leaders and constituents to give their best performance and
cooperation in the implementation of programs and projects.
Applicability and Suggested Improvements
Gingoog City's outreach method (i.e., G-TIDA) of providing

health care services is useful as temporary measure only for coping
with the inadequate number of BHSs. The long-term solution is to
provide additional BHSs to reach all barangays. People benefit from
the curative and preventive health services provided during an
outreach visit but there are health services that have to be done on a
regular basis. The G-TIDA approach may be adopted by cities that
are in the process of setting up additional BHS structures or looking
for a facility to house, even temporarily, the BHS. To sustain health
activities initiated by the outreach team, the CHO could train local
residents as health workers and nutrition scholars. It could also form
and mobilize people's organizations.
Cotabato City's strategy of using barangay halls and rooms or
spaces in private homes as BHSs is a sort of progression from the G-
TIDA method. The strategy enables regular provision of health
services rather than a one-shot approach. Another alternative is to
rent a space for the BHS. Since the barangay will be the beneficiary
of the BHS, the OHS, through the mayor or sanggunian, may ask the
barangay officials to take the lead in finding a suitable place for a
BHS.
Equally important as having a BHS facility is the awailability of
health personnel or workers to deliver the health care services.
Mobilization of volunteers and mothers in particular is a good way to
supplement the existing health manpower resources while providing
the city considerable savings in salaries. Likewise, Lapu-lapu City's
utilization of free services of private medical practitioners and doctors
of private companies does not require any cost.
The hiring of part-time doctors, as practiced by Puerto Pfincesa,
enables the provision of curative services in the barangays. BHS
personnel are mostly midwives who mainly focus on preventive health
care. Because of the availability of doctors in the satellite clinics, the
number of patients going to the hospitals for consultation and minor
illnesses was reduced. Such strategy may also be extended to other
health personnel such as dentists and medical technologists. Medical
personnel serve a number of barangays on rotation basis. The

barangays covered may contribute to the salaries of part-time docto1_
and other health personnel.
The providers of emergency medical assistance--Naga and
Puerto Princesa--could learn from each other. Puerto Princesa could
follow Naga City's mobilization of volunteers to handle emergencies.
On the other hand, Naga City could station ambulances in strategically
located barangays, as done in Puerto Princesa's sattelite satellite clinics,
or in the farthest barangays. This way, the ambulance need not come
from the city proper. Instead, any ambulance nearest to the place of
emergency can respond immediately, thus saving on travel time.
The cities in the case studies provide free services and medicines
in their health facilities (BHSs and satellite clinics) and in the use of
ambulances. In some cases, they were able to obtain cash and in-kind
contribution from individuals or priwate companies. However, another
option to source funds is cost-recovery, specifically by charging fees
for the medicines, use of ambulances and medical services. Only those
who are really indigent may be exempted from paying. This
suggestion, however, requires a system for determining the people's
capability to pay.
Conclusion
Like all LGUs, the cities in the case studies faced challenges
arising from the devolution of functions. They were also confronted
with various constraints to the delivery of health care services. Because
of their ability to overcome these limitations and make devolution
work to their advantage, they can be considered as model cities for
others to emulate.
Devolution is a step toward the fulfillment of the DOH's vision
of"Health in the Hands of the People" by year 2020. In the course of
the devolution, the government devised various measures to assist
the LGUs. To advise the LGUs on health plans and budget, the 1991
Local Government Code provides for the creation a Local Health
Board per LGU composed of local chief executives and health offic-
ers, representatives from the DOH and the private sector or NGO.
To ensure the speedy resolution of devolution-related issues and per-
sonnel problems, Transition Action Teams at the provincial and re-
gional levels have been created. The DOH also established and tapped
the Local Government Assistance and Monitoring Service to attend
to local government concerns. It also provided for Comprehensive
Health Care Agreements, wherein priority health programs are imple-

mented through DOH and LGU cooperation.
A number of studies have identified some remaining issues that
should be addressed so that devolution could work well [Legaspi
(1995), BriUantes (1997) and Gaffud (1997) in Herrin (1998)].
Specifically, the following measures are needed:
* resolution of the issue of the inequitable distribution of IRA

shares vis-a-vis devolution burdens (IRA reallocafion bills are
currently pending in Congress);
* technical assistance to LGUs in exploring alternative ways for
raising additional financial resources and in improving their
capability in the management of devolved hospitals;
* greater participation of NGOs and people's organizations in
local special bodies; and
* development of alternative modes of intergovernmental
cooperation to deal with issues of service delivery and
monitoring that cut across jurisdictional boundaries and to
consolidate and strengthen efforts in advocacy and social
mobilization.
Meanwhile, the DOH could jointly undertake with the LGUs

revenue enhancement projects in devolved hospitals and other
facilities just as it has done in its retained hospitals such as the Rizal
Medical Center in Pasig City and the Ilocos Regional Hospital in La
Union. It could provide technical assistance in improving pricing,
billing and collection systems of devolved facilities. Moreover, the
DOH could help enhance the LGUs' capability in managing devolved
facilities by providing Continuous trainings to LGU officials and
personnel.
The model cities provide some useful ways _br dealing with
devolution issues. In general, their leaders and health officers
promoted good management by interacting with the people and
finding out their needs and problems. To alleviate financial
constraints, they obtained funds and other forms of assistance from
private companies, congressmen, and civic-minded individuals.
Furthermore, they encouraged people to participate in the delivery
of health care services by mobilizing volunteers, women's groups, and
private medical practitioners. Inter-LGU cooperation was also
achieved in the provision of emergency rescue services, as in the Case
of Naga City's ERN which has evolved into a Metro Naga activity
involving a total of 15 LGUs.
With the political will of leaders, commitment of health officers,
and people participation (as exemplified by the model cities)n
supplemented by national government support in terms of DOH
assistance and equitable IRA distribution--and given sufficient dme
for adjustment, devolution could work well and result in the
improvement of health service delivery to the people.
References
Asis, M. 1994. Community-based Initiatives in Health: Development,

Growth and Transformation. Occasional Paper No. 8. Manila:
Department of Health (DOH)-Health and Management
Information System (HAMIS).
Borlagdan, S., G. Gabronino and A. Tracena A. 1993. Health Service

Delivery: Issues, Problems, and Prospects of Devolution.
Philippine Journal of Public Administration 37 (1).
Herrin, A. 1998. Beyond 2000: An Assessment of the Health, Nutrition

and Education Sectors, 1992-1996. Unpublished PIDS paper.
Local Government Assistance and Monitoring Service (LGAMS) n.d.

Devolution Matters: a Documentation of Post-Devolution
Experiences in the Delivery of Health Services. Manila:
Department of Health (DOH).
n.d. Health Services and Local Autonomy. Manila:

Department of Health.
Manasan, R. 1995. Fiscal Decentralization: The EarlyYears of Code

Implementation. Development Research News, Vol. 13, No. 4. Makati
City: Philippine Institute for Development Studies.
NCSB (National Statistical Coordination Board). 1997. Philippine

Statistical Yearbook. Makati City: NSCB.
Quieta, R. 1994. Health Strategies and Interventions: Extended Case

Studies on Good Health Care Management in the Philippines.
Occasional Paper No. 9. Manila: Department of Health (DOH)-
Health and Management lnformatinn Sv._tem (HAMI.q_
Chapter
5
Local Efforts
in Housing Provision
Anicia C. Sayos, Ross Q. Quisao and Rosario G. Manasan
Introduction
urbanization, resulting in a number of serious problems.

n some placed
.These cities, economic
extreme growth opportunities
pressure on urban servicesaccelerated
and
infrastructure. Some of the urgent tasks that local government units
(LGUs) in urbanized areas now face include coping with the demands
of increased employment opportunities; insufficient housing
(aggravated by high rental and land costs); congestion, pollution and
other forms of environmental deterioration, lack of health and
sanitation facilities as well as of peace and order. With the passage ot
the Local Government Code (Republic Act 7160) in 1991, managing
local projects to ease these urban problems has become more
challenging. The Act mandates LGUs to discharge functions and
responsibilities previously performed by national agencies in the
delivery of basic services and facilities, including low-cost housin_
projects. The Code specifically states:
Chapter 2. - Section 17 (a) "Local government units shall

endeavor to be serf-reliant and shall condnue exercising the
powers and discharging the duties and functions currently
vested upon them. They shall also discharge the functions
and responsibilities of national agencies and offices devolved
to them pursuant to this Code. Local government shall
likewise exercise such other powers and discharge such other
functions and responsibilities as are necessary, appropriate,
or incidental to efficient and effective provision of the basic
services and facilities enumerated herein.
ManagingUrbanizationUndera DecentralizedGovernanceFramework
(g) "The basic services and facilities herein enumerated shall

be funded from the share of local government units in the
proceeds of national taxes and other local revenues and
funding support from the National Government,..."
Strengthened by these provisions of the Code, a number of

LGUs have successfully provided the much-needed housing to the
less-privileged sector of their communities. This paper presents an
overview of the existing knowledge and policy experience in local
housing finance and provision considering the recent decentralization
initiadves and the notable innovations introduced in the cities of
Puerto Princesa in Palawan, Naga in Camarines Sur, and San Carlos
in Negros OccidentaU
The next section of this study presents its objectives. The third
section describes the level of urbanization and housing status of the
cities under study. The fourth section documents the different
approaches cities used to help ease their housing problem. And the
last section highlights the key concerns and issues culled from the
experiences of these cities. Additional concerns in urban housing
strategies are also incorporated in this section to provide LGUs more
options in addressing their respective housing problems.
Objectives
This study's main objective is to document the housing strategies
and processes used by model cities to meet the challenges of rapid
urban and population growth. This will examine the "replicability"
and "adaptability" of the housing programs by other urbanized LGUs
by exploring:
1) The key elements of the model cities' local housing initiatives;

2) The innovative manner by which these housing schemes were
implemented in terms of financing and management,
catalyzing the institutional involvement of other levels of
government, private and government shelter agencies,
nongovernment organizations (NGOs) and people's
organizations (POs); and
1All three cities are classified as fast income class cities as of 1996.
Local Efforts in Housing Provision 129
3) The extent to which LGUs approach the full utilization of

the authority and responsibilities in social service provision
and management that are assigned to them under the Local
Government Code (LGC).
It is hoped that through a comparative discussion of the

strengths and weaknesses of the programs in relation to the
capabilities of the implementing LGUs, others may be guided in
pursuing their own programs. The study does not prescribe but merely
provides options on the type of housing program strategies other
LGUs may find fit for their needs.
Urbanization and Housing Needs

The country's population increased from 36.7 million in 1970
to 48.1 million in 1980 and 60.7 million and 68.6 million in 1990 and
1995 and is projected to reach 76.3 million by the year 2000. 2 Twenty-
six (26) out of the 65 cities in the country in 1995 (Appendix 1) are
classified as 100 percent urban. With most of the population living in
urban areas, one of the significant areas of concern is the settlement
of the urban poor as growing urbanization and poverty created serious
shelter problems.
The rising costs of land and construction materials especially in
urban areas have deprived the "vulnerable sections of society" of the
chance for available self-help housing. Housing costs rise due to land
value speculations, and the problem is aggravated further by the high
rents in the cities. Under this situation, the informal settlers are left
with no choice but to squat. Generally, squatters or informal settlers
are those people occupying government land and structures; those
residing in reclamation areas and danger areas those affected by the
road-widening project of the government; and those who are squatting
in privately owned land.
Ways to ease the burden of homelessness in the country have
been the national government's concern as early as 1938 with the
creation of the People's Housing Corporation. Later, in response to
other shelter requirements, related housing agencies were created,
including the National Housing Authority (NHA). Another law,
2 1997 Philippine Statistical Yearbook, National Statistical Coordination Board.

Executive Order (EO) No. 90, was issued on December 17, 1986 to
identify and define the mandate of government housing agencies s
in ensuring the accomplishment of the National Shelter Program
(NSP). The NSP is a comprehensive program aimed at assisting the
lowest 30 percent of the income population with an affordable housing
package 4. A more recent Act is the Urban Development and Housing
Act (UDHA) of 1992, which provides the fi'amework ['or a continuing
urban development and housing program and mandates the LGUs
to take a principal role on the provision of housing services.
Table 1 shows the degree of urbanization 5 of the three cities
included in this study. Although San Carlos City is not as highly ur-
banized as the other two cities (with its urban population accounting
for only 36 percent of total population in 1995), its "homeless" popu-
lation are scattered all over the city. From 726 squatter households in
1992, the figure rose more than fourfold to 3,233 in 1995. Note that
the number of household in owner-occupied dwellings rose from
19,889 in 1990 to 20,390 in 1995, reflecting an increase of less than 3
percent.
"_The key housing agencies of the National Shelter Program (NSP) are the National Housing
Authority (NI-_), National Home Mortgage Finance Corporation (NHMFC), Housing and
Land Use Regulatory Board (HULRB), and the Home Insurance and Guaranty Corporation
(HIGC)_
4 Zorayda A_CJklonzo in "Developments in Philippine Housing Finance" categorized the
Philippine housing market into threc types: the ultra-poor or marginalized sectorwho cannot
afford to pay for any Lype of housing; the low-income sector with low affordability but who can
pay given file right package and some measure of financial assistance; and the middle/high
income sectors who can afford to borrow at. market rates.
_• The National Statistics Office defines an area as urbanized if it has the following characteristics:
1. In their entirety, all cities and municipalities having a population density of at least 1,000
persons per square kilometer_
2- Poblaciones or central districts of municipalities and cities which have a population density of
at least 500 persons per square kilometer.
3. Poblaciones or central districts regardless of the population which have the following:
a. street pattern, i.e., network of street in either parallel or right angle orientations.
b. at leastsix establishment, (commercial, manufacturing, recreational and/or personal
services) ; and
c. at least thrcc of the following: (1) a town hall, church or chapelwith religious services
at least once a month; (2) a public plaza, park or cemetery; (3) a market place or
building where ta-ading activities are cm_ied out at least once a week; and (4) a public
building like a school, hospital, puericulture, and health center or library.
4. Barangays having at least 1,000 inhabitants that meet the conditions set forth in 3 above, and
where the occupation of the inhabitants is predominasafly nonfarrniag or nonfishery.
Table l. Status of Urbanization
City Population LandArea Population Density % Urban

(sq kin) (person/sq. kin) Population
1990 1995 1990 1995 1990 1995
Puerto
Princesa 92,147 129,577 2,106.7 43.7 61.5 70.7 58.0
Naga 115,329 126,972 77_5 1,488.1 1,638.3 100.0 100.0
San
Carlos 105,713 101,429 451.3 234.2 224.7 38.3 36.4
Naga, being the center of trade among the three cities of Region
V, also has the highest city population density among our three case
studies. It is considered the most congested, population-wise, and
has been classified as 100 percent urban since 1990. With a land area
of only 77.5 square kilometers, Naga's 1995 population is about as
large as that of Puerto Princesa, which has a land area of 2,106.7 square
kilometers. Thus, Naga's population density is almost 30 times that
of the latter.
It is estimated that 25 percent of those who reside in the city's
21 urban barangays are either squatters or slum dwellers. Naga City's
1996AnnualReport states that the city's urban poor population ranges
between 4,000 and 5,000 families compared to only 2,266 in 1980.
While the city has granted business permits to 35 subdivisions (of
which 27 are completed) covering a total area of 855.38 hectares to
date, only 72 percent of Naga city households actually own or are
amortizing their respective dwelling units, and 44 percent are
amortizing their home lots.
The survey conducted in 29 priority areas by the Office of the
Mayor of Puerto Princesa in 1993 reveals that there are 5,174
households in 4,352 structures needing housing assistance. In that
year, 912 illegal structures were demolished and a total of 901 families
were assisted. The city projects that for the period 1995-1999, a total
of 6,473 housing units or 1,295 units a year would be needed. These
projected figures are from a study conducted by the TCGI Engineers
based on the data provided by the Office of the City Planning and
Development Coordinator (OCPDC).
Local Efforts in Housing Provision

Population growth and migration to urban centers combined
magnify the challenges being faced by city g6vernments in imple-
m endng programs for adequate shelter. Lands are more difficult to

purchase due to increased demand. This in turn adds pressure to the
already-limited financial resources of local governments. Selecting
beneficiaries for the program also becomes more challenging as LGUs
grapple with program sustainability while targeting the poor sector
of the society. Lastly, the increased number of groups participating in
housing programs has required creative institutional linkages and
political will to ensure sustainability.
This section documents local efforts in housing provision in
the context of a decentralized governance, focusing on program pack-
age, identification of beneficiaries, measures against new squatters,
funding requirement, cost recovery and institutional linkages.
Programpackage
The first order of business in designing a housing program is to
identify the appropriate package for the LGU concerned. Normally,
the choice is between lot and house/lot provision. The first option
involves land acquisition, site development and establishment of
property rights. The other includes, in addition to the above-cited
elements, the construction of housing units. An LGU can either
directly or indirectly finance and manage this component.
Land acquisition is critical to any housing program as the rate
of distribution depends on the available lots for disposal. The Local
Government Code (RA 7160) speed up the procurement of lands
among LGUs. Chapter 2, section 22 states that "every local government
unit, as a corporation, shall have the following powers...4) to acquire
and convey real property." Essentially, this provision waives presidential
approval in acquiring land, especially in cases where the cost of the
property exceeds the "fair market value." With this waiver, perennial
problems on bureaucratic red tape are avoided.
On the one hand, establishing property rights prevents possible
conflicting claims of ownership thatcan cause insecurity to the
beneficiaries. It also means avoiding an administratively and financially
demanding resettlement process among LGUs.
On the other hand, LGUs' role in site development is enhanced
by the authority given them to approve subdivision plans, which was
previously the sole prerogative of the Housing and Land Use Regula-
tory Board (HLURB) (Sec.458 (2) IX]). Moreover, the Code facili-
tates the provision of basic services in the site like electricity by allow-
ing LGUs to grant financial assistance to local electric cooperatives.
The housing programs of the three cities in this study centered

on land acquisition, except for Puerto Princesa, which had a housing
component. San Carlos and Puerto Princesa opted for the traditional
direct purchase mode of land acquisition while Naga supplemented
this scheme with swapping, exchange and sharing.
San Carlos City's "Lote Para sa Mahihirap Housing Program"
(phases 1, 2 and 3) distributed lots to members of the urban poor
communities and government.employees. Phase 1 has a land area of
five hectares, phase 2 has two hectares and phase 3 has three hectares
with a total of 950 lots for distribution. This figure was 29 percent of
the estimated 3,233 households that needed housing assistance. The
average size of a lot is 54 square meters. The city directly purchased
the lands and gave them out at cost to predetermined beneficiaries.
The price of the land incorporated acquisition cost and site
development. The latter includes construction of individual septic
tank and toilets; basic facilities like roads, power lines, drainage and
water systems; school buildings, health and day care centers and
recreational facilities. The San Carlos's engineering staffhandled site
development. In effect, the city subsidized the land price by excluding
the cost of money and assuming the site development cost.
Local officials of San Carlos maintained its "lots only policy"
for all phases except phase 2 to give the poor a greater hand in
building their house and to ease pressures on the city's resources:
Besides, informal settlers were observed to utilize whatever material
resources were at hand such as scrap wood cartons and flattened tins
in home construction.
Phase 2 of_the San Carlos housing project included the
construction of housing units for city hall employees. However, the
city was not directly involved in this component. Instead, the city
government mobilized the Consuelo Zobel Alger Foundation-
Philippine Branch, a nongovernment organization, to finance and
manage this component.
oThere is an empirical basis for such a strategy. A recent study by Urban Poor Associates
(University of the Philippines) and Urban Research Consortium and the Alternative Planning
Initiative (Ateneo) revealed that government-designed "medium- and high-rise buildings aimed
at easing the urban housing problem are potential nuthouses for poor families occupying them."
Designs such as long corridors in residential projects resulted in a feeling of alienation and
dehumanization among the inhabitants ( Philippine Daily Inquiwr, August 20, 1998).
In contrast, Naga City experimented with various schemes to

land acquisition. The Kaantabay sa Kauswagan Program adopted the
twin approach of on-site and off site settlement. The on-site strategy
involved facilitating transfer of land ownership from government and
private owners to the individuals occupying the property in question.
Meanwhile, the off, ire strategy required provision of resettlement
sites for demolition and eviction victims. In both strategies, the city's
primary task was to negotiate with landowners and other stakeholders
with the ultimate goal of acquiring parcels of land. In this regard,
direct purchases, land swapping, land sharing and land exchange were
schemes adopted by the city.
Direct purchase was the most commonly used mode. Seventeen
projects applied this scheme, notable of which involved the 5.5
hectares of Catholic Church-owned prime residential land located at
Barangay Penafrancia. In the case of the Bagong Buhay Resettlement
Project, land swapping--an exchange of property with another of
roughly the same value (preferably without occupants)--was adopted.
A total of 13,000 square meters of land were also given to beneficiaries
under a mutual agreement between the private owner and the urban
poor occupants (land sharing). Another project using the same
scheme with 70 families from Barangay Concepcion Grande as
beneficiaries is still under negotiation. The Community Mortgage
Program was also successful in assisting 141 families to purchase a
private property they were occupying in the Abella and Ronquillo
properties located at Barangays Lerma and Igualdad, respectively.
Lastly, the housing program obtained a resettlement area in 1996
covering 14,900 square meters through a land exchange scheme.
On the other hand, Puerto Princesa's response to improving
its housing condition stemmed from its intent to clear the coastal bay
of squatter shanties whose daily refuse pollutes the are a and eventually
causes the outbreak of diseases. It was an offshoot of "Oplan Linis"
that aimed to make Puerto Princesa a "squatter-free city."
In 1993, 5.4 hectares of land in Barangay Sicsican was acquired
at P4 million (at P73.86/square meter) using the city government's
own funds. Also, P8 million was spent for horizontal development
(P165.47/square mel:er) and another P19 million (P128,834.49/unit)
for the construction of the housing units. A total of 452 families were
expected to benefit in the program. As of this writing, an initial 150
units were awarded an additional 170 units of duplex and 114 row
houses were being negotiated for construction in collaboration with
the National Housing Authority. At present, the city is implemendng

17 housing projects. Like Naga, Puerto Princesa adopted other
schemes for procuring lands: three through the Community Mort-
gage Program (CMP); one through the Gro/up Land Acquisition and
Development (GLAD) Program; eight through direct purchase; two
public lands; and another two through land donation.
t,u,,tltrtio,, ofb
Identifying the target beneficiaries of the program can help to
determine the legal claimants of housing projects. It also helps in
prioritizing those who need immediate shelter given the limited
number of lots available. Lastly, it defines what particular sectors are
bound to benefit from the project. All cities included in the study
formulated their own set of criteria with particular attention to
socioeconomic status.
The official census listing and structure mapping of the priority
barangays along the coastal areajof Puerto Princesa was the primary
basis in selecting prospective beneficiaries. Results of the census of
squatters as of january 1995 yielded 4,009 households occupying
coastal areas of the city. Another 638 families were found living in
other places like watersheds. Puerto Princesa projected its housing
needs at 6,473 (1995-1999), 7,078 (2000-2004) and 5,443 households
(2005-2009). This estimate is based on the city's population growth;
relocation of households living in dangerous/uninhabited areas,
public parks, sidewalks; and lands needed by the government and
squatters occupying private lands with orders of eviction. Initially, there
were 2,990 prospective families in the nine target barangays. They
represented 42 percent of the total number of households needing
housing assistance.
The city followed the Urban Development and Housing Act's
(RA 7279) specific requirements. The law stipulated that heads of
families muscVbe Filipino citizens; be underprivileged and homeless
or living in makeshift dwellings with no security of tenure; not own
any real property anywhere; not have availed of any government
housing program except those in leasehold or rental payments; be
residents of the area before the affectivity of the Act (March 1992);
and not be professional squatters or members of a squatting syndicate.
First preference was given to the qualified census-listed owner-
occupant of the duly tagged structures. Secondary preference was
accorded to those census-listed rent-free or sharer of the duly tagged
structures. The prog_am prohibited the sale and/or transfer of the

property. It also prescribed disqualification of the guilty party from
receiving any government housing assistance.
Lastly, Puerto Princesa created the Council against Squatting
Syndicates and Professional Squatters (CASSPS) as a safeguard against
the proliferation of new squatters. It also organized the Coastal Area
Protection or Coastal Patrol to assist barangay officials in monitoring
and dismantling al! illegal construction in their respective barangays
within 24 hours.
Similarly, there were 3,233 households recorded as informal
settlers in San Carlos City in 1995. These included people inhabiting
government lands, structures, reclamation areas and private proper-
ties. Some were victims of road widening projects. In February 1992,
a fire hit the city leaving 145 families homeless. The city, through the
aggressive efforts of its mayor, recognized the need of these groups
for shelter and they, thus, became the first beneficiaries of the Lote
Para sa MahihirapProject. To expand sectoral coverage, requirements
were made more liberal: residency of at least six months in the city
and nonpossession of real property anywhere in the country. The
beneficiaries iucluded tricycle/pedicab drivers, market vendors, car-
penters, painters, construction workers and government employees.,
Section 5 Paragraphs 2 and 3 of the Deed of Absolute Sale given
to program beneficiaries prohibited the sale or transfer of ownership
of the lots and the offering of the same as collateral:
"2. Unless through hereditary succession, the BENEFICIARY cannot

sell or transfer ownership of the lot except by way of donation
or sale to the City Government at the fair market value as
determined by the City's Assessor's Office.
3. Should the lot be offered as a collateral to any financing
institution or any private party, the beneficiary shall first secure
the approval of the City, represented by the City Mayor, of such
mortgage proposal; and in the event there is foreclosure, the
City Government shall be given the first option for its
acquisition."
Likewise, Naga City required that the recipient be a fitmily head,

a permanent employee not an owner of house and/or lot and,
preferably, from the locality. The city also required the beneficiaries
to be members of community organizations recognized by the
Local Effortsin Housing Provision 137
Securities and Exchange Commission (SEC), the Home Insurance

and Guaranty Corporation (HIGC) and by the Urban Affairs Office.
Naga tasked community organizations to process requests from
indigents for housing assistance. The requirements on permanent
employment and community membership are unique features of the
city's program.
Funding requirement
The three cities in this study primarily tapped the substantial
increases in their annual internal revenue allotment (IRA) to finance
housing-related activities. The IRA is the share of LGUs from taxes
collected by the national government. It is a regular source of funds
for development activities like housing. Section 28 of RA 7160 states
that "each local government unit shall appropriate in its annum budget
no less than 20 percent of its internal revenue allotment for
development projects." At present, most LGUs obligate only 20
percent of their IRA for development projects. Thus, the Local
Development Fund is commonly known as the "20-percent
Development Fund."
From a mere P34.91 million in i991, San C'arlos' IRA increased
to P125.1 million in 1993 and P169.1 million in 1996. With huge
increments in its resources, the city allocated 3 percent of its annum
budget to purchase home lots for squatters from 1994 to 1996.
Moreover, departing from the prevailing practice, the city
government of San Carlos appropriated 30 percent of its IRA for
development projects starting in 1997. This liberal interpretation of
section 28 of RA 7160 in favor of the social sectors reflected the serious
commitment of the local leadership to provide housing to the poor.
Essentially, this move enhanced the city's financial base for social
development initiatives.
This was an important measure because LGUs are, by nature,
dependent on the IRA and other external resources. For instance,
San Carlos' IRA share to total income is 68.9 percent in 1991, 83.7
percent in 1993, and 79.7 percent in 1996. 7
7The share of IRA in total LGU income rose from 42.3 percent in 1991 to 77.6 percent in 1993
for all provinces, from 41.7 percent to 52.7 percent for all municipalities and from 35.3 percent
to 48.7 percent for all cities (Manasan 1998).
Naga City's IRA grew from P18.3 million in 1991 to P81.9 million
in 1993 and P112.5 million in 1996. The share of housing investment
in tile city's total budget was 4.2 percent in 1991. Then it rose to 10.2
percent (1992) and 16.2 percent (1994). In 1995, however, it was
down to 6.9 percent. The city government is committed to allocate
P10 million per year or a total of P50 million in the five-year period
(1991.-1998) to the Socialized Housing and Resettlement (SHARE)
Program under the Medium-Term Development Plan (1994-98). It
also plans to address price fluctuations in the market by buying more
lands when they are cheap. Through this, Naga can stock parcels of
land for distribution to beneficiaries without necessarily bloating the
local budget.
Owing to its big land area, Puerto Princesa received a larger
share from national taxes compared to the two other cities in the
study. In 1991, the city's IRA was P83.9 million, then rose to P325
million in 1993 and P438.7 million in 1996.
The average annual IRA growth rate during the years immedi-
ately "after the Code was implemented (1991-1993) was 96.8 percent
in Puerto Princesa, 89.3 percent in San Carlos, and 111.5 percent in
Naga. But in 1994-1996, IRA growth decelerated to 8.06 percent in
Puerto Princesa, 6.96 percent in San Carlos and 5.8 percent in Naga.
Moreover, recent budget guidelines from the Department of Budget
and Management, which withheld 10 percent of LGUs' IRA in 1998,
further tightened the financial position of most LGUs (Table 2).
Aside from the IRA, LGUs fund local projects from locally
sourced revenues. In this regard, LGUs have varying degrees of suc-
cess. Per capita local-source revenue (LSR) in Naga and San Carlos
increased substantially in 1991-1996. Per capita LSR in Naga rose by
30.8 percent and 18.7 percent annually on the average in 1991-1993
and 1994-1996, respectively. Likewise, per capita LSR in San Carlos
grew by 23.3 percent and 17.1 percent yearly during the same two
periods. In contrast, Puerto Princesa's LSR increased by only 7.3 per-
cent yearly on the average in 1991-1993 and declined by 11.5 percent
annually in 1994-1996.
Naga City also made use of other sources of finance. The city
government through the Sanggunian sought the assistance of a sena-
tor in the amount of P1 million fbr the upgrading of a resettlement
site in Barangay Calauag. The same body also authorized the mayor
to secure an additional credit line of P10 million from any commer-
cial bank. Lastly, a trust fund was set UP for collections/proceeds from
Table 2. Income of Local Government Units
Years Puerto Princesa City Naga City San Carlos City

Total IRA LSR Per Total IRA LSR Per Total IILA. LSR Per
Inc°melRA LSR Shz.re Share Capita Income IRA LSR Share Share Capita Income IRA LSR Share Share Capita
(%) (%) LSR (t_) (%) (%) LSR (t_) (%) (%) LSR (t_)
1991 104.283.9 10,311 80.52 19.0 193.11 55.2 18.3 30,578 33.15 53.0 259.14 50.7 34.91 15,707 68.86 31.0 149.59
1992 194.1 174.5 19,629 90.00 10.0 183.45 81.4 44.8 36,567 55.00 45.0 304.73 84.1 67.2 16,925 80.00 20.0 162.74
1993 400.4 325.0 25,346 81.17 06.0 222.33 136.0 81.9 54,123 60.22 40.0 443.63 149.5 125.1 23,433 83.68 16.0 227.60
1994 432.3 375.7 50,891 86.91 12.0 417.14 181.8 100.5 59,313 55.28 33.0 474.50 192.7 147.8 31,826 76.70 18.0 312.02
1995 469.5 409.9 37,120 87.31 08.0 285.54 173.0 104.8 67,696 60.58 39.0 533.04 188.0 157.7 37,504 83.88 19.0 371.33
1996 577.9 438.7 45,039 75.91 08.0 326.37 200.1 112.5 86,329 56.20 43.0 669.22 212.3 169.1 43,245 79.65 20.0 428.17
Growth Rat_
Years thletlo Princesa City Naga City San Carlos City
Tot al Total Total

hlcome IRA Income IRA I.ucome IRA
1991-1993 96.02 96.87 56.96 111.55 71.72 89.30
1994-1996 15.62 8.06 4.91 5.80 4.96 6.96
1991-1996 40.86 39.21 29.38 43.79 33.16 37.10
resettlement sites, sale of government properties and community

mortgage program's origination fees.
Cost Recovery
The institution of cost recovery measures can both lessen
dependence on IRA and the need for "militant advocacy" plans to
ensure project sustainability. In housing, cost recovery refers to setting
the right price for each project package and efficiently collecting
monthly amortizations. While the project by nature involves subsidy
from the local government, defining a cost sharing scheme between
the LGU and the beneficiaries concerned is important. For the cities,
it means easing the pressure on its budget. On the part of the
beneficiaries, shouldering the cost gives them a sense of dignity and
ownership. Cost sharing can also ensure available funds for housin
The cost and payment scheme that San Carlos offered Lv
beneficiaries of its housing program was tailored-fit to the lowest
income earners of the city. The city acquired parcels of land for the
first phase at P45 per square meter and was sold at P100 per square
meter. The difference of P55 per square meter was treated as site
development cost. Home lots have an average size of 54 square meters.
An easy mode of payment of P5 per day (Monday to Friday) for five,
years (phase 1) with no downpayment and interest was provide -_ °
Section 4 of City Ordinance No. 160 series of 1994. The ordinance
also stipulated that "any default in the payment of 40 accumulated
dally installments shall cause the cancellation or termination of the
Conditional Deed of Sale between the City Government and applicant-
beneficiary." A collection officer was assigned to receive the daily
payments. Of the 436 residents in phase 1 (1996), eight were fully
paid. However, no data were available on the payment status of other
beneficiaries.
Naga City relied on community organizations in determining
the share of the beneficiaries in the financial requirements of the
projects. In the land sharing project of the Naga Centrum property,
the recipients paid P469,900 (12 percent) out of the P3.9 million
total cost. The city initially shouldered the remaining P3.43 million
(88 percent) of the purchase price. For the direct purchase mode,
the following cost sharing ratios between city and beneficiaries were
formulated: 53-47 percent (Archdiocese property); 70-30 percent
(Belmonte property); 89-11 percent (Veterans' Bank property). The
eviction/demolition victims. Otherwise, all claims and assistance were

through NGO representatives.
Naga City also coordinated with NGOs in determining the
qualified beneficiaries and in conducting value re-orientation
seminars. Four NGOs, which are members of Naga's urban poor
association, were the main partner-beneficiaries of the city's housing
program. As such, these groups handled the process of identifying
the beneficiaries and their corresponding financial share. With this
setup, the UPAO was able to focus on land acquisition. The Bicol
Business Development Foundation, a private foundation, was also
tapped as originator for the Community Mortgage Program. This
tripartite organizational strategy helped minimize potential
administrative bottlenecks (Table 3).
In summary, Naga City shouldered the financial requirements
of its various activities in coordination with national governments.
However, it delegated to people's organization, NGOs and private
business some of the administrative functions vital to the successful
implementation of its housing program.
For local programs that could not afford to take on the
responsibility of constructing housing units, the assistance of NGOs
may also be helpful. The city government of San Carlos authorized
the Consuelo Mgers Foundation, a Hawaii/Guam-based NGO,
through S.E Ordinance No. 187, to directly finance the construction
component of phase 2. Thus, the foundation managed the site
development and construction of houses for city hall employees. It
also provided housing loans to city hall employees. Furthermore, the
NGO conducted value-orientation seminar for the beneficiaries.
In contrast, San Carlos' program under phases 1 and 3 focused
only on lot purchase and distribution. In this regard, the local
bureaucracy took charge of all administrative aspects of the project
from selection, relocation, collection, tiding, and livelihood to
monitoring.
Unlike Naga's and San Carlos', Puerto Princesa's project ap-
proach depended both on its own financial and administrative re-
sources. The city acquired 5.4 hectares of land at P4 million in
Barangay Sicsican using money from its coffers. It also spent P8.5
million and P19.3 million for site development and construction of
housing units, respectively. To date, a joint venture proposal with the
National Housing Authority is being finalized for the construction of
Table 3. Participants and Their Respective Roles in the Kaantabaysa
Name of Nature of
Illdividtml_/Oggani_ltlorm Org'ani_tion Role/Area(s) of Involvement
Government Agencies:
1. Naga City government Local Main program implementor

government unit
2. Department of Environment Line Provider of authority to city

and Natural Resources govemment government to supervise
(DENR) department disposition of public lands in
Naga City
3. National Housing Authority Land shelter Production of housing units;
(NHA) agency assistance in developing
relocation sites
4. National Home Mortgage Financial support for the

Finance Corporation Community Mortgage Program
(NHMFC) (CMP)
5. Home Insurance Guaranty Government- Provider of interim financing to

Corporation (HIGC) owned and CMP projects; property seller of
controlled BLISS-I housing projects
corporations
(GOCCs)
6. Government Service Financial support provider

Insurance System (GSIS) through the _Tulong sa Lokal
na Pamamahala" window
7. Presidential Cmmmission for National urban Issue and program advocacy;

the Urban Poor (PCUP) poor agency accreditation of urban poor
organizations
Nongovermnent Organintlons:
1. Naga urban poor associations Nongovernment Main program partner-
organizations beneficiaries
(YGOs)
2. Community Organization of Development Community organization; social

the Philippines Enterprise NGO preparation; issue and program
(COPE) foundation advocacy
:5.Bicol Business Development Private business CMP originator
Foundation foundation
4. Caceres Social Action Chureh-based
Foundation (CASAF) organization
Property Owners:
1. Archdiocese of Caceres Religious
2. Abella Family Private Sellers of property

RonquiUo Family landowners
Dy-Liaco Family
Borebor Family
Bernardo Family
Belmonte Family
Heir of Fabiana Arcjola
144 ManagingUrbanization
Undera DecentralizedGovernanceFramework
additional units. By virtue of City Ordinance No. 55-93, a housing

council was further created. The mayor headed the council with the
fiscal officers, environment and natural resources officer and the
chairperson of the committee on housing and urban poor of the
Sangguniang Panlunsod (city council) as members. The 20-percent
Development Fund served as the annual financial source of the coun-
cil.
At the same time, other government agencies such as the
Department of Environment and Natural Resources, NHA, NHMFC,
HIGC, GSIS and Presidential Commission for the Urban Poor (PCUP)
assisted the three cities in providing financial support, supervising
the disposition of public lands, assisting in developing relocation sites
and in program advocacy. Private sector participation was also
encouraged in lending assistance projects such as the CMP and GLAD.
Or_n/x/ng the/oca/bure___,_,___cy for program succe,_

PolitiCal will in the context of a housing program is determined
by two factors. The first is the introduction of measures to ensure
financial sustainability of the project. It involves both the identifica-
tion of regular source of funds and the institution of cost recovery
schemes. Just as important is the need to define the appropriate or-
ganizational structures within the LGUs' structure and their respec-
five roles. In this regard, the city can either assume full responsibility
in administering the project or it can delegate some of its functions.
Two of the three model cities in this study put in place new
structures that became the focal point of its housing efforts. In Puerto
Princesa, City Ordinance No. 55-93 (Aug. 2,1993) instituted the
Housing Council. Its primary responsibility was to implement the city's
housing program. Originally, the Council was composed of the mayor
as chairperson and the chief of police, the president of the Urban
Poor Coordinating Council, the city attorney, and the chairperson of
the Landed Estate of the City Council as members. At present, the
members of the Housing Council include the city's fiscal officers, the
environmental and natural resource officer and the chairperson of
the committee on housing of the sanggunian. As in San Carlos, the
local chief executive supervised the entire project.
Similarly, the creation of the Urban Affairs Office (UPAO) was
Naga's distinct local initiative. A separate unit in the local bureaucracy,
UPAO took charge of negotiating and formulating appropriate land
purchase schemes. It was also tasked in resettlement and auxiliary
Loca|Efforts in HousingProvision 145
services. Lastly, UPAO was mandated to accredit community

organizations involved in the program.
At the same time, Naga harnessed community organizations in
identifying potential benefits and their corresponding financial share.
This setup augured well for UPAO as it focused more on land
acquisition schemes. At the same time, the city sought the assistance
of other government agencies like DENR, NHA and NHMFC, to name
a few, in providing financial support, supervising the disposition of
public lands and assisting in the development of relocation sites. By
adopting a tripartite strategy, the city lessened its dependence on the
local executive's initiative, unlike Puerto and San Carlos.
In contrast, San Carlos opted for the collaborative efforts of the
different units of the city's bureaucracy to manage the project. The
Office of the Mayor exercised general supervision of the entire project.
Thus, the local bureaucracy took charge of all administrative aspects
of the project from selection, relocation, collection, tiding, and
livelihood creation to monitoring in coordination with the NHA and
homeowners' associations (Figure 1).
Figure l. Organiza_onal Chart of the Lore Para sa Mahirap Program
PANLUNSOD
CITYMAYOR I [ SANGGUNIANG
I
CITY ] 1CITYADMINISTRATOR
ADMINISTRATOR [ 1CLERK
cOORDINATOR
PROJECT [
, i
URBANPOOR 1CYIYF_NGINEER 1CITYLEGAL II_GISTZR

OF iCITYPLANNING lCITYPLANNINC
FEDF._,ATIONITRUCXDR/VKR OFFICER DZKDS & DEVELOPMENT ANDDEVT,
1BARANGAY 4C..,AR/_.._ 1(_Y 1BOCUMLNTATION OFF/CER OF'flCF_R
CAFTAIN 27 VOLUNT_RS TREASURER OffiCER 1CITYSOCIAL ICLERK
ASSESOR 1_ 1 CLERK WELFARE 8tDEaf.
OFFICBR
1 DEC.$OYFfCER
1 CONSUELOALGERS
OR NGO OFFICER
146 ManagingUrbanizationUndera Decentralized
GovernanceFramework
Key Concerns
While varying levels of success have been achieved in the three
model cities, other LGUs experiencing growing urbanization can
further evaluate the strategies they have undertaken to determine
the most appropriate solution to their own housing problem.
Significant concerns from the experience of the three model
cities in this study are highlighted here to provide further lessons
and guidelines to other LGUs.
Projectopao
The experience of other countries shows that "given the
heterogeneity of people's prefbrences for a type of shelter and the
speed at which they can or want to improve its quality," public housing
projects do not often fit the "ideals" of the beneficiaries (Bahl and
Linn 1992). People from all income brackets appear to be able and
willing to finance the construction of their own housing unit provided
that the required inputs like tenure, site development and to some
extent capital are readily available. Even in cases of resettlement
resulting from a disaster like the Mt. Pinatubo eruption, beneficiaries
are observed to value their "freedom to build" their own house. In
light of these facts, it is crucial for policymakers at the local level to
decide whether the housing package should include the construction
of housing units at the LGU's expense. Thus, in many instances, public
resources allotted for housing construction are better placed in
complementary inputs to housing like tenure and on-site services.
Naga's case is a good example. The city's "lot only" policy,
together with its participative organizational structure, allowed it to
experiment more on various modes of land acquisition other than
direct purchase of lands. Another option available to LGUs is to
catalyze other institutions (NGOs, private sector) to undertake the
construction of housing units. This was exemplified by San Carlos
City, which authorized the Consuelo Algers Foundation to take charge
of the housing construction component of phase 2 of its program.
Such an arrangement allowed local government efforts to be re-
directed to lot distribution and construction of septic tanks and toilets,
roads, power lines, drainage and water systems, school buildings,
health/day care centers and recreational facilities.
The econon_ of housing subsidy

Local housing programs in these case studies heavily subsidized
the provision of home lots. This is consistent with the experience of
many countries that subsidized housing consumption either by
underpricing land or implicitly by subsidizing interest. Often, land is
valued at its acquisition cost to government. "While a first project
may be able to draw on financially cheap public land, follow-up projects
may have to purchase land at commercial prices from private owners.
In that case, the replicability of the first project--it relies on subsidized
land costs---is in doubC (Bahl and Linn 1992).
At the same time, subsidies on housing tend to result in the
overconsumption of this service relative to other goods and in overly
ambitious expectations on housing standards because full cost is not
borne by beneficiaries. Thus, the problem with these subsidies is that
land appears to be cheap when in reality it is not. There is a tendency
for the programs to provide bigger lot sizes than would otherwise be
the case if the land were properly priced. Puerto Princesa's project in
Baiangay Sicsican is a case in point. Individual lots measured 99 square
meters, bigger than those in typical housing projects.
I asdy, subsidies could also limit local government's capacity to
finance the essential components of housing supply like urban
infrastructure and services for which it usually has sole responsibility.
Finn/ pta,m/ng
All three cities in the study financed their programs utilizing
the substantial increases in the IRA. As has been stressed earlier,
growth in IRA should be seen in the light of devolution: more money
for more responsibilities. Moreover, it is noted that the rapid growth
in the IRAin the early years of the Code's implementation is no longer
the norm. The growth in the IRA has, in fact, tapered off in recent
years.
An alternative scheme is financing through increased local tax
effort. San Carlos and Naga both score high in this regard. They have
expanded their local source revenues even as their IRA increased
significan fly in 1991 -1996.
Potentially another good source of continuing funding for the
LGU's housing program is cost recovery. Cost recovery has two prin-
cipal components: (1) correct service pricing; and (2) collection effi-
ciency. All three cities in the case studies have not shown much suc-
cess in this regard.
Lastly, after forecasting the potential financial needs and re-
sources, the local government can explore the sourcing of funds from
external sources like credit facilities s and the countrywide develop-
ment fund of legislators.
Structure and advocacy

Slower IRA growth and poor local tax effort, together with in-
creased responsibilities on social service delivery, has increasingly
constrained the financial positions of LGUs. Housing programs had
to compete with other priorities of the cities in the allocation of their
resources. All three cities were fortunate to have mayors who share
concern for housing. They exhibited strong political resolve in imple-
menting their projects. They utilized their executive powers and in-
fluence to institutionalize the operational, financial and organizational
aspects of the program. The office of the chief executive, possibly
with new structures that are closely linked to him, acted as the overall
operational nerve center.
But the strong identification of housing program with the may-
ors is also a potential problem in the long run. Mayors are elected for
a three-year term and if he fails to win a re-election, the new leader
should at least have the same commitment to sustain the program.
Unfortunately, Philippine policymaking both at the national and lo-
cad levels is observed to exhibit discontinuities. The creation there-
fore of a critical mass for housing is signiticant. In this regard, the
role ofnongovernment and peoples' organizations in ensuring a con-
tinuous advocacy for housing cannot be minimized. They have been
proven active and effective partners in program implementation as
well.
Lastly, the three model cities have all managed to tap the
resources (financial and institutional) of various housing agencies at
the national level such as NHA, NHMFC, CMP and DENR.
s Llanto et aL (1998) formulated a framework for local government units' access to private
• capital markets.
References
Alonzo, Z.A.C. 1997. Developments in Philippine Housing Finance.

Housing Finance International.
Bahl, R. andJ. Lim. 1992. Urban Public Finance in Developing Countries.

New York: Oxford University Press.
Llanto, G.M., R.G. Manasan, M.B. I amberte andJ.C. Zoya. 1998. Local
Government Units Access to the Private Capital Markets. Makati City:
Philippine Institute for Development Studies.
National Statistical Coordination Board. 1997. Philippine Statistical

Yearbook.
National Tax Research Center. 1997. The Philippine Housing

Program: A Study. NTRC Tax Research Journal 9 (5).
Philippine Daily Inquirer. August 20, 1998. p. 1,14.
Rebullida-Genato, M.LG. 1993. Alternative Self-help Financing

Schemes for Housing: an Exploratory Study on Indigenous,
Voluntary, Community-based Groups in Urban Areas. Working
Paper No. 934)3 Makati City. Philippine Institute for Development
Studies.
_,. n.d. Economic and Social Indicators. Pasig City: National

Economic and Development Authority.
Republic Act 7160. The Local Government Code of 1991.
Republic Act 7279. 1993 Urban Development and Housing Act.

Appendix Table 1. Cities' State of Urbanization

Land Population Intercensal % Urban
CITY Population* Area Density Growth Population ***
(person/sq. kin) Rate**
May. 1990 Sep 1995 (_q.km).. May 1990, Sep 1995 (1990-1995) 1990 1995
NCR
Manila 1,601,234 1,654,761 38.3 41,807.7 43,205.2 0.62 100.0 I00,0
Quezon 1,669,7761,989,419 166.2 10,046.8 11,970.0 3.34 100.0 i00.0
Pamy 368,366 408,610 13.9 26,501.2 29,396.4 1.96 100.0 1O0.0
Caloocan 763,4151,023,159 55.8 13,681.3 18,336.2 5.64 1O0.0 100.0
Mandaluyong 248,143 286,870 26:0 9,544.0 11,033.5 2.75 100.0 100.0
Pasig 397,679 471,075 13.0 30,590.7 36,236.5 3.22 100.0 100.0
Makati 453,170 484,176 29.9 15,156.2 16,193.2 1.25 100.0 100.0
Muntinlupa 278,411 399,846 46.7 5,961.7 8,562.0 7.02 100.0 100.0
RegionI
Dagupan 122,247 126,214 37.2 3,286.2 3,392.8 0.60 100.0 1O0.0
Laoag 83,756 83,386 107,5 779.1 821.7 1.00 47_9 47.7
San Carlos 124,529 134,039 166.4 748.4 805.5 1.39 11.7 10.7
CAR
Bagoio 183,142 226,883 48.9 3,745.2 4,639.7 4.09 100.0 100.0
Region11
Santiago nda 98,542 255.5 385.6 nda 1.55 nda nda
Regionm
Angeles 236,686 234,011 60.3 3,925.1 3,880.8 -0.21 100.0 100.0
Cabanatuan 173,065 201,033 192.7 898.1 1,043.2 2.85 53.3 49.2
Olongapo 193,327 179,754 103.3 1,871.5 1,740.1 -1.35 100.O 100.0
Palayan 20,393 26,851 35.6 572.8 754.2 5.29 46.4 39.7
San Jose 82,836 96,860 180.5 458.9 536.6 2.97 31.1 29.9
Rein IV
Batangas 184,970 211,879 283.0 653.6 748.7 2.58 68.3 100.0
Cavite 91,641 92,641 11,8 7,766.2 7,850.9 0.20 100.0 100.0
Lipa 160,117 177,894 209.4 764.6 849.5 1.99 70.0 68.6
Lucena 150,624 177,750 68.5 2,189.9 2,594.9 3.15 100.0 100.0
Puerto Princesa 92,147 129,577 2,106.7 43.7 61.5 6.60 70.7 58.0
San Pablo 161,650 183,757 214.0 755.3 858.7 2A3 45.3 39.1
Tagaytay 23,739 29,419 74.0 320.8 397.6 4.10 17.2 8.2
Trece Martires 15,686 20,451 39_1 401.2 523.0 5.10 37.9 37.7
RegionV
Iriga 74,269 82,482 119.6 621.0 689.6 1-98 59.4 60.3
Naga 115,329 126,972 77.5 1,488.1 1,638.3 1.82 100.0 1O0.0
Legazpi 121,116 141,657 153.7 788.0 921.6 2.98 58.1 44.8
_egimaVI
Bacolod 364,180 402,345 156.1 2,333.0 2,577.5 1.88 100.0 100.0
.Bago 122,863 132,338 402.1 305.6 329.1 1_40 42.6 41.6
Cadiz 119,772 125,943 516.5 231.9 243.8 0.95 36.7 38,1
Iloilo 309,505 334,539 56.0 5,526.9 5,973.9 1.47 100.0 100.0
La Cat'lota 56,443 56,414 137.3 411.1 410.9 .4).01 52.4 49.5
Roxas 103,171 ,118,715 102.0 1,011.5 1,163.9 2.66 100.0 100.0
San Carlos 105,713 101,429 451.3 234.2 224.7 -0.77 38.3 36.4
Silay 101,031 122,748 214.8 470.3 571.5 3.72 46.4 47.8
l_egionVII
Bais 59,591 63,355 316.9 188.0 199.9 1.15 100.0 100.0
Canlaon 37_165 41,334 160.7 231.3 257.2 2.01 19.5 19.8
Appendix 1 (continued)
Land Population Intercensal % Urban
CI'IY Population* Area j (person/sq.DemitYkm) _Rate** Population ***

May 1990 Sep 1995 (sqatmj Malt 1990 Sep 1995 (1990-1995) 1990 1995
Cebu 610,417 662,299 280.9 2,173.1 2,357.8 1.54 100.0 100.0

Danao 73,358 79,932 107.3 683.7 744.9 1.62 33.4 33.3
Dumaguete 80,262 92,637 55.8 1,438.4 1,660.2 2.72 100.0 100.0
Lapu-Lapu 146,194 173,744 58.1 2,516.2 2,990A 3.29 100.0 98.6
Mandaue 180,285 194,745 11.7 15,409.0 16,644.9 1.46 100.0 100.0
Tagbilaran 56,363 66,683 30.3 1,860.2 2,200.8 3.2 100.0 100.0
Toledo 119,970 121,469" 174.5 687.5 696.1 0,23 13.1 13.7
Reglonvm
Calbayog 115,390 129,216 903.0 127.8 143.1 2.14 25.3 24.3
Ormoc 129,456 144,033 464.3 278.8 310.2 2.02 40.1 36.2
Tadoban 136,891 167,310 100.9 1,355.7 1,658.2 3.83 100.0 100.0
ReglonIX
Dapitan 60,213 62,997 215.0 280.1 293.0 0.85 17.5 20.7
Dipolog 79,887 90,777 220.0 361.3 412.6 2.42 46.0 40.3
Pagadian 106,$07 125,182 378.8 280.6 330.5 3.11 57.2 49.7
Zamboanga 442,345 511,139 1,414.7 312.7 361.3 2.75 63.6 03.0
Region
X
Cagayan de Oro 339,598 428,314 412.8 822.7 1,037.6 4.44 98.2 98.2
Gingoog 82,582 87,530 404.6 204.1 216.3 1.10 36.0 36.0
Oroquieta 52,500 56,012 194.9 269.4 287.4 1.22 50.5 49.2
Ozamis 91,503 101,944 144.2 634.6 707.0 2.05 46.1 45.8
Tangub 42,926 46,004 119.2 360.1 385.9 1.31 17.4 17.7
m_io_xI
Dawao 849,947 1,006,840 2,211.3 384.4 455.3 3.22 70.2 64.0
General Santos 250,389 327,173 423.0 591.9 773.5 5.14 85.8 41.7
ReglonXg
Cotabato 127,065 146,779 176.0 722.0 834.0 2.74 100.0 100.0
Iligan 226,568 273,004 730.5 310.2 373.2 3.56 30.7 18.2
Marawi 91,901 114,389 22.6 4,066.4 5,061.5 4.19 nda nda
CARAGA
Butuan 227,829 247,074 526.3 432.9 469.5 L53 52.5 52.5
Surigao 100,379 104,909 245.3 409.2 427.7 0.83 47.9 44.3
Memo Item:
PIqlIJPPlNES 60,703,206 68,616,536 500,000 202.3 228.7 2.32
Sources: 1997_neStatiaical Yearbook, National Statistical Coordination Board.

* 1990 and 1995 total Philippine population includes the household population, homeless
population, Filipinos in Philippine embassies/consulates and missions abroad, and
institutional population who are found living in institutional living quarters such as penal
institutions, orphanages, hospitals, military camps, etc., at the rime of the census taking.
** Intercensal growth rate from =Cities in the 90's: A Compilation of Basic Information."
Compiled by E.T.Joaquin and E.S. Valeroso, Local Government Center, College of Public
Administration,
*** Percent Urban data (computed).
nda - no dataavailable.
Part II. Case Studies
Chapter
1
Closing the Urban
Fiscal Gap: An Overview*
Rosario G. Manasan
Introduction
rbanization has certain advantages. Agglomeration economies

result in higher productivity as compared to the rest of the
economy. As urbanization proceeds, cities are better able to
capture the benefits from economies of scale, bringing about
reductions in unit cost of delivering certain types of services like
sewerage treatment, public t_nsportafion and the like. Urbanization
also induces increases in the taxable capacity of cities such that more
revenues can be mobilized from the same jurisdiction.
There are, however, also certain problems which urbanization
is associated with. Congestion is one. It leads to diseconomies like air
and water pollution, slum settlements, and increased need for disease
control and fire/police protection, which then offset the positive
effects of technological economies of scale on input costs. Of course,
basic services like potable water supply, telephones and health facilities
also become critically inadequate in many large cities.
Two types of responses are known to have been made to address
these problems. One is to impose controls on rural-urban migration
and rapid populadon growth. Another is to find efficient ways to
manage and finance the urban sector. This pape r focuses on the
latter--searching for ways to finance and deliver adequate public
services in urban areas.
The Heart of the Problem

The immediate cause of the shortage and at times, near absence,
of basic public services in large cities is the inability of governments
to fund the delivery of the fight quantity and quality of these services.
* First published as P1DS Policy Notes No. 994)2 entided "Closing the Urban Fiscal Gap: Some
Considerations."
156 ManagingUrbanizationUnderaDecentralized GovernanceFramework
In short, urban local government units (LGUs) typically face a

financing problem known as _fiscal gap." This is defined as a gap
between perceived service needs and available financial resources.
This fiscal gap is different from the concept of fiscal deficit that reflects
a shortfall of actual revenue collections relative to actual LGU
expenditure. It is important to note this difterence at the outset since
in the Philippine context, LGUs are not encouraged to engage in
deficit financing of recurrent expenditures. .
How does urbanization ilafluence the fiscal gap?
To be able to answer this, one should first take a look at how
urbanization and population growth affect the expenditure
requirements and revenue collections of urban LGUs. The increase
in demand for public services is mostly driven by growth in population
induced by natural growth and migration. In order to sustain a given
level of service, some argue that LGU expenditures have to increase
at a rate that is at least proportional to the rate of population growth.
In cases where service provision entails an increasing marginal cost,
the need for such response becomes even more pronounced. Clearly,
urbanization exerts an upward pressure on local government budgets.
However, LGU revenues may not respond as quickly and strongly to rapid
population growth. Thus, while population growth, urbanization and
the associated growth in per capita income at/tend to expand the revenue
capacity of urban governments, the growth in LGU revenue may not
automatically expand since it is held back by the LGUs' limited taxing
authority and lagging revenue efforts. One example is in terms of
property values. While they tend to rise with urbanization, the increase
is not immediately reflected in the statutory tax base unless assessment
values are automatically indexed. Another illustrative case is the issue
of inflation. Inflation drives up government spending requirements
almost instantaneously, what with the rise in the cost of materials and
supplies and the pressure to increase governmentemployees' salaries
to be able to cope with the higher costs of living. Yet, LGU revenues
are not as responsive. Again, this is because there is, among others,
no automatic indexation of the assessed values of real property for
tax purposes in most places.
To bring adequate public services to the urban sector, then, it
becomes critical to close the fiscal gap. To close the fiscal gap, more
money should flow into governments. Conversely, service delivery must
be made more efficient or innovative in order that some money may
be saved and put into the government coffers.
Closingthe Urban Fiscal Gap: An Overview 157
Dissecting the Urban Fiscal Problem

It is useful to analyze and evaluate the determinants of the city
local government units' (CLGUs) revenue performance and expen-
diture behavior to understand where and how more funds (and sav-
ings) can be sourced for the city government coffers thereby closing
the fiscal gap.
Determinants of revenue performance

Reviewing the 1991-1995 period, the study measures LGU rev-
enue performance in terms of per capita total LGU income and two
components of per capita locally-generated revenues: per capita lo-
cal business tax revenue (PCLBT) and per capita real property tax
revenue (PCRPT).
Results of a series of regression runs indicate that the degree of
urbanization has a positive and significant effect on PCLBT. It is like-
wise positive but not significant in terms of its relationship or effect
on the PCRPT. The latter apparently shows that real property tax sys-
tems have not been able to fully capture the positive effects on land
values brought about by urbanization.
Cities earn income from both local and external sources. Local
sources come mostly from local business tax and real property tax
while external sources are largely accounted for by the internal rev-
enue allotment (IRA). A previous Manasan study (1995) showed that
instead of acting as a stimulant for LGUs to raise their local revenue
generation effort, the IRA served as a disincentive to local
government's resource mobilization effort since it became a substi-
tute source of income for LGUs.
In view of this and because, as noted earlier, efforts in generat-
ing potential tax earnings from higher valued real property brought
about by urbanization were not fully realized, it is therefore not sur-
prising to find that the effects of urbanization and population growth
on per capita LGU total income had simply been neutral.
Determinants of CLGU expenditure behavior

Meanwhile, the growth in demand for public services is often
associated with the increase in population. Logically, LGU expendi-
tures are expected tO grow more or less proportionately with respect
to population in order to maintain a constant level of service.
Ditto with the effects of urbanization. As urbanization proceeds,
per capita personal income tends to rise. With the increase in per
capita personal income is the tendency to have an increase in the

demand for most public services. Subsequently, too, the level of per
capita expenditure is expected to rise.
However, results of the regression analysis conducted by
Manasan using data on Philippine LGU expenditures show that in
1995, the degree of urbanization and per capita LGU expenditure
(PCLGUEXP) were negatively and significantly related. For the other
years, except 1994, while the urbanization coefficient turned out to
be positive, it was nonetheless not significant.
When the regression analysis was further extended to take a
look at the effects of urbanization and population growth on the per
capita LGU expenditure for health and education, the results showed
that except in 1991, the association had been negative and statistically
significant. Said result/s contrary to initial expectations and to what have
been obtained in other countries, notably developed countries.
What accounts for such difference and what is its implication?
The Unfortunate Consequence

Put simply, the results showing a negative relationship between
urbanization and population growth, on the one hand, and per capita
CLGU expenditure, on the other, means that instead of increasing as
would have been expected, the actual CLGU per capita expenditures,
specifically for health and education services, declined as population growth
rates and the degreeof urbanization rose.
Consequently, the fiscal gap is not reflected in terms of a higher
LGU fiscal deficit, as in other countries, but rather in reduced level
of per capita expenditures. The implication of this is that the delivery
of basic services, notably health and education, is adversely affected.
It therefore becomes not merely afiscal problem but, sadly, a shortage
and deterioration of urban service delivery especially in the areas of health
care and education.
Recommendations: Interventions to Close the Urban Fiscal Gap

The urban fiscal gap can be closed in four ways:
• increasing local revenue effort with unchanged revenue

authority;
• increasing LGU taxing authority;
• increasing transfers from central government; and
• more efficient use of existing financial resources in service
delivery.
Closingthe Urban Fiscal Gap: An Overview 159
l_ng,/octd _,_ _fort

To counteract the substitutive effect of the IRA distribution
formula on local source revenue, tax effort may be explicidy taken
into account in the IRA allocation formula. Alternatively, the IRA
distribution formula may also be allocated to the different LGUs based
on equalization of net fiscal capacities (revenue capacity net of
expenditure needs).
To address the problem of CLGU real property tax systems not
fully Capturing the rise in urban land values, the Local Government
Code should be amended in favor of automatic indexation of the
schedule of fair market value between general revisions. This will
protect the real property tax base from inflation during the years
when no general revision is undertaken. By avoiding the need to make
lumpy adjustments in the schedule, it will also narrow the gap between
the official schedule of fair market values and the true market values
of real property in the medium term. Moreover, to counter the
tendency of local assessors to value real property below its true market
value, the me of the zonalvalues of real property (on which the BIR
bases its assessment of transfer taxes) should be considered.
On the collection side, there is a need to separately monitor
current real property tax coUectibles from delinquent accounts.
Aggressive collection and enforcement after each quarter through
notices of delinquencies would do the government good. At the end
of the second quarter, when an account becomes delinquent, warrants
of levy should be issued. If by the end of the third quarter, the account
is still delinquent, auction notice should be issued.
For local business taxes, the biggest problem is the
underreporting of gross receipts of establishments. Requiring
taxpayers to submit their income tax returns (ITRs) filed with the
Bureau of Internal Revenue is perhaps the most direct way of obtaining
information. Given the present tax calendar, this implies that local
business tax be initially assessed on the basis of the previous year's
ITR and adjusted later in the year as the current ITR becomes
available. In addition, local treasurers may require large establishments
to submit supplementary accounting records. In large urban areas,
local treasurers should be trained in field examination to check the
veracity of reported gross receipts. The use of presumptive income
levels, particularly for small establishments, should also be explored.
To improve collection and enforcement of nonreal property
taxes, meanwhile, the following may be considered:
* establishing a roll for each type of tax (the conduct of a tax

census and the development of a revenue data bank are key
steps in this regard);
* maintaining systematic records where tax payments are
automatically entered as they occur;
• Sending tax bills and conscientiously monitoring tax payments
and delinquencies; and
° strictly implementing, sanctions and penalties on erring
taxpayers.
A good number of cities has already implemented user charges

to defray hospital expenditures. To supplement the effort, local
sanggunians (councils) need to pass legislation removing restrictions
on the retention of income generated by these hospitals since such
restrictions discourage hospitals from collecting user fees.
Meanwhile, the poor financial performance of CLGU business
enterprises is becoming worrisome. Cost-based pricing is a way of
addressing the problem. Still another way is through management
contracts with the private sector.
Increasing LGU taxing authority

In the medium term, the assignment of taxing powers to various
levels of government must be reviewed. Theory suggests that
residence-based taxes and taxes on immobile factors such as the real
property tax are appropriate for local taxation. Motor vehicle taxation
is also suitable for CLGUs. Betterment levies (a tax aimed at recouping
the public costs of providing urban infrastructure from the
beneficiaries) should also be explored. Such charges have had positive
• effects in Korea and Colombia.
Improving efficiency and effectiveness in service delivery

Case studies of best practices in LGU service delivery indicate
that much improvement could be achieved in this area. Below are
three major characteristics of selected Philippine cities which, faced
with inadequate funds to finance urban services, shifted strategy by
innovating and making more efficient the delivery of ser vices.
One, there is greater participation ofv_ous stakeholders (local
institutions and people) in the implementation process and funding.
This helps ensure efficient and effective program results and sustmn
implementation. For example, Surigao City and Lapu-lapu City
_nobilized their women's groups to deliver health services. Naga City
Closing the Urban Fiscal Gap: An Overview 161
tapped community organizations to identify and come up with the

financial counterpart of housing program beneficiaries while Puerto
Princesa's citizens participated widely in cleanliness and reforestation
programs.
Two, LGUs in best practice cases broke free from the financial
constraints that face most urban LGUs. They took different routes in
addressing the fiscal gap. Some introduced user fees (as in Olongapo
City) while others designed well-planned cost recovery schemes (as
in San Carlos City). Still other LGUs focused on mechanisms that
reduced the cost of service production and delivery. Cotabato City
used barangay halls and private homes in the absence of barangay
health stations. Cotabato, Olongapo and Naga mobilized health
volunteers. Other LGUs tapped additional funds from higher levels
of government and the private sector. Olongapo city required its
barangays to allocate five percent of their IRA to health and welfare.
Surigao City obtained P1.5 million for the construction of a training
center from the Countrywide Development Fund (CDF) of a senator.
Partnership with the private sector was a popular option. Other LGUs
maximized own-resource use to finance development. San Carlos City
set aside 30 percent of its IRA (instead of the mandated 20 percent)
for its Local Development Fund.
Three, the laudable programs are characterized by an integrated
and intersectoral development strategy in order to capture the synergy
from Program interdependencies. Puerto Princesa's Low-Cost
Housing Project is, in reality, just one Component of a wider program
called Bantay Dagat Program. Olongapo City strengthened the link
between health and sanitation by integrating its environment program
with health activities.
Reference
Manasan, R. 1995. Revenue Mobilization in Local Government Units:

The Early Years of Local Government Code Implementation.
PIDS Discussion Paper Series No. 95-02. Makati City: Philippine
Institute for Development Studies.
Chapter
2
Metropolitan Arrangements
in the Philippines:An Overview*
Ruben G. Mercado and Rosario G. Manasan
contemporary regional development phenomenon occurring

n the Philippines is the emergence of new regional spaces
hrough the formation of metropolitan arrangements. A
metropolitan arrangement is a conglomeration of a highly urbanized
city and the local government units contiguous to it, engaging in
cooperative urban development ventures.
Metropolitan/Arrangements vs. Decentralization

Both th/e 1986 Philippine Constitution and the 1991 Local
Government Code grant local governments the power to group
themselves for purposes commonly beneficial to them. While these
provide the legal basis for some intergovernmental structure as in
metropolitan arrangements, the creadon of such a structure is
interpreted by some as a form of re-centralization and a potential
threat to the autonomy of local governments.
Advocates of metropolitan arrangements counter that

metropolitanization in fact strengthens decentralization when local
governments themselves initiate such move. This view sees metro
arrangement as a refinement of the decentralization thrust since it
allows for a subnational level government as against central
government provision of services characterized by economies of scale
and externalities.
From an economic standpoint, urban services can be more
efficient if they are jointly planned and delivered thereby creating
economies of scale. Moreover, greater positive externalities will spill
over to society as a result of metro arrangements.
There is, of course, difficulty in determining the best
organizational structure to adopt considering that LGUs have equal
* First published an PIDS Policy Notes No. 98-10 entitled _MetroDolitan Aslangements in the
Philippines: A New Urban Development Challenge."
pohtical legitimacy. Competition and antagonism may hinder the

prospects of a workable relationship among local governments within
the metropolitan arrangement.
Metropolitan Arrangements in the Philippines

With the exception of Metro Manila, metro arrangements in
the Philippines are a phenomenon of the 1990s. There are four major
precursors of metropolitanization. First, common pressing problems
can lead local governments to band together in hopes of a better
soludon. Second, regional development programs, which define
certain areas targetted for development, often provide the impetus
for these areas to metamorphose into metro arrangements. Third, a
simple edict from the national government can put a previously
nonexistent metro arrangement into the map. And last, the initiatives
of the locals themselves can give rise to metro arrangements.
Majority of the country's metro arrangements are still in the
process of forming their metro bodies. Many have a bias for an
authoritarian style of leadership although local leadership is
emphasized in executing councils. Again, majority of these metro
arrangements are locally led. Local officials make the decisions within
the framework of metropolitan bodies.
Local governments are the driving force behind the
sustainability of metro arrangements since component LGUs give
fixed contributions (a percentage of the LGU's internal revenue
allotment,) for the upkeep of the metro arrangement.
Activities That Metro Arrangements Do Best

While there is a general understanding and acknowledgement
of the problems confronting them, many metropolitan arrangements
still have to formalize systems to solve these problems.
Theory says functions that are characterized by economies of
scale and externalities are appropriate concerns for higher level
governments. Practice bears this out. Water supply, sewage disposal
and solid waste management--services requiring areas larger than a
local jurisdiction for cost-effectiveness--are generally assigned to
metropolitan governments worldwide. The same is true for services
such as public health whose benefits and costs accrue to nonresidents
of a local jurisdiction (i.e., ser vices which give rise to spatial
externalities). Common to all metro arrangements are the pressing
concerns of development planning, solid waste management, and
transport and traffic management.
MetropolitanArrangementin the Philippines 165
Policy Issues
Majority of metropolitan arrangements in the country are still
in a nascent stage of development and as such, are still concerned
with the problem of solidifying their identity.
The following are issues that need to be resolved to enable metro
arrangements to evolve into fully-functional political and economic
entities:
What structure to adopt

Many metro arrangements are still searching for their ideal
structure. Afew have made their choice but are still shopping around
for better options. Problems are inherent in the Choice of structure
especially since a core requirement is that it should be acceptable to
all LGUs within the metro arrangement.
The problem of structure also involves the problem of
leadership. There are two sides to the issue. First, who should initialize
the process of consensus-building on what structure io adopt. Second,
how to determine a mode of leadership agreeable to all. The dominant
city is expected to take the initiative because it has the greatest stake.
It is recognized as a big brother to lesser LGUs. Moreover, other LGUs
are constrained to make the first move, being structurally under the
provincial government. Still, there is the apprehension that lesser
LGUs may misconstrue the initiative as a political overture to expand
power. Unhappily, this can result into a political stalemate. The choice
of who should lead the formal structure adopted is thus a major
challenge.
Clearly-delineated and well-understood roles and functions of
all political entities involved in the metro arrangement are paramount
concerns for an effective metro structure. A metro arrangement, when
it takes on the cloth of a formal metropolitan structure, inevitably
also requires a full-time organization to become effective.
Financial sustainability
Sustainability requires a steady stream of financing to bankroll
the metro arrangement. Different modes of financing are open for
exploration.
The introduction of a metropolitan structure changes

significandy the relationships of political units in the local government
system. Cities and municipalities planning to join a metro arrangement
can be faced with conflicting relationships with the province and the
metropolitan body.
Many believe, though, that this issue is not necessarily a problem
in the legal-administrative perspective but may be so in thepolitical
reRlm,
Problems arise when local executives prioritize the interest of

their respective constituents over that of the whole metropolis. The
garbage problem is a prominent issue raised by LGUs for not wanting
to join a metro arrangement. Municipalities with vast tracts ideal as
landfill sites perceive such arrangement as a means by which they can
be co-opted to serve as trash bin for the entire metro area.
Harmony in diversity
A formidable challenge is harmonizing the activities of sectors
and agencies in urban development services. These agencies often
develop independently of elected government and may resist
participation in metro-wide planning.
Sustaining Metropolitan Arrangements
Addressing the issue through effe_ve metro planning

and manogeme_
A clear understanding of the essentials of metropolitan planning
and management, based on the experience of other countries, is
necessary and would help identify the fight policy interventions.
Effective metropolitan planning and development entails a
common vision of preservation and development of the region, a
unified economic and political base to implement the vision, and an
appropriate metropolitan structure to provide an institutional
framework. Ideally, the metropolitan area should also have a unified
political jurisdiction and well-coordinated economic agencies
operating in the area. Metropolitan planning and management differs
from city or town planning since dealing with disjointed political
jurisdictions often thwarts unified planning.
Dealing with the legal limitations

The 1991 Local Government Code, while strengthening the
power of local governments, has overlooked the unique requirements
of metropolitan arrangements. Serious problems have resulted in the
sharing of power between capital cities and peripheral municipalities.

Meanwhile, although the Constitution authorizes the creation of
special metropolitan political subdivisions, it delimits the extent of
metro management. It rules that higher jurisdictional bodies such as
a metropolitan authority can be established only through an act of
Congress and that in the aftermath, cities and municipalities retain
their basic autonomy and their local executives and legislative
assemblies. These inadequacies should be remedied through
appropriate amendments.
Agenda for National Policy

Metropolitan planning and development is fast becoming a
feature of local governance. While most of the groundwork has been
undertaken by local governments themselves, the national
government plays a critical role by providing the legal framework and
environment conducive to such undertakings.
Below is an agenda in support of metropolitan development.
Review of basic laws

There is a need to review Article l0 of the Constitution to
strengthen metropolitan structures and promote metropolitanization.
Amendments could include a legal definition of a metropolitan area
as a recognized territorial and political subdivision of the country.
With recognition, provisions can be made for metro arrangements to
exercise powers inherent in the definition.
Review of provisions in the Local Government Code

The 1991 Local Government Code has overlooked the dynamics
of urbanization as it relates to local governance. Rapid urbanization
has compelled local governments to expand their political and
administrative linkages with neighboring cities and municipalities.
There are at least two areas where amendments are needed.
First is the assignment of urban functions to a metropolitan unit that
is consistent with other LGUs or other government agencies. At the
very least, the functions can take into account those which are
metropolitan in character. Potential services for metropolitan units
to assume include land use planning, traffic management, solid waste
management, water and sewerage services, transport services, flood
control and management, among others.
The second area concerns the functional-relationship of the
metropolitan Unit to other government entities which must be made
clear to maximize benefits. For instance, the 1991 Local Government

Code gave the Department of Budget and Management power to
review LGU budgets in lieu of the Metropolitan Manila Development
Authority. This has institutionalized the disjointed programming and
budgeting process in the metropolis and prevented the maximization
of resources. The same lack of institutional linkage exists with sectoral
line agencies making it difficult for the Metro Manila Development
Authority (MMDA)to influence their priorities.
Recognizing the role of nwtropolitan planning and insthttions

Planners should recognize the implications of metropoli-
tanization in the medium and long term. Recognition of metro insti-
tutions as orchestrator of inter-local service delivery is also impor-
tant. The Regional Development Councils, as the development plan-
ning and policymaking body in the regions, can provide support to
local governments which are politically constrained to initiate metro
arrangements.
Research and devdopment

Philippine literature on metropolitan planning and
management, including rigorous policy studies, are lacking. Focus
has largely been only on Metro Manila. There should be more studies
in metropolitan governance to assist in policy interventions especially
in the areas of institutional development, financial management,
urban environmental management and global competitiveness of
megacities.
Choosing the Appropriate Metro Structure
There are three basic models of governance from which local

governments may choose their preferred structure.
Metropolitan city
One is the metropolitan city under which a single LGU has
responsibility for all local functions. This structure has the advantage
of ease in coordinating activities and implementing plans. Duplication
of services is less likely. The formation of a new city also resolves the
issue of legal administrative ties between the province and the towns
involved in the metro arrangement. Its weak point lies in its general
inability to account for intra-city or neighborhood differences in the
demand for the package of services.
3_t_d__ _ second._er
The second model is jurisdictional fragmentation side by side
with a second-tier governance structure, under which the
responsibility for the same local functions is lodged with the
component LGUs of the metro arrangement. The model promotes
economic efficiency by bringing the government closer to the people
and consequently, making it more responsive to local preferences.
However, it is less able to capture the benefits from economies of
scale. It is also not able to address well the problems associated with
spillover effects of certain types of services. The creation of the second-
tier governance structure in this model is precisely aimed at
counteracting this inherent weakness in jurisdictional fragmentation.
The upper-tier structure can be any of these three: a council,
an authority or a metro government. The difference lies in the sharing
of power among the LGUs in the metropolitan arrangement and the
leadership structure in the second-tier.
The metropolitan development council is a governing body
composed of city and town mayors comprising the metro
arrangement. Leadership is appointed from among the members.
The structure provides relative ease in obtaining national support. A
presidential executive order is all that is needed to make it legal.
However, financial sustainability of the council is at risk because its
budget is tied with the executive department.
A metropolitan development authority is a much more attractive
structure in view of its relative institutional permanence, greater
corporate powers and functions and fiscal advantage. Since it is more
of a technocratic organization than a political body, decisionmaking
is de-politicized. An authority can only be created through a
congressional law. The head of the authority is typically government
appointed.
A third form of upper-tier structure is the metropolitan
government wherein component LGUs are subjected to a higher
jurisdictional authority or government with an elected governor.
There is a single-tier council and the city and municipal mayors act as
area managers. The governor coordinates the sectoral departments
of the national government. In the Philippines, this setup will only be
possible with the amendment of the Constitution.
Finally, the third model is functional fragmentation under which

component LGUs have limited responsibilities for service delivery.
The model authorizes autonomous local endties with corporate
powers to undertake specific services on a metro-wide basis. This is
suitable in addressing economies of scale in capital-intensive services
like public utilities and transportation which smaller LGUs would
normally have difficulty financing. Corporatizing service delivery also
has the advantage of encouraging the management of service delivery
by professionals (versus politicians) whose decisions tend to be
shielded from political interventions. Moreover, this mode promotes
greater cost recovery.
Case Studies of Metropolitan Arrangements
Owning the Metropolitan Vision:

The Case of BLIST
Setting an Institutional Framework

for Metropolitan Management: Metro Cebu
Providing a Metropolitan Perspective

to Development Planning: Cagayan de Oro
Metro Naga: A Continuing Challenge

of Local Autonomy and Sustainability
Metro Iloilo: A Struggle

for Acceptance and Organization
Metro Davao: In Search

of Metropolitan Definition
Governance and Urban Development:

Case Study of Metro Manila
Case Study 1
Owning the Metropolitan

Vision: The Case of BLIST
Ruben G. Mercado and Carmel P. Chammag
contiguous areas in the regional center of the Cordillera

LIST stands for Region
Administrative Baguio, La Trinidad,
(CAR). Itogon, isS_tblan
The BUST and Tuba--
not a geopolitical
entity but a planning area. When the Regional Physical Framework
Plan of CAR was formulated in 1990, the BLIST was identified as a
major subregional area due to the fast urban growth of Baguio City
influencing the adjacent municipalities, most especially La Trinidad.
The other municipalities close to the city are showing potentials of
becoming the catchment area for Baguio's rapid growth. The BLIST
currently plays a key role in the development of the CAR and the
Northern Luzon as the region's educational, tourism and commercial
center. The BLIST area is also one of the growth nodes of the North
Western Luzon Growth Quadrangle (NWLGQ), which is being
promoted as an economic and tourism zone linkingthe coastal
provinces of Ilocos Norte, Ilocos Sur, La Union and Pangasinan with
the BLIST in Benguet Province of CAR.
Serious planning for the BLIST area has been undertaken after
Baguio City was seriously damaged by the earthquake in 1990. It was
thought then that rehabilitating the city should go beyond restoration
and should address the city's long-term reconstruction. This
necessitates a deliberate attempt to include in the development plan
the city's future interaction and integration with its neighboring areas.
Metro BLIST is a new term being introduced in this paper, which
refers to the Urban BLIST. The original term was Metro Baguio, but
was received with a strong negative reaction because it left the
impression that the other areas are just extensions of Baguio City.
This paper reviews the developments and challenges of Metro
BLIST, focusing on the steps needed to deal with its present and future
concerns.
Development Trends in Metro BLIST

The population of Metro BLIST in 1995 is less than half a
million, of which about 59 percent resides in Baguio City (Table 1).
The population growth rate in the whole area is a little higher than
the.national average. However, this average rate is unevenly distributed
across each of the political units. While Sablan is growing ata modest
rate of 1.67, Baguio and La Trinidad are experiencing very rapid
growth of more than 4 percent. In contrast, Itogon and Tuba are
losing population, quite rapidly in Itogon. Population density in
Baguio City and La Trinidad is high relative to that of other
municipalities because having a limited land size, they are home to
three-fourths of the entire metropolitan population.
Particular land uses would reveal the physical development
features of areas composing Metro BLIST (Table 2). Average rates
for the entire BLIST area do not accurately represent the land use
features of Baguio City and La Trinidad. These areas have definitely
larger built-up areas (almost half of the total land area in Baguio City)
and smaller forest lands. Pressures of urbanization and urban
development are expected to be experienced in the BLIST areas
especially within Baguio City and La Trinidad. On the other hand,
grasslands and forest lands dominate land uses in the three other
municipalities.
The BLIST Master (Structure) Plan

A master plan has been prepared for the development of what
soon will become a Metro. BLIST. This plan is essentially a structure
Table 1. Metro BLIST: Demographic and ! and Characteristics
City / Population Level GrowthRate Land Area PopulatiOnDensity

Municipality 1990- (_ km) 1995
1990 1995 1995 (persons/sq.
km_
Bagnio City 183,102 226,885 4,38 48.9 4639.73
La Trinidad 48,252 63,089 5.51 61.4 1027.51
Itogon 61,773 47,781 -5.01 423.7 112.77
Sablan 8,440 9,170 1,67 91.6 100.11
Tuba 39,635 39,589 -0.02 314.4 125.92
Metro BLIST 341,202 386#12 2.53 940.0 411.18

Philippines 60,679,725 68,616,536 2.32 300,000 229
Basic source: 1995 Census of Population and Housing, National Statistics Office.
Case Study:MetroBLIST 175
Table 2. Metre Blis_ I-_d Use (in percent)

[=md Use _ La Trinidad ltogon Sablan Tuba BLIST
Built up 48.3 21.1 1.6 7.2 1.7 6.1
Agriculture 1.6 6.9 1..6 _.3 0.0 1.6
Grassland 44.7 60.8 56.8 76.3 53.7 57.3
Forest 5,2 11.1 39.0 13.7 43.7 34.2
Others 0.2 0.0 0.9 .05 0.9 0.8
TOTAL !00.0 100.0 100.0 100.0 100.0 100.0
Basic source: BDUPP Report, Volume B. Source of BDUPP report is DENR - CAR Geology
Division,
Land Use Map, 1:50,000scale,
December 1991.
plan thatconnotesgreaterflexibility than a masterplanwhich is

conceptually stadcand fixed. The Urban BLIST planwaspreparedin
1993byajointgroupofEuropean and Filipino consultants
following
theJuly 1990 earthquake.Although itisexpected thatfuture
urbanization willbc feltmore increasingly in Baguio Cityand La
Trinidad, theplanconsidereda largerplanningareainviewof the
influence and integradonofdevelopmentofotherareassurrounding
thesetwo places. Thus,Itogon,Sablanand Tuba,alongwithBaguio
and La Trinidad, formcd partofthelargerurban planningarea.
Completed inOctober 1994,the planhasalreadyinfluenced
theplanningand invcstmcnt programming oflocal govcrnmcntunits
(LGUs) as wellas regionalinstitutions, includingthe Regional
Development Council (RDC, which consistsof the Cordillera
ExecutiveBoard,Cordillera RegionalAssemblyand RegionalLine
Agencies)and other government institutions. Since itsformal
launchingin1994,theBLIST Urban MasterPlanhasinfluencedthe
developmentplansoftheregionand LGUs (BcnguctProvinceand
theBLIST LGUs). In addition, programs and projects found inthe
planhavebecome aguideorbasisforprogram orprojectproposals
forthearea.Consistency withthemasterplanhasbecome one ofthe
suggestedacceptancecriteria fortheseproposals.
The formulation of the master plan was not an easy undertaking.
It was met with strong resistance and open cridcism all throughout
the stages of its development from various sectors, even among BLIST
member-municipalities. One of the concerns articulated was the
impression that the BLIST planning wasa strategy for Baguio City to
transfer the city's problems to its neighbors. Some thought that urban
concerns were not viewed as important by the municipalities of Itogon,
Sablall and Tuba than it was by Baguio and La Trinidad. Because of
these sentiments, public consultations and information dissemination
176 Managing Urbanization Undera DecentralizedGovernance Framework
were undertaken to clarify the objectives of the planning activity and

to raise awareness about the need to integrate plans as well as to involve
many sectors in plan formulation and decisionmaking.
Potentials for Cooperation

The following presents some of the master plan's major
development areas where BLIST members can mutually benefit from
a strong alliance and coordination:
Water supply and distribution

One of the most daunting challenges for Metro BLIST is the
development of water sources and water distribution. The current
water supply (as measured in average liters per capita demand (LPCD)
for the area is still below the standard 220 liters (Table 3). Strategies
to address this issue include the need to reduce system leakage and
to install meters on all connections.
The problem of water supply not only pertains to its production
but more importantly, the distribution within the BLIST area. Most
affected is Baguio City, whose topography constrains it to yield more
water from the city's site itself, making water distribution technically
difficult and expensive to manage. The situation is further complicated
by an institutional problem. The Baguio Water District is perceived
to exploit water resources in neighboring areas but does not have
the responsibility of serving the needs of areas outside Baguio City.
This led to serious conflicts in recent years--confficts that continue
to fester the BLIST-member municipalities, x
The three new water sources that are located in the BLIST area
are the Budacao spring and waterfalls in Tuba, the Mohawk water
sources at Baguio Gold Mines in Itogon, and the Irisan spring in
Sablan. The challenge of the metropolitan arrangement in BLIST, in
this case, is how to have an adequate water supply to meet the growing
1 For example, the municipality of Tuba expressed its opposition to a proposed BLIST-
wide Water Resources Study (one of the projects proposed to be conducted under the
Baguio and Dagupan Urban Planning Project). Resolution 377-96 of the Sangguniang
Ikayan of Tuba dated October 29, 1996 said that "the BLIST Water Resources Study is
rejected since it uses the municipality as resource tapping for the benefit of Baguio City
without addressing the issue of revenue sharing and without a study for agricultural,
domesd¢ and future industrial uses of the waters for future investors in the municipality.
The municipality of Tuba has its own Development Plan for its water resources."
TableS. Metro BLIST: Water Demand, 1994-2020

Year Population % Served Average Water _ Reqti_neuts
LPCD Ave. (cu. m/day) Peak (cu. m/day)
1994 312.000 58 190 34,400 48,135

2000 358,000 70 210 54,600 73,700
2010 421,000 80 220 74,100 103,700
2020 473,000 90 220 93,700 131,100
Source: Baguio and Dagupan Urban Planning Project (1994).
requirements of Baguio City given the area's continuing rapid

urbanization and development and, at the same time, how to pro,vide
mutual benefit to the municipalities from where these resot.rces
originate.
Sol/dwaste
Another important concern is solid waste management,
particularly in the identification and development of a landfil_ site
for the BLIST area. This is an immediate concern especially for Ba,guio
City, whose dumping site is already reaching full capacity, and lotated
within the city proper in an inhabited, steeply sloping area. It i_,also
a source of conflict between Baguio City and Tuba as solid waste_,
flowing down and seeping leachate _reaten the public health ;n the
nearby barangay of Tadiangan. The presence of weathered rocks in
the area also contribute to the pollution of the groundwater _able
and downstream springs.
The present dumpsite in Wangal, La Trinidad, is also beset with
similar problems. It is located near an inhabited area and adjacent to
a cemetery. The high population growth in La Trinidad is expected
to further add to its present solid waste disposal problems. The other
municip_dities (Itogon, Sablan and Tuba) do not undertake solid waste
management activities. Households in these municipalities usually
resort to burning or to placing their garbage in vacant lots or river
banks, neither of which is enviionment friendly. Thus, these five
municipalities stand to gain through reduced solid waste treatment
and disposal cost if they come together for a joint development, use
and maintenance ofa BLIST-wide solid waste management program.
The waste collection scheme can further be made to service
the more urbanized areas of La Trinidad and Baguio City as well as
other BLIST areas, particularly Tuba. This will necessitate more
garbage collection vehicles, equipment and manpower as well as a

better collection system.
mnqt
People in the BLIST area rely on road-based public transport
for mobility. Such mode of transport remains indespensable and
therefore shall continue in the future. All-weather highways, thus,
play a very important role. At present, there are four main roads
serving Metro BLIST, all of which needs rehabilitation and major
improvement to withstand future earthquakes: Naguilian Road,
Marcos Highway, Kennon Road and the Halsema Highway north to
Bontoc. Since there is no road linking these major roads, the BLIST
Master Plan proposed a Western Link Road that connects Halsema
Highway to Naguilian Road (first phase), the Naguilian Road to
Marcos Highway (second phase) and Marcos Highway to Kennon
Road (third phase). This western link road provides an alternative
route to the central business district (CBD) of Baguio City for those
bound for La Trinidad or Tuba, thus reducing the number of vehicles
passing through the CBD.
Other alternative routes should also be developed to relieve
the already congested areas such as Baguio City and La Trinidad as
well as to encourage the development of peripheral locations. One
such route proposed is the Western Link road which, according to
the Plan, "will relieve pressure on the existing Baguio-La Trinidad
route and open up the north and northwest of Urban BLIST for
development." The new road will also serve as an emergency
evacuation route, should both Naguilian and Marcos highway become
impassable. The planned road also hopes to link Naguilian Road with
Marcos Highway and the latter with Kennon Road. The new road will
also help decongest Baguio City as travelers can bypass the central
Baguio City to reach other areas of Benguet Province.
A perennial problem is the heavy traffic between La Trinidad
and Baguio along the major thoroughfares (Baguio-Bontoc Road),
which continues despite the road-widening measures in this route.
The large number of vehicles plying the Baguio-La Trinidad Road
also somehow contributes to traffic along the Magsaysay and Bokawkan
Road. This is because La Trinidad is where many workers in Baguio
reside (and vice-versa). La Trinidad is also slowly transforming itself
as a regional government center as some regional government offices
CaseStudy:MetroBLIST 179
(e.g., Department of Science and Technology) have located in the

municipality.
Tour/smmanogvnwm
Tourism is one of the important sectors in the BLIST economy.
BLIST faces greater competition in attracting visitors or tourists
considering the wide range of alternative locations in the Philippines
and outside the country. Thus, there is a need to develop a
comprehensive strategy that will maintain or improve existing tourist
attractions as well as identify and develop new attractions or sites,
especially outside Baguio City.Among the promising sites in the area
are the West Itogon Countryside Park, Asin Hot Springs in Tuba and
some water- and hill-based sites in Sablan. In addition, Baguio City's
wooded parks, a popular destination for picnics, are no longer as
available in the city as before. Instead, communal parks in the other
LIST municipalities can be promoted for tourism and recreation,
provided such will be complemented by the right facilities and
playground for children.
The BLIST area is one of the tourism clusters to be promoted
under the Cordillera Tourism MasterPlan. Itwill also serve as a primary
service center and gateway to introducing other tourist destinations
in the CAR. A string of places and activities within their cluster will
be promoted. The BLIST municipalities stand to gain from this
clustering, as it will ensure that their respective tourist attractions/
sites will likewise be visited.
Baguio City's perennial problem is =squatting"or the prevalence

of _infonnal dwellers."There is no definite data on how many squatters
there are in Baguio City but they are widely acknowledged to be
occupying various kinds of government reservations (such as forest
andwatershed reservations) and even hazardous areas (steeply sloping
areas). Where to relocate these "squatters _ and identify areas for
housing development is a big problem. Baguio City is limited by not
only the land area but by the fact that many of its available lands are
declared as government reservations (meaning, not available for
housing).
Through the BLIST arrangement, housing development outside
the city can continue to be encouraged, thereby lessening the pressure
180 Managing UrbanizationUndera DecentralizedGovernance Framework
on land water resources in Baguio and La Trinidad while promoting

economic activities and higher income from real property taxes in
Itogon, Sablan and Tuba.
Managing Metro BLIST

Metro BLIST is fortunate to have a ready guiding framework
for its development. Through the comprehensive Structure Plan, the
area's physical framework plan has been formulated and policies,
strategies, programs, projects, and investment costs, and schedules
for implementation have been identified. There are two
organizational setups handling BLIST-wide issues and programs. First
is the BLIST Consultative Council (or BLIST Forum), which was
organized when the BLIST Master Plan was being finalized in 1994.
The second is the BLIST Area Task Force created by the North Western
Luzon Growth Quadrangle (NWLGQ)Commission. Of these two,
the BLIST Area Task Force is the more active in coordinating the
area's affairs. As to which of these two organizations is more responsive
in promoting the sustained implementation of the BLIST Plan will
be discussed in the subsequent sections.
Recommended organization for BUST under the Structure Plan

The Plan points out two alternative structures that can
implement the Plan and other BLIST-wide projects. These are the
"metro authority" and the "consultative forum."
A metropolitan authority, as explained in the Plan, is a body
"which subsumes most or all major political and administrative powers
and responsibilities currently undertaken by the individual BLIST
authorities." The Plan explains that based on the public consultations,
the LIST authorities do not favor such concept for two basic reasons.
First, urban population is currently concentrated in Baguio City. The
creation of a Metro BLIST would only be appropriate once the BLIST
• population spreads into or increased in the other municipalities.
Second, the need to establish a metro authoritywould only be urgent
if inteflocal issues are not resolved within political boundaries. It is
believed that mayors, however, are "talking" to each other to resolve
these common issues.
A more workable and acceptable proposal according to the Plan
is the formation of a Consultative Forum composed of representatives
from the five BLIST members. Figure 1 graphically illustrates the
Case Study: Metro BLIST 181
proposed organization. The basic idea is that the forum can provide
the general policy direction on BLIST-wide issues and those that would
impact on more than one local entity. At the same time, local entities
can directly control projects, service functions and planning activities
"where these can be managed locally." Where concerns affect two
municipalities, these can be managed jointly on an ad-hoc
arrangement. The body can also set up organizations to deal with
specific BLIST-wide issues. Examples cited in the Plan include a BLIST
Water Board to deal with supply, distribution and identification of
new water sources, an Inward Investment Agency to deal with resource
marketing and a Land Delivery Unit to manage urban land delivery.
The forum is envisaged to be composed of not only the five
municipalities but also representatives from the provincial
government, relevant national and regional agencies, nongovern-
mental organizations (NGOs) and leading private sector groups.
Existing BLIST Structure

It is difficult to categorically state that there is a real institutional
mechanism in place to oversee the implementation of the BLIST Plan.
A BLIST Consultative Council (or BLIST Forum) was informally
organized in a memorandum of agreement signed by BLIST local
government units (LGUs) on 19 February 1994. It was tasked to
"coordinate the planning, implementation and monitoring of
development activities in the BLIST area especially projects and
activities that transcend political boundaries." Since February 1994,
its members have met sporadically to act as adviser in the finalization
of the BLIST Urban Master Plan and to oversee its implementation.
Its last meeting was in the first quarter of 1996, to map out plans for
the approval of the plan by the BLIST LGUs. Since that time, only
the LIST mayors have met informally to discuss mutual issues and
concerns. The forum has not yet been officially dissolved.
Eventually, Executive Order 175 was issued creating the
Northwestern Luzon Growth Quadrangle (NWLGQ) Commission
(conveniently called the North Quad) which would be responsible
for the overxll direction, coordination and supervision of the entire
NWLGQdevelopment efforts. Under this Commission, the Quad East
(or BLIST Area) Task Force, organized on March 26, 1996, was
responsible for promoting the BLIST area as a growth node. Figure 2
presents the current organizational structure of the said task force.
Figure I. Proposed OalganiT_Uion for Metro BIJST Under the Structure Plan _o
General
Policy (e.g., Structure Plan coordination, Water Supply, Tourism) q -_.
CONSULTATIVE FORUM ON BLIST-WIDE ISSUES
,
]
National
I ' a"
o
_ ' _ Regional _-_d

Provincial Q-
Joint Development Western Link

Projects Area Road Private Sector ._
etc.
Plan Projects Countryside Development Areas Development o.

(specific examples) Park & Central Area Area t Oh-3
Individual
Responsibilities
(to organize 3
& coordinate) [ Local Planning/Feasibili_/Fmancing/Development Controt/Im)lementation J = O_

Source: BDUPP (1994). _"
Case Study:Metro BLIST 18,3
The BLIST Task Force (BTF) essentially has the same

composition as the Consultative Forum under the BLIST Plan. The
BLIST Plan proposed to consist of five mayors with representatives of
the provincial government, other relevant national and regional
agencies, NGOs and leading private sector organizations. The function
of the BTF is to oversee the planning, coordination and
implementatioi, of programs/projects in the BUST area within the
context of the overall North Quad Plan.
The same Consultative Forum of the BLIST Plan is being retired
now by the BLIST Task Force on the rationale that the North Quad
Plan is consistent with the original BLIST Master Plan.
Whether the BLIST Task Force has been addressing the very
basic issues of the Structure Plan is a sensitive question. Those in the
know would claim that the BUST Task Force has been tackling these
urban development issues and are trying their best through their
regular meetings to address such. For example, in terms of solid waste,
the agreement of the BTF in their February 1998 meeting is to wait
for recommendations of the consultancy firm undertaking a feasibility
study on the BLIST solid waste project. On the other hand, others
think that since the local governments in the BUST area are still
singly undertaking solid waste management in terms of recycling and
re-use of refuse as well as landfill site identification through local or
nationally assisted programs, it may indicate that the BTF may not be
completely successful in this regard. It should be emphasized that
the BLIST LGUs are aware of the need to have a common solid waste
management system for the entire BLIST area. The same holds true
for water supply distribution and development of new water sources.
Also, the fact that other urban development concerns such as housing
shortage, traffic, transportation are not given much attention by the
BLIST Task Force may add to the need for a more responsive BLIST-
wide structure other than the Task Force.
In terms of projects, the BLIST Task Force was able to exert
some "pressure" on line agencies to "implement" the identified BLIST
projects. The NWLGQ Commission _champions" these identified
priority projects to then President Fidel V. Ramos and the heads of
the national departments. These priority projects refer to those
identified in the BLIST Plan such as the Western Link Road and the
West Itogon Countryside Park.
It may, however, be unreasonable to judge the effectiveness of
the BLIST Task Force on the basis of how it addresses these concerns.
Functionally, it was created to look into area project planning,

coordination and implementation in the context of the North Quad
Plan. Moreover, activities of the Task Force are also determined
substantially by higher order structures and the availability of funds
within the NWLGQ Commission. The BLIST Task Force, by virtue of
its name, is not a policymaking body but an implementing arm of the
larger structure (the NWLGQCommission) and gets its overall policy
guidelines from the Commission. One of the policy guidelines of the
Commission is that activities to be promoted within the BLIST Area
should complement or be supportive of other activities being
promoted in other growth nodes within the North QUAD Area.
Given such a case, it can be said that there is a form of structure,
i.e., BLIST Task Force looking at BLIST concerns. However, its
propensity and motivation to deal with the larger and broader
concerns and the scope of its responsibilities can stand improvement,
Recent events in the CAR, particularly the revival of the metro
issue, show the lack of mechanism that deals with current urban
concerns. Various groups now have different understanding or
interpretation of the "BLIST cooperation," which surfaced with the
rejection during a plebiscite of the Cordillera Autonomous Region
Act. 2 To all these, the Office of the President had initiated reforms in
the management of the BLIST by tasking the National Economic
Development Authority-CAR to draft an executive order that will
create a BLIST Coordinating Council.
Points for Consideration in Handling Metro BLIST

Given the preceding account of development planning in the
BLIST area and the institutional transformations that took place, the
following may be of value to policymakers who would want to take a
second look at BLIST and the challenges that it continues to face.
Recently, the Metropolitan Baguio concept was again revived as a means of spurring
development in Baguio City and its neighboring areas after the defeat of Republic Act 8438 (An
Act to Establish the Cordillera Autonomous Region). An article in the March 29, 1998 issue of
M/d/and Cour/er rifled "Groups Asked To Be Calm on Post-Autonomy Moves" mentioned that
some leaders vowed to convert Baguio City and its neighboring towns into a Metro Baguio
status similar to that of the Metro Manila Development Authority. Likewise, an article rifled
"Autonomy Officially Rejected" in Z/g-Zag dated March 15, 1998 mentioned that the "creation
of a Metro Baguio composed of Baguio and adjoining areas was also reiterated by Congressman
Edgar Avila as another avenue for development" The revival of the metropolitan Baguio concept
came a_ this was perceived to be a strategy to achieving development at least for Baguio City as
an alternative to the rejected Cordillera Autonomous Region Plala.
Case Study:Metro BLIST 185
]F_I_L_,
2. BUST Ate-. TaskForceUnder theNWLGQ
(Governor of Benguet , (Mayor of Baguio

Province) City)
Clmlrmml J Co-Chsirmg
1
.(NGO Rep)
1
(BLIST Mayors, Line Agencies)
Owning the vision and revonsidmng the benefits of coopem6on

The difficulty in instituting a mechanism to handle BLIST
concerns can be partly attributed to the municipalities' seeming lack
of appreciation of the benefits to be gained from cooperation under
one structure. Although they understand the importance of the
BLIST Plan, the mayors are uncertain about the benefits. The
historical resistance and the allegation that the plan will mostly benefit
Baguio while the adjoining municipalities will only absorb Baguio's"
dirt may have created a barrier to forming a more solid cooperative
management or structure in the BUST area. The mayors also fear
that they may consequently lose their executive powers and
prerogative to the formal structure that will be installed for this
purpose.
Looking at BLIST as a "single organism," one of the metaphors
shared in one of the BLIST public consultations, may provide a graphic
concept of a BLIST cooperation. It would be worthwhile for
municipalities to revisit what they have conceived to be the benefits
as well as their major contribution to the cooperation as expressed
during the various consultations held for the BLIST plan preparation
(Table 4). From this initial listing, they can sit down again and validate
or add other items they expect from the cooperation, and discuss
how they can work out their full realization.
In,vb_ing a more binding and authoff__6ve structm'e

It is important for local governments to talk to one another.
Local governments in the BLIST area discuss mutual concerns but
the public have complained that *talking takes too long." This concern
indicates the public's clamor for local governments to deal with issues
with dispatch and authority; especially on immediate issues. To effect
such call, a strong management structure has to be in place.
As have been the experience of many emerging metropolises
in the country, the crafting of an appropriate institutional structure
is not an easy undertaking. Metropolitan arrangements in the
Philippines vary in form, functions and scope. Under the current
decentralized system, however,the structure that has received much
attraction is one that guarantees LGU executives sufficient powers
while surrendering certain functions or responsibilities to an
integrative body. A menu of options is available, including a
metropolitan government, a metropolitan corporation or a
reconstituted political entity.
It may be worthwhile to evaluate two alternative structures
proposed in the Structure Plan. First is the metro authority. Defined
as a body "which subsumes most or all major political and
administrative powers and responsibilities currently undertaken by
the individual BLIST authorities," the metro authority is close to
establishing a metropolitan government. However, it is not feasible
to establish because of resistance from the BLIST municipalities. Also,
it violates the present Constitution. The present charter safeguards
LGUs from any form of disempowerment as a result of the
establishment of metropolitan authorities or similar bodies.
The other proposal calls for a consultative forum that is similar
to a metropolitan council (as in the case of Metro Naga and Metro
Cebu) in that membership largely consists of the member
municipalities. Leadership, however, is not well defined in this
•proposed forum. Perhaps one can derive a lesson from the
experiences of a former Coordinating Forum whose leadership was
vague and eventually ceased to exist. _It may be workable to adopt
such model for evolving a new BLIST structure. However, the structure
should have a comprehensive mandate, power and authority, have
the independence to work out its own policies within the BLIST area
of coverage (not necessarily being limited to working within a higher
framework of development), be given sufficient funds for its
operations and have a full-time secretariat.
There are instances where the need for cooperation is so glaring
and completely understood but not one of the member municipalities
or cities would want to take the initiative. Generally, the initiative is
Table 4. Expected Benefits From and Share in the BLIST Cooperation

BUST Wbat It Can Benefit What It Can Simre/Prevlde
Baguio Water source from Sablan, Itogon, Perform the role of a service center
Tuba or La Trinidad to meet high to LIST.
demand for water.
Provide a sustainable market for
Po_ble an-angements for a ccmmnon LIST products and services.
landfdl s/re.
Provide payment for water provided
Better traffic situation espcciaUy with by LIST municipalities.
effective coordination with La
Trinidad. -' Provide gateway to other BLIST
tourism sites.
De-congestion as other _ f_ctiom
(/ndusuial,r_dentt_,c_
and institutional) can be relocated to
the other LIST municipalities.
Cleaner, better urban environment

with the decongestion of urban
functions and better traffic situation.
La More integrated approach to better Provide an altemat/ve busine_,

Trinidad handle urban growth and expan_on educational, industrial center and
especially in the aspect of housing residential area for Baguio
and road development, residents or other in-migrants.
Water eourccs from Sablan, Tuba or Provide poesible area for landfall.
Itogon.
Tourism sites.
Local economy more developed due
to relocation of certain urban Agricultural production area.
functions such as commerce,
education, industry, etc. and due to IndusU-ial sites for light, non-
more expanded and intensified pollutive, low-water consumption
tourism activities. More employment industrieS.
opportunities and potential for
higher income for its residents.
Higher revenue collections from

greater real property and businem
taxes collection on the part of the
LGU.
Itoggn Tourism plans can increase Provide water source.

employment oppornmities and
income of residents. Provide land for housing,
industrial, residential purposes.
Road development for better access.
Provide possible area for landfill.
188 Managing Urb:,,_ization Under a Decentralized Governance Framework
Table 4 (continued)
_JST What It C_t Benefit What It Cam Share/Provide
Itogon Local economy more developed due Provide area for countryside
(cont'd) to relocation of certain functions such tourism.
as commerce, education, industry,
etc. and due to more expanded and Agricultural production area.
intensified tourism activities. More
employment opportunities, potential
for higher income of its residents.
Higher revenue collections t/or' real

property and business taxes on the
part oftheLGU.
Additionalincome from payment of

waterfrom otherBLIST
municipalities_
Market foritsagricultural
products.
Sablan Road development and positive Provide water source.

effects on transport of vegetable
produce. Provide possible area for landfill.
Resolution of boundary disputes with Provide possible area for housing

La Trinidad and Tuba. and industrial sites.
Local economy more developed due Tourism sites.

to relocation of certain functions such
as commerce, education, industry, Agricultural production area.
etc. and due to more expanded and
intensified tourism activities. Better
employment opportunities, potential
for higher income for its residents.
Higher l_evenue collections from real

part of the LGU.
Additional income from payment of

water from other BLIST
municipalities.
Market for agricultural products

leading to higher income.
Tuba Road development. Provide water source.
Arrangement can provide • Land fo/- residential, institutional,

opportunity for local government to commercial, industAal purposes.
determine resource utilization and set
appropriate user fees for the same. Tourism site.
Table 4 (continued)
IKJST What It Can Benefit What It C_m Share/Prevbie
Additional income from payment of Agricultural production area.

water used by other BLIST
municipalities. Possible area for landfill.
Local economy more developed due

to relocation of certainfunctionssuch
as commerce, education, industry,
etc. and due to more expanded and
intensified tourism activities. Better
employment opportunities and
potential for higher income for its
residents.
Higher revenue collections from real

part of the LGU.
Market for agricultural products

..... leading to higher income.
Basic source: Documentation of various municipal public consultations on BDUPP, 1994 and
inputs from NEDA-CAR Technical Staff.
expected to come from the dominant city because it has the greatest
stake in the arrangement and is usually regarded as the "big brother"
to other LGUs. Also, the other municipalities are ethically constrained
to make the first move because they are structurally under the
provincial government. Even though Baguio City admittedly has the
largest stake in the arrangement in the immediate term, it is
concerned with the sensitivities of the other municipalities. Hence,
its initiative might be misconstrued as a move to expand its political
power or authority given the past adverse reaction against the
formation of Metro Baguio. On the other hand, the "little brothers"
(adjoining municipalities), who find the urban development problems
too enormous and complex, may prefer other agencies to handle or
coordinate the resolution of the metropolis problems, but with their
cooperation. The mayors of these other "little municipalities" can
then concentrate their efforts on "doable" and "high-impacC projects
within their political jurisdiction.
In this particular situation, national leaders or regional
authorities can provide the push for the creation of the needed
management structure. There are existing models that can be
replicated in this regard. The recent establishment of the Metro Cebu

Development Council is an example of a Regional Development
Council (RDC) initiative. On the other hand, the Metro Naga
Development Council is an arrangement formed by Naga City and
the 14 municipalities in the province of Camarines Sur but only legally
created through an executive order by the President so it can find
funding support for its programs and projects.
In all these options, it would, however, be unwise to adopt a
model without understanding the socioeconomic and political context
within which the model was proven to be workable. It is important to
realize that the failure to operationalize the BLIST metropolitan
arrangement is largely due to the difficulty in fostering local ownership
of the vision for BLIST area. Until this is resolved and fully
comprehended by all concerned, structures that will be placed even
those originating from top leadership will not be effective and
sustainable.
Conclusion
The paper has suggested the need for BLIST municipalities to
reconsider their full support to a cooperative arrangement by
considering the benefits to each and the support they can give to
such cooperation. With this as the foundation, an institutional or
management structure can be created to directly address the
immediate and long-term urban BLIST concerns.
The BLIST Task Force plays an important role in realizing the
North Quad Plan and in facilitating the implementation of the BLIST
Master Plan, given the "hiatus" of the Consultative BLIST Forum.
Thus, it is suggested that the Task Force be retained. However, it seems
imperative to evolve an independent structure (similar to the BLIST
Forum) thatwill directly handle key urban issues such as water supply,
solid waste management, transport, road development and tourism.
This structure should likewise oversee the updating or re-planning
of the BLIST area and coordinate, implement programs/projects.
Given the sociopolitical dynamics in the area and in the spirit of
decentralization, such structure must be locally led and managed.
However, it must be clothed with sufficient powers and authority to
equal the responsibility involved in setting up BLIST-wide policies.
The public complaint that "talking takes too long" may be
addressed if local government try to get organized, make agreements
more binding and translate the same into concrete actions. The BLIST
mayors have to be the first to fully own or espouse the vision presented
in the BLIST Master Plan and recognize the urgency to come together
to attain greater synergy in their development efforts.
References
Baguio and Dagupan Urban Planning Project. 1994. Baguio (Urban

BLIST) Main Volume, Final Report.
Department of Environment and Natural Resources - Cordillera

Administrative Region (DENR-CAR). n.d. Feasibility Study for
Integrated Solid Waste Management and Development in BLIST
Area of Cordillera Region, Diagnostic Report.
National Economic and Development Authority. 1993. CAR Regional

Development Plan 1993-1098.
Case Study 2
Setting an Institutional Framework

for Metropolitan Management:
Metro Cebu
Ruben G. Mer_do
etropolitan Cebu or Metro Cebu is undoubtedly as well-

known domestically and internationally as Metro Manila.
Since the early eighties, regional plans refer to Metro Cebu
as the principal urban setdement of the Central Visayas Region
(Region VII). Its pre-eminence over the rest of the areas in the region
has been attributed to the following: its importance as one of the
earliest Spanish setdements; its excellent harbor; and its central
location both in the Cebu island and in the whole region.
Composition and Management of Metro Cebu

What composes Metro Cebu? While the name Metro Cebu has
been an accepted term for an extended Cebu City, its composition
has yet to be formally defined. Various planning documents, however,
have attempted to define the cities and municipalities constitute the
metropolis. For instance, the Central V'tsayasRegional Project (CVRP)
in 1983 has defined Metro Cebu as consisting of the administrative
areas of three cities (Cebu, Mandaue and Lapu-Lapu) and the six
municipalities (Naga, Minglanilla, Talisay, Cordowa, Consolacion and
Lilo-an). The Metro Cebu Development Project (MCDP), which is
the reconstituted project of the CVRP, has carried on this definition.
The Cebu integrated Area Development Master Plan Study
(CIADMPS) undertaken in 1994 redefines Metro Cebu based on a
25-kilometer radius to include the municipality of Compostela. The
recently proposed bill for the creation of the Metro Cebu
Development Authority (MCDA) defines its composition as one with
this metropolitan coverage. Interviews conducted with key informants
in the region suggested the inclusion of Danao City. There are others,
however, who, albeit unusual, defined Metro Cebu as encompassing
the whole Cebu island.
The development of Metro Cebu has been carded out by a

council called the Metro Cebu Planning Advisory Council (also known
as MCC). It is chaired by the governor of the province, with the mayors
of the three cities and six municipalities as members. The MCC is
supported by a secretariat drawn from the regional offices of the
Ministry of Local Government and Community Development
(MLGCD), Ministry of Human Settlements (MHS), and the National
Economic and Development Authority (NEDA) (whose Regional
Executive Director serves as the head). The MCC has been beset not
only by insufficient manpower to work full-time on Metro Cebu
planning but more importandy, by its weak authority to implement
the decisions because city and municipal governments can elect not
to adhere to the recommendations. The MCC thus became a short-
lived body when the UP School of Regional Planning (SURP)
undertook the Metro Cebu Land Use and Transport Study
(MCLUTS), which later became the urban component of the CVRP.
(The CVRP became the MCDP.)
The MCDP structure took on the management of development
activities in Metro Cebu although geared mostly on infrastructure
provision. The MCDP, however, covers only six out of the 10 local
government units (LGUs). Four municipalities excluded are those.
of Liloan, Compostela, Minglanilla and Naga.
This study is an attempt to present the metro-wide challenges
faced by Metro Cebu in critical services and discusses the issues and
optional management structure that can deal with these challenges.
Metro Cebu Population and Land Characteristics _

There are about 1.4 million people in Metro Cebu based on
the 1995 Census of Population and Housing. Metro Cebu's growth
rate during the five-year intercensal period 1990 to 1995 approximates
the national average (Table 1). Looking at the cities and municipalities
that constitute the metropolis, one finds that except for the cities of
Cebu and Mandaue, population growth rates registered more than
the metropolitan average. In fact, except for the municipality of Naga,
these areas grew more than three percent during the period.
I For the purpose of this paper, Metro Cebu shall refer to the CIADMPS definition of
Metro C,ebu.
Case Study:MetroCebu 195
Table 1. Metro Cebu: Demographic Chamcteri_cs
City / Population level _mCdl

ra_ Land Population
Density
Mmfidimllty 1990- area 1995
1990 ]995 1995 (sq. lun) (persons/ha)
Cebu City 610,417 662,299 1.54 315 21

Lapu-Lapu City 146,194 173,744 3.29 58 29
Mandaue City 180,285 194,745 1.46 25 77
Cordova 22,331 26,613 3.34 17 15
Consolacion 41,270 49,295 3.35 147 3
Lfloan 42,587 50,973 3.43 52 9
Compostela 22,006 26,499 3.04 54 4
Talisay 97,955 120,292 3.92 86 13
Minglanilla 50,875 62,523 3.94 66 9
Naga 60,425 69,010 2.52 102 6
Metro Cehu 1,274,345 1,435,903 2-$9 923 15
Phl "lippines 60,677,725 68,616,536 2.49 300,000 229
Source: National Statistics Office (1995).
Table 2. Urbanization Projections for Metro Cebu
Metro Celm in 1990 1.3 708 18

M©wo Gclm in 2010 2.3 708 32
Land Area with le_ erosion
potential in Metro Cebu 2010 2.3 212 92
Source: JICA/RDC VII (1994).
Population density in Metro Cebu and for the areas constituting

it is relatively low. However, because of its hilly topography, only 212
square kilometers out of the 708 square kilometers have been assessed
to be areas with less erosion potential (JICA/RDC VII 1994). Thus,
rapid urbanization would bring pressure to hilly areas, which may
lead to environmental problems such as erosion, further deforestation
and flooding of lowland areas, in the process. Thus, the CIADMP
study team has proposed a desirable urbanization projection for Metro
Cebu of 2.3 million or a density of 32 persons per hectare or 92 persons
per hectare based on the land area with less erosion potential (Table
2).
Current Activities in Metro Cebu

The development of Metropolitan Cebu has been propelled
primarily by the various regional projects implemented. Metro Cebu
has been continuously promoted as the regional administrative and
industrial center of the Central Visayas Region and the major link
with the rest of the Visayas and Mindanao. With the presence of an
international port, airport and other higher-order infrastructure and
facilities, it is most preferred as the site for a regional industrial center
(RIC).
I_ devdopment
The MCDP in the past nine years has implemented
infrastructure projects in Metro Cebu. These projects include the
construction/improvement of national roads, bus terminals, and
traific management. These infrastructure efforts aim to assist local
government in Metro Cebu in coping with rapid urbanization as well
as enhance these areas' potential for further economic development.
The responsibility over the coordination and management of the
MCDP lies with the Regional Development Council (RDC) of Region
VII.
Health and sanitation

Cebu City, through its City Health Office, has been initiating
various activities on health services and sanitation together with the
other city and municipal health offices in Metro Cebu. For instance,
some foreign-funded projects being implemented in the different
LGUs require each LGU to prepare and submit its work and financial
plan. Initially, all health officers representing each LGU meet
beforehand to discuss how best to synchronize their efforts so that
complementarities are achieved and duplication or inconsistencies
are avoided in the implementation of the project. This applies to the
purchase of health equipment and other facilities. Such mechanism
for joint planning has been established with the initiative and
leadership of the Cebu City Health Officer.
Potentials for Cooperation
Sol/d waste ma_

In the absence of data for other areas in Metro Cebu, Table 3
presents a picture of the quantity of solid waste generated in Cebu
City alone. CIADMP study revealed that a significant volume of
garbage remains uncollected. Household and industries continue to
dump their garbage along the main streets as well as in many rivers
and creeks.
Case Study:MetroCebu 197
Table 3. Quantity of Solid Waste in Cebu City

1991 1992 1993
Average solid waste
Generation (tons/day) 363.1
Total solid waste

Collection (1000 cu. m) 309.53 343.19
Average solid waste
colloclion per.day (cu. m/day) 775.0 859.91 953.31
Source: J'[CA/RIX_ VII (1994),
Garbage disposal in the metro area is a growing problem as

garbage collection. The absence of a sanitary landfill for the
metropolis' garbage provides some health risk as open dumping can
increase the risk of disease outbreak or lead to an epidemic. Moreover,
water-borne diseases may be caused by continued disposal of garbage
near water systems such as rivers and creek. Sanitary landfill
investment, however, is admittedly huge and so is maintaining its
operation. Considering the land and money involved to develop and
maintain a landfill site, this cannot be undertaken by one local
government unit. Economies of scale can be realized in this regard
through an inter-LGU cooperation.
Tra
In Metro Cebu, transport and traffic management is one of the
priority concerns. Although its traffic situation may not be as severe
as in Metro Manila, Metro Cebu is confronted with traffic congestion
especially in its major road sections. If the existing situation is not
improved (i.e., unless new road constructions and/or road expansions
are undertaken in the future), aU of these areas will be totally clogged
with road users by the year 2000.
Table 4 shows past and future traffic demand and how this
translates in selected road sections of MetroCebu. Metro Cebu's traffic
demand will continue to experience rapid growth of over 3 percent
in the millenium. By then, its major roads would have gone beyond
their full capacity as revealed by the computed congestion ratios.
Traffic management and engineering as well as road
development in the metropoliswill need a strong cooperation among
LGUs. The challenge also applies to the provision of railway transport
and reorganization of routes of various existing public transport
modes.
Table 4. Past and Future Traffic Demand in Metro Cebu, 1979-2010

1979 1992 2000 2010
Person trips (000)
Private 111 347 583 901
Public 1029 1346 1728 2309
Total 1139 1695 2311 3210
Annual growth rate 3.05 3.89 3.29
Selected sections
(person trips in 000)
Talisay_-.ebu 35 61 85
Cebu-Mandaue 51 110 159
Mandaue-Consolacion 25 55 82
Mactan-Mainland 17 36 58
Road congestion ratio
Talisay-Cebu 1.18 2.03 2.83
Cebu_Mandaue 0.64 1.38 1.99
Mandaue-Consolacion 1.25 2.75 ' 4.10
Mactan-Mainland 0.86 1.8 2.90
Assumptions
Population (000) 1,274 1,712 2,301
Trip maker (000) 956 1,284 1,726
Trip rate per trip maker 1.68 1.8 1.86
Private vehicles (000) 65 110 170
Source:JICA/RDC VII (1994).
Water su_/y d/st__

As early as 1975, a metropolitan organization has been formed
to develop and manage water supply and distribution in Metro Cebum
the Metro Cebu Water District (MCqArD).The MCWD is tasked to
plan, design, construct, operate and maintain water works within areas
of Metro Cebu, namely, Cebu City, Talisay, Compostela, Liloan,
Consolacion, Mandaue City and Lapu-Lapu City. Funding is sourced
through the Local Water Utilities Administration (LWUA).
Recent studies (JICA/RDC VII 1994; David et al. 1998) show
that the water supply capacity of the MCWD at present isnot sufficient
for the growing number of urban population in the metropolis. Table
5 provides a picture of the current shortfall and the projected demand
and supply of urban water up to the year 2020 based on the identified
water projects during the period, especially the operation of the
Lusaran Dam.
The challenge for Metro Cebu, therefore, is how it will formulate
a long-term solution to the current and future water supply problem.
This will mean more projects that allow the development of other
alternative water sources, including the rehabilitation of non-
Case Study:Metro Cebu 199
Table 5. Water Balance in Metro Cebu (in cu. m/day)

1995 1997 2000 2005 2010 2015 2020
Wate¢ suppty 108,118 116,466 157,000 417,000 547,000 807,000 807,000

257,000* 387,000* 647,000*
Water Demand
PIDS1 (High use 293,483 357,583 429,374 508,092 592,485 680,806

anumpaon)
PIDS2 (Low use 254,352 309,905 372,124 440,346 513,487 590,032
assumption)
aADMPS (Med. 216,374 270,501 331,944 406,877
Ass.)
Expcrtelligence 227,744 270,662 509,999 360,067
Electrowatt 223,540 281,794 349,469 424,543
JICA 161,918 211,507 316,164 478,356 609,315 763,288
Source: David et.al. (1998).

* Without Lusaran Darn Project.
operational dams, have to be fast-tracked. More importantly, as David

et .al. (1998) has highlighted, there is an urgent need for a more
integrated and holistic approach to the otherwise fragmented and
relatively weak institutional structure that handles water resource
management. The study also sought the resolution of current conflicts
related to inter-LGU water transfers and intersectoral use of water
such as the case of Compostela wellfield.
Institutional Structure for Managing Metro Cebu

Metro Cebu's development has been carried on without a formal
inter-local government structure. Cebu City, as the "Big Brother," has
traditionally taken the lead in many respects and since the
reorganization of the Regional Development Council (RDC) in the
region, the concerns of the metropolis has been addressed especially
with the implementation of the MCDE
Lately, there has been a stronger call for the establishment of a
permanent body that will look closely at the various needs of the
metropolis beyond the infrastructure needs already addressed by the
MCDP.
M0ot/t..
In 1998, a bill creating a Metropolitan Cebu Development
Authority (MCDA) has been filed in Congress. The proposal is almost
200 ManagingUrbanization Undera DecentralizedGovernanceFramework
the replica of the MMDA as far as functions, responsibilities and

organizational structure are concerned. The only differences are that
MCDA is not under the Office of the President and the Chairman
will be elected annually from among the members of the council. In
contrast, the MMDA's chairman is a presidential appointee.
Interestingly, however, the MCDA general manager and the assistant
general managers shall be appointed by the president. In addition,
the Chairman is vested the rank, fights and privileges of a cabinet
member--in effect making him part of the presidential cabinet.
Because of political complexities in the region, the proposed bill has
waylaid and the call for its passage was received poorly.
Metropolitan council
Triggered by the end of the MCDP and the absence of a
coordinating body to plan, implement and monitor metro-wide
programs and projects, the RDC passed a resolution on ] 2 December
1997, approving the creation of a Metro Cebu Development Council
(MCDC).
The MCDC shall be the coordinating body that will deal with
the priorities of the metropolis, including garbage disposal, traffic
management, power, water, mass transportation, peace and order, and
maintenance of basic urban infrastructure.
The MCDC shall be composed of the governor of Cebu, the
mayors of the cities of Cebu, Mandaue and Lapu-lapu and the mayors
of the municipalities of Compostela; Liloan, Consolacion, Cordova,
Minglanilla,Talisay and Naga. The former MCDP office project
director has been designated as the MCDC executive director, and
fund balances, records, equipment and facilities of the MCDP Office
will be turned over to the MCDC.
The operationalization of the newly created MCDC, however, is
yet to happen. The RDC Secretariat, which is the NEDA Regional
Office in Central Visayas, has been tasked "to prepare the necessary
documents and conduct consultations with concerned LGUs and
agencies for the orderly and immediate implementation of the
resolution."
One of the most important tasks this new metropolitan organi-
zation could initially take on is to clearly define its authority, delin-
eate the roles and clarify the expectations of the various actors that
would be involved in addressing Metro Cebu's development priori-
Case Study:Metro Cebu 201
des. There are two levels of coordination that must be addressed.

First is the structural relationship and second the functional relation-
ship of these various institutions.
With respect to the structural relationship, two levels of coordi-
nation must be clarified: vertical and horizontal.
Vertical coordination refers to how the MCDC shall relate with
the regional institutions especially the RDC. Will the MCDC be un-
der the direct supervision of"the RDC or can it act independendy?
Can it deal directly with national government agencies, private groups
or foreign institutions? What are and how far can the MCDC exert its
power and authority considering that it is a body created by the RDC?
What does the term "coordinate _ mean in operational terms in the
aspect of project development planning, implementation and moni-
toting?
Horizontal coordination refers to how the MCDC shall deal with
government agencies, NGOs, private sector and business groups. No
mention was made on how these groups will participate in the MCDC
as the composition of the MCDC is purely interlocal government
based. In terms of the member-LGUs, how leadership will be deter-
mined would be an important Consideration. Will there be an incum-
bency issue in the leadership of the MCDC and the RDC?
On functional relationship, one needs to look at the mandate
and responsibilities of existing institutions in the regions regarding
provision of urban services in the metropolis. There might be a need
to identify which ones MCDC will take on so that all parties concerned
can assist each other and avoid or reduce an overlap in functions,
Once they have looked at how their roles and functions are and can
be delineated, the next step is to discuss and come up with a consen-
sus on how to go about defining their roles further.
Conclusion
The creation of the MCDC by the RDC can be considered as
the first big step toward a more focused approach to Metro Cebu's
development in almost 20 years. Defining the composition of Metro
Cebu is not direct but implicit in the participating areas of the MCDC.
It is not surprising that in the future, the composition will expand to
other areas. But first, it has to start somewhere and the 10 local areas
in the inner core may provide the impetus for such growth and ex-
pansion.
The success of Metro Cebu rests primarily on how well the

various development actors cooperate and work togethor. The
initiative of the RDC to create the MCDC may be the initial step toward
instituting a collaborative system among government agencies, LGUs
and the other development sectors.
References
David, C.C., A.B. Inocencio, EM. Largo and E.L. Walag. 1998. The
Case of Policy and Institutional Reforms in Metro Cebu. Paper
presented at the Workshop on Urban Water Issues in Metro
Cebu, Cebu City.
House of Representatives. 1996. House Bill No. 1316 (Introduced'by

Rep. Raul V. del Mar). An Act Creating Metropolitan Cebu,
Establishing the Metropolitan Cebu Development Authority,
Defining Its Powers and Functions, Providing Funds Therefore
and for Other Purposes.
Japan International Cooperation Agency (JICA)/Regional

Development Council (RDC) VII. 1994. The Study on the Cebh
Integrated Area Development Master Plan (CIADMP).
Metropolitan Cebu Development Project Office. 1995. Final Report

on Metro Cebu Development Project, Phase I.
Regional Development Council - Central Visayas Region. 1994.

Regional Physical Framework Plan.
. 1996. Updated Central Visayas Regional Development

Plan 1996-1998.
.1997. RDC Resolution No. 117: A Resolution Approving

the Creation of a Metro Cebu Development Council.
Republic of the Philippines. 1992. Central Visayas Regional

Development Plan 1993-1998.
World Bank. 1979. Development Strategy and Investment Priorities

for the Central Visayas. Working Paper.
Case Study 3
Providinga Metropolitan
Perspectiveto Development
Planning:Cagayande Oro
Ruben G. Mercado and Cas/m/m E/kdandra
agayan de Oro (CDO) is the regional capital of Northern

Mindanao and considered the primary gateway to the rest of
the Mindanao region s. As a port city, it is a transhipment hub
and economically linked with other port cities of the country. With a
population of over 400,000 people occupying mostly the urban
portion of its 469 square kilometer area, the city's socioeconomic
and political influence extends to another 400,000 people sparsely
distributed in almost 5,400 square kilometers of the provinces of
Bukidnon and Misamis Oriental. It will not be long before CDO
develops into one of the bustling metropolises in the country.
The perceived emergence of a metropolis with CDO as the core
city led to the conceptualization of the Metro CDO Special
Development Project (MCSDP) in 1990. With the joint leadership of
the Cagayan de Oro-Iligan Chambers of Commerce and Industry and
the support of Regional Development Council (RDC) X and XII, the
MCSDP paved the way for the Czagayan de Oro-Iligan Corridor Special
Development Project (CIGSDP) in 1993. Out of the government-
private sector partnership, the CIC Master Plan and Feasibility Study
for a CIC International Airport was born, which was completed on
November 30, 1991. After two years of public consultation which
• ended with the presentation and approval of the CIC Master Plan by
the NEDABoard on September 8, 1992, Executive Order 85 was issued
on May 5, 1993, ushering the plan's implementation. However, after
five years of CIC investment promotion both locally and abroad, so
much still needs to be done specially in the development of projects
that will impact on the originally conceived Metro Cagayan de Oro.
Authorities later realized that the Metro CDO SDP had focused
more on the development of the infrastructure links between CDO
and Iligan City. Thus, in 1996, a comprehensive master planning for
the Metro CDO was proposed, this time focusing more on the
planning for Cagayan de Oro City and its immediate environs. Toward
this end, the Cagayan de Oro government undertook preparatory
consultations with the municipalities in Misamis Oriental, including
Jasaan, VtUanueva, Tagoloan, Claveria, Opol, E1 Salvador, Alubujid,
Laguindingan, Gitagum, and the municipalities in Bukidnon
including Libona, Manolo Fortich, Talakag, Baungon, Malitbog, and
Sumilao. These areas, together with CDO City, comprise the
envisioned Metro CDO. Such composition was determined based on
the areas' interdependence in watershed and water supply as well as
infrastructure linkages for seaports, airports, and highways. The
Misamis Oriental and Bukidnon provincial governments were also
represented in these consultations.
This study aims to discuss recent developments related to the
planning of Metro CDO and to highlight areas that need greater
emphasis and further improvements.
Metro CDO Current Development and Prospects
Demographic cha_
Almost half or 49.7 percent of the over 800,00 people in Metro
CDO, as it is presently defined, is largely concentrated in Cagayan de
Oro City (Table 1). The city grew at a high rate of 4.7B percent during
the period 1990-1995. The 10-year intercensal growth rate of the city
has been high, registering 6.5 percent in 1960-1970, 5.9 percent in
1970-1980, and 4.0 percent in 1980-1990.
The development activities undertaken through the years in
terms of infrastructure support, investment generation, and the
promotion of the city as a regional growth center, especially with the
establishment of the country's largest industrial estate in the mid-
seventies, have affected other localities, especially the municipalities
geographically close to the city. Thus, one will note that population
in most of these municipalities have been growing at rates of over 3
percent during the period 1990-1995. Among these municipalities
areJasaan, Villanueva, Tagoloan, Claveria, Opol, and El Salvador whose
high population growth rates are attributed to the employment-
generating impact of the PHIVIDEC Industrial Estate.
Other areas comprising the envisioned Metro CDO are also
expected to increase both in their population level and growth rate
in the near future. The Northern Mindanao Regional Development
Case Study:MetroCagayan de Oro 205
Table 1.Metro CaCayam

deOro: DemolFaphicCharacteristics
City/ Population Level _ rate Land area Population density
Municipality 1990 1995 1990-95 (sq. kin) (persons/
_q.k=) __
Cagayan de Oro City 339,598 428,314 4.75 469.30 913
MJmmisOriental
1. Tagoloan 33,919 40,929 3.83 117.73 348
2. Vfllanucva 17,122 21,310 4.47 48.80 437
3. Claveria 31,130 39,020 4.62 894.90 44
4. ja,_,q 29,146 33,598 2.88 77.02 436
5. Opol 20,473 23,958 3.19 80.85 296
6. El Salvador 26,721 31,500 3.34 87.13 362
7. Alubijid 19,531 21,765 2.19 103.45 210
8. Laguindingan 15,503 16,521 1.28 16.74 987
9. Gitagum 10,994 11,327 0.60 43.40 261
Bukidnon
1. Libona 29,652 31,897 1.47 343.20 93
2. Manolo Fortich 61,329 67,400 1.91 405.19 166
3. Talakag 35,379 39,378 2.16 186.40 211
4. Baungon 19,774 22,617 2.72 245.30 92
5. Malithog 14,934 16,414 1.91 581.85 28
6. Sumilao 13,494 15,640 3.0 196.95 79
Metro Cagayande Oro 718,699 861,588 3.69 3,898.21 221

Metro Manila 7,929,867 9,454,040 $.58 633.21 14,930
pl'n".'Bplfil_ 60,677,725 68,616,556 2.49 300,000.00 229
Plan for the 21= Century identified three major events that will shape
the future of CDO City and its surroundings. These are the
construction of an international standard airport in Laguindingan,
expansion and upgrading of the CDO port, and development of the
PHIVIDEC Industrial Estate in Tagoloan and Jasaan where an
integrated steel mill will be put up. The implementation of these
flagship programs will boost economic growth and attract movement
of people into these areas.
Land use deve_

Cagayan de Oro 1 is the first city in the country to have a zoning
plan. Guided by the 1962 zone plan, its growth further accelerated
lCagayan de Oro became a chartered city on June 15,1950 during the term of President
E. Quirino. Among the five cities studied in the mid-sixties under the Regional Cities
Development Project (RCDP), Cagayan de Oro was considered as one of the best planned
cities in the country, owing to its first Land Use/Zoning Plafi dating back to 1962.
206 ManagingUrbanizationUnder a Dec,entralizedGovernanceFramework
when it became the regional capital (in 1972) of Northern Mindanao.

The region was originally composed of 10 provinces and nine cities.
The composition was reduced to seven provinces and seven cities when
Region XII was created in 1976. When Region XIII (CARAGA) was
established in 1994, the composition was further brought down to
only four provinces and six cities. Despite the reduction in the region's
geographic size, Cagayan de Oro's socioeconomic influence continues
to extend even beyond these areas.
In 1986, the city's agriculture, pasture and forestlands accounted
for 91.5 percent of the total land area. At present, it is down to less
than 82 percent (including open spaces). Almost 60 percent of
agricultural lands (37 percent of total) are devoted to corn and
coconut, while some 30 percent are aUoted to banana, rice, and
cassava. The remaining 10 percent are used to grow abaca, root crops,
and vegetables.
While builtup areas then was only 8.5 percent, it is now a little
over 18 percent and still growing. Residential districts/areas alone
increased from 4 percent to 12.4 percent in just a decade (Table 2).
The central business district (CBD), which includes commercial and
institutional areas, parks and plazas; accounts for a little over 4 percent,
while the industrial area is just about 2 percent.
The full development of the Phividec Industrial Estate-Misamis
Oriental (PIE-MO) and the strategically located mini-industrial parks/
estates will impact on the overall development of the corridor,
including the hinter areas, which should by then be reached through
farm-to-market and bypass roads.
CDO: Mindanao's transhi_ hub

Cagayan de Oro City, while being primarily agricultural, has
become one of the important commercial centers not only for
Mindanao but also for the Philippines owing to its strategic location
as a port city. The city's international seaport and trunkline airport
facilitate the flow of people and cargoes from the Visayas and Luzon
to all points in Mindanao and vice versa. This is through a network of
highways originating from the Agora station, a five-minute drive from
the seaport and 20 minutes from the airport.
Foreign ships unload and pick up cargoes coming from as far
south as Davao City. Luxury liners, waterjets and passenger-cargo boats
ply the Cagayan de Oro-Manfla route (via Cebu, Iloilo or Bohol) almost
Case Study:Metro Cagayande Oro 207
Table2. Exi_ L_d Uses

LandUse_ 1986 1996
Agriculture 37.0
Pasture 38.0
Forestlands 14.0
Wetlands and miscellsneous 9.5
Bvdltup m-eas 8._ lg.t l, %

Residential ._:.1
Others 4. _:
Institutional, parkBand _,0_

plazaJ and commerciat
Residential _,_.38
Tetel 100,0 % I_,.0%
Source:CAtyPlanningand Development Office,C_gaya_ d¢ 0__ City,
Table $. PassmgerandCargoTra_ attheCI)O-PMO andAirport

1995 1996 1997
== paperer
r
__..C._'gO Passenger Cargo Pas_nger C_,go - ....
CDO-
PMO* ,_,I_7,68_ 4,085,281 mt 2,147,787 4,B29,517 mt 2,748.777 4,385,351 _r_t
Airport 324,442 8,263 mt 85S,872 9,093 mt 516.571 9,[29 mt
Total _4_1,124 4=_09&_144mt 2_i01,659 4.q29,610 mt 3_65,348 4,$94,480 mt
Annual Growth Rate (1995-97) 14.7% 3.6%
* CDO-PMO covers the parts of CDO, Misamis Oriental .and Camiguin.

Sources: Philippine Ports Authority (PPA) Region X;, Air Traffic Office (ATO) Region X.
daily. Moreover, owing to Cagayan de Oro's long-standing trade links

with Cebu, the Cagayan de Oro_ebu route has the heaviest traffic as
may be gauged by the two-to-three passenger cargo and waterjet trips
taken daffy by four of the country's major shipping companies (WGA
Ferries, Sulpicio Lines, Tram-Asia, and Negros Navigation). A random
interview with arrivees confirms that final destination is Cagayan de
Oro and including Bukidnon, Camiguin, Lanao, Davao, and even
Cotabato and Zamboanga. During the last three years, the passenger
and cargo traffic rose by 14.7 and 3.6 percent, respectively (Table 3).
The Agora bus stadon is filled with passengers to/from all major
centers in Mindanao, specially the Cagayan de Oro-Bukidnon-Davao
route, 24 hours of the day. On the other hand, the Cagayan de Oro
trunldine airport serves the needs of the Cagayan-Iligan Corridor as
well as the provinces of ARMM and Region XII. The airport is served
by four airline companies (Philippine Airlines, Cebu Pacific Air, Grand
Air, and Mindanao Express).
Econom_ andfinan¢4_ acc/_t/es

From the 1989 Survey of Establishments by the Department of
Trade and Industry, 14 percent or 8,312 of business firms in Northern
Mindanao (the old Region 10) were located in Cagayan de Oro City.
About two-thirds of the total were trading firms; almost one-fourth
were service establishments; and the remaining 10 percent,
manufacturing and agribusiness (Table 4).
Cagayan de Oro serves as the commercial center of Northern
Mindanao. It trades in consumer goods, construction materials,
hardware and auto supplies, and agricultural products, most of which
are produced in the region.Its dominant industries are food
processing, furniture and metalworks. Agribusiness largely constitutes
livestock and poultry, and fruits/crops production and processing.
Cagayan de Oro is likewise the financial capital of Region 1.0
and nearby areas. In anticipation of more growth in commerce and
industry, especially along the corridor, banks and financial institutions
have converged phenomenally in the regional capital. More than 60
bank-branches, 200 or more financial institutions, including
pawnshops have located in the city. Many of the banks provide regional
banking services with broader authority to act with dispatch on major
Table 4. Types of Busin_-ssEstablishments

Sea_ Number %Share
Txading 5,486 66+0

Service 2,070 _4.9
Manufacturing
andAgrilmsiness 756 9.1
Total 8,312 100.00
financing and credit decisions involving domestic and foreign

transactions. The frenzy of activities within the Metro Cagayan de
Oro and its influence areas paves the way for specialized credits such
as Quedan financing, International Guarantee Loan Fund (IGLF),
integrated rural financing, including Barangay Credit Guarantee
Schemes. The government likewise offers regional development funds
for agribusiness, small and medium enterprises, schools and hospitals
as well as special development financing for strategic sectors such as
transportation and communication, power and other utilities, on a
long-term basis. The other service subsectors are those that are
supportive of tourism like hotels and restaurants, travel agencies, rent-
a-car services, tailoring, and recreation parlors. Warehousing, trucking
service, and auto repair shops are located in strategic places.
Flagship pr_ects
As have been mentioned in the preceding sections, the Northern
Mindanao Plan for the 21 _tcentury (RDP21) identified three major
events that will shape the future of Metro Cagayan de Oro and its
surroundings. These are: (1) the construction of the CIC international
standard airport in Laguindingan; (2) the expansion/upgrading of
•the Cagayan de Oro Port or the establishment of a Cargo port at the
PIE-MO, the country's largest industrial estate; and (3) the setting
up of the Integrated Steel Mill (ISM) at the PIE-MO.
The first two will further enhance Metro Cagayan de Oro as a
major transshipment hub of Mindanao. The CIC airport will likewise
hasten the construction of by-pass/farm-to-market roads (1) to
decongest traffic along the existing highway; (2) to facilitate
movement of people from as far as Bukidnon to this new airport; and
(3) to open up the resource-rich areas within the hinter part of the
corridor and bring them closer to the markets. The option of
establishing a new commercial cargo port at the PIE-MO will shorten
travel time coming all the way from Davao. Most importantly, it will
lessen the tm_c in the city proper (i.e., should the traffic of the cargo
component of the port service be re-directed.).
The establishment of an integrated steel mill at PIE-MO will
induce both upstream and steel metal-based downstream industries,
enhancing the full development of the PIE-MO, including SMEs.
Agricultural development could also be hastened with the

manuihcture of appropriate farm tools and implements. Thereafter,
farmers will be motivated to achieve higher productivity levels to
ensure 'adequate inputs for processing.
I-Ii_hways/raa&% bridges and railway

CIC highwaysroads. Very essential to the development of the
Lintedands and ren,o_: areas of the MeU'o Cagayan dc Oro and the
corridor is a iletwol'k of improved farm-to-market roa,_ls, Both RDC
10 and 12 have endol'aed this pcopoaal to _he Deparam'•• E:_•t of Public
Works and Highways (DFWH) celitral o_ce. This complements the
CIC Highway Expansion projec_ from Jasaan, Misamis Oriental to
Tubod, Ianao del Norte, for a total length of 157 kilometers and a
•cost of t_1.9 billion. This Higkway Expansion project is aimed not
only to ease up the worsening traffic problem along the Iligan-
Cagayan-Butuan roads but also to facilitate the integration of the
corridor with other growth centers in Mindanao.
CDO bridge& The Cagayan River, which separates the city into
die easters and westem bay areas, is presently connected by only two
bridges: one of an early 20th century American vintage steel bridge
and another which is a wider Marcos-era concrete bridge.
Considering that the airport as well as new middle- and upper-
class subdivisions are in the western bay while the seaport, bus: station
and shopping malls are in the eastern side, the worsened traffic
problems can only be. solved with the construction of two more
bzidges. The Puntod Bridge will require another access road and
bridge across the Iponan River. This requiI_es more budget than the
Macasandig..Upper Baiulang Bridge wkich will decongest the Upper
Balulang trat_c running from the airport and the mushrooming
middle- and upper-class subdivisions. Both have an initial budget of
_zS0 million (from CDF) and _g23 million (Cagayan de Oro
Government Budget), respectively.
• Another bridge provides the critical gateway from the city proper
to the country's largest industrial estate, the PIE-MO. Yhis is part of
'_le Cagayan de Oro-Butuan backbone serving vehicles to and from
_:_ao, Bu_uai% and Surigao ana even aU t_Teway from a:i_d_o VisaFas
and Luzon mrough [he Lipata, Surigao Ferry Service Station. The
bridge, which requires a prestressed concrete parallel with a capacity
of 20-25 tons, needs a P166 million budget and targeted to be f'mished
by2000.
Case Study: Metro Cagayan de Oro 211
Mindanao Railway and Metro CDO/CIC-wide LRT Project. The

entire project involves a 1,436-kilometer single railway line passing
through major cities in Mindanao. Phase I of this project will stretch
from Iligan City, pass through Cagayan de Oro-Bukidnon and end in
Davao City. At least 10 local and foreign companies have reportedly
expressed interest to form a consortium to undertake the project by
built-operate-transfer system. While the Cagayan de Oro government
had already signed a memorandum of agreement in 1997 with the
Metro Cagayan de Oro LRT Project consortium for the conduct of a
feasibility study for the construction, finance and operation of the
Light Railway Transit system, the DOTC recommends the inclusion
in the study of th e entire CIC stretch to ensure financial viability of
said project.
Telecommunications
Metro Cagayan de Oro now enjoys an 8.20 telephone per 100
persons density and even the entire CIC enjoys a 5.6 densitym
definitely higher than the national average of 4.09 in 1997. This is
the favorable result of the deregulation of the telecommunications
industry through EO 109, known as the Service Area Scheme.
However, the present system still lacks interconnection lines among
its service providers/telephone companies.
By year 2000, a total of 222,503 lines shall have been installed
and subscribed to in Metro Cagayan de Oro. This constitutes a 193
percent increase over what were installed and subscribed to as of 1997
•(Table 5). It is hoped that by then, these various telephone systems
will have been interconnected.
Approaches to Metro CDO Development
A growth center perspective

Metro CDO is presendy viewed in the context of a regional
growth area, Lying at the central section, and identified in the
Mindanao 2000 Development Framework Plan as the North Coast
Economic Growth Cluster (the land mass from CARAGA in the
Northeast to Panguil Bay in the Northwest), Metro Cagayan de Oro
is expected to sustain its crucial role of linking and unifying this high
potential growth cluster for both agricultural and industrial
development. The North Coast Economic Growth Cluster with the
Metro-Cagayan de Oro and Iligan Corridor at the center is envisioned
Table 5. Telephone Situation in Metro Cagayan de Oro
Currently
Installed Planned Projected Total
Company/Service Area Lines/ Expansion (2000)
Subscribed (1998- Number Ave. Annual
to (1997) 2000) of Lines Growth Rate
A. Company
1. MISORTEL Digital (Cagayan de 10,900 38,450 49,350 65.4%
Oro, Alubijid and Claveria)
2. Cellular Mobile Telephones 27,311 27,311

(CDO)
EXTELCOM 7,897 7,897
PILTEL 5,000 5,000
SMART 10,000 10,000
GLOBE TEL 1,714 1,714
ISLACOM 2,700 - 2,700
3.1TALTEL (NTP Tranche 1-3) 7,152 14,838 21,990 45.4%

Phase il (Cagayan de Oro) 7,152 5,698 12,850 21.6%
Phase IV (Misamis Oriental) 9,140 9,140 -
4. PHILCOM (Major Telecoms) 29,280 92,553 121,833 60.8%

C,agayan de Oro 29,280 54A62 83,742 41.9%
Misamis Oriental 38,091 38,091
51WEMORTELCO (Opol-Lugait) 219 219
6. PLDT (PHIVIDEC) 1,020 780 1,800 20.8%
B. Service Area
I. Metro Cagayan de Oro 75,882 146,621 222,503 43.1%
Digital 48,571 146,621 195,192 58_99%
Cellular 27,311 27,311
Density 8.2 telephones/100 21.5 telephones/100
persons persons
2. Lanao clel Norte/I]igan City 20,602 27,368 47,970 32.5%

Digital 13,752 26,668 40,420 43.2%
Analog 200 200
4.0 telephones/100 19.2 telephones/100
persons persons
3. CIC 96,484 270,473 41.0%

Digital 62,323 173,289 235,612 55.8%
Cellular 33,961 700 34,661 0.7%
,Analog 200 200
Density 5.6 telephoneC100 21.1 telephones/100

persons person
Source: CIC-SDP PMO (1997).
to play triple roles in the next 15 years. These are: (1) as domestic
food basket and agri-industrial exporter; (2) as the Industrial Corridor
of Southern Philippines; and (3) as the gateway to the domestic market
with potential for creating market niches in the Northeast Asia.
The current Metro CDO Special Development Project aims to
spur the growth of the Northern Mindanao region through the
implementation of strategic infrastructure including seaports, airports,
and highways; and promote agri-industrial activities including
industrial estate development in CDO City and its surroundings.
Recently, a master planning of Metro CDO is being proposed to be
undertaken. The master plan is based on the framework of this growth
center strategy, with the objective of producing what is essentially a
land use plan for CDO and the 15 adjoining municipalities. This plan
will serve as basis for amending zoning ordinances, guide land
reclassification, and provide direction to government and private
sectors regarding their investment decisions.
A metropolitan perspective
An important complementary perspective in looking at CDO
City and the neighboring municipalities as a regional growth center
is to view it as an emerging metropolitan settlement. Cagayan de Oro
City is now behaving like a widely sprawling city, spreading its influence
to nearby municipalities. It is difficult now to distinguish its boundaries
as the differentiation between localities is already being virtually
erased. For example, the DMPI plantation in Manolo Fortich
(Bukidnon) and the Industrial Estate ofTagoloan-V'fllanueva (Misamis
Oriental) are part of Cagayan de Oro City's tourism-investment
promotion package.
Moreover, the normative experience of a metropolis, including
urban blight and decay in the inner core resulting from slum dwelling,
mounting garbage, and rising criminality, are already being felt even
at this stage. The spillover effects of urbanization, especially
population pressures to convert agricultural land for urban uses such
as housing and industry, are a threat to food security. Enticed by
better income opportunities and the good life in the city, farm workers
have abandoned their seasonal farm activities in search of the
proverbial greener pasture but only to land in odd jobs or end up as
beggars in the city. Thus, a paradigm shift in planning and
management has to be looked into to be more prepared in the
immediate future in dealing with complex urban issues inherent in a

metropolis.
Metropolitan Concerns in the CDO Area

Current urban concerns that transcend local boundaries and
assume a metropolitan character have been identified by regional
and local officials in the region's development plan for the next
century. These include water supply and distribution, solid waste
management, and transport and traffic management.
Water supp/y and d/str/bu6on

In the city proper, water is not yet a problem, what with a density
of 13 persons to a Level III facility or 9 persons per combined Level II
and Level III facility. However, the adjoining municipalities of the
Metro Cagayan de Oro are still partly served by Levels I and II facilities.
One municipality each of Bukidnon and Misamis Oriental are largely
served only by Level I facility (Table 6).
Although the water supply may not yet be a critical problem,
there is a growing concern over the existing uneven water distribution
among households in various LGUs. Such is attributed to the
increasing rate of population primarily due to in-migration and the
entry of new industries. There are ample evidences that the per capita
cost of developing an effective and efficient water distribution system
across municipalities is lesser if done in an integrated fashion. Thus,
the master plan for Metro Cagayan de Oro must consider a water
distribution and management program that is integrated and holistic.
Need for improved solid waste rna_

One of the thorniest issues confronting highly urbanized cities
concerns solid waste management. As pointed out in the region's
physical framework plan (RPFP, 1995-2025), the indiscriminate
disposal of wastes by households, institutions and industries into
waterways and water bodies (lagoons, rivers and seas) causes water
pollution of major water sources for domestic and industrial/
commercial uses.
Under the Local Government Code of 1991 (RA 7160), both
waste collection and disposal are now a responsibility of the LGUs.
For most LGUs, waste collection is presently managed effectively.
However, for some, waste disposal is a major problem, particularly
with regard to the choice of a landfill site where pollution effects will
Case Study:Metro Cagayan de Oro 215
not spill over to the nearby LGU. For instance, Tagoloan's landfill
•lies along the precipice of a highway boundary leading to Malitbog,
Bukidnon, where the wastes are eventually scattered in a nearby creek
(Malitbog side). Another difficulty usually faced by the LGUs is the
costly establishment and maintenance of a landfill site or an
incineradon facility. Discussions among municipalities will ensure a
workable arrangement especially concerning the issue of landfill site
identification, waste recycling program that can be jointly
implemented by a cluster of LGUs and arrangement relative to cost
sharing and management.
Worsening traffic
As in other highly urbanized cities, traffic congestion in CDO is
becoming a serious problem. Most of the work establishments in the
city have adopted a "flexi-time" work schedule due to the
unpredictability of the road traffic. This is blamed on the tremendous
increase in the number of vehicles. Heavy traffic occurs in the
intersections fronting the City Hall and after the Carmen Bridge
leading to the Cagayan de Oro international Airport, the JR Borja
Hospital, and the Carmen market; and the crossing in front of the
malls/commercial complexes, especially those leading to the Agora
Market and the Cagayan de Oro port. The worst traffic happens within
the one-kilometer stretch where one goes through six choke points
from the Ororama Megamall to the Licoan (leading to the Cagayan
de Oro port or the Divisoria.), and the intersection at the western
end of the Marcos bridge.
The increased economic linkages between the eastern and
western bay areas and the surrounding municipalities/cities on both
sides have increased the mobility of both people and goods. Strategic
infrastructure development, including road widening, construction
of two more bridges, and installation of a metro rail transit, will help
decongest the traffic not only within the Metro CDO area. It will
help the Cagayanqligan and the Cagayan-Bukidnon-Davao corridors
as well. A more purposive coordination among the concerned
provinces, cities, and municipalities will further improve traffic
management.
Metro CDO Planning and Governance

Both the opportunities and challenges that transcend
geopolitical boundaries have implications on the planning of an
216 Managing UrbanizationUndera DecentralizedGovernanceFramework
Table 6. Water Supply Facilities, 1996

Number of Facilities by Level Potential
Population Level I Level n Level Eli Sources
Cagayan de Oro 427,627 0 31 46,519
Tagoloan 42,543 859 173 2,469 Rosario _pring
Villanueva 23,080 142 10 2,957 Imelda spring
Jasaan 36,251 116 70 3,840 springs*
Oaveria 37,021 166 96 526 Mat-i spring
Opol 20,473 122 7 590 spring
E1 Salvador 26,946 136 99 155 Deepwell
Alubijid 22,265 565 201 415 spring
Laguindingan 17,677 58 125 514 spring
Gitagum 12,231 62 96 471 spring
Libona 31,821 258 32 1,923 Sil-ipon spring
Manolo For rich 70,331 65 172 4,023
Talakag 38,719 39 10 362
Baungon 22,655 716 55 179 Pat-pat spring
Malitbog 17,044 27 84 288 spring
Sumilao 13,378 56 69 350 Lupiagan
spring
Total 860,062 3,387 1,330 6_,581
*Napapong, Dagulos, Inlomayang

Level I - Deepwells, shallow wells, spring development
Level II - Community faucets
Level III- Individual faucets
Source: Schema Konsult, Inc, (1996).
emerging metropolis. Individually, LGUs cannot efficiently and

effectively handle the type and magnitude of concerns and services
that have spilled over effects on the nearby LGUs. Traditional urban
planning approaches confined to a single political unit would have to
give way to a metropolitan planning and governance system whose
concerns transcend the LGUs'.
LGU Preferences on the Sharing Pattern of Urban-Related

Activities and Service Delivery
Majority of LGUs have expressed their desire and willingness "
to collaborate with the Metro Cagayan de Oro in undertaking the
following:
Planning activities 80%

Delivery of public health services, along with
hospital grants and ambulance services - 80%
Pofice and fire protection 67%
Housing and resettlement 60%
Case Study: MetroCagayande Oro 217
Public transport:
Infra and traffic management - 60%
Garbage collection, recycling and disposal - 53%
The LGUs also recognize the need to collaborate with line agencies
and/or the private sector in the following areas:
Planning - 53%
Health - 47%
Housing - 47%
The institutional mechanism should not create unhealthy

competition among implementing agencies/LGU/NGOs. The members
of the Metro Cagayan de Oro governing body must complement and
collaborate for greater results. Any unabated conflict between and among
member LGUs agencies or NGOs can be dysfunctional to the entire
system and impede the progress of the metropolis. Rather, the
mechanism should serve as a means to cut red tapes and enable the
community to participate in the decisionmaking process. As the Metro
Cagayan de Oro progresses, the existing institutional mechanism would
have to sustain the same momentum of change in the component LGUs/
areas of the metropolis.
The LGUs are willing to cooperate with NGOs and the private
sector on two areas, namely:
a) Garbage collection and disposal/recycling - 40%

b) Housing and resettlement - 40%
Only a few favor the idea of Metro Cagayan de Oro to solely

undertake the following development activities:
a) Transport 40%
b) Garbage collection and disposal 20%
c) Housing and resettlement - 20%
On the question of what activities are for LGU undertaldng only

the results are as follows:
Licensing and inspection 80%

Finance and taxation - 73%
Planning, particularly land use

planning and zoning - 67%
Housing and resettlement - 67%
Garbage collection/disposal - 53%
Health services - 53%
Police and fire protection - 53%
Public transport 40%
The LGUs' response shows their eagerness to undertake by

themselves manyofthe important activities or to provide services over
which they would want direct responsibility. However, they are ready
or willing to collaborate with Metro Cagayan de Oro, line agencies
and NGOs in many of these concerns. In fact, some expressed their
impatience at the slow process of "metropolitanizing" that hampers
their being able to deliver better and higher levels of facilities and
services.
The installation of an institutional mechanism for metropolitan
governance within Metro Cagayan de Oro is a unique challenge in
itself. The models in Mindanao are those of the Area Development
Board of SOCSARGEN and the CIC Steering Committee of the CIS-
SDE These institutions operate as coordinative mechanisms that can
provide a forum not only to coordinate the broad concerns of"
development but also to facilitate the implementation of inter-agency/
inter-LGU projects as well, They also provide the mechanism for
encouraging participation and support of national agencies, LGUs
and NGOs, and the private sector.
Ex-i_'ng/poten6al barriers to Metro CDO

The LGUs were candid in pointing out some critical barriers to
metropolitanization:
No-xlzLnvolvement of the provincial governmext_s_i.n the

organt px
The support of the provincial governments is crucial to the
smooth functioning and enjoyment of mutual benefits. However, the
initial reluctance of the provincial government of Bukidnon stems
from the unclear delineation of what type of development will happen
in the participating LGUs. Moreover, there is an emerging fear of
losing its municipal constituents once these political units join Metro
Cagayan de Oro.
Once the momentum is established, the second task is to undertake

a meaningful master plan for Metro Cagayan de Oro, which shall
proceed from a comprehensive review and analysis of human
resources, natural endowments, economic advantages and
opportunities as well as sociopolitical institutions. By reviewing what
it has, Metro Cagayan de Oro will be able to define its power base.
This will serve as the benchmark for framing doable initiatives that
can respond to the complex challenges and concerns of an emerging
metropolis.
How policymakers regard the area would have implications not
only on the concerns from which development programs shall be based
on but also on the institutional mechanism that will be established to
address the formidable tasks at hand. It is thus important to clearly
distinguish the perspectives on Metro Cagayan de Oro as a geographical
subject for developmenL Taken as a regional growth area, Metro Cagayan
de Oro can be seen as a strategic area for locating major infrastrucutral
and capital investment that will set the stage for its economic growth.
Seen as a metropolis, more attention can be provided to the challenges
of Metro Cagayan de Oro that would have to be addressed, which are
unique to such form of an urban area.
References
CIG-PMO (Cagayan de Oro-Iligan Project Management Office). 1997.

CIC-SDP 1997 Accomplishment Report.
CPDO City Planning and Development Office). 1997. Socio-

Economic Profile of Cagayan de Oro City.
DMJM International, Inc. 1995. Mindanao 2000 Development

Framework Plan.
NEDA-RDC X. 1995-2025 Regional Physical Framework Plan (RPFP).
1999-2004 Regional Development Plan of the 21"tCentury

(i DP21).
NSO (National Statistics Office). 1995. Census of Population and
Housing.
Schema Konsult, Inc. 1996. Assessment of Domestic Water Supply

and Sanitation Sector of Northern Mindanao.
Case Study 4
Metro Naga:
A Continuing Challengeof Local
Autonomy and Sustainability
Ruben G. Mercado and V/ctor B. Uba/do
etro Naga is composed of Naga City and the surrounding

municipalities ofBombon, Calabanga, Camaligan, Canaman,
Gainza, Magarao, Milaor, Minalabac, Pamplona, Pasacao, Pill,
and San Fernando. Recently, the municipalities of Bula and Ocampo
have been included in this metropolitan composition. These
municipalities are all in the Province of Camarines Sur. Metro Naga is
relatively new, having been given official recognition as a metropolis
only in 1993.
The metropolis is located within the heart of Bicol's largest fiver
basin area. Thus, it is dominated by a flat topography. It lies on the
foot of Mt. Isarog where a rolling terrain may be found. The area is
part of the traditional rice granary of Bicol. The extent of prime
agricultural lands for rice production has become a major constraint
in the urban expansion of the component municipalities. In addition
to the extensive prime agricultural lands, large tracts in the metropolis
are likewise flood-prone as these are in the lower basin area.
Management of the Metropolis

Under Executive Order 102, the Metro Naga Development
Council (MNDC) has been tasked to formulate, coordinate and
monitor programs, projects and activities in the areas composing
Metro Naga for "the acceleration of the economic and social growth
and development .... in coordination with the governor of the province
of Carnarines Sur." The MNDC is composed of the mayors of the
political units in Metro Naga plus a representative each from the
provincial government of Camarines Sur, the departments and
agencies represented in the National Economic and Development
Authority (NEDA) Board, including the Department of Education,
222 ManagingUrbanization Undera DecentralizedGovernanceFramework
Culture and Sports (DECS), and the Department of Social Welfare

and Development (DSWD). Representatives from the private sector
and nongovernment organizations comprise one-fourth of the fully
constituted council.
Metro Naga is one model of metropolitan arrangements created
by virtue of local initiative and cooperation. This paper attempts to
document Metro Naga's experience in metropolitan development
and presents the challenges involved in the process of sustaining
metro-wide activities in the spirit of local cooperation and autonomy.
Demographic and Land Characteristics

Metro Naga's population is only a little over halfa million with
about 23 percent of it found in Naga City (Table 1). Population growth
rate in the whole metropolis is lower than the national average but
higher than the regional average. The population in seven component
local government units (LGUs), including Naga City, grew at rates
lower than the regional average. However, the rest have registered
high growth rates, especially the municipalities of Milaor, Pili and
San Fernando, where growth is close to or over 3 percent. The rapid
population growth of Milaor and San Fernando may be due to their
being receptacles of population spillover from Naga City as these areas,
have extensive potential areas for urban expansion. This is evidenced
by the increase in the number of residential and subdivision
development in the area. Pili, on the other hand, is a traditional
secondary growth center and a hub of agricultural trading activities
especially for the Caramoan-Partido area. Recent trends indicate an
increase in local economic activities. These factors may have served
as a magnet for the rural population to relocate to this growth node.
Population density in Naga City and Camaligan is relatively
higher compared with the other areas in the metropolis. Moreover,
the population density of Camaligan is higher as compared with that
of Naga. Camaligan has the smallest land area but has a population
bigger than Gainza and Bombon (where the land area is 5 and 9
times that of Camaligan). But Camaligan's proximity to the central
business district of Naga City was a major reason for the municipality's
high urban development. It has become the primary receiver of Naga
City's population spillover. Its attractiveness was further intensified
with the location of the Camaligan Fishing Port complex in the
municipality.
Case Study: Metro Naga 223
Table1. Metro Nasa: DemographicandLand Characteristics
CAty/ Population Level Growth Land Population

Municipality Rate, Area Density, 1995
1990 1995 1990-1995 (sq. km) (pentons/sq. kin)
Naga City 115,329 126,972 1.82 84.5 1,503

Bombon 10,874 11,739 1.44 44.2 266
Calabanga 54,261 59,164 1.63 163.8 361
Camaligan 15,436 17,411 2.28 4.7 3,720
Canaman 20,298 22,732 2.14 43.3 525
Gainza 7,095 7743 1.65 14.8 524
Magarao 16,623 18,264 1.78 45.0 406
Milaor 18,199 21,213 2.91 33.6 630
Minalabac 35,922 37,574 0.85 126.1 297
Pamplona 24,097 26,176 1.56 80.6 325
Pasaeao 31,960 36,070 2.29 149.5 241
Pill 52,481 61,520 3.02 126.3 487
San Fernando 20,608 24,196 3.05 71.8 337
Bula 48,240 54,650 2.37 151.3 361
Ocampo 30,876 34,898 2.32 118.3 295
Metro Naga 502,299 560,322 2.19 1,257.7 445
Region V 3,910,001 4,325,307 1.91 17,633.4 249
Philippines 60,679,725 6,861,6556 2.32 300,000.0 229
H3storical Antecedents/The Metro Naga Development Program

(MNDP)
When shortage of oil products was experienced resulting from
the Gulf War in 1991, Naga City and the surrounding municipalities
worked together in resolving the issue of gas sourcing and allocation.
This initial interlocal discussion on an immediate concern eventually
paved the way for more interaction on other broader issues. Naga
City spearheaded the conceptualization of a Metropolitan Naga
Development Program (MNDP), which provided the framework for
the development of the areas that constitute Metro Naga and the
required organizational machinery to orchestrate such development
activities.
The MNDP seeks to improve the employment condition,
agricultural production and delivery of basic services in the
development area. With these objectives, the MNDP identified the
roles of participating LGUs based on their resource endowments and
comparative advantage and potentials for future cooperation. The
process of identifying these roles is a worthy example of how local
governments can meet and decide on issues with due consideration
to their extemal environment. Initially, these roles met stiff resistance

from some of the LGUs specially those that perceived their assigned
roles as minimal and running counter to their own local aspirations
and development path. It took them a long and difficult time to come
to termswith each other. But the general welfare of the metropolitan
area and the realization that a holistic approach is needed to solve
major problems and challenges confronting the metropolitan area
eventually dawned on the local chief executives. Thus, the local chief
executives came to agree on their identified roles, which are
summarized in Table 2.
Naga City and the other municipalities have been informally
meeting to discuss how they would operationalize the strategy. Based
on the provision of the Local Government Code, particularly in
Section 23, a Memorandum of Agreement was signed on 23 April
1993 wherein each member-LGU was:
1) To formulate and implement an equitable and complemen-

tary development program;
2) To establish the Metro Naga Common Fund through contri-
butions of the members, which shall be no less than 2 per-
cent of the LGUs' Economic Development Fund (or 2 per-
cent of 20 percent of their respective internal revenue allot-
ment [IRA]);
3) To participate in the identification, preparation and imple-
mentation of development programs, projects and activities;
4) To supervise, implement, assist and/or coordinate programs,
projects and activities of the council within their respective
territorial jurisdiction in coordination with the council; and
5) To extend technical, resource, financial and other forms of
assistance to member LGUs to the extent allowed by the gen-
eral welfare of their respective constituents.
Because of the huge financing needed to concretize the vision,

they sought a means to access national funds. They hoped to tap some
financial sources such as an annual subsidy from the Philippine
Amusement and Gaming Corporation (PAGCOR) or the Philippine
Charity Sweepstakes Office (PCSO). To effect this, they asked
Malacafiang to issue an executive order creating the MNDC and
providing funds for its programs and operations through these
sources. Eventually, Executive Order 102 from the Office of the
Table 2. Area-Specific Roles in Metro Naga

Resource Endowment/ Potential Development Activity/
City/Municipality Comparative Advantage Industry
Naga City Modern urban facilities Center of trade, financial,
educational and professional
services/convention site
Surface water in Panicuason Source of potable water
Agriculture Auxflliary food crop supplier
Historical sites and religious Tourism
festivities
Pili Airport Airlinktomajor centersof the

country
Trade and comlnercial center
Bombon Rich agriculture Primary food bowl

Presence of spring water Source of potable water
Calabanga Rich agriculture Primary food bowl

Fishery Source of fresh fish and processed
fishery products and by-products
Camaligan Modern fish port, ice plant Expansion offish processing

and cold storage facilities industry
Nearness to Naga City Trading activities
Spillover of residential population
from Naga City
Canaman Nearness to Naga City Trading activities

Spillover of residential population
from Naga City
Gainza Agriculture Auxiliary food crop supplier

Handicraft enterprises Further development of handicraft
industry
Magarao Rich agriculture Primary food bowl
Milaor Nearness to Naga City Ideal site for warehouses and bulk
Lower tax rates storage
Minalabac Agriculture Auxiliary food crop supplier
Pamplona Hilly terrain idealfor grazing Gatflc and dairy industry
Pasacao Hilly terrain ideal for grazing Cattle and dairy industry
Port Port development to accommodate
deep sea vessels and serve as Metro
Naga's gateway to domestic and
foreign market
Fishery Source of fresh fish and processed
fishery products
San Fernando Hilly terrain ideal for grazing Catde and dairy industry
Presence of spring water Source of _otable water
Source of basic data: Mendoza (1997).
Table 3. Financial Sources of the MNDC
LGU
YearXSource Contributions GAA/CDF/CIA Total
1993 539,000* 500,000** 1,039,000
1994 600,000 2,000,000 2,600,000
1995 No data available 0 0
1996 100,000 4,000,000 4,100,000
1997 500,000 5,000,000 5,500,000
Total 1,739,000 11,500,000 13,239,000
"Naga City's contribution is P328,000 or about 65 percent of total while the rest are divided
among the other member-municipaiities.
*'Released from the Office of the President as seed money for operations.
President was issued on 18June 1993 creating the MNDC. The order
also provided an amount of P500,000.00 from the Office of the
President as seed money for its operations and mandated the inclusion
of the MNDC in the General Appropriations Act (GAA) for the
succeeding years in consultation with the Department of Budget and
Management.
From 1993 to date, member-LGUs have contributed a total of
P1.73 million (Table 3). Due to the relatively good financial standing
of Naga City, more than half of the contribution came from this city.
The amount was used to finance the priority activities the council.
lined up for the member-LGUs. The absence of a hiatus in the
council's activities may have contributed to the LGUs' sustained
interest in the partnership.
The internally generated •financial resources were augmented
by externally generated assistance, most of which are assistance from
the national government. However, some activities such as the medical
and health mission being held yearly were financed by the private
sector.
To date, the MNDC received a total of P1.5 million in assistance
from the national government through the GAA, inclusive of the seed
money provided in Executive Order 102. The appropriations in the
GAA were mosdy attributed to the collective lobbying of congressmen
from the province of Camarines Sur. The MNDC has likewise received
a total amount of P1.73 million in contributions from the LGUs.
Programs/Accomplishments
As of June 1997, the Council formulated and implemented the
following programs and projects in response to the immediate needs
of its member-LGUs:
• Establishment of the Metro Naga Emergency Rescue Network;

• Metro Naga Senior Citizens Program;
• Formation of the Metro Naga Equipment Pool;
• Metro Nag_a Enterprise Development Program;
• Metro Naga Employment and PlacementAssistance Program;
• Metro Naga Water Supply Enhancement Project;
• Metro Naga Project Assistance Fund;
• Support to Health Services; and
• Resource/Project Accessing.
Metro Naga Emergency Rescue Netumrk

There was a need to pool resources for emergency use because
out of the 14 member LGUs, only four had fire protection bureaus
while five had ambulances. Moreover, hospitals are still concentrated
in Naga City only. To ensure access to these facilities in times of
emergency, an extensive radio network was installed in all mayors'
offices, and ambulance, police and fire stations. Hand-held radios
were also distributed to key personnel of each LGU. All Metro Nag_a
LGUs were provided with VHF base and portable radios while all
ambulances had mobile base radios. Completing the network were
the VHF facilities of the Bureau of Fire Protection. Communication
network has since formed the backbone of the Metro Naga Emergency
Rescue Network (MNERN). It proved crucial not only in maintaining
the coordination among member-LGUs. As the base and portable
radios were also made available at the barangay level, the
communication network was also crucial to the success of activities
within each LGU.
Some noteworthy accomplishments of the MNERN include:

1)Conduct of annual Emergency Medical Technician
(EMT) course for the paramedics handling the
ambulances of the member-LGUs;
2) Conduct of one medical mission in one barangay in
Calabanga to check the spread of illnesses after
Typhoon Rosing;
3)Establishment of a coordination center among
different emergency units of Metro Naga, particularly
when there is a need for additional ambulance units
or for the services of the Bureau of Fire Protection;
228 Managing UrbanizationUndera DecentralizedGovernanceFramework
4)Rescue of trapped residents in flooded areas of

Magarao and Naga City during the height of typhoons
Monang and Posing; and
5) Distribution of potable water to flooded areas of the
municipalities of Minalabac, Milaor, Camaligan,
Calabanga, Bombon and Magarao after the typhoons.
Metro Naga Senior Citizens Program

The program that bestowed privileges to Naga City senior
citizens under the city's own senior citizens program was later
extended to other senior citizens within Metro Naga. These consist
of discounts in selected stores and establishments within the city and
in the use of certain facilities of the city government. Upon the
effectivity of the Senior Citizens Law, the program rationalized the
grant of privileges to all the senior citizens within Metro Naga,
particularly when it came to discounts on medicines.
The program also organized the Metro Naga Senior Citizens
League that serve as an umbrella organization of the different senior
citizens federations within the metropolis. The league coordinated
the activities of different federations so as to facilitate the grant of
senior citizen privileges as well as inter-LGU senior citizens activities.
Through the league, in cooperation with the Department of Social
Welfare and Development (DSWD) and the Camarines Sur Drugstores
Association, a total of 13,000 medicine purchase discount booklets
were printed and distributed to members. The league also became
the venue for the formation of the Metro Naga Senior Citizens'
Cooperative that now runs its own drugstore. Elderly residents in
Metr ONaga can now avail of discounts while gaining some profit from
their own purchase. The drugstore also drew support from the city
government of Naga when the latter provided the site and building,
and from the SOLCENTF, which added P200,000.00 to Metro Naga's
working capital.
Metro Naga Equipnwnt Pool

One of the important MNDC projects is the pooling of
engineering equipment for use by the MNDC-member LGUs. The
Metro Naga Equipment Poolwas formed to give member-LGUs access
to heavy equipment for local infrastructure projects as well as vehicles
for transportation purposes. The MNDC assumes the maintenance
cost of these equipment while the borrowing LGU shoulders the fuel
cost. Through this scheme, savings have been generated by the LGUs
in their construction activities, especially in the repair of farm-to-
market roads.
Equipment from the pool were utilized for the following:
• Opening of Comaguinking Road, Calabanga

• Opening of Tugayan-Comaguingking Road, Calabanga
• Repair and rehabilitation of Labog-Binanwaanan Road,
Calabanga
* Repair and rehabilitation of various sugar roads, Pili
° Repair and maintenance of various barangay roads,
Pasacao
• Repair and maintenance of various barangay roads,
Canaman
° Repair and maintenance of unpassable portions of the
Naga-Gainza Road
Metro Nabou Enterprise Deve!opnwnt Program

This program assists rural entrepreneurs in undertaking micro-
enterprises or in augmenting their working capital. Priority is given
to disadvantaged sectors such as women and the disabled and to
projects that utilize indigenous materials. To date, 14 organizations
have benefited from the program.
Metro Na_ Emp/oyment and P/acement Ass/.Cance Program

This program aims to match the skills of the local labor pool
with the needs for domestic and foreign enterprises. In coordination
with the Department of Labor and Employment, the MNDC regularly
holds annual jobs fairs. It is also into job placement and has established
an Overseas Placement Assistance Fund using the prize it received
from the Galing Pook Awards. The OPAF provides funds to those
who have already secured firm employment contracts abroad and
ensures their speedy deployment. To date, about 27 residents of
Gainza, Magarao, Pili, Milaor, Pamplona, San Fernando and Naga City
have been extended overseas placement assistance.
Metro Naga Water Supply Enhancement Project

This project was undertaken in response to the need of distant
Metro Naga communities for clean and potable water. Under the
program, Level I water systems are distributed to member-LGUs. To
date, about 280 units of Level I water systems have been deployed
throughout the Metro Naga area. Each unit consists of ajetmatic or
pitcher pump, three to four pieces of GI pipe and a bag of cement.
Labor for the construction of the water system is provided by either
the local government or by the beneficiary groups. Also under this
program is the assistance extended by the MNDC to the municipal
government of Canarnan in the expansion of its Level IIi water services
to three barangays adjacent to the poblacion (central district).
Metro Naga Project As_istance Fund

As co-host of the PalarongPambansa in 1997, the council alloted
P100,000 to each member-LGU for Palaro-related projects and
activities. This scheme of sub_alloting the council's resources has now
been adopted as a mechanism to augment member-LGU resources
for other priority projects of the council.
Support for hea/th serv/ce_

When the provision of health service functions were devolved
to LGUs by the Local Government Code, many municipalities were
unable to provide the medical supply requirements of their respective
health centers. The little financial resources that accompanied the,
devolved function have often been used to pay for personal services.
Becoming aware of this predicament, the MNDC aimed to support
this function and provided medicines to the rural health units (RHUs)
of its member municipalities. In 1996, over P800,000 worth of generic
drugs were purchased by the council and distributed to the members.
To further support health services provision, the Council--in
coordination with a foreign-based association of Bicolanos, the Bicol
Medical Center and the Naga City Hospital-----organized a surgical
mission primarily to address the increasing number of untreated
surgical cases in the metro area. The council packaged the mission
such that both professional services and pre- and post-operative
medicines were given free to patients. A total of 127 patients were
treated during the mission.
Resource a_cess/ng and generat/on act/v/t/es

The. council used its collective clout to access resources to
finance priority development projects of member-LGUs. The
financing of the following projects was facilitated through the council's
intermediation: (1) construction of the Pili diversion road; (2)
construction of cut-off channel no. 3; (3) upgrading of the Naga

•airport; (4) increased calamity assistance for member-LGUs; (5)
reconstruction of the Calabanga municipal hall; and (6) concretizing
of the Naga-Gainza road.
The council also played an important role in the generation of
additional private sector investments in the area. By projecting Pili
and Calabanga, Pamplona and Naga City as attractive investment areas,
the council was able to convince private investors to put up businesses
in these areas.
Future Plans
To sustain the momentum of the MNDC initiatives, the council
engaged in several long-term activities that include the preparation
of a Metro-Naga Development Plan, promotion of ecozone
development and preparation of the Mt. Isarog Watershed
Management Program.
Metro Naga Development Plan

The Metro Naga Development Plan has been on the drawing
board for quite some time now. The council's limited resources
that could be used for planning had to be supplemented. Thus,
the council had to explore external financing assistance in the
early stages of this proposed activity. The council tapped a
consortium of NGOs to access funding from the Ford Foundation.
The consortium initially proposed to prepare a master plan for a
pilot area that consisted of Naga City's immediate neighboring
municipalities of Gainza, Camaligan, Milaor and Canaman. Upon
presentation of the plan to the council, however, other member-
LGUs began to request for their inclusion in the master planning
activities. A revised proposal was therefore submitted by the
consortium to the Ford Foundation.
While waiting for a feedback from the Ford Foundation on the
revised proposal, the council was able to access additional trading
from the national government---enough to be able to proceed with
the proposed master plan preparation. It first requested the National
Economic and Development Authority Regional Office V to help
prepare the Terms of Reference and related documents preparatory
to the bidding and hiring ofa consultancy firm. Hopefully, they could
start on the study on the Metro Naga Master Plan before the terms
of existing local executives expire.
Promotion of ecozone devdopment

The Council, in coordination with the provincial office of the
Department of Trade and Industry, has begun laying the groundwork
tbr the entry of an ecozone developer in Pamplona and a self-
contained agro-processing community in Magarao. Contacts with
investors had been established and all possible assistance extended
to facilitate their entry to the project.
ML Isarog Watershed Management Program

The council, together with various NGO groups, has been in
the process of preparing a watershed management program for Mr.
Isarog through the assistance of the Asian Institute of Management.
The project is meant to protect its main source of water as well as
mitigate the runoff of surface water that causes flash floods in the
Bicol River Basin area. Among the participating member-LGUs are
Pill, Magarao and Naga City.
Key Features of Success
Leadership and lon_term development vision of Mother City

The MNDC's success was principally bolstered by the leadership
of the mother city, Naga City. Because the city's strategy was anchored
on long-term city development and local inter-dependency, the
development goals had been far-sighted and had considered a
planning perspective that went beyond political boundaries. The
current Naga City leadership did not view its development challenges
as something confined to the city itself. It knew that the shortage of
space, water, migration, squatting and employment could not be
resolved by the city alone; rather, it had to integrate the development
factors of the surrounding areas. Its good relations with neighboring
LGUs and ability to integrate each other's concerns helped sustain
the development efforts. Moreover, Naga City took its role seriously
as the Big Brother in the area by initiating programs or activities that
helped other LGUs deliver basic services to their respective
constituents.
In a nutshell, Naga City's long-term view of city development,
together with its resolve to help its neighbors and the political
leadership to initiate cooperation, are significant hallmarks of the
MNDC success.
De-,,topme,ven vs.poratea cooperation

Naga City's MNDC is an exercise in partnership that viewed
mayors not just as political figures but as investors in the development
business. The solid partnership among the LGUs as well as their
accomplishments so far are manifestations of a cooperative
undertaking that ignores partisan considerations in favor of achieving
development benefits. Municipal mayors acknowledged the benefits
gained by the arrangement, most claiming to have received more
than what they give to the partnership. This arrangement has sustained
the interest of members-LGUs on the activities of the council.
Resource poling and serowe

The MNDC experience shows how it maximized the use of
existing assets and resources. By pooling resources, either financial
or nonfinancial, LGUs find that such could be extended to other
government units rather than confmed to only one or few local areas.
This combination of resources increases LGUs' capacity to d_eliver
services and is particularly crucial for those with meager resources.
Seriously taking on major development roles is important if

cooperating LGUs are to have a workable and sound integrated
development plan for their areas. This integrated plan could form
the basis upon which individual LGUs' socioeconomic and physical
development plans would be formulated or revised. Meanwhile, the
roles that LGUs have agreed upon under the MNDC will serve as the
guiding framework for the detailed master plan that will be developed
for Metro Naga. It is opined that this master plan will be operational
and useful than the master plans formulated by professional
organizations or consultants that were based on formal regional
development theories and approaches only. It is hoped that any
consultant that would be hired would base his/her recommended
master plan on and/or enhance the development concept and the
area-specific roles that the MNDC has envisioned.
Future Challenges
The MNDC faces three major challenges hereon. First is to beef
up its organizational machinery. Second, to address financial
sustainability. Third, to manage the transition of leadership and sustain
the partnership.
The first challenge stems from the MNDC's mounting

development activities and the insufficient technical support existing.
Management support must be expanded. Meanwhile, more
accomplishments can be achieved and innovations introduced if
technical planning and administrative support for MNDC are in place.
The LGUs' contribution and national government support to
MNDC should also be in line with any expansion of MNDC
responsibilities in the future. The council has to be more creative in
sourcing funds especiallywhenever the national government tightens
its belt.
Finally, the most critical to MNDC's sustainability is leadership.
Given that the strength of the MNDC largely lies in its leader and the
strong partnership forged among the current members, it is hoped
that the current vision will continue and the development-oriented
perspective as well as the established camaraderie of the proponent-
leaders will be carded on by whoever would be chosen to replace
them.
References
Mendoza, F. 1997. Metro Naga: A Model in Integrated Area

Development.
Naga City Government. 1996. Annual Report 1996: Naga City.
Naga City Mayor's Office. n.d. A Briefing Paper on the Metro Naga
Development Council.
Case Study 5
Metro Iloilo: A Struggle

for Acceptance
and Organization
Ruben G. Mercado and Raul S. Anlocotan
stablished in 1890 and located in the Western Visayas Region,

Iloilo City is one of the oldest cities in the Philippines. Currently
one of the major urban centers in the country, the city is densely
populated with a small land area (56 square kilometers) and a
population of more than 300,000 residents as of 1995.
The burgeoning population in a small land area greatly affected
the urban functioning of the city. Among the city's current problems
include a domestic airport that cannot be expanded, slum dwellers
in the city's commercial district that cannot be relocated, and solid
wastes that cannot be properly disposed of. The easiest solution is to
expand the city's land area. However, this is an impossible option for
Iloilo as it is bounded in the east by Guimaras Strait, where the trench
is steep, making reclamation improbable. Four municipalities bound
the other sides of the city, namely, Oton in the south, San Miguel in
the northwest, and Pavia and Leganes in the north. As such, urban
planners are seeking viable alternative solutions that will decelerate
urban blight.
The creation of Metro Iloilo has been a dream of many urban
planners and businessmen in the city. The plan involves the formation
of a metropolitan arrangement between Iloilo City and its adjacent
municipalities within a 15-kilometer radius. While it is difficult to
establish how this concept was brought to the fore, some precursors
to its formation can be identified.
In an interview with key informants in the Western Visayas
Region, the idea of a Metro Iloilo was first spread by a group of
businessmen and eminent persons in Iloilo City sometime in the early
nineties. The idea was not given much attention as the city was
experiencing its most turbulent period. At that time, the incumbent
mayor was in the midst of a political battle with the Department of

the Interior and Local Governments (DILG) over several suspension
orders issued to him by the DILG. For several months, the city was
placed under the care of the vice-mayor who eventually gained the
mayoral post in the succeeding elections. The incessant political
bickering in the city during the first half of the nineties severely
constricted long-term development efforts as local officials concerned
themselves with parochial matters. The lackadaisical attitude of the
SangguniangPanglunsod (city council) toward long-term planning even
aggravated the lack of coherence in the city's developmental efforts.
In 1996, the concept was revived. Mayors of the four concerned
local government units, namely, Iloilo City, Oton, Pavia and Leganes,
met to identify areas of possible cooperation. These three
municipalities and the city of Iloilo were identified to constitute
Metropolitan lloilo. With the help of the private sector, a draft
memorandum of agreement was prepared for the creation of the
Metropolitan Iloilo Development Council (MIDC). For this
cooperative undertaking to be legally binding, it has to comply with
the requirements of the Local Government Code of 1991 which
stipulates that a resolution stating the concurrence of the Sanggunian
has to be passed. All the Sangguniang Bayan (municipal council) of
the three municipalities, except that of Iloilo City, passed their
respective resolution of concurrence for the creation of the MIDC.
The implementation of the Metro Iloilo concept was stalled by
the political stalemate between the Iloilo City mayor and the
SangguniangPanglunsod, In refusing to pass the necessary resolution,
the Sangguniang Panglwnsod of Iloilo argued that the memorandum
of agreement did not pass through a process of consultation with
concerned sectors of Iloilo City. The council alleged that the mayor
acted on his own and without the SangguniangPanglunsodproviding
him the mandate to undertake formal arrangements with the
concerned municipalities. The members of the Sangguniang
Panglunsod also alleged that it will be the city of Iloilo which will be
carrying most of the financial burden entailed by this metropolitan
arrangement.
On the surface., it seems that the SangguniangPanglunsod view
the issue as not based on substance but rather, on the process that
went through such undertaking. However, there seems to be a deeper
issue involved. A source commented that the memorandum of
Case Study: Metro Iloilo 237
agreement was drafted without a technical study to back it up. There

is, therefore, a very unclear understanding and appreciation of the
rationale for such cooperative arrangement.
With the preceding account as backdrop, this paper will attempt
to present the local officials' initial thinking on the substantive aspects
of the said cooperative undertaking. It will also try to briefly present
the crucial steps that have to be taken to address the current dilemma.
All of these are in line with the ultimate goal of effecting a more
acceptable cooperative arrangement for Metro Iloilo in the context
of the institutional and political arrangements existing in the area.
Demographic and Land Characteristics

Metro Iloilo, as to its initial compositional definition, has a
population of close to half a million largely concentrated in Iloilo
City (76.5 percent in 1995). Next to CAMADA (Metro Dagupan),
Metro Iloilo is the smallest in terms of population and land size and
the slowest in terms of population growth rate compared to other
metropolitan arrangements in the country. The slow growth in
population reflects the overall low growth rate in the whole Western
Visayas Region attributable to the significant level of population out-
migration (NEDA 1993). Relatively high growth rate, however, can
be observed in Pavia in view of the designation and promotion of the
area as a Regional Agro-Industrial Center (RAIC).
While the present level and growth rate of the population in
the various areas of Metro Iloilo are quite low, increased urbanization
can be anticipated following the increased vigor to establish
infrastructure support for the development of the RAIC and other
industrial sites. The spadal expansion of the city to the north (to the
municipalities of Leganes and Pavia) is supported with a
comprehensive road network connecting Iloilo City to other points
Table 1. Metro hollo: Population and Land Characteristics

Population level Growth rate Land area
Area
1990 1995 1990-1995 (sq. kin)
Iloilo City 309,505 334,539 1.47 56,0
Leganes 18,505 19,235 0.83 32.2
Pavia 23,814 26,756 2.21 35.0
Oton 52,125 56,821 1.63 84.6
Metro lloilo 403,909 437,351 1.59 907.8
in Panay Island. The latest of these projects is the coastal road opening
a second link to the municipalities of Leganes and the adjoining
municipalities of Zarraga and Dumangas in the north as well as to the
Iloilo International Port Complex. The municipality of Leganes has
also started a large-scale multipurpose land development that will
establish it as an attractive industrial and residential zone. The plan
includes a reclamation of about 200 hectares of seashore along the
Guimaras Strait.
Identified Areas for Cooperation

The municipality of Pavia was identified by the Regional
Development Council in the late eighties as the region's center for
industrial development. Since then, infrastructure support projects
were implemented by different government agencies to enhance the
attractiveness of the area. In the early nineties, however, the
municipality of Leganes, an adjoining town, started promoting itself
as an industrial center. A grandiose plan, including schemes to reclaim
part of the seashore to give way to an international port, an industrial
site, and other facilities was hatched. A multinational firm indicated
its willingness to finance the project through the build-operate-
transfer (BOT) scheme.
Confusion as to where the industrial site should be located
ensued. A presidential directive instructed the Regional Development
Council of Region VI to decide immediately which of the two
municipalities, Pavia or Leganes, should be proclaimed as the RAIC.
The RDC decided in favor of Pavia. Several businessmen, however,
proposed that a cooperative scheme between Iloilo City and the
surrounding municipalities will avoid this kind of confrontation in
the future. They believe that collaboration rather than competition
will provide the synergy necessary for the area's progress.
The urgency of the matter prompted a group of well-meaning
individuals in the city and the three concerned municipalities to
conduct consultative meetings to push for the metropolitan concept.
The group, in consultation with the representatives of the four
concerned LGUs, proposed the creation of the Metropolitan Iloilo
Development Council (MIDC), which will be composed of members
coming from these four areas. After concurrence by the mayors of
Iloilo City and the three concerned municipalities was received, a
memorandum of agreement was then drafted and presented to the
respective sanggunians.
The draft memorandum of agreement listed the following as

the areas to be coordinated in by the proposed MIDC:
Development planning. This refers to the "preparation of medium-

and long-term development plans including the formulation of
projects, investment programming, and monitoring of its
implementation." The areas constituting Metro Iloilo, presently within
a 15-kilometer radius, is envisioned to have a common development
plan. If the metropolitan arrangement is found successful, the area
can be expanded to cover the 25-kilometer radius. The plan basically
identifies their major development roles so that complementarity of
development goals will be assured. Moreover, land use planning will
be more coordinated and investment planning will be more
rationalized. For instance, the network of road system can be more
reasonably designed and implemented if functional service roles will
be identified (e.g., Pavia for agroindustry, Leganes for heavy industry,
Oton as a primary residential area, and Iloilo City as the trade,
commercial and industrial center).
The Metro Iloilo concept is seen as a way of sharing benefits,
especially in logistics and resources. The objective is to provide avenue
where issues of consumer concerns can be discussed and addressed.
An example of a possible cooperative undertaking is the water
resources that Leganes is willing to share if a formal arrangement
can be made with other areas. Leganes and interested investors would
like to take advantage of the economies of scale in the development
of the water system. According to its former mayor, Leganes has
approximately 80 million gallons of surplus water. Several investors
have indicated their willingness to finance the construction of water
reservoirs and distribution systems provided there is a commitment
from other areas to open their markets and share in the investment
cost.
Transport, traffw engineering and management. This encompasses
"the formulation, coordination, design and monitoring of policies,
standards, and programs and projects to rationalize the existing and
proposed transport operations, infrastructure requirements with the
end in view of integrating into a single network the roads andmajor
thoroughfares of member local government units."
Iloilo City is the center of trade, commerce and industry in Panay
Island. As a trading center, the city boasts of several shopping malls
and retail market facilities. It is also one of the major centers of higher
learning in the country, having five major universities, including the

Visayas campus of the University of the Philippines and a number of
tertiary schools. Iloilo City is "alsothe regional center of Western Visayas
Region. During ordinary days (especially school days), the city's
population bloats significantly. Considering the enormous number
of people coming in and out of the city, there are only four exit points,
one for each of the four adjoining municipalities.
Worsening the city's traffic problems is the tremendous increase
in the number of utility vehicles plying the city's major thoroughfares.
Fueled by rising standards of living, car ownership in the city and
surrounding municipalities rose. Unfortunately, the city, like other
aging cides, still has streets designed to accommodate only the caretela
and calesa. Worse, provincial buses and public vehicles have to enter
the "city proper" (as the downtown area is called). Currently, buses
and other public vehicles coming from the provinces of Antique, Aklan
and Capiz have stations or terminals in the city proper. To resolve
this, the plan calls for two bus terminals outside the city proper, one
for southbound buses and another for northbound ones.
A road network that will ease the ingress and egress of vehicles
in the city is imperative. During rush hours, the four exit points are
clogged. Collaborative arrangements can, therefore, be made to
design a road system that will ease the traffic flow from the city's
commercial district to other urban centers in Panay Island. To
encourage city dwellers to reside in Oton and the adjoining
municipalities in the south, the main road leading to southern Iloilo
must be expanded and rehabilitated. Moreover, there is a need to
plan a road network that will open wide tracks of land in Oton for
residential purposes.
A road network directly linking Oton to Leganes and Pavia
should be carefully studied. This will enable industrial workers in Pavia
and Leganes to commute to their residences in Oton without passing
through the major thoroughfares of Iloilo City. Presently, commuters
coming from the north to the south, and vice versa, will have to pass
through Iloilo City.
Environmental sanitation, waste management and disposal This
involves the "formulation, coordination, design and monitoring of
policies, standards and programs and projects for proper and sanitary
waste disposal. It shall likewise include the establishment and
operation of sanitary landfill, incinerator, recycling facilities and
related facilities intended to develop an environment-friendly

metropolitan level."
The establishment of a common solid waste management system
and facilities will greatly benefit many. Currently, Iloilo City is having
difficulty in the disposal of solid waste. Residents in the Mandurriao
district are protesting that the current disposal site is too near the
residential areas. An alternative common solid waste disposal site
located at the outskirts of the metropolitan area (preferably in Oton)
will prove to be more sustainable and cost-effective. The needed
facilities will not only be built with dispatch through sharing of costs
but their use will also be maximized. Moreover, considering that the
selection of a landfill site is a contentious issue, it can be worked out
so that the host municipality will be provided disturbance
remuneration or other forms of compensation.
Flood control and sewerage management. This refers to "the
formulation and implementation of policies, programs and projects
for an integrated and comprehensive flood control system, drainage
and sewerage."
Like many old settlements in the Philippines, Iloilo City sprouted
at the mouth of major rivers---the Iloilo and Jaro rivers. As transit
point for commercial goods, Iloilo City's economy grew and
progressed, and migrants from outlying municipalities came to reside
in the city. The proliferation of squatter colonies especially in the
riverbanks, took its toll on the environment. Stilt houses were built
along riverbanks thereby constricting the rivers' flow. Moreover,
subdivisions and residential houses in theJaro district claimed several
esteros (natural floodway) leading to Jaro River. The onset of the
rainy season during the month of May proved to be devastating to
the residents of Jaro and Lapaz districts and Pavia. Old residents would
claim that floodwaters rising above their roof decks was just a recent
phenomenon. In some cases, Pavia and Leganes are virtually cut off
from Iloilo City for several days, halting commerce and trade between
these areas. The constant flooding of the Jaro district and Pavia
significantly affected the attractiveness of the latter as an
agroindustrial zone.
Only a comprehensive flood control system in the whole
metropolis can ease the perennial flooding in Iloilo City and Pavia.
In this regard, a cooperative scheme can be worked out that will involve
the dredging of the Jaro River from Jaro district upstream to Pavia
and the construction of a network of floodways that will facilitate the

flow of floodwater during heavy rains.
Moreover, as the pace of urbanization accelerates, the need for
a comprehensive and efficient sewerage system must already be
considered for Iloilo City and the surrounding municipalities. The
absence of a system is causing the underground water aquifer to be
continuously degraded.
Urban reTwwal,land use and zoning and shelter services. This refers
to the "planning and implementation of'policies, rules and regulations
and programs and projects to rationalize and optimize land uses and
provide direction for urban growth and expansion."
Because of the small area, the uses for Iloilo City's land are
limited. A larger scale for physical planning will allow for a more
rational use of its existing land and permit greater economic and
spatial links with its neighboring areas. The concept of a Metro Iloilo
and the formulation of an integrated land use and zoning plan will
synchronize and give more meaning to the existing land use and
zoning plans and regulations of the respective member-areas. The
metropolis plan, for instance, can identify and develop suitable land
for industry, housing sites for urban dwellers, including the
resettlement of slum dwellers in the city, and a suitable landfill site,
for solid waste management, among others. It should also anticipate
the need for future expansion and any implications on infrastructure
support that will sustain and manage urban growth.
Networking of economic support infrastructure. This involves the
"identification and implementation of a system of transport networks
linking and integrating the various road networks of the member
local government units into one big web of roads and thoroughfares."
In addition to the existing four exit points from Iloilo City,
another one known as the "coastal road" is soon to be opened. The
road will link the eastern coast of Iloilo City to the municipalities of
Leganes and Dumangas in the north. The eastern coast has been
identified by the Iloilo City government as the city' s site for industrial
development. It is the location of the Iloilo International Port
Complex and a number of commercial warehouses. Once completed,
it will complement the proposed industrial complex in Leganes and
win open a wide area of Iloilo City, Leganes and Dumangas for housing,
industries and commercial establishments.
Collaboration between Iloilo City and Leganes is essential for

•the success of both the Iloilo International Port Complex and the
proposed industrial complex in Leganes. Located just less than 10
kilometers from each other, any competition between the two ports
can result in ill feelings between the two local government units. The
proposed MIDC is the best venue for discussing how the two ports
can complement each other.
Another major infrastructure support project that will require
collaborative efforts between the province of Iloilo and Iloilo City is
the proposed construction of an international-standard airport in lieu
of the present airport located at the Mandurriao district in Iloilo City.
The limited land area currently used by the Iloilo Domestic Airport
significantly restricted the size of aircraft that can land. Also, the
increasing number of residential houses around the airport's
periphery makes aircr_t navigation hazardous and difficult.
The province of Iloilo is proposing that an airport of
international standard be constructed in the municipalities of
Cabatuan and Sta. Barbara, which are adjacent to Pavia. The proposed
airport wiU require a wider national highway, which incidentally passes
through Pavia. Such plan will greatly enhance the attractiveness of
Pavia as an industrial area since the airport will increase the volume
of traffic along the highway.
Public safety, maintenance of peace and orderand disaster manag_m, nt.
This refers to "the creation of metro wide police force and the control
and supervision of police force in the member local government
units...the setting up of mechanisms for the prevention of disasters
and effect mitigation of the same."
As there are separate police commands in four areas of the
would-be metropolis, coordination of police matters is done by the
police directorates in Camp Delgado, Iloilo City. This setup does not
create confusion as police command and responsibilities are well
defined and efficiently structured. It can, however, be enhanced if
coordination of peace and order efforts by the four-government unit
is improved. A coordinating unit preferably situated at Camp Delgado
can be created to coordinate and supervise police activities in the
metropolis. This is to ensure immediate action on reports of disaster
and crimes such as kidnapping, carnapping, robbery, and incidences
of hit-and-run.
Trade and investment promotion. This pertains to "the formulation

and implementation of a comprehensive investment strategy for the
whole area, and the rationalization of investment rules and
regulations, with the end view of developing the whole area into one
big economic zone."
The brewing conflict between Pavia and Leganes as related
earlier prompted several concerned individuals to reconsider the
metropolitan idea of making Leganes, Pavia, and Iloilo City as one
investment area. The current practice of implementing separate trade
and investment promotion activity is not cost-efficient and oftentimes
conflicting. While the Department of Trade and Industry, the Iloilo
Business Club, and the Iloilo Investors Foundation, Inc. have devised
_romotional packages for these three growth sites, they did not
nprove the proposed investment area's attractiveness. What is needed
succeed is an assurance from investors that industrial development
a the area will be holistic and well-coordinated. The translation of a
omprehensive and integrated socioeconomic and physical framework
lans duly ratified and endorsed by all four concerned LGUs can
elp achieve success in this regard.
'ossible Next Steps
Dealing with the acceptance dilenuna

The basic current issue among LGUs pertains to how they are
) provide everyone a clear understanding of the need to forge an
tterlocal arrangement. At present, the need to accept the benefits
f collaboration lies strongest in Iloilo City, where the acceptance
ilemma is evident and strongest. Both the substance and the process
ave to be dealt with.
What is needed is a broad discussion among LGUs on the
meral concept of the metropolitan arrangement as well as the
_ecific areas where cooperation will be forged. A concept paper might
e needed to articulate the basic discussions and the already-
;tablished agreements among the leaders of the member-areas. A
sk force composed of mayors and/or representatives from the
ember-areas may be created to draft this concept paper.
Dffinlng the appropriate ins6tutlonal structure

Having a clear understanding of the concept and objectives of
the arrangement, the next Step is to identify the appropriate
institutional structures that will coordinate the arrangement. While
the draft memorandum of agreement has initially proposed for a
council type of body (i.e., the MIDC), there might be a need to
consider such suggestion vis-A-visother alternative structures that may
be proposed. Whatever the agreed structure will be, it should be clear
about its roles and how itwiU sustain its organizational structure and
financial requirements. It should also define how it will horizontally
and vertically relate with existing institutional structures in the region.
Conclusion
Metro Iloilo is a metropolitan arrangement that is struggling
for acceptance and organization. Customarily, the difficulty in forging
the cooperation occurs in the member-municipalities involved in the
arrangement. In the case of Metro Iloilo, it is the city that has caused
delay in making a headstart. While the problem may be tagged as
something political, it may seem to have brought the need to make a
rethinking of the whole concept and objectively assess the real need
for such cooperative undertaking. The present paper hopefully can
be useful in providing the impetus for further discussion through
the documentation of the initial thoughts articulated by the local
executives concerned on the substance of the desired cooperation.
References
Provincial Government of Iloilo. n.d. Draft Memorandum of

Agreement (between the mayors of Iloilo City and the
municipalities of Leganes, Pavia and Oton)
National Economic and Development Authority. 1993. Western Visayas

Regional Development Plan 1993-1998.
• 1997. Western Visayas Regional Development Plan 1998-2004.
National Statistics Office. 1995. Census of Population and Housing•

Case Study 6
Metro Davao:In Search

of Metropolitan Definitions
Ruben G. Mercado
theoretical sense. Angotd (1993), in writing a modern-day

efining a metropolis
perspective should not be has
on metropolitanization, difficult, at least
suggested in the
a general
rule-of-thumb in defining a metropolis or at least distinguishing it
from a city. In the context of the twentieth century, the term
"metropolis" refers to large urban setdements, usually crossing local
jurisdictional boundaries, with at least one million population. The
term "city,, on the other hand, refers to a medium-sized settlement
of between 100,000 and one million population. Following this
categorization, therefore, settlements under 100,000 population are
considered "rural." Admittedly, this is a broad definition. However,
the definition is handy in making a broad categorization of urban
settlements.
Another criterion has also evolved from the experience of other
so-called metropolises in the country. This criterion defines a
metropolis beyond the urbanization measure and population size.
That is, an area is considered a metropolis if it undertakes
metropolitan functions or activities. These activities refer to those
which are distinctly urban in nature and dimension. Usually, when
one or more political jurisdictions are involved, an institutional
mechanism is needed to undertake them. This criterion helps avoid
loosely defining metropolis only on the basis of population or the
amalgamation of contiguous political units. The term _metropolitan
arrangement" becomes more applicable to any cooperation between
city/ies and municipalities which do not meet the population and
largely urban criteria but are performing expanded urban service
functions.
The case of Davao presents some major definitional dilemma.
Reference to Metro Davao has taken on new meanings in recent years.
What is being referred to by the term "Metro Davao_? Is it Davao City
or is it beyond the city's political and administrative jurisdiction? How

valid and meaningful are these defnitions?
This paper attempts to describe three emerging operational
definitions of Metro Davao. The aim is not only to present the
definitional dilemma at hand but more importantly to draw insights
or lessons on the importance of definitions beyond the terminological
exercise.
The Three Def'mitional Models of Metro Davao

Model I: Davao City
Based on the basic definition of a metropolis, Davao City may
in itseffbe considered a metropolis. In 1995, Davao City registered a
population of a little over one million from about 850,000 in ]990
(Table ]). Growth rate has remained high since the ]980s, posting
3.39 percent growth from the period 1990-1995. A large percentage
of its total population resides in areas classified as urban. However, it
should be noted that the urban land area is only less than 2 percent
of the total land size. Thus, it is necessary to distinguish density in the
whole city and density in the urban areas within the city to appreciate
the' state of its urban geography. One needs to understand also that
Davao City is, land-wise, a predominantly agricultural and forest area.
Table 2 presents the land use pattern in Davao City in 1994, showing
that the built-up area (depicting urban area) comprise only less than
6 percent of the total land area of the city.
Table I. Davao City:Basic Demographic and "LandCharacteristics

1980 1985 1990 1995
Population 614,124 724,935 849,947 1,006,840
Growth Rate 3.32 3.18 3.39
Percent Urban 67 69 74 n.a
Population Densityin
the City (persons/ha)* 2.5 2.97 3.48 4.53
PopulationDensityin Urban
Areas(persons/ha)** 116.9 142.1 178.7
* Total land area: 244,000 ha.
** Total urban land area: 3,520 ha.
Basic sources: National Statistics Office, Census of Population and Housing (for 1980, 199()
and 1995 figures) and population projections, 1980-2010 (for 1985 figures).
Case Study: Metro Davao 249
Table 2. General Land Use, 1994

Use Area (ha) Perc_t to Total
Built-up 13,373 5.48
Agricultural 184,651 76.84
Forest 43,147 17.86
Total 244,00@ 100.00
Source: 1996 Solid Waste Management Profile, Davao City.
Table 3. Population Distribution, Land Area and Density, 1990

District/ Population Land Area Density
mmmgay (ha) (poputation/ha)
DisWict1
Poblacion 141,090 1,028 137.0
Talomo 183,356 11,040 16.6
District II
Agdao 75,295 489 184.5
Buhangin 118,550 9,222 12.8
Bunawan 68,785 6,550 10.5
Paquibato 27,756 23,360 1.0
District Ill
Baguio 19,894 82,725 0.2
Calinan 53,379 22,360 2.4
Marilog 35,295 50,796 0.7
Toril 82,501 13,130 6.3
Tugbok 44,096 23,300 2.0
Total 849,947 244,000 3.5

Source: City Government of Davao, 1996 Solid Waste Management Plan.
Davao City is considered the largest city in the world in terms of

land area) Its size is more than three times the size of Metro Manila
and more than twice of Metro Cebu. Nevertheless, population is
unevenly distributed. The city is divided into three major districts.
Table 3 presents how population is distributed in each of these three
administrative areas in 1990. Note that majority of the population is
concentrated in the first district, where the built-up areas are located.
This district alone comprises already more than a third (38 percent)
of the total population while occupying only 5 percent of the total
land area.
Davao City, taken as a whole, can be considered a metropolis in
terms of its population level. High growth rate has been exhibited in
t Recently, however, Puerto Princess City also now claims to be larger than Davao City in terms
of land area (253,982 hectares).
the recent past, and is expected to continue in the medium- and long-
term future. While majority of the city's area is agricultural and forest,
the percentage of population living in the urban area is considerable:
more than 75 percent of the city's total population.
Model 2: Davao City plus neighboring nmnicipalities

A recent (re)definition of Metro Davao (Carino and Kintanar;
Gaffud 1997) is the one that takes Davao City in relation with the
immediate municipalities of Sta Cruz in the south and Panabo in the
north. The definition is, admittedly, prospective and based on the
fact that these municipalities are the nearest catchment areas for
Davao City's eventual expansion. Sta. Cruz and Panabo are 38 and 32
kilometers away, respectively, from the city proper.
The involvement of the two municipalities is seen as just a
possibility and there are actually no immediate interlocal concerns at
hand. In fact, data on average daily traffic (ADT) shows that it is in
the city proper, particularly in the central business district (CBD) of
Davao City, where traffic is greatest and where choke points are
located. Furthermore, the three local government units (LGUs) have
their own water districts. The Davao City Water District alone has an
excess production capacity of about 5 million cubic meters, more
than enough to supply its population. On solid waste management,
Panabo and Sta, Cruz generate a relatively small amount of garbage
although Panabo has a six-hectare sanitary landfill (dump site). Davao
City ha'_ a four-hectare dumpsite, and because the city has land, any
future expansion and/or addition of sanitary landfill sites will not be
as much problem as those experienced by other rapidly growing cities.
The garbage issue is not a metropolitan problem since each of the
three -0oliticaljurisdicfions can singly handle the concern. Housing
is similarly a local government issue and can be handled through the
respective LGUs' housing programs.
Table 4. General Information on Davao City, St& Cruz and Panabo

Population
Land
Area Population Growth Percent
1995 Urban
(sq. km) 1990-95
Davao City 2440 1,006,840 3.39 74
Sta. Cruz 320 59,139 1.11 35
Panabo 193 130,585 3.40 50
Total 2,953 1,196564 2.66 69
Source of basic data: National Statistic Office (1990/1995).

.Case Study:MetroDavao 251
While there is no problem viewing Metro Davao as one that

encompasses the city as well as the adjoining municipalities of Sta.
Cruz and Panabo in terms of population size as a criterion, it is still
premature to define Metro Davao in this manner in view of the
absence of a real need for the areas to jointly undertake basic
metropolitan services and to establish an institutional mechanism for
this purpose. These municipalities may be considered only as a
geographic expansion rather than an interlocal cooperation. The
addition of Sta. Cruz and Panabo into the urban circle even makes
the whole area less urban.
Model 3."Lkwao City Plus Neighboring Provinces

The third definition of Metro Davao is more expansive in scope
in that it brings together Davao City and the three provinces of Davao
del Norte, Davao del Sur and Davao Oriental. Unlike the second
definition, the inclusion of these provinces is based on a formal
agreement between the concerned political units. This consolidation
is specified in the established Davao Integrated Development Program
(DIDP).
The DIDP evolved from the original proposal for a Metro Davao
Integrated Development Project Master Plan and Feasibility Study. A
similar suggestion was submitted in June 1993 to NEDA Regional
Office XI by a group ofJapanese consultants. The Metro Davao being
referred to in the plan is Davao City only. The proposal aimed to
enlarge urban functions by improving or expanding urban
infrastructure and utilities for the growing urban population while
maintaining a balance with agricultural activities in the predominantly
rural area. There are, however, numerous activities in the program
which extend beyond the urban concerns.
In October 1993, an initial discussion in Hong Kong by the
Chairman of the Regional Development Council, councilors of Davao
City and the Governor of Davao Province (del Norte) focused on the
possibility of ajoint socioeconomic undertaking between the city and
the three provinces of Davao. This was later followed by consultations
and meetings among the local government units. Eventually, in July
1994, a Memorandum of Agreement (MOA) for the implementation
of the DIDP was signed by the Davao City mayor and governors of
Davao del Norte and (]el Sur. The original proposal in July 1993 was
revised to expand the planning space and widen the areas for concern
by considering the complementarity and integrated development of
252 Managing Urbanization Under a DecentralizedGovernance Framework
these territories. In October 1994, the MOAwas amended to include

Davao Oriental.
The DIDP has identified nine key result areas or sectoral focus:
agri-industrial and marine industry, sea and air transport services,
physical infrastructure development, tourism, natural resources
management and conservation, peace and order, disaster
preparedness, cultural exchanges, human resources and technology
development.
Of the above, the immediate opportunities for joint undertaking
are found in tourism, infrastructure and maintenance of peace and
order. The development of Samal Island, one of the priority tourism
development sites under the Tourism Master Plan, is also a priority of
DIDP concern. Supporting tourism are programs meant to maintain
peace and order, particularly in the border areas of Davao, as well as
the rationalization of plans for the development of infrastructure to
enhance the area as a tourist investment destination through the
provision of more access roads, wharves,jetties and other embarkation
points. Similarly, tourists' interests will be promoted if land and water
transportation facilities are made available for key destination points.
The DIDP is being run by an Executive Committee composed
of the Local Chief Executives of the LGUs who are members and
participants of the Program and the Chairman ofRDC XI as Ex-officio
member, it is a collegial body and its meetings are chaired and
presided over by the host Local Chief Executive.
The DIDP is a local government undertaking without national
government funding. It relies solely on the contribution of each LGU.
Each contributed P300,000 for the initial funding requirements of
the program. A Project Management Office was set up in May 1996 to
provide overall supervision and coordination in the implementation,
monitoring and evaluation of DIDP projects and activities.
It is difficult to classify the DIDP arrangement as the new Metro
Davao. If the areas are consolidated, population would go beyond
one million and the entire areawould become more rural than urban.
Table 5 shows that with the low percentage of urban population in
the three provinces, the total urban proportion of the entire area is
only 43 percent. It is also not appropriate to refer to them (DIDP
areas) as a metropolitan arrangement inasmuch as the concerns of
the DIDP are neither primarily urban-related nor metropolitan in
character. It is instead appropriate for such consolidation to be called
Case Study: MetroDavao 253
Table 5. General Information on Davao Integrated Development Program

Land
DAVAO Area PopulationPopulation Percent No.of No.of Capital
(_q"k_) 1995 Growth Urban MunicipalitiesBarangaysTown
City 2,444 1,006,840 3.37 74 180
Del Norte 8,130 1,191,443 3.82 30 22 458 Tagum
Oriental 5,165 413,472 2.40 24 11 183 Mad
Del Sur 3,934 677,069 2.72 30 15 337 Digos
Total 19,673 3,288,824 2.29 43 48 1,158
Source: Davao Integrated Development Program.
a subregional development cooperation or conventional integrated

area development (IAD) undertaking.
Conclusion
The above analysis presented the three emerging definitions of
Metro Davao and evaluated these based on the simple definition of a
metropolis as "a largely urban settlement with a population of at least
a million and usually extending beyond political jurisdictions." Of
these, viewing Metro Davao as comprising Davao City alone is the
definitional model that meets the two criteria. The second model
(Davao City plus neighboring municipalities) would also qualify but
is still considered prospective because of the absence of immediate
inter-urban concerns at present. Also, based on the theoretical
distinction between a city and a metropolis, Davao City was found to
have graduated from being a city and into a full-fledge metropolis in
1995. Thus Davao City alone can already be classified as a metropolitan
city.
Given the high growth in population experienced not only in
Davao Citybut in all of the Davao provinces, Gaffud (1997) has rightly
pointed out that the DIDP can be "an initial vehicle in the promotion
of cross-border management of urban services." Perhaps, there might
also be a need to develop a subcomponent of the program for Metro
Davao (i.e., Davao City) concerns. Because Davao City has a strategic
role as the international trade center and gateway to the Southern
Pacific Rim, particularly in the BIMP-EAGA, a distinct program must
be crafted to make the city a well-functioning and competitive me-
tropolis. It might be useful to develop a separate Metro Davao Devel-
opment Master Plan (i.e., Davao City concept) but anchored on the
framework and broad strategies of the DIDE
The transformation of Davao City into a metropolis should not

be seen only as an urban redefinition. More importantly, it implies
that the urban management paradigm of the city should be broad-
ened rather than follow the traditional city management approach.
The development plan for the new metropolis must consider a con-
temporary urban-management system (i.e, organizations, human
resources, operational systems and approaches) that will aid this tran-
sition process.
References
Angotti, T. 1993. Metropolis 2000. Planning, Poverty and Politics. New

York.
Carifio, L.V. 1997. Preparing for a Developed Future Through a

Comparative Study of Five Current and Emerging Metropolitan
Areas: An Introductory Statement for Consideration of Local
Governments. Unpublished.
Davao City Government. 1996. Solid Waste Management Profile.
. n.d. Terms of Reference for the Feasibility Study on Metro

Davao Urban Development Project.
Gaffud, R. and N.E. Kintanar. 1997. The Interplay of Population,

Resources and Public Services Toward Balanced Development
in the Emerging Metro Davao. Unpublished. University Center
for Integrative and Development Studies, University of the
Philippines.
NEDA Regional Office X. 1993. Profile of the Davao Integrated

Development Program. Davao City.
Case Study 7
Governanceand Urban
Development:CaseStudy
of Metro Manila
Rosario G. Manasan and Ruben G. Mercado
Introduction
etro Manila has had a long history. For 250 years before the
Spanish arrived, Manila has been a prosperous city engaged
in trading with neighboring China, Vietnam, Indonesia,
Malaysia, Borneo and Kampuchea and with Acapulco as well. Because
it was a progressive city with rich agricultural hinterland, Manila be-
_:ame the Spanish and, then later, the United States' colonial capital.
Aside from being the direct link between the Philippines and its co-
lonial rulers, Manila served as the gateway for the export of agricul-
tural products and raw materials and the import of manufactured.
goods from Europe and the United States. During the Spanish and
American rule, colonial policies promoted the development of Ma-
nila as a primate city. In this sense, the countryside was "economically
exploited to support the colonial bureaucracy in Manila" (Caoili 1985
based on Cushner 1971 and Regidor and Mason 1905/1925). After
World War II, economic policies have contributed further to the un-
even development between Manila and the rest of the country. Ma-
nila was the favored location of industrial establishments because of
its developed infrastructure and its being the country's principal port
and financial and commercial center. This, together with political
unrest and underdevelopment in the other regions, has encouraged
rural migration to Manila and accelerated the urbanization process
in the area.
Geography
Metropolitan Manila (or the National Capital Region, NCR) is
located in the southwestern portion of Luzon, directly below Central
Luzon. It is bounded by the province of Bulacan in the north, the
Sierra Madre mountains and Laguna de Bay in the east, Manila Bay
in the west, and the provinces of Cavite and Laguna in the south.
With a land area of 636 square kilometers, Metro Manila is comprised
of the cities of Manila, Caloocan, Las Pifias, Mandaluyong, Makati,
Marikina, Muntinlupa, Parafiaque, Pasay, Pasig, and Quezon, as well
as the municipalities of Malabon, Navotas, Pateros, san Juan, Taguig,
and Valenzuela.
Oemogmphy
In 1995, the total population of Metro Manila reached 9.5
million, accounting for 13.8 percent of the country's population and
some 25.1 percent of its urban population (Table 1). The primacy of
Metro Manila has been declining continuously after reaching a peak
of 34 percent in 1970. The diminishing primacy of the metropolis is
partly attributed to the deceleration of the rate of growth of its
population from a peak of 4.9 percent annually in the 1960s to 3.0
percent in the 1980s (Pernia and Israel 1994).1 Still another factor
that helps explains primacy reversal is the decline in the contribution
of net migration to the growth of the metropolis. To wit, the
proportion of migrants in Metro Manila's population in 1975-1980
was 18.2 percent compared to only 11.5 percent in 1985-1990.
The population density of Metro Manila in 1995 is estimated at
14,865 persons per square kilometer, 65 times the national average
of 229 persons per square kilometer. Congestion in Metro Manila is
more glaring if one looks at the individual cities and municipalities
in the region. Congestion, as measured by population density, is more
evident in Manila, Makati, Pasay, Navotas Pasig and Caloocan.
Although population growth in the first three local government units
(LGUs) has slowed down in 1990-1995, the same cannot be said for
the last three LGUs.
Metro Manila's population is young and a substantial portion is
at the peak of their productive years. While the metropolitan
population is not as young as that of the entire country with only 4g
percent of its population below 20 years of age compared to the entire
country's 49 percent, the proportion of the population between 20
and 35 years of age is higher in Metro Manila (30.7 percent) than in
the rest of the country (24.6 percent).
t However, the population growth rate of Metro Manila rose to 3.3 percent yearly in 1990-1995,
almost 50 percent higher than the national average of 2.3 percent-
Case Study:MetroManila 257
Gross domestic product

The gross domestic product (GDP) of the NCR reached P835.6
billion (US$28.4 billion) in 1997. The share of Metropolitan Manila
in the total economy's GDP initially went down from 30.1 percent in
1980 to 28.3 percent in 1985 before recovering to 32.7 percent in
1997 (Table 2). Thus, it appears that although the NCR was more
badly affected by the economic crisis that confronted the Philippines
in 1983-1985, it was also the major beneficiary of the turnaround in
the economy in the late 1980s and the 1990s. In more specific terms,
the annual rate of growth of NCR's real GDP declined from 6.3
percent in 1975-1980 (compared to the Philippines' real GDP growth
rate of 6.2 percent) to negative 1.9 percent in 1980-1985 (compared
to the national average of negative 0.5 percent) but bounced back to
3.9 percent in 1985-1997 (compared to the national average of 3.2
percent). Consequently, the region re-established its hold on
economic primacy (in contrast to urban primacy) in 1986-1997.
Table 1. Demographic Facts About Metro Manila

1948 1960 1970 1980 1990 1995 1998 _'
Total Metro Manila
Population ('000) 1,569 2,462 $,967 5,926 7,948 9,454 10,012

Urban Metro Manila
Population 1,526 9,427 $,967 5,926 7,948 9,454 i0,012
Level of Urbanization _-
Total Metro Manila 97.3 98.6 100.0 100.0 100.0 100.0 100.0
Level of Urbanization -
27.0 29.8 31.8 $7.1 47.0 55.0
Total Philippines
Metro Manila Primacy 29.4 30.1 34.0 33.2 27.8 25.1
Metro Manila Population
as % of Total Philippine 7.9 9.0 10.8 12.3 13.1 15.8 13.7
Population
Growth Rate of Total
Metro Manila Population 3-8 4.9 4.1 3.0 3.3 1.9
Growth Rate of Total
2.9 3.1 2.7 2.4 2.3 2.1
Philippine Population
Growth Rate of Urban
3.9 5.0 4.1 3.0 3.3 1.9
Metro Manila Population
Growth Rate of Urban
Philippine Population 3.8 3.8 4.3 4.8 5.7
Total Philippine
Population ('000) 19,234 27,088 36,684 48,098 60,703 68,617 73,131
* 1998 figures arc based on NSO medium assumption projections.

Table 2. Gross Domestic Product Structure
1975 1980 • 1985 1990 1999 1997 Ave

1985-1997
Metro Manila (MM) Share in National Gross Domestic Product (GDP)/

Gross Value Added (GVA)
GDP 28.99 30.16 28.35 32.27 32.39 32.74 34.48
GVAin Industry Sector 44.18 40.94 42.97 38.82 38.30 38.41 38.71
GVA in Manufacturing 47.86 48-02 45.80 42.97 42.03 43.26 43.82
GVA in Construction 38.40 32.84 40.97 36.49 34.09 30.08 30.46
GVA in Service Sector 3'7.84 37.89 35.06 43.29 43.69 44.09 44.81
Rate of Growth (in constant prices)

MM GDP 6.28 (1.88) 5,01 (1A3) 5..04 3.92
MM GVA in Industry Sector 6.84 (2.20) 2.16 (3-68) 5.16 2.39
MM GVA in Manufacturing 6.45 (2.00) 2-13 (3.51) 4.63 2.19
MM GVA in Construction 9.16 (6.37) 5.72 (10.13) 7.10 3.45
MM GVAIn Service Sector 5,69 (1.52) 7.54 0.26 4.96 5.22
Phil GDP 6.21 (0.54) 3.30 (0.12) 4.43 3.19

Phil GVA in Industry Sector 7.34 (2.82) 4.97 (1.61) 5.33 3.99
Phil GVA in Manufacturing 5.82 (1.42) 4.09 (1.09) 4.45 3.36
Phil GVA in Construction 12.54 (9.83) 8.76 (6.93) 9.59 6.31
Phil GVA in Service Sector 5.76 (0.40) 4.05 0.59 4.71 3.74
Source: National Income Accounts, National Statistical and Coordination Board (NIA, NSCB).
The resurgent economic primacy of the NCR is largely driven

by the recovery of the services sector (especially the finance and
housing subsector). In contrast, NCR's industrial sector (including
the manufacturing and construction subsectors) lagged behind the
rest of the regions'. In particular, NCR's gross value added (GVA) in
the services sector grew by 5.2 percent yearly on the average in 1985-
1997 (compared to the national average of 3.7 percent) while its GVA
in construction and manufacturing increased by 3.5 and 2.2 percent,
respectively (compared to the national average of 6.3 and 3.4 percent,
respectively).
Consequently, the services sector became the most dominant
sector in the NCR starting in 1988 in terms of GVA shares. Prior to
this year, the industrial sector contributed the majority of regional
GDP. The relative contraction of the industrial sector in the NCR is
largely attributed to the declining share of the manufacturing
Case Study: MetroManila 259
subsector in the said period. In turn, this development may be traced

in part to the deconcentration of manufacturing activity from the
NCR to Southern Tagalog and Central Luzon in the late 1980s al-
though the encroachment of the peripheral regions appeared to have
waned in the 1990s. However, the manufacturing subsector, which
accounted for over 40 percent of total NCR GDP in 1985, exhibited a
less vibrant performance in the 1990s.
F rxapaa_gne
In 1997, per capita GDP in Metro Manila stood at P82,832
(US$2,811). Although there has been some diminution in the relative
well-being of the NC1L as measured by per capita GDP in 1975-1985,
this trend was reversed in 1985-1997. However, the improvement in
Metro Manila's per capita GDP in the latter period was not enough
to bring it back to the position it enjoyed (relative to the other regions)
in 1975. Nonetheless, the metropolitan region continues to dominate
all the other region s with a per capita income that is 2.5 times the
national per capita GDP of P33,722 US$1,144), 2.1 times the per capita
GDP of the second richest region, Cordillera, and 7.7 times the per
capita GDP of the poorest region, Muslim Mindanao (Table 3).
Poverty
The sterling performance of Metro Manila in terms of
improvements in per capita GDP is mirrored in the trend in poverty
reduction. Of the 2.0 million households living in the metropolis, 8.0
percent live below the 1997 poverty line of P71,800 per year for a
family of five. This compares favorably with the national poverty
incidence of 32.1 percent_ It also represents a marked improvement
in poverty reduction as the 1985 poverty incidence in the region was
almost three times higher at 23.0 percent (Table 4).
spa a/opm
The composition of Metro Manila has not changed since its
formation in 1975 under Presidential Decree (PD) 824 to the current
legal geopolitical composition under Republic Act (RA) 7924. The
only change has been the recent reclassification of some municipalities
into cities, namely, Makati, Muntinlupa, Mandaluyong, Pasig, Marikina,
Las Pifias and Parafiaque.
Metro Manila has been geographically subdivided in previous
planning documents into inner core and intermediate core. This
Table 3. Regional GDP Per Capita
1975 . 1980 1985 1990 1992 1995 1997
Regiomd Per Capita Product
NCR METRO MANIL _, 6,690.74 [3,470.54 25,019.63 43,248.94 5 t ,037.53 65,997.11 82,832.38
PHII.IPPINES 2,7_'26.30 5,502.34 11,207.01 17,611-42 21,107.53 27,778.00 33,722.49
Ratio of Regional Per Capita Product to National Per Capita Product (%)
NCR METRO MANILA 245.41 244.81 223.25 245.57 241.80 237.59 245.63
PHILIPPINES i00.00 100.00 100.00 100.00 100.O0 100.00 100.00
Annual Rates of Change (%), at Constant Prices

1975-1980 1980-1985 1985-I990 1990-1992 1992-1997 1985-199
NCR METRO MANILA 2.60 (4.93) 1.98 (4.58) 1.68 0.73
PHILIPPINES 3.4I (3.06) 1.01 (2.38) 2.05 0.86
Source: Basic data from NIA, NSCB.

Case Study: Metro Manila 261
Table 4. Poverty Incidence of Families, by Region and Urbanity, 1985-1997

Reduction
Region 1985 1988 1991 1994 1997" 1985-1994 1985-1997
Philippines 44.2 40.2 39.9 35.5 32.1 8.7 12.1
NCR 23.0 21.6 13.2 8.0 7.1 15.0 15.9

Areas Outside NCR 47.5 43.1 44.2 39.9 36.2 7.6 11.3
* Preliminary results of the 1997 Family Income and Expenditure Survey_

Source: Economic and Social Stadstics Office, NSCB.
subdivision has been largely based on the circumferential road

boundaries (Figure 1). The inner core is composed of the cities of
Manila, Pasay, Caloocan, Quezon, Makati and Mandaluyong and the
municipalities of San Juan, Navotas and Malabon. The intermediate
core consists of the cities of Pasig, Parafiaque, Muntinlupa, Marikina,
! :_ Pifias and the municipalities of Valenzuela, Taguig and Pateros.
In the immediate post-war period, urban development radiated
from the city of Manila, which has been the administrative, economic,
educational and social center since the colonial period, and situated
northwards to Caloocan City and southwards to Pasay City. Meanwhile,
the development of government housing projects in Quezon City and
the private sector development of Makati as a financial, commercial
and residential center in the late 1950s and the 1960s completed the
filling up of the inner core between Manila Bay and EDSA (or C-4).
Industrial and residential development intensified in Navotas,
Malabon and Valenzuela in the late 1960s and in Marikina, Pasig,
Parafiaque, Las Pifias, and Mundnlupa in the 1960s and 1970s (League
1993). By 1975, the distinction between inner and outer core has
been obliterated as infrastructure and economic finks have virtually
made all these local units a unified core and have spatially merged
them into a metropolitan area that was then loosely referred to as
Greater Manila Area.
Related to this, the Physical Framework Development Plan for
Metro Manila (MMDA 1996a) identified an outer core consisting of
municipalities beyond the originally identified intermediate core and
located in the neighboring regions particularly in the provinces of
Rizal, Cavite, Laguna and Bulacan. These areas are outside the legal
Figure 1. Major Road Network of Metro Manila
_ource: MMDA (1996a)
composition of Metro Manila but are included as part of the planning

region of Metro Manila.
The development of Metro Manila beyond its present legal
boundaries has been more pronounced in recent years than it was 20
years ago. Aside from the above cited planning framework for Metro
Manila, the Philippine National Development Plan for the 21" Century
or Plan 21 (NEDA 1998) has made explicit its recognition of Metro
Manila's spatial development by referring to a Metropolitan Manila
Growth Network that includes the industrial areas of the neighboring
regions, namely, the Southern Tagalog Region (Cavite-Laguna-
Batangas-Rizal Quezon or CALABARZON and the Manila-Rizal-
Laguna-Quezon or MARILAQUE areas) and the Central Luzon
Region (areas linking Manila with the Subic and Clark Special
Economic Zones).
Metropolitan Governance
Early antecedents of metropolitan m__

In the 1950s and 1960s, rapid and uncontrolled population
growth, resulting from a high rate of natural increase and significant
internal migration, contributed to the economic growth of Manila
but brought countless problems in the process. These problems
include poverty and housing shortage exemplified by the proliferation
of slums and squatter settlements, inadequate public transportation
system, traffic, deteriorating health and sanitation condition due to
lack of potable water and unsanitary disposal of waste, lack of drainage
and sewage system, pollution (air, water and noise) and worsening
peace and order situation. Caoili (1985) argues that the failure to
address the problems of Metro Manila during the immediate post-
war period up to the 1960s stemmed from the piecemeal and
uncoordinated solutions employed by local governments due to party
politics and jurisdictional disputes over responsibility for service
delivery. Also, there was a highly uneven distribution of financial
resources among local units resulting in wide disparities in the
availability and quality of public services. _
The need to consolidate service efforts in view of the urban,
services transcending local jurisdictions in Metro Manila became more
obvious in time. Thus, ad-hoc bodies or local government
arrangements were established to address specific problems or needs.
These included the United Intelligence Operations Group (tasked
to implement cooperative laws among the cities and municipalities),
Fire Protection Organization, Metropolitan Health Council, Inter-
Police Coordinating Council and the Metropolitan Mayors
Coordinating Council. Nonetheless, these ad-hoc arrangements were
found to be inadequate in addressing the complex problems of the
metropolis.
At about the same time as well, the needs of Metro Manila
became a priority concern of the national leadership. This concern
was hinged on two major considerations. The first centered on the
Caoili (1985) cites that "...in fiscal year 1974-75, per capita revenue among MMA units ranged
from P16 in Pateros to P223 in Manila. Per capita expenditures during the same year varied
from P19 in Pateros to 243 in Makati. In calendar year 1980, per capita revenue among MMA
units ranged from P$4 in Pateros to P412 in Makati. Per capita expenditoreB during the same
year varied from P28 in Pateros to P351 in Makati."
need to improve public services in the areas geographically embracing

the center of government. Inefficient and uncoordinated services in
the metropolis in the face of rapid urbanization caught the attention
of the Marcos leadership. The second stemmed from the need to
develop a region that will serve as the showcase of the country's
modernization thrusts. Given these considerations, Memorandum
Order No. 314 (dated November 10, 1972) was issued creating the
inter-Agency Committee on Metro Manila.
The Inter-Agency Committee was tasked "to study the system of
municipal/city government in Metropolitan Manila and to
recommend whatever measures of coordination and integration are
deemed appropriate and to study the functions and responsibilities
of the National Government in the metropolitan area, and to
recommend whatever changes in structure and interrelation with
municipal governments are deemed appropriate". The committee
proposed for the creation of a Metropolitan Manila Authority under
the Office of the President through a promulgation of a Presidential
Decree.
Metro Manila C_ 1975-1989

A referendum was called for to get the people's support for the
new jurisdictional delineation of Metro Manila and to give the
President the authority to create a new administrative structure for
the National Capital Region (NCR). Eventually, PD 824, creating the
Metro Manila Commission (MMC), was issued in 1975. Moreover, PD
824 delineated the territorial jurisdiction of the MMC to include the
17 LGUs enumerated earlier. The important features of the MMC
are summarized in Table 5.
The MMC was tasked to take primary responsibility in the

delivery of garbage collection and disposal, transport and traffic
services and fire control services. It was also mandated to coordinate
and monitor government and private activities pertaining to the
delivery of essential services like water supply and sanitation, flood
control, health, social welfare, housing, and park development. Moi-e
important, the Commission was ordained to develop a comprehensive
social, economic and physical plan for the region.
PD 824 enabled the MMC to act as a central government to

establish and administer programs and provide services common to
the area. The MMC was also vested with legislative powers; it can enact
and approve ordinances and resolutions. In addition, the MMC was
also authorized to levy and collect taxes and fees, expend and borrow
money, issue bonds and others instruments of indebtedness.
Moreover, it was empowered to review, amend, revise or repeal all
ordinances and resolutions of the different LGUs within its
jurisdictions including their annual budgets.
Organizational strucABr_
The MMC was composed primarily of the Governor, Vice-
Governor, and three Commissioners, one each for Operations,
Finance and Planning. All of these officials were appointed by the
President of the Philippines.
The Governor and Vice-Governor also assumed the position of
General Manager and Deputy General Manager, respectively. As such,
they were responsible tbr the implementation of MMC's policies,
programs and regulations. At its peak, the MMC's personnel
numbered 35,000, majority of whom were in Operations.
Finance
The MMC had access to the following revenue sources: (1)
internal revenue allotment (IRA) share; (2) central government
subsidies; (3) contribution from the member-LGUs; (4) share in
proceeds of specified taxes imposed by member-LGUs; and (5) own
collection of taxes and fees. Effectively, the MMC was treated much
like a provincial-level government in terms of share in the IRAs and
in terms of taxing powers. Specifically, the MMC received 45 percent
of the proceeds from the municipal collections of real property tax.
Itwas also entided to varying proportions from the collection of other
taxes and fees imposed by member-LGUs like the corporate residence
tax, excavation fees, building and sanitary permit fees, parking fees
s The IRA is the mandated share of LGUs in internal revenue collections of the Bureau of
Internal Revenue (BIR). Prior to 1991, total IRA was at the maximum equal to 20 percent of
BIR collections three years prior to the current year. The IRA is allocated to the different levels
of local government and to specific LGUs within each level according to a pro-determined formula
that is based on population, land area.and equal sharing.
Case Study:Metro Manila 267
and the like (HUDCC and LOGODEF 1995). Moreover, the MMC
also imposed and collected the following taxes/fees: cinema tax,
franchise tax, delivery van tax, peddlers tax, tax on transfer of real
property and traffic violation fees. Lasdy, member-LGUs were
ordained to contribute 20 percent of their regular income to the
MMC.
In 1988-1989, yearly MMC revenues amounted to P1,037 million
on the average in 1992 prices. Statutory contributions of member-
LGUs were the single biggest source of revenue for the MMC. Its
share in total MMC income was 34.7 percent on the average during
this period. More than 30 percent of total MMC income came from
its share in the real property tax, 13.1 percent from other taxes, 11.1
percent from fees and charges (non-tax revenues), 5.4 percept from
the IRA and 5.6 percent from subsidies from the central government
(Table 6).
MMC-LGU relations
PD 824 effectively emasculated its member-LGUs. It abolished
the legislative councils of the member-LGUs and vested MMC the
power to enact ordinances. In principle, the city/municipal mayors
retained the powers and functions assigned to them prior to the
issuance of PD 824. However, they were also tasked to execute MMC-
approved programs in their respective jurisdictions. Thus, they
became area administrators/managers.
l,inkages with national government agendes

As earlier stated, the MMC was mandated to coordinate and
monitor key sectoral services. Largely, because of the political clout
of the First Lady (Imelda Marcos) who was Governor/General
Manager of the MMC for 10 years, the MCC exercised more than a
coordinative function over said services (League 1993). Senior officials
of key national government agencies (like the Department of Public
Works and Highways, Department of Health Department of
Education) were appointed as Action Officers of the MMC. Through
this arrangement, the MMC formalized its influence over national
government line agencies in terms of ensuring budget support to
metropolitan projects.
Table 6. Comparative Revenue Sources of Metropolitan Organization
I. Metro Manila Commission 1988-1990
Level in Cm'rent Prices (P million) Level in 1992 Prices (P million) % Shares
Sotwce 1988 1989 Average 1988 1989 Average 1988 1989 Average
t. Tax Revenues 268.75 336.37 302.56 416.20 477.78 446.99 44.25 42.16 43.20
A. Real Property Tax 192.37 228.17 210.27 297.9i 324.09 311.00 3]..67 28.60 30.13
B. Business Taxes 45.26 55.29 50.28 70.09 78.53 74.31 7.45 6.93 7.19
C. Other Taxes 31.12 52.91 42,02 48.19 75.15 61.67 5.12 6.63 5.88
1. Non-Tax Re_,enues 62,13 94.64 78.39 96.22 134.43 115.32 10.23 11.86 11.05
2. Other Income
(Receipts) 276.50 366.91 321.71 428.20 521.15 474.68 45.52 45.98 45.75
A. Statutory Contributions 198.28 293.15 245.72 307.07 416.39 361.73 32.65 36.74 34.69
B. Internal Revenue
Allotment 26.01 52.61 39.3 t 40.28 74.73 57.50 4.28 6.59 5.44
C. Capital Revenue 0.08 0.33 0.21 0.12 0.47 0.30 0.01 0.04 0.03
D. Grants & Aids 52.13 20.82 36.48 80.73 29.57 55.15 8.58 2.61 5.60
Total Income 607.38 797.92 702.65 940.62 1133.36 1036.99 100.00 100.00 100.00
% of GDP 24.18 26.72 25.51
H. Metro Manila Authority 1991-1993

Level in Cm-rent Prices (P million) Level in 1992 Prices (P million) % Shares
1991 1992 1993 Average 1991 1992 1993 Average 1991 1992 1993 Average
1. Tax Revenues 464.87 167.08 79.14 237.03 501.62 167.08 74.16 247.62 41.01 28.57 13.35 27.64
A. Real Property Tax 355.31 " i49.13 79.i4 194.53 383.40 149.13 74.16 202.23 31.35 25.50 13.35 23.40
B. Business Taxes 62.85 10.67 0.00 24.51 67.82 10.67 0.00 26.16 5.54 1.82 0.00 2.46
C. Othec Taxes 46.71 7.28 0.00 18.00 50.40 7.28 0.00 _9.23 4.i2 1.24 0.00 1.79
1. Non-Tax Re_,enues 112.02 85.46 77.42 91.63 120.88 85A6 72.55 92.96 9.88 14.61 13.06 12.52
2. Other Income
(Rec eip_s ) 556.64 332.27 436.25 441.72 600.64 332.27 408.82 447.25 49.11 56.82 73.59 59 _84
A. Statutory Contributions 422.26 0.00 0.00 140.75 455.64 0.00 0.00 151.88 37.25 0.00 0.00 12.42
B. Internal Revenue
Allotment t28.36 184.45 32i .28 211.36 138.5i 184.45 301,08 208.01 11.32 31.54 54.20 32.35
Table 6 (continued)
II. Metro Manila Authority 1991-1993
Level in Current Prices (P million) Level in 1992 Prices (P million) % Shares
C. Capital Revenue 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
D.Grants & Aids 6.02 147.82 114.97 69.60 6.50 147.82 107.74 87.35 0.53 25.28 19.39 15.07
Total lacome 1,i33.53 584.81 592.81 770.38 1223.14 584.81 555.54 787.83 100.00 100,00 100.00 100.00
% of GDP 27.66 13.36 12.34 17.79
HI. Metro Manila Development Authority 1996-1998

Level in Cument Prices (P million) Level in 1992 Prices OPmillion) % Shares
1. Tax Revenues 0.00 0.0O 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
A. Real Property Tax O.O0 0.00 0.00 0.00 0.00 0.O0 0.00 0.00 0.00 0.00 0.00 0.00
B. Business Taxes 0.00 0,00 0.00 0.O0 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
C. Other Taxes 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
1. Non-Tax Revenues 120.51 111.73 122.50 118.25 87.55 76.4t 76.16 80.04 7.68 6.11 6.77 6.85
2. Other Income
(Receipts) 1448.28 1716.24 1687.61 1617.38 1052.18 1173.72 1049.21 1091.70 92.32 93.89 93.23 93.15
A_ Statutory Contributions 37'2.96 471.62 476.99 440.52 270.96 322.54 _'296.55 _o96.68 23.77 25.80 26.35 25.31
B. Internal Revenue 307.89 313.16 361.80 327.62 223.68 214.17 224.94 2,_0.93 19.63 17.13 19.99 18.92
Allounent
C. Capital Revenue 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
D. Grants & Aids 767.43 931.46 848.82 849.23 557.53 637.01 527.73 574.09 48.92 50.96 46.89 48.92
TotalIncome 1568.80 1827.97 1810.11 1735.62 1139.73 1250.13 119_5.38 1171.74 100.00 100.00 100.00 100.00
% of GDP 21.78 21.88 19.59 21.06
Sourve: Data for MMC and MMA from MMM_S 1993; Data for MMDA from MMDA_
cO
_s_s_e
ssme nt
League (1993) noted that because of the unique situation
brought about by the appointment of the First Lady as Governor of
Metro Manila while being the head of the powerful Ministry of Human
Settlements (MHS), the MMC enjoyed a position of primacy in the
metropolis. While no formal evaluation of the performance
effectiveness has been undertaken, there is some agreement that the
MMC was effective in more ways than one (League 1993; HUDCC
and LOGODEF 1995). For instance, the squatter problem was
reportedly better controlled; traffic and public transport were better
managed; the environment was cleaner and greener. Moreover, the
MMC was able to generate strict compliance from LGUs with respect
to the remittance of their mandated contributions. The MMC was
able to prepare the first metropolitan land use and zoning plan which
was enforced through a zoning ordinance. Much of this success was
dependent of the personality/individuality of the First Lady who was
able to generate the greater support and cooperation of LGUs and
national government agencies than would have been possible if any
other person were appointed Governor (HUDCC and LOGODEF
1995).
In spite of the MMC's enormous power and influence, it did
not evolve into a real metropolitan institution. The MMC actually
performed a rather limited range of normal metropolitan services.
For most services, it was unduly dependent on national government
agencies.
Table 7 shows that in 1988-1989 the MMC spent 84.3 percent of
its budget on operations. In turn, 91.9 percent of this amount was
expended on solid waste management. On the other hand, Table 8
documents MMC's reliance on central government agencies. In 1988-
1989, MMC's expenditures accounted for a low 7.5 percent of total
general government expenditures in Metro Manila,. The bulk (62.2
percent) of total general government expenditures in the region was
expended by central government agencies. In comparison, member-
LGUs contributed a sizable portion (30.3 percent) of total general
government expenditures. The latter were allocated largely to local
concerns.
Case Study:MetroManila 271
League (1993) further noted that without a NEDA 4 Regional

Office in the NCR, there was no Regional Development Plan to guide
the development of the metropolis in an integrated fashion with its
neighboring regions and with national priorities. Consequently, the
MMC had a tendency to concentrate on "high visibility impact
projects .... reactions to specific problems or showcase projects which
were not sustainable". It was not until the 1980s when the
Commissioner for Planning (within the MMC structure) was
appointed to take on the functions and responsibilities similar to those
of a NEDA Regional Director. However, the MMC was shortlived with
the ouster of the Marcos government following the People's Power/
EDSA Revolution in February 1986.
Metropolitan Manila Authority, 1990-1995

The collapse of the Marcos administration in 1986 and the
adoption of a new Constitution (which passed on to Congress the
task of determining the appropriate institutional mechanism for
metropolitan management) placed Metro Manila in institutional
limbo, with an ambiguous structure and leadership. The growing
problems of Metro Manila, most especially with respect to traffic and
garbage, triggered then President Corazon Aquino to issue Executive
Order (EO) 392 in 1990 that created the Metro Manila Authority
(MMA) as an interim body pending the creation of a more permanent
metropolitan organization fbr the region in a manner that is consistent
with the provisions of the 1987 Constitution.
The MMA is considered by many as a weaker version of its
predecessor (the. MMC) in terms of both executive and revenue
powers. Moreover, the passage of the new Local Government Code
in 1991, which enhanced the autonomy of LGUs, further debilitated
the MMA. The more important features of the MMC under the more
decentralized framework are presented in Table 5.
The MMAwas given jurisdiction over the delivery of basic urban

services requiring coordination. These basic services included among
others: land use, planning and zoning; traffic management; urban
4National Economic and Development Authority (NEDA) is a constitutional body mandated to

provide overall leadership in economic and social development planning and policy formulation.
development and renewal; disaster management; and sanitation and

waste management.
The MMA had no legislative authority. Prior to the passage of

the Local Government Code (or LGC), the MMA had the authority
to collect taxes which were accruing to it 100 percent. This was no
longer true in the post_LGC period.
Organizational structure
The MMA was governed by the Metro Manila Council which
was composed of the mayors of the member LGUs. The Chairman of
the Council was elected from among its mayor-members for a six-
month term and performs a largely titular (e.g., preside over
meetings) and recommendatory function. The Secretaries of the
Department of Transportation and Communication (DOTC),
Department of Public Works and Highways (DPWH), and Department
of Budget and Management (DBM) attended the meetings of the
Council as non-voting members. The Council was responsible for the
formulation of policies on the delivery of services and the
promulgation of resolutions of metro-wide application. However, EO
392 provided that a General Manager, appointed by the President of
the Philippines, was to be in charge of day-to-day operations.
Finance
EO 392 reduced mandatory LGU contributions to the MMA
from 20 percent to 15 percent of LGU regular income. With the
implementation of the Local Government Code in 1991, the share of
the MMA in the real property tax was also reduced from 45 percent
to 35 percent. Moreover, provincial taxes, previously accruing to the
MMA prior to the LGC, were withdrawn and assigned to member
LGUs. Also, the Implementing Rules and Regulations (IRR) of the
LGC provided that cities and municipalities were no longer required
to make contributions to the MMA, causing the member LGUs not
to remit any contributions at all. However, the LGC provided for
higher aggregate IRA levels. In sum, the MMA, post-LGC, had to
content itself with the following sources of revenue: (1) higher IRA
share; (2) reduced/voluntary LGU contributions; (3) reduced share
in some taxes levied by member-LGUs; and (4) central government
subsidies.
Table 6 highlights the diminution of MMA income with the

implementation of the LGC. Effectively, MMA income (expressed in
1992 prices) was reduced by more than 50 percent in spite of larger
central government subsidies during the period. Expressed as a
proportion of GDP, MMA declined from 0.3 percent of GDP in 1991
to 0.1 percent of GDP in 1992/1993.
At the same time, there was a dramatic shift, in the composition
of MMA income. The IRA emerged to be the most important revenue
source. Its share in total MMA income rose from 12.2 percent in 1991
to 50.8 percent in 1993. The share of central governments subsidies
also rose dramatically from 0.6 percent to 18.2 percent. In contrast,
the share of tax revenues dropped from 44.2 percent to 12.5 percent.
MMA-LGU relations
LGU legislative bodies were re-constituted with the
implementation of the LGC. As earlier noted, mayors of member
LGUs are voting members of the Metro Manila Council. While the
MMA was given the primary responsibility over metro-wide services,
LGUs were assigned locality-specific services. In the post-LGC period,
LGUs refuse to remit their contributions to the MMA.
Linkages with national government agencies

The MMA coordinated the program implementation with
sectoral national government agencies. The venue for this was
essentially the participation of selected Secretaries in the Metro Manila
Council.
The combination of institutional ambiguity and reduced

revenue generating powers as a result of the passage of the Local
Government Code constricted and hampered MMA's provision of
public services in the metropolis. Given its very limited funding, the
MMA has had to rely more on its coordinative role. However, in
practice, neither the MMA Chairman nor the General Manager has
sufficient clout to effectively coordinate with national government
agencies or with themember LGUs. Moreover, the very short term of
office of the MMA Chairman did not promote continuity in policy
formulation and program implementation. As such, the focus of
policies and programs changes with every turnover in the
chairmansh:-
Table 7. Expenditure Pattern of Metropolitan Body

Levels (in million pesos) % distribution
L MMC 1988 1989 Average 1988 1989 Average
Administrative
Office 53.41 97.17 102.00 10.99 13.59 12.09
Operations 417.46 587.64 711.28 85.89 82.22 84-33
of which:
solid waste 383.23 540.63 653.54 78.85 75.64 77.49
others 34.23 47.01 57.74 7.04 6-58 6.85
Other Purposes 15.18 29.94 30.i5 3.12 4_19 3.57
Total 486.05 714.75 843.43 100.00 100.00 100.00

IL MMA 1991 1992 1993 Average 1991 1992 1993 Average
Administrative
Office 80.16 72.06 73.48 225.70 7.29 8,97 10.37 8.64
Operations 888.70 720.97 625.82 2,235.49 80.77 89.79 88.32 85.59
of which:
solid waste 822.94 658.97 561.99 2,043.89 74.79 82.07 79.31 78.26
others 65,76 62.00 63.83 191.60 5.98 7.72 9.01 7.34
Other Purposes 131.42 9.91 9.29 150.62 11.94 1_23 1.31 5.77
Total 1,100.28 802.94 708.59 2,611.81 100.00 100.00 100.00 100.00

m. MMDA 1996 1997 Average 1996 1997 Average
Administrative
Office 124,920.85 128,125.38 188,983-54 8.05 7.27 7.77
Operations 1,247,011_37 1,377,775.76 1,935,899.25 80.34 78.20 79.57
of which:
solidwaste 1,041,997.15 1,188,062.01 1,636,028.15 67_1.3 67_43 67_24
traffic 119,523.79 125,132.01 182,089.80 7.70 7.10 7.48
infrastructure
dev't_ 57,070.44 36,661.87 75,401.37 3.68 2.08 3.10
pollution
control 7,288.19 6,098.17 10,337.27 0.47 0.35 0.42
others • 21,131.81 21,821-69 32,042.65 1.36 1.24 1.32
Other Purposes 180,246.01 255,936.17 308,214.09 11.61 14.53 12.67
Total 1,552,178.22 1,761,837.31 2,433,096.88 100.00 100.00 100.00
Sources: Data for MMC and MMA from MMMS (1993); data for MMDA from MMDA.
Concomitant with the dramatic decline in MMA income with

the implementation of the Local Government Code, MMA
expenditures also contracted from 0.3 percent of GDP in 1991 to 0.1
percent of GDP in 1993. However, the composition of MMA
expenditures did not change that much. In 1991-1993, 86.3 percent
of MMA expenditures went into operations. Of this amount, 78.3
percent was allocated to solid waste managemerrt (Table 7).
Case Study: MetroManila 275
During this period, LGUs gained increasing prominence as their

share in total general government expenditures rose from 31.5
percent in 1991 to 42.6 percent in 1993 (Table 8). This occurred as
the expenditures of both the MMA and central government agencies
declined in terms of 1992 prices and when expressed as a proportion
of GDP. Note that many health and social welfare functions previously
discharged by the central government were devolved to LGUs during
this period. In like manner, LGUs took over some of the services in
solid waste management that the MMC used to provide.
Metropolitan Manila Development Authority,

1995 to the present
Mounting metropolitan problems continued to beset Metro
Manila and the clamor for a better and stronger metropolitan body
became stronger. It was not until 1995 that the Lower House and the
Senate were able to reach a compromise bill and enacted RA 7924.
RA 7924 reaffirms the compositional definition of Metro Manila
constituting it into a "special development and administrative region"
subject to direct supervision of the President of the Philippines. The
law also provided for the creation of the Metropolitan Manila
Development Authority (MMDA). In general terms, the MMDA shall,
perform planning, monitoring, coordinative, regulatory, and
supervisory authority over the delivery of metro-wide services within
Metro Manila without diminution of the autonomy of LGUs
concerning purely local matters. RA 7924 grants a more permanent
term for the MMDA Chairman. A feature of RA 7924 not found in
previous legislation is the prescription for the MMDA to work closely
with nongovernment organizations (NGOs), peoples' organizations
(POs) and the private sector.
R 9 maaut
RA 7924 mandates the MMDA to (1) formulate, coordinate,
and regulate the implementation of medium- and long-term plans
and programs, including investment programs, for the delivery of
metro-wide services, land use, and physical development; (2)
undertake and manage its own metro-wide programs and projects
for the delivery of specific services under itsjurisdiction; (3) set policies
concerning traffic in Metro Manila; and (4) install and administer a
single ticketing system; fLx,impose and collect fines and penalties for
all kinds of traffic violations.
RA 7924 defines the scope of MMDA's functions to include

services "which have metro-wide impact and transcend local political
boundaries or entail huge expenditures such that it would not be
viable for said services to be provided by the individual local
government units comprising Metro Manila." These services include
development planning, transport and traffic management, flood
control and sewerage management, urban renewal, zoning and shelter
services, health and sanitation, urban protection and pollution control
and public safety.
Auths/riti_
The MMDA, like the MMA, has no legislative powers. Neither
can it levy nor collect taxes.
Organizational structure
The MMDA structure is almost identical with that of the MMA.
It has a Chairman, a General Manager (GM), and three Assistant
General Managers (AGMs), one each for Planning, Operations, and
Finance and Administration (Figure 2). The Chairman is given
executive functions, which he shares with the General Manager. The
Chairman is appointed by the President of the Philippines, holds the
rank of a Cabinet member and holds office at the discretion of the
President. The GM and AGMs are also appointed by the President.
The Metro Manila Council remains the policymaking body. The
membership of the Metro Manila Council is expanded to include the
president of the Metro Manila Vice-Mayors League, and the president
of the Metro Manila Councilors League, the heads of the Department
of Tourism (DOT), Housing and Urban Development and
Coordinating Council (HUDCC), and the Philippine National Police
(PNP) in addition to all the mayors ofmember-LGUs and the heads
of the DOTC, DPWH, DBM.
MMDA has 10,820 personnel service positions, 70 percent of
which are filled as of April 1998. About 90 percent of the total plantilla
positions are allocated to the Environmental Sanitation Center (ESC),
which are mainly composed of metro hardinero or streetsweepers.
There is a realization that the MMDA should no longer hire street
sweepers in as much as the LGUs hire their own in their respective
localities. The current proposal to correct the lopsided distribution
of manpower complement in the whole organizational structure has
been submitted by MMDA to the DBM for consideration and study.
Figure 2. Organizational Structnre: Metropolitan Manila DeveLopment Authority
NI_DAC
COUNCIL SECRETARIAT Te_l nica[II'lS(_-_{_ - B_ _"
GENERAL _.
MANAGER
| _=
s_ _.
-I
i
L----- / i
Pubiclr_Of_ : /
...........
M_B_e
. C
=
Q.
Managerfor Rnanceand _ Gerlera_

Managerfor [_ t GeneralManagerfor _
Treasury /_oundt_ I I -- {
TRAFRC AND _
• • I ,SOLIDW,a_i"E TRANSPORT Ul"banOesign Planning
I_°'_t--_Ad_"
B_ Opera_(_ AdIl_h!_m_te I co_°,
MANAGEMENT I
........
,............
I .......
CENTER
_ _ -- "--"
S.pp0rt and <
o
O
(D
CONTROL AND URBAN In_e_'et_ve Z0_ing -n

DRAINAGE - PROTBC'RON Ranning Adrnini_
L''_'_'"__ _1 _._j_,_ _,._,_ C_R _

o
[ .s Gr_.,p ] _--
Source:MMDA ([996_).
Case
Study:MetroManila 279
The proposal basically reduces the number of ESC personnel while

beefing up personnel complement in the technical departments
especially in the office of planning, operations and administration.
Finance
RA 7924 prescribes the following sources of revenue for the
MMDA: (1) its own IRA share; (2) subsidies from the national
government; (3) contribution ofmember-LGUs set equal to 5 percent
of their total annual gross revenue of the preceding year, net of IRA;
and (4) fines and fees the MMDA may impose and collect for services
rendered. As such, the MMDA is highly dependent on central
government subsidies. In 1996-1998, central government subsidies
accounted for 48.9 percent of total MMDA income (Table 6). In
comparison, the share of mandatory contributions from member-
LGUs was 25.3 percent while that of the IRA was 18.9 percent during
the period.
MMDA-LGU relations
Policy coordination with the LGUs is done within the MMDA
structure through the Metro Manila Council. However, operational
coordination with respect to area-wide services such as traffic and,
transport management, solid Waste management, disaster manage-
ment as well as planning functions such as physical framework, socio-
economic and land use planning are coordinated with individual
LGUs.
I.inkages with national government agencies= NGOs/POs and

nrivate sector
"Several sectoral national government agencies and government
corporations are undertaking various programs and projects in Metro
Manila. These include the DPWH responsible for roads, bridges, flood
control and drainage as well as traffic engineering; the DOTC and its
various bureaus 5 dealing with transport and traffic management; the
National Housing Authority (NHA) on housing; the Housing and
_These include the Transportation Planning Service of the DOTC CenWal for overall formulation
of transportation policies; Land Transportation Office (LTO) for vehicle registration, vehicle
inspection and issuance of drivers' license; and the Land Transportation Franchising and
Regulatory Board (LTFRB) for issuance of franchises to motorized road ba_d modes of public
transport services_
Land Use Regulatory Board (HLURB) for subdivision plans; the

Metropolitan Waterworks and Sewerage System (MWSS) for water
supply; the Department of Environment and Natural Resources
(DENR) for environmental management; the Laguna Lake
Development Authority (LLDA) for the management of the Laguna
de "Bay region encompassing the five cities in Metro Manila; the
Department of Interior and Local Government (DILG) for
management of LGUs as well as in police assistance; the National
Economic and Development Authority (NEDA) for the planning,
monitoring and evaluation of plans and projects; and the Department
of Health (DOH) for health and sanitation. On top of these
government agencies are ad-hoc commissions or task forces created
by the President including the Presidential Task Force on Solid Waste
Management, the Presidential Task Force on Traffic Improvement
and Management (TRAFIMM), the Philippine Council for Sustainable
Development and the Cabinet Officer for Regional Development
(CORD) ° for NCR who is the HUDCC Chairman serving as the link
of Metro Manila to the President.
MMDA coordinates its interregional concerns basically through
the NEDA. This is with respect to the formulation of its regional
development plan and physical framework taking into account the
spatial development of the metropolis in the neighboring regions of
Region III (Central Luzon) and Region IV (Southern Tagalog).
However, MMDA needs to improve its linkage with institutions
responsible for translating the intererregional framework to actual
plans and programs. For instance, at present, the MMDA has no
involvement in the MARILAQUE Commission established by the
President to plan for and develop the growth corridor from NCR to
the provinces ofRizal, Laguna and Quezon. Neither is MMDA involved
with efforts relative to CALABARZON development.
The MMDA is mandated to enhance institution-building and
effective people's participation in governance through (1) private
sector/NGO involvement in MMDA programs and projects; (2)
The CORD system was introduced by the Aquino administration and was carried over by the
Ramos administration. Each of the 15 regions is assigned a CORD coming from the members of
the Executive Cabinet. During the Estrada administration, Executive Order No. 7 created seven
(7) Presidential Assistants for Regional Concenls (PARECO). Unlike the CORD system where
the CORD is a Cabinet member, the PAKECO is a Presidential appointee under the adnfinistrative
control and supervision of the Executive Secretary and holds office at the NEDA Regional Office.
The PARECO system has been carried on by the Macapagal-Arroyo Administration.
improved transparency through the provision of better private sector

access to information on government activities; and (3) promotion
of private sector initiatives in urban development.
Asse.amxem
The relatively stable term of office of the Chairman of the
MMDA enhances institutional focus and sharpens its vision. Although
the scope of its mandate over metro-wide services has been expanded
to include more services, it continues to perform a largely coordinative
role because its revenue-raising powers are still limited.
The expenditures of the metropolitan entity (expressed in terms
of either 1992 prices or a propordon of GDP) doubled with the
establishment of the MMDA. But what is perhaps more significant is
the fact that the MMDA effectively expanded its ambit to include
more metro-wide responsibilities. While the operations budgets of
both the MMC and the MMA were spent almost solely on solid waste
management, that of the MMDA's is now allocating sizable amounts
for traffic and infrastructure development (Table 7).
However, the majority of total general government expenditures
in Metro Manila still come from central government agencies. At the
same time, LGUs continued to expand in 1996-1997 (Table 8).
Major Metropolitan Governance Challenges

In a nutshell, the problems in metropolitan governance in Metro
Manila manifest themselves in the inefficient and inadequate deliv_-y
of metro-wide services. Largely, this lack stems from the rather
unwieldy institutxonal setup. The following discussion on the
important management challenges in Metro Manila provides a more
detailed explanation of these problems.
and
As in many big cities in the world, traffic management dominates
Metro Manila's development challenge. The deterioration of
transport and traffic condition has afflicted Metro Manila since the
1950s. Simply put, traffic woes in Metro Manila stem primarily from
an insufficient road system, the rapid increase in car ownership, the
lack of quality public transportation services, poor enforcement of
traffic regulations and lack of discipline on the part of both motorists
and pedestrians. These problems are again validated in the initial
findings of the Metro Manila Urban Transportation Integration Study

(MMUTIS 1997).7 In addition, there is a problem of overlapping of
functions and duplication., of services in view of the multiplicity of
players involved in transport and traffic management in the
metropolis.
Insufficient road system

Major roads in Metro Manila are no longer sufficient to
accommodate the rapidly rising traffic volume that have increased by
more than 50 percent on the average during the last 15 years (Table
9). Private cars and trucks dominate tr'_c volume even in bus and
jeepney-dominated major routes such as EDSA (C4) and Shaw
Boulevard (R5).
AccdeaatedJncr_easedo.xar_wnexzhip
The number of registered vehicles in Metro Manila more than
doubled during the period 1980 to 1995, growing at an average rate
of 6 percent annually (Table 10). The increase has been more evident
during the 1990s. During this period, personal incomes have
improved significantly concomitant with the economic recovery. At
the same time, liquidity in the banking system was relatively relaxed
and credit access (for car financing) easy.
At present, more than 40 percent of all registered vehicles in
the country are plying in Metro Manila. This represents 1.1 million
private and "for-hire" vehicles. Of these, almost half are privately
owned cars and utility vehicles. Household car ownership doubled
from 9.5 percent in 1980 to 19.7 percent in 1996 (Table 11). The
percentage of households with more than one car has also risen. A
similar trend is also evident in areas adjoining Metro Manila.
7 The MMUTIS Project was launched in March 1996 with technical assistance from the Japan
International Cooperation Agency (IICA). The project, join@ undertaken by the Depas-tment
of Transportation and Communication (DOTC), Metro Manila Development Authority
(MMDA), National Economic and Development Authority (NEDA) and the University of the
Philippines (UP), is based at the UP National Center for Transportation Studies (NCTS). The
long-term objective of the projects is to established and update transporation database that will
aid in the fo_nulation ofa transportaion master plan for Metro Manila within the present time
to year 2015. The short-term objective is to prepare feasibility studies on priority projects that
can be implemented within the present time to year 2005.
Table 9. Traffic Volume on Major Roads, 1980 and 1995 (vehicles/day)

1980 1995 Ratio of
Road (Location) Total Total Car/ Jeepney/ Total Cotmt

Count Cotmt Truck Bus 1995/1980
1. EDSA
(between Guadaiupe and Buendia) 99,900 172,500 154,700 17,800 1.7

2. South Super Highway
(intersecting Pres. Quirino Avenue) 72,900 113,700 111,300 2,400 1.6
3. Quezon Avenue
(near Espafia Rotonda) 53,300 102,500 68,400 34,100 2.0
4. Roxas Boulevard
(intersecting P. Burgos) 67,800 82,300 74,100 8,200 1.2

5. Ortigas Avenue
(intersecting Santolan) 51,500 76,300 72,900 3,400 1.5
6. Shaw Boulevard
(intersecting Acacia Lane) 37,300 43,500 27,800 15,700 1.2
Source: 1990JUMSUT and 1995 DPWH-Traffie Engineering Center (TEC) (inJICA/MMUTIS

1997).
Table 10. Number of Registered Vehicles in Metro Manila, 1980, 1990

and 1995
Type 1980 1990 1995 1980-1995
Ratio % / year
Pr/mU
Motorcycles 36,854 50,159 73,014 2.0 4.7
Cars 218,964 297,094 410,814 1.9 4.3
Utility Vehicles 36,770 223,976 368,002 10.0 16.6
Buses 918 491 -
Trucks/Trailers 97,590 51,351 76,060 7.1 10.3
Subtotal 391,178 623,498 928,381 2.4 5.9
For Hire
Motrocycles 4,801 16,418 34,478 7.2 14.0
Taxis 10,125 1,715 21,702 2.1 5.2
Cars 1,461 8,150 5,601 3.8 9.4
Utility Vehicles 27,202 27,659 53,362 2.0 4.6
Buses 3,578 4,329 7,824 2.2 5.4
Trucks/Trailers 8,797 3,009 4,344 0.9 -12.5
Subtotal 55,964 61,280 127,331 2.3 5.6

TOTAL (Metro
Manila) 446,142 684,778 1,055,692 2.4 5.9
Source of basic data:JICA/MMUTIS (1997); Land Transportation Office (LTO).
The increase in household car ownership has been found to be

positively correlated with household income. Thus, MMUTIS (1997)
projected car ownership to increase by 2 percent annually from 1996
to 2015 as population and income levels continue to rise. Car
ownership in the adjoining areas was projected to increase at an even
higher rate of 5.1 percent.
Increased demand_ua_ty publicdxansport services

Public transportation services are mainly provided by buses,
jeepneys, taxis and tricycles. While the supply of these services had
increased dramatically through the years (Table 12), traffic congestion
has decreased the quality of service of these transport modes in terms
of travel speed, riding comfort and in-vehicle air quality. Although
air-conditioned bus units have increased in terms of both the number
of units and routes, in-vehicle crowding is still evident and only a few
are well-maintained to provide comfort to the riding public. To satisfy
the demand for better transport services, the number of Tamaraw
FX or shared taxi on fixed route has increased rapidly since 1905. On
the one hand, the addition of these udlity vehicles provided an
alternative mode of transport for passengers willing to pay a higher
than the normal fare for efficiency and travel comfort. On the other
hand, it contributed further to the increase in the already high traffic
volume and to the further worsening of the traffic situation in the
metropolis.
Urban rail transport services are still limited. While there are
already three light railway transit (LRT) lines that are operating in
addition to the Philippine National Railways (PNR) that provides rail
transport services, a comprehensive inter-urban rail strategy for Metro
Manila needs to be established.
Table U. Car Ownership Structure, 1980 and 1996

Metro Manila
1980 1996 Adjolnh_g Areas
% of Car-owning Households 9.5 19.7 16,9
Average No. of Cars per

Car-owning Household 1.4 1.3 i .2
% of Multiple
Car-owning Households 19.0 20.1 13.3
Source:JICA/MMUTIS (1997); MMUTIS Person Trip Survey.

Table 13. Transport and Traffic Management in Metro Manila

Governance National Metro Local Others
_Activity
Policy OP MMDA LGUs
Formulation DOTC (Traffic
(Central, LTO, LTFRB) Management
DPWI-I Units,
(Central, DPWH-NCR) Local Traffic
DILG (PNP) Ordinances)
TRAFFIM
Transport DOTC MMDA LGUs DeveLopers

Planning (Central, LTFRB, LRTA, BCDA (Fort and
PNR) Bonifacio) Operators
PEA (Manila of busi.ness
Bay Area) complexes
Transport
Services
Rail DOTC
(PNR, LRTA)
Bus DOTC (L'ITRB) Private

MMTC Companies
Jeepneys DOTC (Office of

Transport Cooperatives,
LTFRB)
Tricycles LGUs
and
Pedicabs
Shuttle Private
Services Companies
with MMA or within the member agencies of the MMLTCC. For

instance, the construction by DPWH of a fly-over along a section of
Circumferential Road 4 (C-4) that favors private vehicles conflicted
with the DOTC's long-term plan to construct a public-oriented rail
• transit system within the same corridor, The presence of the fly-over
led to complications in the construction of the ongoing Metro Rail
Transit thereby increasing construction and engineering cost,
prolonging" the construction, and further aggravating traffic
congestion in the area.
In the initial phase of the MRT project, there has been a serious
clamor from private citizens and the business sector to address the
traffic problem in the metropolis that has already reached a crisis
stage. Then President Ramos issued Administrative Order No. 351 in
287
August 1997 creating the Presidential Task Force on Traffic

Improvement and Management (TRAFIMM) as the integrating,
coordinating and directing authority on traffic management
nationwide, particularly in Metro Manila and other urban centers.
The TRAFIMM in Metro Manila is headed by the Secretary of the
Department of Transportation and Communications with a
representative from the private sector appointed by the President as
co-chairman. The members include the Secretaries of the DPWH,
the Department of Interior and Local Government (DILG) and the
Department of National Defense (DND), the Chief of the PNP, the
Chief of the Armed Forces of the Philippines, the MMDA Chairman,
concerned local chief executives, and three representatives from the
private sector appointed by the Chairman of the Task Force. While
the TRAFIMM has made a significant effort in easing the traffic
condition in Metro Manila through the enforcement of new rules
and regulations for land transportation, the Task Force is faced with
certain constraints. It does not have the policy formulation mandate
and review and approving authority over programs and projects of
the various agencies that would have direct or indirect impact to the
transport situation in the whole metropolis. Moreover, TRAFIMM's
area of intervention is only limited to the national highways of the
metropolis. The management of traffic in the rest of the road network
remains the responsibility the LGUs concerned. The traffic
management in Metro Manila thus reflects weakened metropolitan
planning and policymaking vis-a-visthe national government and local
government policy processes.
F/ood control
The occurrence of both big and isolated flash floods is one of
the biggest problems facing the metropolis. The reasons for flooding
are multitu_nous.They include the overflow of major river systems
during intense rain or storm, poor local drainage due to inadequate
capacity and maintenance of the system, and illegal encroachment
on river and other natural channels by squatters, business
establishments and residential houses (MMDA 1996b; HUDCC and
LOGODEF 1995). Coordination problems between DPWH, MMDA
and LGUs have also caused delayed response to flooding and hindered
a more proacdve approach to solve or to mitigate flooding in known
flood-prone areas like the KAMANAVA area (Kalookan, Malabon,
Navotas, Valenzuela), Central Metro Manila (Tondo, Sta. Cruz,
Sampaloc, Sta. Mesa, San Andres, Balon-Bato, Talayan-Tatalon and

San Juan-Mandaluyong), Upper Marikina area, and North Laguna
Lakeshore (Manggahan and Taguig-Pateros). Moreover, there is an
inadequate regulatory framework with respect to subdivision and
housing development, particularly that related to the provision of
sotind and sufficient drainage facilities.
Flood control in Metro Manila is the concern of a number of
national and local government instrumentalities. The DPWH is the
major implementor of all flood control and drainage projects. The
NCR Office of the DPWH provides administrative and technical
supervision over the operation and maintenance of completed flood
control and drainage projects. With the establishment of the MMDA,
this responsibility including the operation and maintenance of
pumping stations and floodgates, is transferred to the MMDA within
a transition period of about two years. At present, the turnover of
DPWH functions and facilities to MMDA relative to flood control has
yet to be formalized. The acquisition of the necessary technical and
management capabilities of the MMDA from the DPWH is yet to be
determined and evaluated before a turnover shall be effected.
The nature of the flooding problem in the metropolis is
multidimensional as it does not only require infrastructure
improvement but also institutional approaches and regulatory policies.
Thus, program and policy coordination may have to be tightened by
rationalizing the functions of the various agencies that have roles to
play in flood mitigation, including the Environment and Management
Bureau of the Department of Environment and Natural Resources
(DENR/EMB), the Housing Land Use and Regulatory Board
(HLURB), the Metropolitan Water Supply and Sanitadon System
(MWSS), the DND, NEDA, the Laguna Lake and Development
Authority (LLDA), and the LGUs.
Sol/d waste managvment

Metro Manila is facing three major challenges with respect to
solid waste management. The first concerns the need to improve waste
collection. The second is the need to address the problem of final
disposal. The third concerns an institutional dilemma.
_/aztex.ollecdoa
Out of the 5,350 tons per day waste generated in Metro Manila,
about 75 percent are collected while the rest are illegally dumped in
open spaces or thrown in metropolitan waterways (JICA and MMDA

1998).
Under the current metropolitan arrangement, LGUs are
responsible for waste collection while MMDA is primarily responsible
for final disposal of waste collected. Collection coverage for 1997
among the 17 LGUs range from a low of 40 percent in the case of
Navotas to a high of 98 percent in the case of Makati City. The disparity
may be attributed to the fiscal capacity of the respective LGUs. LGUs
having high collection coverage performance are those that have fully
or partly consigned waste collection and haulage to private companies.
JICA (1998) has projected collection coverage of LGUs in the
metropolis to increase or approximate full coverage with greater
privatization of collection and haulage services during the next
decade.
Waste disposal
One of the biggest challenges in solid waste management in
Metro Manila is the identification and maintenance of final disposal
sites. At present, there are tour available sites for final waste disposal
in the metropolis: the two open dumpsites in Payatas and Catmon
and the two landfill sites in San Mateo and Carmona. The Payatas
and Catmon sites have been closed because of health and
environmental risks. The Carmona site was also closed due to
complaints from the nearby residents and the municipal government.
The San Mateo landfill will reach its full capacity by 2004 but with the
closure of the other sites its full capacity will be reached before the
turn of the century. In this regard, the identification and development
of a new landfill site will be a critical concern in the immediate term.
The recently prepared study/master plan for solidwaste management
in Metro Manila by jICA (JICA 1998) has identified and made a
technical evaluation of possible disposal sites. Five sites were identified
and ranked: Pintong, Bocaue (Rizal), sea landfill in the Navotas
offshore area, Kalawakan (Bulacan), Maragondon (Cavite) and
Bacolor (Pampanga). The development of any of these sites will be
critical given the circumstances plaguing the existing disposal sites.
Institutional problem
Pardo (1996) in his analysis of solid waste management in Metro
Manila highlighted the absence of a single agency that has overall
responsibility for all aspects of solid waste management from
290 Managing UrbanizationUndera DecentralizedGovernanceFra
Table 14. Land Use Classification in Metro Manila

Land Use 1972 1980 1991
Hectares % Hectares % Hectares %
Residential 13,750 28.0 18,948 29.4 41,405 65.0
Commercial 530 1.0 2,573 4.0 1,911 3.0
Industrial 1,365 3.0 4,037 4.7 2,548 4.0
Institutional 1,800 4.0 2,892 4.5 3,185 5.0
Utilities 890 1.4 637 1.0
Open Space 30,980" 64.0 14,380 22.3 5,096 8.0
Agricultural 7,806 12.1 5,733 9.0
Cemetery/Memorial Parks 637 1.0
RecreationParksSports 13,012 20.2 6_7 1.0
Rivers/Waterways 1,911 3.0
Reclamation 671 1.0
AgTo-Industrial 236 0.4
TOTAL 48,425 I00.0 64,445 100.0 63,760 100.0
* Open space and others.

Basic sources: 1972 figures from Manosa (1974) in NEDAJoumedofDevelopmentVol. 1/2.
1981 figures from Metro Manila Commission (1983).
1991 figures from NCR Regional Development Pla_l (1993-1998).
collection, transport and transfer, recycling and final disposal. MMDA,

the LGUs and the various units of the DENR and DPWH take on
various functions, jurisdictions and SWM responsibilities. However,
there is no single body that orchestrates all these activities to ensure
that they will be complementary and not conflicting. Such
coordinating entity can also develop mechanisms to improve financing
arrangement in the delivery of this important urban service.
Land use, housing and urban poverty

Land use
Rapid urbanization over almost 30 years has altered Metro
Manila's landscape as can be gleaned from the changes in the land
use mix from 1972 to 1991 (Table 14). Residential land use currently
predominate land use activity in the metropolis. Three decades ago,
open spa_e was the__predominant land use. Recreation land uses
including parks and sports area comprise only one percent of total
land area in 1991 compared to 20 percent in 1980. A large percentage
of dlese lands for open spaces and for other purposes have been
used for housing.
In spite of this large tract of land currently allocated for
residential use, lack of housing is still a major problem as manifested
by the increased demand for rental housing, the concomitant rise in
rental rates, and the increased number of squatter households. High

land prices and the low-income capacity of many families in the
metropolis hinder many households to participate in government and
private housing projects. Thus, about halfofNCR households do not
own the land they occupy. The number of squatter families has been
rising as many opt to build substandard dwellings in private and public
lands within the metropolis so as not to be too distant from their
employment or livelihood source.
Institutional arrangements
Housing programs for the poor and low-income had been the
purview of national government and LGUs rather than of the
metropolitan body. The HUDCC is the national agency tasked with
coordination of all government and private housing programs. It
provides guidelines to implement RA 7270rathe basic law for a
comprehensive and continuing homing program being participated
by national agencies, LGUs, NGOs and the private sector. The National
Housing Authority (NHA) is the sole agency engaged in direct shelter
production. The Unified Home Lending Program (UHLP) supports
the financing requirements of the Social Security System (SSS),
Government Service Insurance System (GSIS) and the Home.
Development Mutual Fund (HDMF), otherwise known as the PAG-
IBIG Fund. The 1991 Local Government Code empowered LGUs to
assume greater responsibilities in delivering and financing basic
infrastructure and urban services.
Squatting problem
In Metro Manila, the biggest task of LGUs is how to deal with
the many squatters that occupy danger areas such as riverbanks, esteros,
railroad tracks, garbage dumps, shorefines, waterways and other public
places sach as sidewalks, roads, parks and playground. There are also
those who are threatened with eviction by private landowners. The
law allows for the eviction and demolition under these circumstances.
However, LGUs and the NHA are given the responsibility to provide
a relocation or resetdement site "with basic services and facilities and
access to employment and livelihood opportunities sufficient to meet
the basic needs of the affected families".
There are not many LGUs in Metro Manila that have been
successful in resetding squatters not only because of the political
repercussions but also due to the operational and financial cost,

especially when the LGU does not own the available land for such
relocation. Two cities, however, have successfully done so, namely,
Marikina City and Muntinlupa City. Marikina City, as part of its river
management effort, facilitated the relocation of families from the
riverbanks through the Community Mortgage Program (CMP). The
CMP is an innovative concept of low-income home financing program
of the National Home Mortgage Finance Corporation (NHMFC), the
government corporation which administers the UHLP, whereby an
undivided tract of land may be acquired by several beneficiaries
through community ownership. Marikina City took effort in
convincing families of the dangers of residing along the riverbanks
and the benefits of eventually owning their own house with very
minimal financial cost. Muntinlupa City also availed of the CMP
program and enjoined an NGO to provide interim financing and
assistance in negotiations with private landowners. There is no
denying, however, that some LGUs have tolerated squatting for
political advancement.
Squatting problem as a metropolihan governance challenge

While LGUs are given the biggest responsibility in dealing with
the squatting problem, the issue takes on a metropolitan dimension
in the following situations: (1) when LGUs are constrained with the
absence of land for relocation; (2) when the constraint for relocation
is the inaccessibility of people to their place of work due to poor
transport system; (3) when squatting becomes a major factor in the
clogging of waterways and sewerage and fiver systems causing flooding
and aggravating the traffic condition in the metropolis; and (4) when
the substandard living environment becomes the breeding ground
for infectious diseases and viruses causing illnesses and deaths in the
metropolis (e.g., dengue fever). It becomes a national issue when
taken in totality as squatting is the glaring symptom of urban poverty
which have to be dealt with by improving not only the macroeconomic
condition but also by providing employment opportunities in the
other regions to curtail further in-migration to the metropolis. The
current administration has put forward poverty alleviation as its major
tbcus. In terms of housing for the urban poor, the newly installed
leadership underscored the need for government intervention in
housing production, which forms part of its pro-poor program and
addresses the current crisis in the government's housing finance.
Future Challenges and Directions

Addressing the challenges of Metro Manila over the medium-
and long-term would entail pursuing three development direcdons:
regional development dispersal, institutional strengthening of the
metropolitan body, and setting up of a more unified and coordinated
mechanism for the various key players involved in the management
of Metro Manila.
History tells us that the problems of Metro Manila have to be
dealt with at its roots: addressing the uneven development between
geographic regions. Developing the metropolis should be done
simultaneously with the other equally promising cities in the country
as well as promoting growth in the countryside. This would contribute
to minimizing further pressure on the already strained metropolitan
environment and would invariably help in managing the continued
growth of Metro Manila. Furthermore, the development of Metro
Manila should always take into account the development of its
immediate regions and spillover areas. In this respect, interregional
efforts taken through the MARILAQUE Commission should be
continued. The same effort should be extended with respect to
developments in the CALABARZON area so that it will not conflict
with and instead contribute to realizing the metropolitan vision.
On the other hand, a sound and respectable metropolitan
institution, politically and technically armed to address the problems
and needs of the metropolis is critical, if success is to be achieved.
Metro Manila's management experience under three governance
regimes over the past three decades has highlighted the importance
of finding the optimal mix of powers, functions and responsibilities
among the national government agencies, LGUs and the metropolitan
body in managing the metropolis. What is evident is that the LGUs
can singly handle local concerns effectively and efficiently depending
on the leadership, the administrative capability and the financial
capacity of the LGU concerned as shown by the model cities
presented. However, international experience indicates that a
metropolitan body plays a distinct and critical role in addressing
concerns that transcend local boundaries and are characterized by
economies of scale and externalities.
A number of challenges and opportunities are evident in the
need to strengthen the MMDA. First, although it may still be relatively
premature to evaluate the effectiveness of the exisdng organization
in tackling metropolitan issues, there is a perception among the LGUs
in Metro Manila at present of the MMDA's incapability to command

respect and authority over them. The appointment of the MMDA
Chairman should always be given serious thought--the same fervency
as appointing a major cabinet post. The MMDA leadership must be
able to put political and national government leaders together while
making the organization more credible to earn the command and
respect from the LGUs it coordinates.
Second, in the medium-term, the national government has to
seriously examine MMDA's proposed reorganization plan so that it
will be enabled to improve its capacity to fulfill its roles and functions
both from the standpoint of effectiveness and efficiency. Of greatest
importance is the need for the metropolitan body to revitalize the
development planning function that has not been adequately carried
out of late. MMDA should provide the planning leadership in the
pursuit of area-wide functions and in inspiring LGUs to attain a
common vision for the metropolis. Such planning function cannot
be carried out effectively if human resource availability and
professional expertise are not improved.
Third, the review of the performance of the different
metropolitan arrangements in Metro Manila in the past indicates that
a common thread that runs through the various experiments is the
very limited role the metropolitan body has actually played in terms
of actual delivery of metro-wide services. The MMC, MMA and MMDA
have all relied for the most part on national government agencies in
ensuring that metro-wide services are made available to Metro Manila
residents. To a large extent, all three metropolitan bodies have
exercised their coordinative function more than their service delivery
function. While the MMDA appears to have taken on more
responsibilities in the delivery of metro-wide services, a hefty
proportion of metro-wide services still remains with national
government agencies. This development is primarily explained by
the fact_ that although the national government has continuously
provide d subsidies to the metropolitan body, it still allocates a sizable
portion 6fthe budget for metro-wide services to national government
agencies. Thus, funding support for metro-wide services is principally
retained in the budgets of national government agencies. (In contrast,
funding support given to the metropolitan body, whether in terms of
revenue-raising powers or direct budget support, has never been
commensurate with its expenditure assignment.) These agencies,
being line departments, are inherently concerned with their own

sectoral priorities rather than with serving the needs of the metropolis
per se. Consequently, the metropolitan body is left with the very
difficult task of having to orchestrate the sectoral programs of various
national government agencies, including metro-wide services. This
situation not only makes government effort almost intractable but
also increases costs in terms of both manpower and financial costs.
The recently installed national leadership has recognized the
problems of urbanization, in general, and Metro Manila, in particular.
The present study, which attempts to digest some of the lessons
learned from the experimental laboratory that Metro Manila has
become in the recent past, should help provide the needed inputs in
moving the metropolis toward greater efficiency and global
competitiveness.
References
Caoili, M. 1985. Reflections on Metropolitan Manila Reorganization

and Social Change. Journal OfPublic Administration 29 (1).
Congress of the Philippines. 1995. Republic Act No. 7924. An Act

Creating the Metropolitan Manila Development Authority,
Defining Its Powers ar.d Functions, Providing Funds Therefor
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Corpuz, A.G. 1995. Metro Manila Growth Directions: Location,

Distribution and Shape. Input Study for the National Urban
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Go-Soco Jr., B. 1988. A Study on the Possibility of Establishing A

Regional Development Council (RDC) and Promoting
Coordinated Development in the National Capital Region.
Unpublished.
HUDCC (Housing and UrLbgl_Development Coordinating Council)/

Housing and Urban Regulatory Board. 1994. National Urban
Development and Housing Framework 1993-1998, 2"dedition.
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Coordinating Council/Local Government Development
Foundation, Inc. 1995. Metropolitan Manila Management Study.
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Coordinating Council/Planning and Development Colla-
borative International). 1992, Urban Development Sectoi
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Interagency Committee on Metropolitan Manila. 1973. Metropolitan

Manila Authority: A Development and Reform Strategy Proposal.
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JICA (Japan International Corporation Agency). 1997. A Factbook

on Metro Manila's Transportation and Traffic Situation (draft
version prepared by the MMUTIS Study Team).
JICA and MMDA (Japan International Cooperation Agency and

Metropolitan Manila Development Authority). 1998. The Study
on Solid Waste Management for Metro Manila in the Republic
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League, j.A.L. 1993. Manila Metropolitan Management Experience.

Paper prepared for the World Bank in connection with the
Metropolitan Management Systems Workshop on Policy
Options, 6 February 1993, Manila.
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Regional Development Plan 1993-1998.
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Man: The Metro Manila Approach to Urban Management.
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Humane World Class Metropolis: A Physical Framework
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_. 1996b. Urban Planning and Development in Metro Manila.

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J=lealth Management Strategies of Selected Cities 301
Coping with Insufficient Health Stations
Reaching out
Gingoog City delivers basic services to people who live far from
government facilities through an outreach program. The Gingoog
Total Integrated Development Approach or G-TIDA was initiated in
December 1988 as an outreach program to rural barangays. It provides
health, medical, infrastructure and other services.
A core group, organized by the mayor, plans and implements
the program. It is composed of several coordinators and a secretariat.
Outreach activities are done once or twice a month. The G-TIDA team
meets directly with the people and their leaders to discuss the
problems of the barangay. If problems cannot be given immediate
attention, they are referred to higher authorides. The team informs
people about the services provided by agencies in the city so they
would know which to approach for their specific needs.
Througlx the G-TIDA approach, people in some of the far-flung
barangays were able to install water pipes connected to a spring using
local resources and relying on the bayanihan (mutual assistance and
exchange of labor) system.
Gingoog's outreach program is now on its tenth year and has
provided a means for delivering health services in areas without health
stations. At present, all 50 rural barangays have health stations manned
by a midwife and volunteer health workers. During the program's
early years, the G-TIDA team stayed for two days and one night in a
barangay. However, outreach is now limited to one day per barangay
due to increased demand for outreach set vices.
Expenses for outreach activities by participating agencies are
taken from their regular agency budgets. There are no additional
appropriations except for overhead expenses such as gasoline,
transportation and food. In 1996, Gingoog City appropriated P189,400
for the program.
Tapping privale homes for public needs

To solve its lack of BHSs, Cotabato City tried a different
approach. Since building costs for a concrete BHS is about P100,000,
the city can, at most, only afford to build three structures a year. Unable
to build more of these structures due to its limited funds, Cotabato
302 ManagingUrbanizationUndera DecentralizedGovernanceFrarnewm,
k--
City opted to use barangay halls and priwate homes as venues for health
services. These alternative venues are flee of charge. Today, Co_abato
City has at least one health station for its 37 barangays and seven
more extensions. Of these, 23 are pemaanent structures constructed
by the city while the rest are lodged in barangay halls or private homes.
When Health Workers Are Scarce
Volunteers for the comnum good

Another major problem when providing health care is the lack
of personnel. The common approach to beef up manpower is to
mobilize volunteers. Cotabato City activated 100 volunteers, mostly
trained hilots (traditional midwives), to assist midwives in BHSs.
Olongapo City has some 300 health volunteers. For its rescue and
emergency medical assistance program, Naga City has 400 trained
first responders and emergency medical technicians, all of whom are
volunteers.
Since volunteers render free services, the city is'able to save on
salaries. In return, the cities reward them through other means. For
instance, Cotabato City gives a P500 Christmas gift to each volunteer
while Olongapo City provides them hospitalization benefits. Naga
City volunteers receive uniforms, group insurance, and food while
on duty.
Women power
Women's groups are valuable partners of city governments.
Olongapo's Balikatan Ladies of Olongapo Movement (BLOOM) has
6,000 members, many of them housewives. Aside from cleanliness
projects, members volunteer as nursing aides in the city hospital, assist
health workers in immunization drives and conduct health classes.
Lapu-lapu City has mothers support groups consisting of 410
members. The city taps this group in its advocacy activities such as
feeding children during nutrition month. In Surigao City, the Primary
Health Care FederatedWomen's Club (PHC) laid claim to over 12,000
members in 1996, over 63 percent of households in the city at the
time. As volunteers, PHC members operate and maintain BHSs and
feeding centers. They record and follow up the immunization of
children, assist pregnant women to obtain pre-natal checkup and
lealth Management Strategies of Selected Cities 303
onduct health education activities. They also learned to treat

ommon illnesses through herbs and liniments.
Involving private companies and medical practitioners

Lapu-lapu City requested private companies and institutions to
assist in the health needs of specific barangays. Companies donate
supplies and facilities as well as the services of doctors (retainers)
who provide free clinics in adopted barangays on a monthly basis. At
present, ten companies and five educational institutions have adopted
eight barangays. Lapu-lapu City's Health Office has also involved
doctors affiliated with the Mactan Doctors Organization and nurses
from the Mactan Community Hospital in its immunization program.
The city provides the vaccines while the volunteers provide their
services. Currently, 50 doctors and 100 nurses offer free services to
different barangays.
Maximizing available health praeationer,s

Cotabato City's Office of Health Services initially targeted at
least one midwife stationed to each barangay. However, limited funds
again hampered this goal, so the city shifted strategy and hired casual,
instead of permanent, midwives. Salaries were sourced from the 200
percent Development Fund. Starting 1993, the city was able to provide
one midwife, employed on a casual basis, to all 37 barangays. More
casuals were hired to beef up manpower in its main health center.
Salaries for casuals total P2.5 million yearly.
Puerto Princesa City's satellite clinics, another project financed
by the 20-percent Development Fund, hired five doctors on a part-
time basis. The city has five strategically located satellite clinics. A
doctor provides medical services in his assigned clinic for two days
per week. The remainder of the week, he works in hospitals or engages
in private piactice. The city pays its doctors P10,000 a month each.
The schedules of doctors in satellite clinics are synchronized to
maximize their availability. For instance, in one satellite clinic, the
doctor's schedule is Monday and Tuesday. In the other nearest satellite
clinic, the doctor's schedule is Thursday and Friday. This way, during
those days when the doctor assigned to a satellite clinic is not
scheduled to come, the patient can instead go to the nearest satellite
clinic and avail of another doctor's services.
Meeting Medical Emergencies
Qui_k re_,ase saves lives

Naga City initiated Emergency Rescue Naga (ERN) under its
disaster preparedness program in April 1991. The ERN is a quick
response unit led by the Naga City Hospital. It provides emergency
medical assistance, rescue services, and transport to a hospital. It also
gives medical backup assistance to particular events.
The ERN has two telephone hotlines and two VHF controls. Its
volunteers are equipped with beepers. Average ERN response time is
three to five minutes within the city proper and 30 minutes for the
farthest mountain barangays some 17 kilometers away. Emergency
calls come not only from within Naga City but also from neighboring
towns. ERN has an extensive radio network linking the offices of the
mayor, the ambulances, police and fire stations within Metro Naga.
Key personnel of the 14 local government units (LGUs) comprising
Metro Naga were also provided with hand-held radios.
ERN has one paramedic, a driver, and 400 trained first
responders and emergency medical technician volunteers. Regular
hospital staff, numbering 40, are On call. Assistance is rendered by
the Philippine National Police, Bureau of Fire Protection, City Disaster
Coordinating Council, Task Force COMET (for calls involving peace
and order problems) and other civic organizations. Facilities consist
of three ambulances, one all-terrain rescue vehicle, one rubber boat,
and a trauma van.
In 1996 alone, ERN responded to 2,257 emergency and t_ansport
cases or an average of six trips per day. It has provided valuable rescue
services during calamities such as super typhoon Rosing which caused
floods of more than fwe feet in Naga in 1996. ERN evacuated more
than 1,700 persons during that operation. The city spent P150,000
on ERN operations in 1997.
Emergency Rescue Naga won the Galing Pook Award (top 20)
in 1994, the Disaster Management Award for the regional level in
1995 and 1996, the national level in 1995, and the DOH Alay Buhay
Award in 1996.
Saving lives in the boondocks

Puerto Princesa City has five strategically located satellite clinics
to serve far-flung barangays with no access to health services. The
Health Management Strategies of Selected Cities 305
clinics handle emergency cases as well as simple illnesses. For more

serious cases, ambulances bring patients to hospitals within the city.
All barangays and tribal communities are provided with hand-
held radios (VHF transceivers). Emergencies are reported to the
barangay chairman who relay the information to the nearest satellite
cliriic which fields an ambulance and health personnel. If patients
require hospitalization, the satellite clinic makes an advance call to
the receiving hospital.
A satellite clinic is manned by two midwives, a radio operator, a
driver, and a utilityman. A doctor provides medical services for two
days a week and a dentist comes every two weeks. A clinic is equipped
with four or five beds.
Between 1993 and 1997, the clinics have served an average of
47,000 patients per year. Most cases were simple illnesses such as
respiratory infections. The clinics serve as a vital link to the city's
referral system. They resulted in the increase in emergency cases and
the decline in the number of patients with simple illnesses clogging
hospital docks.
Puerto Princesa City's satellite clinics had a budget of P6.2
million in 1997 and are among the top 20 Galing Pook winners in
1996.
Augmenting Finances
Mandatory baranguy allocations for health

Olongapo City requires its barangays to allocate five percent of
their IRA to health and welfare. Drugs allocated to the barangays are
sourced from this fund. In Cotabato City, baiangays also finance their
own medicines. Lapu-lapu City requires its barangays to provide
allowance for barangay health workers ranging from P400 to P1,500
per month.
Twenty percent Community Development Fund

Cotabato City and Puerto Princesa City both use their 20-percent
Community Development Fund for projects, salaries of temporary
health personnel and satellite clinics.
Contr/buaom
In Surigao City, the Barangay Environmental and Sanitation
Tmplementation Group (BESIG) members contribute their labor
.,-306 ManagingUrbanizationUndera DecentralizedGovernanceFramework
while the government provides the fu,lds for infrastructure projects

such a_shealth stations and feeding centers. The city's PHC Feder-
ated Women's Club obtained P1.5 million for the construction of its
training center from a senator's Countrywide Development Fund.
Under the share-food project of a Butuan City barangay, well-
to-do families sponsor malnourished children for three months. In
Lapu-lapu City, companies and congressmen contribute to a milk feed-
ing program for school children while a food manufacturer regularly
gives noodles. They also donate facilities and supplies to the barangays.
Identifying Health Needs: Knowing the Problem Gets You Half

the Way There
Tour of duty
In Lapu-lapu City, the city health officer toured all the barangays
tor one month to identify the people's needs and ways of improving
health service delivery. He traced the city's low performance in the
Expanded Program of Immunization (EPI) to the absence of a specific
schedule for immunization and doctor's visits and people's lack of
interest. A permanent schedule was set and people were encouraged
to go to their BHSs. As a result, Lapudapu was awarded the "Most
Accelerated City in EPI" in 199 I.
Currently, the city health officer goes to the barangays three to
four times a week to check on the status of programs. The mayor goes
visiting with him three to four times a month. The health officer also
conducts a barangay assembly every quarter. He presents current
government health projects and solicits comments from the
community on their health priorities. The community participates
in coming up with solutions to address its problems.
Going down to the grassroots levd

In Olongapo City, the mayor goes to the barangays accompanied
by his depar_lent heads to sce the actual situation at the grassroots.
The mayor visits all 17 barangays within a quarter. During barangay
consultations, the people air their problems to the mayor. The
department head who has jurisdiction over the problem is tasked to
take action and start with the solution the following day. People report
to the mayor in case the problem remains unsolved.
Integrated Approach: The Sum Is Greater Than Its Parts

Gingoog City opted for an integrated approach for its outreach
program, well aware that there are problems which cannot be solved
by one agency alone but by several agencies working together.
Olongapo City strengthened the linkage between health and
sanitation by integrating its environmental management program with
health activities. The Community Health Office plays a major role in
solid waste management. Its sanitary inspectors conduct regular
rounds and issue citation tickets (fines) to violators of sanitation
ordinances (such as unclean premises and putting out garbage outside
of the scheduled collection time), This combination of health and
environmental management resulted in the reduction of sanitation-
related diseases such as typhoid fever and paratyphoid infections. The
occurrence of these diseases declined from 75 percent in 1988 to 9
percent in 1995 per 100,000 population.
Clustering of Barangays: A New Meaning for Hamletting

For more effective supervision and monitoring, Cotabato's
Office of Health Services grouped its 37 barangays into seven Clusters.
Each cluster is supervised by a coordinator who monitors the activities
of his respective cluster. Dividing the 37 barangays among seven
coordinators simplified the task of supervision and monitoring since
it enabled the coordinators to immediately respond to the problems
of the barangays within their respective clusters.
Planning, Monitoring and Evaluation:

Don't Expect What You Don't Inspect
Sem/nars
Butuan City's nutrition personnel together with the Department
of the Interior and Local Government conducts planning seminars
with bavangay leaders. They compare the nutritional status ofpuroks
(subvillages) in the barangay and guide leaders in making their
quarterly action plans. The Cotabato Office of Health Services
conducts semi-annual and annual review of programs.
Regular feedback through meetings

In Surigao City, the PHC chapter monthly meetings provide
the means for identifying community problems at the purok level.
Monthly staffmeetings, in addition to reports, are also conducted in
Olongapo City to monitor and evaluate perfbrmance in the harangays.

Health workers in each of Lapu-lapu's eight districts and nutrition
workers in each of Butuan's 10 barangay clusters hold monthly
meetings for the same purpose.
Community data board

Surigao City's community data board posts the health status of
households. Each household is represented in the board by a small
hut. The hut shows the house number, the name of the family head,
the health concerns, and the period covered (first to fourth quarter).
For comparison purposes, the previous year's quarterly performance
is included as baseline.
The community data board is updated every quarter through a
survey of all households. The survey inquires on health concerns such
as pregnancies, immunization and nutrition status of children,
garbage disposal, water source, occurrence of diseases, PHC health
insurance membership, and availability of toilet. For each health
concern, the health worker assigns a colored circle to indicate health
status (below is an example).

Blue Not applicable Nobody is pregnant in the household_
Yellow Improving Degree of malnutrition changed from
severe t.o mild.
Green Safe Children are fully immunized.
Red Danger No PHC health insurance.
By looking at the red circles, the health personnel is alerted on

the most pressing health need of the households. The concerns of
the ]mrok can also be prioridzed according to the number of red circles.
It follows that the health concern with the most number of red circles
is the most pressing health need of a purok. Comparison with the
previous quarter shows where performance has improved or
deteriorated.
The Best and the Worst: Appealing to the Filipino Ego

In Surigao City, the PHC recognizes outstanding performance
based on'a set of criteria such as the number of babies immunized
and the number of sanitary toilets constructed. Awards are given to
10 outstanding PHC chapters, five outstanding workers, and
outstanding couple during the PHC annual convention.
Butuan City conducts an annual contest for outstanding

barangay. Every quarter, the performance of the barangays are
evaluated using various criteria such as primary health care activities,
food production and livelihood programs. Prizes range from P50,000
to P100,000. The city also ranks barangays according to prevalence of
health problems such as the rate of malnutrition, and announces the
poor performers in ABC (Association of Barangay Captains) meetings.
Recognition of best and worst performers motivates the barangays to
give programs and projects their best shot.
More Improvements in the Current Setup

Gingoog City's outreach method is useful as a temporary
measure for coping with insufficient BHSs. However, the long-term
solution is to provide additional health stations to reach all the
barangays. While people benefit from the curative and preventive
health services provided during outreach activities, othei- health
services have to be done on a regular basis. The G-TIDA approach
may be adopted by cities while they are in the process of setting up
additional health structures. To sustain outreach activities, local
governments could train people from within the area as health workers
and nutrition scholars. In addition, they could mobilize people's
organizations.
Cotabato City's use of barangay halls and private homes as
additional health stations is a progression from the G-TIDA approach.
This enables regular provision of health services rather than being
just a one-shot approach. Another alternative is to rent a space for
the BHS.
Equally important is the availability of health workers. Mobili_ng
volunteers and mothers, in particular, is a good way of supplementing
manpower without paying salaries. Likewise costless is Lapu-lapu City's
channeling of the services of medical practitioners who are retained
by private companies.
The hiring of part-time doctors, as practiced by Puerto Princesa,
enables curative services to reach remote barangays. The availability
of doctors in satellite clinics reduce the number of patients going to
hospitals for minor illnesses. The city's strategy can be extended to
dentists and medical technologists. To sustain this activity, barangays
may contribute for the salaries of part-time doctors and other health
personnel. The latter may serve the barangays on a rotation basis.
3] 0 ManagingUrbanizationUndera DecentralizedGovernanceFramework
Naga and Puerto Princesa can learn from each other's

experience in emergency medical assistance. Puerto Princesa could
follow Naga's mobilization of volunteers for handling emergencies
while Naga may consider the stationing of ambulances in strategically
located barangays as done in Puerto Princesa's satellite clinics. This
way, the ambulance need not come from the city proper but any
ambulance nearest to the place of emergency can respond
immediately, thus saving travel time.
Cities provide free services and medicines in public health
facilities including the use of ambulances. In some cases, they are
able to obtain financial and in-kind contributions from individuals
or companies. One possible source of funds is cost-recovery,
specifically, charging fees for medicines, use of ambulances, and
medical services. Only the really indigent may be exempted from
payment. This, of course, requires a system for determining people's
capability to pay.
Health in the Hands of the People: in Conclusion

The Department of Health (DOH) sees health in the hands of
the people by 2020. Devolution was a major step toward this vision.
The government has set mechanisms to soften the impact of
devolution. To advise local governments on health plan and budget,
the 1991 Local Government Code mandated local governments to
create Local Health Boards (LHBs) composed of local executives,
health officers and representatives from the DOH and the private
sector or nongovernmental organizations. To ensure the speedy
resolution of problems brought about by devolution, Transition Action
Teams (TATs) at provincial and regional levels were created. The DOH
added another office to its structure--the Local Government
Assistance and Monitoring Service (LGAMS)--to attend to local
government concerns. It also provided for Comprehensive Health
Care Agreements (CHCAs) between the DOH and local governments
to implement priority health programs.
A few more kinks, of course, need to be ironed out. Specific
studies have identified these concerns, namely, the resolution of the
issue of the inequitable distribution of IRA shares vis-a-vis devolution
burdens (IRA reallocation bills are currently pending in Congress),
technical assistance to LGUs in exploring other schemes for raising
financial resources and in improving the management capability of
311
devolved hospitals, greater participation of nongovernment

organizations and people's organiTations in local special bodies, and
development of alternative modes ofintergovernmental cooperation
to deal with issues of service delivery and monitoring that cut across
jurisdictional boundaries.
On the part of the DOH, it can jointly undertake revenue
enhancement projects in devolved hospitals with local governments
just as it has done in hospitals that continue to stay in its aegis (such
as the Rizal Medical Center in Pasig City and the Ilocos Regional
Hospital in La Union). It can provide technical assistance in improving
pricing, billing and collection systems of devolved facilities. Lastly,
the DOH can help local governments gain competence in managing
devolved facilities through continued trainings.
Case Studies of Health Management Strategies
Reaching Out: Gingoog City's Total Integrated

Development Approach (G-TIDA)
Puerto Princesa City's Satellite Clinics:

A Curative Rural Network
Emergency Rescue Naga: An LGU-Managed

Emergency Rescue Project
People Power at Work: The Case of Surigao City's

Primary Health Care (PHC) Federated Women's Club
Financing and Delivery of Health and Sanitation

Services: A Case Study of Cotabato City
Lapu-lapu City's Partnership for Health
Butuan City: A Consistent Regional Outstanding

Winner in Nutrition
Case Study 1
ReachingOut: Gingoog City's

Total Integrated Development
Approach (G-TIDA)
Virginia S. Pineda and Clark Y. Clarete
ingoog City is on the northern coast of Misamis Oriental, 122

kilometers east of Cagayan de Oro City and 74 kilometers
west of Butuan City. It has a total land area of 404.6 square
kilometers, 1.71 percent of which is classified as urban areas. Around
56 percent of its total area are public forest lands (both classified and
unclassified forests). The city is composed of 79 barangays, of which
29 are classified as urban and 50 as rural barangays. As of 1995, it has
about 17,128 households.
In 1990, the city's population was estimated at 82,852 persons.
By 1995, it has grown to 87,530 persons or by about 5.65 percent. Of
these, 32.51 percent live in urban areas and 67.48 percent in rural
areas. Population density per square kilometer slightly increased from
204 in 1990 to 216 in 1995.
Currently, about 3,924 households (roughly 23 percent of the
population) live within the poverty threshold level (i.e., with average
gross family income of P6,000 and below per month). The middle
income group or those with average gross family income of P6,001 to
P40,000 a month, constitutes 68 percent (11,601 households) while
the high-income group (over P40,000 a month) makes up the
remaining 9 percent (1,603 households) of the population.
Health Facilities and Expenditure/Budget

The health facilities of Gingoog City include one government
hospital--the Gingoog District Hospital (run by the provincial
government)--two private hospitals, one main health center (located
within the urban core), and 50 barangay health stations or BHSs (one
for each rural barangay). It has also five family planning centers and
a puericulture center for maternity services.
] ]6 ManagingUrbanizationUndera DecentralizedGovernanceFramework
The Gingoog District Hospital has a bed capacity of 50 while

the private hospitals have a combined bed capacity of 60. These
hospitals serve the whole population of Gingoog City as well as the
neighboring municipalities of Magsaysay and Medina. Because of the
greater access of the urban barangays to the hospitals and the main
health center, only the rural barangays are provided with BHSs.
In 1991, before the devolution, the city's health expenditures
amounted to P2.3 million, or around 6 percent of its total
expenditures. This was spent almost wholly for basic health services.
In 1994, after devolution, Gingoog's health expenditures and its
proportion to total expenditures increased to P10.7 million and 9
percent, respectively. The city provided financial assistance of P500,000
to the Gingoog District Hospital and spent the remainder for basic
health services, and operation and maintenance of health facilities.
Of its P184.2 million total budget for 1996, the city appropriated
P16.1 million for health services or an equivalent of 8.7 percent of
the total city budget. It set aside P500,000 (or 3.11 percent) of the
health budget for its annual financial aid to the Gingoog District
Hospital. The rest of the health budget is for the operation and
maintenance of the city health facilities, which mainly provide primary
health care services.
Health Performance
Gingoog City's infant, child, and maternal mortality rates have
been declining and were lower than the average for the Philippines
from 1990 to 1995 (Table 1). However, the percentage of malnour-
ished children remained almost the same: 62 percent in 1991 and 60
percent in 1995. The malnutrition rates were even higher than the
national average for the same years.
The G-TIDA Approach 1

In the late 1980s, the Gingoog City government received reports
from concerned citizens that people rated its delivery of services,
particularly health and nutrition, as "very poor" and "very slow." The
mayor at that time, Arturo Lugod, observed that the delivery of services
Information on G-TIDA was sourced from interviews with the G-TIDA coordinator and team
members and fi"om Quieta (1994).
Case Study:Gingoog's City's Total IntegratedDevelopmentApproach 3 ] 7
Table 1. Mortality and Nutrition Indicators, 1990 and 1995

1990" 1995
I,_dt,--tor _ _ c_goog Ph_'p_

Mortality Rates:
Infant 44.7 56.7 36.7 48.9
Child 61.1 79.6 50.2 66.8
Maternal 190.3 209.0 156.1 179.7
Percentage of Malnourished
Children (0-83 nmnths old):
Mild 40.4 41.3 38.2 30.7
Moderate 20.0 14.3 20.4 8.4
Se_re 1_4 2.1 1.5 1.2
Tou.l 61,8 57.7 60.1 40,3
*Malnutrition data are for 1991.
Infant mortality: infa_lt deaths per 1,000 live births

Child mortality: number of deaths among children less than 5 years of age per 1,000
children of the same age range
Maternal mortality: number of maternal deaths per 100,000 live births
Sources: Herrin (1998); National Statistical Coordination Board; DOH Nutrition Service.
by government agencies to rural areas was fragmented and

uncoordinated. In the health sector, for instance, the Emergency
Hospital and the City Health Office implement their respective
outreach programs without coordinating with each other. Mayor
Lugod also noted that people in remote rural barangays have limited
access to services because they live far from government facilities and
those with low education are either shy or afraid to ask for help from
government officials and personnel.
As a response, the mayor's strategy was to bring the services to
the people and make sure that the delivery of basic services is planned
and integrated. At a specific date, various service agencies were to
converge in a target barangay to deliver basic services.
He called the agencies to a meeting and presented this proposal.
The agency heads were initially hesitant because they thought it would
require a huge budgetary allocation. Mayor Lugod assured them that
concerned agencies will be using only their regular allocation and
resources in the implementation of the G-TIDA and that the city
government would provide for overhead expenses like gasoline,
transportation and food subsidies for the participants.
3 ] 8 ManagingUrbanizationUndera DecentralizedGovernanceFramework
Starting with two target barangays (Bal-ason and Hindangon)

in December 1988, the program is now on its tenth year. Its goals are:
1. To bring the government closer to the people, and

2. To improve the delivery of frondine services to the people,
especially in the hinterland barangays.
The G-T1DA team

Through the G-TIDA, the mayor instituted a systematic and
integrated outreach program to rural barangays. He organized a G-
TIDA core group composed of the G-TIDA coordinator, G-TIDA
Secretariat, transportation coordinator, logistics coordinator, and
specific-service coordinators represented by the department heads
of the concerned agencies. The group, which is headed by the mayor,
is responsible for planning, identifying target barangays and
implementing the G-TIDA program.
BeJ_breany outreach activity, the G_TIDA sends a survey team to
assess the needs of the identified barangay and set with the residents
the date for the visit of the main team. After the assessment, all
concerned agencies are called to a G-TIDA meeting, informing them
of the problems and needs of the barangay. The whole G-TIDA
machinery is then set into motion, bringing along all the necessary
equipment and personnel to serve the target barangay. The food
requirements of the team who will be staying in the barangay are
served by the G-TIDA kitchen team.
During the G-TIDA Day, members of the team meet directly
with the people and their leaders to discuss the needs and problems
of the barangay. If problems cannot be solved immediately, they are
referred to the appropriate agency. The G-TIDA team informs the
people about the functions and services provided by each agency in
the city so the latter would know which to approach for their specific
needs.
On the average, about 80 government personnel are involved
in G-TIDA activities. The main G-TIDA team consists mainly of the
personnel from the City Mayor's Office, City Planning and
Development Staff, City Agriculturist Office, City Health Office, City
Population Office, City Engineer's Office, City Treasurer's Office,
Assessor's Office, Local Civil Registrar, Provincial District Hospital,
Department of Agriculture, Department of Social Welfare and
Case Study: Gingoog'sCity's Total Integrated DevelopmentApproach 3 ] 9
Development, a nongovernmental organization representing the

religious sector, and other line agencies.
Services offered
With Gingoog's integrated approach, the people in the
barangays are provided with a variety of services. Topping this list are
health and infrastructure support. Medical services include
consultation, diagnostic tests, circumcision, tooth extraction, pre-natal
care and counseling, family planning services and vaccinations, and
provision of free medicines. Nutrition services are also provided like
supplemental feeding of malnourished children and counseling of
mothers.
Infrastructure services consist mostly of road repairs such as
grading, and filling up of potholes; street lighting; installation and
repair of water facilities; and construction and repair of health and
daycare centers and other structures.
Other services provided include mass weddings, registration of
births, and issuance of community/residence certificates, registration
and issue Of certificate of ownership of large animals.
Frequency of and budget for G-TIDA outreach activities

The city conducts G-TIDA outreach activities once or twice a
month. During the early implementation of the program, the G-TIDA
team stays for two days and one night in the barangay. However, as
requests for outreach activities increased, the conduct of G-TIDA
outreach has been limited to about one day per barangay.
The expenses incurred by the various agencies in providing
services during G-TIDA outreach are taken from their regular agency
budgets. No new appropriations are given except for the budget for
overhead expenses like gasoline, transportation and food. In 1996,
the city government allotted P189,400 for G-TIDA.
Impact of the G-TIDA Program
Improvement in people' "ces

During their initial visits in remote barangays, the G-TIDA team
found many people with untreated diseases as well as crude ways of
treating an illness. Doctors got frustrated because many patients from
the mountains allowed their diseases to worsen before they finally
sought medical attention.
When the G-TIDA goes to the barangay, its medical team

members provide preventive, curative and referral services. They teach
the people proper health practices and disease prevention as well as
provide medical and dental consultation and treatment. If patients
require hospital confinement or longer medical attention, the G-TIDA
team brings or refers them to the hospital. Through the G-TIDA, more
people in the mountains came to know of the Gingoog District
Hospital as a place where they could go for operations and other
health services.
Since 1988, a good proportion of the rural people have benefited
from the program. For the period covering 1988-1991 alone, the C,-
TIDA has served a total of 17,034 persons, of which 70 percent (or
11,879 persons) availed of health services. It is only unfortunate that
the program cannot be properly evaluated because of the absence of
a program impact monitoring mechanism. The testimonies of some
key informants, however, lauded the positive impacts of G-TIDA on
the lives of the rural people.
Eohancement _ .... " --

The G-TIDA approach helped build the people's capalsilities _-
and participation in local governance. It fostered community plan-
ning and teamwork. During public consultations, people air their
problems, views and ideas directly to the agencies and persons con-
cerned. Their direct participation in solving their problems and the
prioridzation of their needs improved their cooperation with the lo-
cal officials in the implementation of their programs and projects.
One decisionmaking example is between installing a water system or
constructing a waiting shed or basketball court. As a result of meet-
ings, the people came to realize that the installation of a safe water
system is more important to their health. The system would help pre-
vent diarrhea and other gastro-intestinal diseases brought by dirty
water supply. Encouraged and guided by the G-TIDA team, people in
some of the far-flung barangays were able to install water pipes con-
nected to a spring using their local resources and relying on the
bayanihan (mutual assistance and exchange of labor) system.
Imlarovem_nt of the imag_ of the _overnmertt

Particularly for the hinterland barangayswhere people feel only
a minimal presence of the government, bringing the services directly
to them can make them realize the government's existence. For some
Case Study: Gingoog'sCity'sTotal IntegratedDevelopmentApproach321
people perhaps, G-TIDA day is the only time they could consult
medical practitioners. For others, it may be the only time in the year
that their barangay roads are repaired and improved.
/_ob/ems encounterad
Noncooperation of some local leaders

There have been instances wherein barangay captains hindered
the implementation of community development projects because
these activities did not benefit them personally. For example, a
barangay captain blocked the opening of the Botika sa Barangay
(village pharmacy) because his daughter was not chosen as the
storekeeper. There was also the case of a barangay captain who did
not cooperate in the installation of a water facility because this would
lessen his chances of being re-elected. Although these may be isolated
incidents, they still point out the need to involve not only the barangay
leaders but all people in the community in selecting and
implementing barangay projects.
People's attitude
Some local residents avail of free medicines by pretending to
be sick and then stock the medicines for possible future use. This
proves to be a problem as the stock could be used by people for the
wrong ailment. Or the medicines may be taken by individuals even
beyond their expiration dates. The people should therefore be
informed of the dangers of self-medication and expired medicines.
Limited resources
The concerned agencies can only provide limited services to a
barangay because the expenses for G-TIDA outreach are supported
by their regular funds only. The most common complaint is the
inadequate supply of medicines distributed during the outreach day.
In some instances, when a team is unable to provide certain medicines,
it could only give out prescriptions slips to the patients.
Scheduling of outreach activities

Although the G-TIDA secretariat prepares a schedule for
outreach activities, the conduct of a G-TIDA outreach is mosdy on-
request basis. Therefore, the barangays that file the most number of
requests get most of the G-TIDA services.
The G-TIDA secretariat plans at least two outreach activities per

month but the actual conduct greatly depends on the availability of
resources, the urgency of requests and the availability of personnel.
if G-TIDA strictly follows its twice-a-month schedule, only 24 barangays
can be covered within one year. Considering that the city has 50 rural
barangays, it will take two years to make a complete round. (G-TIDA
is aimed at rural barangays that are far from city health facilities.)
Ten years since the initial implementation, some barangays (from
the coastal areas) have been visited by the G-TIDA Team two to three
times only.
Very limited time for _mXr_e_

The G-TIDA team used to stay for two to three days in the target
barangay. At present, outreach activities are carried out at an average
of one day per barangay. With this very limited time, the delivery of
services, specifically those pertaining to infrastructure, are often left
uncompleted. In one case, a barangay complained that the one-day
availability of dump trucks and other equipment was not sufficient to
finish the road repairs (filling up of potholes and road grading) they
requested.
Lack_og_impacLmo_it oring mechanism

Evaluating the impact of the program is difficult due to the lack,
if not the total absence, of area-specific data such as the number of
people served, the impact on health status (e.g., reductions in
mortality and morbidity), and many other important information.
The program should therefore include a mechanism for monitoring
and evaluating its impact.
Key Elements for Success

The sustained and successful implementation of the GoTIDA
program for nearly 10 years may be attributed to the following:
Leadership of the city chief executive

The G-TIDA was born out of the insistence of the local chief
executive to bring the services directly to the people. It was the mayor
who proposed a planned, integrated outreach program to rural
barangays, convinced the concerned agencies of its viability, and
organized the G-TIDA team. The outreach program then became a
Case Study: Gingoog's City's Total Integrated DevelopmentApproach 323
regular activity as the local chief executive continues to support it

and allocate funds for its overhead expenses.
Orgunized setup
The creation of a G-TIDA Secretariat to oversee the activities
and the assignment of specific tasks to agencies and personnel
facilitated the mobilization of people and resources and sustained
the G-TIDA activities.
Cooperation of the bara_y officials

Barangay officials play crucial roles in the scheduling of the G-
TIDA outreach and its actual implementation. Although the G-TIDA
Secretariat prepares a calendar of activities, it admitted that the
calendar is often not followed and the actual conduct of the "outreach
day" is dependent on the barangay officials' requests. The barangay
officials are the ones responsible for gathering the people together
and organizing them to provide the manpower and do project
followup activities that may be required.
The Loca/Government Code

Although the G-TIDA started before the devolution, the full
implementation of the Local Government Code contributed to its
successful implementation. With the city executive's direct control
over all the service departments, coordination in the delivery of
services is facilitated.
Areas for Improvement
Clustering of service areas

It may be advantageous if outreach services will be provided
simultaneously to a cluster of two to three adjacent barangays. The
service teams may be assigned to a specific barangay but move freely
into the other barangays within the cluster as soon as they have
completed servicing a certain area. This will lessen the logistical
requirement of the team such as food and transportation and
maximize the number of barangays served per outreach schedule.
Strengthening people "s participation

As the G-TIDA outreach service is practically a one-shot
approach, there is a need to follow it up to sustain its benefits as well
as complete the components that cannot be finished during the G-

TIDA Day. Support in the institutionalization of programs as well as
in strengthening supportive people's organizations may be necessary.
Minimizing dolocmt approaches

Although many of the services offered during the G-TIDA are
welfare services, there may be a need to institute cost-recovery
measures so as not to unwittingly cultivate the dole-out mentality
among the barangay people. Unless all the people in the barangay
e indigents, it may be helpful if certain forms of payments will be
,llected for the services, materials, and supplies being provided.
inimal fees can be charged and then turned over to the local
organizations that will sustain or pursue the completion of programs
or projects initiated during the G-TIDA outreach.
Setting up of an impact monitoring system

To filly appreciate the benefits of the program, an impact
evaluation system is needed. It is necessary to gather and process data
that would allow analysis of the impacts of the projects instituted,
such as monitoring the decrease in the occurrence of diarrhea and
skin diseases after the installation Of a community water system.
Applicability and Replication

The G-TIDA was conceived at a time when only a few of the
rural barangays have health stations. Although the G-TIDA consisted
of all the services available, delivery of health services was the main
concern especially in areas without any BHS.
Presently, all the 50 rural barangays have BHSs manned by at
least a barangay health midwife and volunteer health workers (i.e.,
the barangay health workers and barangay nutrition scholars). On
the other hand, because of their proximity and greater access to the
hospitals and the main health centerin the city, the urban barangays
are not provided with BHSs. Except for the services of BHS in the
rural areas, there is only little, if none at all, of the other services that
could be directly accessed by the people at the barangay level.
The G-TIDA approach can easily be adopted by other local
government units (LGUs), especially those that have not yet fully
provided their barangays with BHSs. They can conduct outreach
activities to unserved barangays while working toward setting up the
BHSs. To undertake an integrated, planned and coordinated outreach
Case Study:Gingoog'sCity'sTotal IntegratedDevelopmentApproach 325
program like that of Gingoog City, local officials could do the

following:
1.Call a meeting with department heads to present the pro-

posal, get their cooperation and involve them in planning.
2.Form an outreach team, select the people and specify their
dudes and responsibilities. The team may be composed of an
overall coordinator and specific coordinators (such as for trans-
portation, logistics, food, medicines and other supplies), the
department heads, and a representative from nongovernment
organizations.
3. Organize a survey unit within the outreach team. The survey
unit will be responsible for scheduling the barangays to be
visited, undertaking a survey and assessment of the needs of
the chosen barangay, setting the outreach date with the
people, and identifying the agencies which should participate
in the outreach activities.
4. Based on the report of the survey unit, the coordinator could
mobilize the persons involved to prepare the activities,
transportation, food, medicines and other supplies that should
be brought to the barang-ay.
5.The outreach team could stay for two or three days in the
barangay, discuss with the people the problems and solutions,
attend to the people's needs, and conduct health education
and other information dissemination activities. The team
should keep a database of the services rendered, the number
of people served, and health indicators in the barangay for
monitoring and evaluation purposes.
6.To sustain health activities after the departure of the outreach
team, particularly in barangays without health stations, the
city health office could train residents to serve as barangay
health workers and nutrition scholars as well as organize
people's groups to promote proper health care. The barangays
could pro#de allowance to the BHWs and BNSs, depending
on their financial capability.
Conclusion
In the final analysis, an outreach method of delivering health
services is useful as an interim or temporary measure for coping with
the problem of insufficient BHSs. People benefit from the curative

and preventive health services provided during an outreach visit but
this is sporadic or nonregular. They should have continuing access to
health services. To make this possible, the long-term strategy is the
provision of additional health stations and health workers to reach
all barangays.
References

and Education Sectors, 1992-1996. Makati City: Philippine
Institute _br Development Studies. Unpublished.
Quieta, R. 1994. Health Strategies and Intervention: Extended Case

Studies on Good Health Care Management in the Philippines.
Department of Health (DOH) - Health and Management
Information System (HAMIS) Occasional Paper No. 9.
Manila:DOH-HAMIS.
Case Study 2
Puerto Princesa City's,

Satellite Clinics:
A Curative Rural Network
Virginia S. Pineda
uerto Princesa City is the capit_ 1 of the province of Palawan

and the largest city in the country. With a total land area of
2,106.7 square kilometers, Puert a Princesa accounts for about
17 percent of the total land area of P_;twan. The city is composed of
66 barangays, 24 of which are urban a nd 42 are rural. It has about
25,542 households as of 1995.
The city's population increased fi om 92,147 in 1990 to 129,577
in i 995 or by 41 percent. About 65 perq :ent of the population resides
in the rural barangays. Settlement ._reas in the city are highly
dispersed. Population concentration i_ densest in the eastern coast,
where the city proper is located. Rural barangays are scattered over
the length of the city's coastline, with undeveloped tracts of lands
separating the eastern from the western barangays. Five rural
barangays in the west coast arca are almost blocked off by rugged
mountains and thick forest. Two of thes e barangays are not yet linked
to the city's road network system (Puerto Princesa City Local
Government Performance Report 1994i).
Health Facilities and Expenditure/]$udget

The city has one main heath cent :r, 18 barangay health stations
(BHSs), three hospitals, and five satellite clinics. The hospitals have
a total capacity of 175 beds: 75 in the go ternment hospital, the Puerto
Princesa Provincial Hospital, and 50 ea_:h in the two private hospitals.
Each satellite clinic has a capacity of fc ur to five beds. The hospitals
and satellite clinics serve patients fror _ the city as well as from the
neighboring municipalities of Palawan.
Prior to the devolution of functions in 1991, the city

government's expenditures on health amounted to P6.5 million,
mostly for basic health services. This constituted 7.5 percent of the
city's total expenditures. After the devolution, the city's health
expenditures increased to P20.1 million in 1994 but its proportion to
the city's total expenditures decreased to 5 percent. Basic health
expenditures also declined to 74 percent of the total health
expenditures with the establishment of satellite clinics that provide
medical services. In 1995-1997, the budget for the city health office
(CHO) and the satellite clinics accounted for an average of 4.4 percent
of the total city budget. Table 1 shows the respective amounts.
Health Performance
Under the city's comprehensive health care program, both
preventive and curative services are provided to the people. The CHO
focuses on primary health care. Its barangay health workers implement
the following programs: expanded program on immunization,
maternal and child care, tuberculosis (TB) control, family planning,
nutrition, diarrheal disease control, environmental sanitation, malaria
control, and laboratory services. If patients need curative care, the
barangay health workers refer them to the satellite clinics. Such health
programs helped reduce mortality and malnutrition rates as indicated
in Table 2.
The city's infant and child mortality rates are lower but its
maternal mortality rates are higher than the average for the
Philippines in both 1990 and 1995. Nevertheless, the reduction in
Puerto Princesa's maternal mortality rates (38 per 100,000 livebirths)
was slightly greater than that for the Philippines (29 per 100,000
livebirths). The percentage of malnourished children in the city also
declined from 66 percent in 1991 to 34 percent in 1995.
Table 1. Budget for the CHO and Satellite Cli.ics, 1995-1997 (P million)
Share in Total
Year City Health Office Satellite Clinics Total City Budget (%)
1995 14.2 5.8 20.0 4.0
1996 17:_ 7.8 22.1 4.6
1997 20.9 6.2 27.1 4.7
Source: Puerto Princesa City Planning and Development Office.

Case Study:PuertoPrincesa'sSatelliteClinics 32 9
Table2. Mortality andNutrition Indicators, 1990and 1995

1990" 1995
__.___or _rto Puerto
Princesa Philippines Princesa Philippines
Mortality Rates:
Infant 52.7 56.7 44.8 48.9
Child 71.8 79.6 61.2 66.8
Maternal 253.1 209.0 215.1 179.7
Children (083 months old)
Mild 48.4 41.3 25.6 30.7
Moderate 16.6 14.2 7.4 8.4
Severe 1.2 2.1 0.9 1.2
Total 66.2 57.6 33.9 40.3
* Malnutrition data arc for 1991.

Infant mortality: infant deaths per 1,000 live births.
Child mortality: number of deaths among children less than 5 years of age per 1,000 children
of the same age range.
Maternal mortality: number of maternal death_ per 100,000 live births_
Sources: Herrin, A. "Beyond 2000: An Assessment of the Health, Nutrition and Education
Sectors, 1992-1996," 1998 (Unpublished PIDS Paper); National Statistical
Coordination Board; Department of Health (DOI-I) Nutrition Service.
The Satellite Clinics Projets

During the 1992 elections, the then-mayoralty candidate Edward
Hagedorn was on his way to Barangay Napsan. In one desolate area,
he saw a small group of people waiting for transport. On his way back,
he saw the same group crying. He learned that a family member died
while waiting for transport to bring them to the hospital. He vowed
to remedy this situation if elected.
The satellite clinic project is the fulfillment of Mayor Hagedorn's
promise. Its objectives are:
1.To provide rural residents access to medical attention and

medicines;
2.To reduce the mortality rate in the rural areas; and
3. To reduce unnecessary suffering due to illness.
The first satellite clinic was opened on 2 January 1993. At

present, the city has five such clinics strategically located to serve far-
flung rural barangays with no access to health services. Napsan covers
the southwest barangays; Cabayugan, the northwest end; San Rafael,
Case Study:Puerto Princesa'sSatellite Clinics 33]
Office of the City Planning and Development Coordinator.

Occasionally, the mayor also visits the satellite clinics.
Impact of the Project

Before the satellite clinics program was implemented, it used
to fie difficult for the barangay people to get medical services. This is
because minimum transport time from the nearest barangay to the
city proper, where most of the health facilities are located, is one
hour. Also, the roads are rough and transport to and from a barangay
averages twice per day. Under these conditions, many people did not
seek medical attention, resorted to quack medication, or consulted a
doctor only when their illness had worsened. Others died without
any medical treatment or while waiting for transport to the hospital.
The satellite clinics gave the barangay people greater access to
curative services. They handle emergency cases aside from simple
illnesses. For more serious and complicated cases, the clinics are
equipped with ambulances to bring the patients to hospitals. Thus,
they serve as vital link to the city's referral system. With the satellite
clinics, emergency cases increased while the number of hospital
patients with simple illnesses declined.
From 1993 to 997, the clinics served an average of 47,000 padents
per year. Table 4 shows the types of services rendered for 1993-1995.
Most of the cases attended to were respiratory infections and other
simple illnesses. Without the satellite clinics, these patients would
have proceeded to hospitals or not have received medical treatment
at all. By their existence, the satellite clinics enabled the early
treatment of diseases and decreased the number of padents going to
Table 4. Satellite Clinics' Services and Number of Patients Served
Number of patienLs served

Services 1993 1994 1995
Consultation 43,665 43,360 37,619
Confined 890 1,582 898
Transport 338 400 363
Delivery 36 76 876
Medical examination 1O0 15
Tooth extraction 590 724 1,254
Others (pre-natal, family
planning, urine exam) 169
Total 45,519 46,242 49,744
Source: Puerto Princesa City Planning and Development Office.

hospitals. They also saved people on time and transportation cost.

(The reported cost of transporting a patient to and from the city
proper [special trip] was about P1,000.)

Leadership
Realizing the need for health facilities that could handle
emergency cases and transport patients to hospitals when necessary,
Mayor Hagedorn acted promptly to meet this requirement. He pushed
for the satellite clinics project immediately after his election. The
project is currently being implemented under the city mayor's office.
Fl_ble hiring policy

Due to its financial constraint, the city could not hire doctors
on a regular or permanent basis. Moreover, there was also a shortage
of doctors. To overcome these problems, the city hired doctors on a
contractual and part-time basis.
Availability of facilltie_ and medical personnel

The barangay people's access to health services has been limited
due to travelling inconveniences (rough roads) and the length of
time to reach health facilities in the city. The provision of satellite
clinics, ambulances, doctors and other health personnel in strategic
locations brought health services nearer to the barangay people and
enabled the latter to avail of these services.
Strategies That Can Be Replicated
Prm, ision of curative services in the barangrtys

Usually manned by midwives, the BHSs focus on preventive
health care. The satellite clinics augment the BHS health services by
providing doctors and curative care. Since patients can proceed to
the satellite clinic in their area directly, these clinics relieve the
hospitals of additional workload. They also save time and
transportation expenses for the barangay people.
Case Study: Puerto Princesa's Satellite Clinics 33 3
Hiring of doctors on contractual and part-time basis

The doctors in the satellite clinics are hired on a contractual
and part-time basis. Each doctor stays for two days per week in the
satellite clinic assigned to him. For the rest of the week, he is free to
work in hospitals or engage in private practice. The city government
pays each doctor a monthly salary of P10,000.
Synchronized scheduling of doctors

The schedule of the doctors in the satellite clinics are
synchronized to maximize their availability. For example, in one
satellite clinic, a doctor is scheduled on Monday and Tuesday. In the
other nearest satellite clinic, another doctor's schedule is Thursday
and Friday. This way, during days when the doctor assigned to a satellite
clinic is not scheduled to come, the patient can go to another satellite
clinic and avail of another doctor's services.
Use of radio communication equipment

In the absence of telephones, the satellite clinics use radio
communication equipment. Each barangay and tribal community is
also provided with hand-held radio (VHF transceivers). Emergencies
are reported to the barangay chairman, who calls the nearest satellite
clinic for an ambulance and health personnel. If patients require
hospitalization, radios enable the satellite clinic to make an adwance
call to the receiving hospital. This gives the hospital time to prepare
and have a team of medical personnel ready for the patient coming
from the rural barangay.
Provision of an ambulance in the rural barang_

During emergencies, time is of utmost importance. Given that
a few minutes or even seconds of delay could cost a person's life, an
ambulance in each satellite clinic guarantees a ready response to
•emergency cases.
Other cities can follow Puerto Princesa's example of providing
doctors and curative services in strategically located barangays, ff they
can afford it, cities can also put up satellite clinics. Puerto Princesa's
San Ratael Satellite Clinic, which was completed in 1996, was built at
a cost of P999,996. To save on construction expenses, other cities can
make use of their existing BHSs and just provide for doctors' services.
Puerto Princesa's Satellite Clinics 3 35
the same symptoms as other diseases/infections is urinary tract

infection or UTI.) A medical technologist is therefore needed in the
satellite clinics so that the doctors can prescribe the exact medicines.
The satellite clinics program is monitored and evaluated based
on the monthly reports submitted by each clinic. To further strengthen
this method, periodic meetings (e.g., every quarter) among the
doctors, coordinator, mayor, and maybe a people's representative, are
recommended. The meetings would allow interaction among the
program participants and provide the venue for sharing experiences,
problems, and solutions.
Conclusion
Satellite clinics were established to fulfill one mayor's
commitment to give people residing in remote barangays immediate
access to medical services. Simple illnesses are treated in satellite
clinics while serious cases are brought to the hospitals. This proved to
be a good system and promoted the efficient use of health facilities
and resources.
Being knowledgeable about their city's condition, Puerto
Princesa's leaders were able to devise creative ways of dealing with
deficiencies, such as the use of radio communication equipment to
overcome the lack of telephone facilities, and the employment of
part-time doctors to cope with financial constraints and shortage of
physicians.
With its satellite clinics, Puerto Princesa City is one local
government unit that has displayed innovativeness mad responsiveness
to people's health needs tinder the devolution process. It has shown
that the delivery of health services could improve, rather than
deteriorate, under decentralization, as local leaders are in a better
position to determine and resolve the situation in their area, and the
problems and needs of their constituents.
C_e Study
EmergencyRescueNaga:
An LGU-ManagedEmergency
RescueProject
Virginia S. Pineda and Rosemarie O. Buan
aga City is located at the center of Camarines Sur, the biggest

province in the Bicol Region. It is about 377 kilometers south
of Manila and approximately 100 kilometers north of Legaspi
City. It is bounded on the north by the municipalities of Canaman
and Magarao, on the east by Mr. Isarog and the Municipality of Pili,
the capital town of Camarines Sur, on the south by the Municipality
of Milaor, and on the west by the Municipality of Camaligan.
The city has a total land area of 77.5 square kilometers. It is
composed of 27 barangays, of which 21 are classified as urban and six
as rural. As of 1995, it has about 23,632 households.
Naga City's population is placed at 115,329 persons in 1990. By
1995, it has grown to 126,972 persons or by about 10 percent (National
Statistics Office Census). Likewise, population density per square
kilometer increased from 1,488 in 1990 to 1,638 in 1995. Of the total
population in 1995, 84 percent live in urban areas and 16 percent in
rural areas.
Health Facilities, Welfare and Expenditures

Naga City has five health centers and five barangay health sta-
tions (BHSs), with an average of five to eight barangays as catchment
areas. It has two government hospitals, and four private hospitals with
a combined capacity of 223 beds. One of the government hospitals is
the Naga City Hospital, which has a capacity of 16 beds. The other is
a regional hospital, the Bicol Medical Center, which has a capacity of
250 beds. It serves not only patients from Naga City but those from
neighboring provinces as well.
Health indicators show an improvement in health conditions
in Naga City. Infant, child, and maternal mortality rates declined from
1990 to 1995 and were even lower than the national averages for the
same years (Table 1).
338 ManagingUrbanizationUndera DecentralizedGovernanceFramew.Erk
On nutrition, the percentage of malnourished preschoolers,

although higher than the national average, also dropped substantially
from 72 percent in 1990 to 59 percent in 1995. Such decrease can be
attributed to the intensified nutrition-related activities in the city.
These activities include food assistance, nutrition education,
micronutrient supplementation and deworming.
These trends manifest an improved implementation of preven-
tive and curative measures and better manpower and facilities. Bicol
Medical Center, for instance, has 87 physicians, 28 nurses and other
medical personnel. At the local level, the city has one physician, five
nurses, 175 barangay health workers (BHWs) and 120 trained birth
attendants. There remains, however, a need for additional health
manpower to serve the population.
In 1991, prior to devolution of functions, the city's expendi-
tures on health was P3.6 million, which was 7 percent of its total ex-
penditures. Of this amount, 48 percent was spent on basic health
and 51 percent on the city hospital. In 1994, after devolution, the
city's health expenditures increased to P10.5 million but its ratio to
total expenditures slightly declined to 6 percent. Likewise, the pro-
portion of basic health expenditures decreased to 41 percent while
hospital expenditures rose to 59 percent. In 1995, the share of health
expenditures in the city's total expenditures increased to 8 percent.
Of the 13.6 million health expenditures, 42 percent went to basic
health while 58 percent went to the city hospital.
Emergency Rescue Naga (ERN)

Emergency Rescue Naga (ERN) is the city's emergency rescue
service initiated by the government in 1991 to immediately respond
to disasters and accidents. Its average response time is 3-5 minutes
within the city proper and 30 minutes for the farthest mountain
barangays some 17 kilometers away. it follows an action plan drawn
up by the City Disaster Control Center.
Since Naga City is located along the typhoon belt, it is prone to
tropical storms and typhoons throughout the year. It is also deemed
vulnerable to floods, earthquakes, fire and other calamities. Before
the creation of the ERN unit, emergency medical assistance to
residents of the 27 barangays was seldom given, especially at night
when transportation to distant barangays was scarce. This contributed
to the high mortality and morbidity rates in these areas.
Case Study: Emergency Rescue Naga 339

1990 1995
Indicator Naga City Philippines Naga City Phih'pplnes
Mortality Rates:
Infant 49.5 56.7 42.2 48.9
Child 66.6 79.6 56.2 56.8
Maternal 150.7 209.0 128.1 179.7
Children (0-83 months old)
Mild 45_3 41.3 36.2 30.7
Moderate 23.7 15.5 21.1 8.4
Severe 2.7 2.3 1.8 1.2
Total 71.7 59.1 59.1 40.3

Maternal mortality: number of maternal deaths per 100,000 live births.
Sources: Herrin, A. "Beyond 2000: An Assessment of the Health, Nutrition, and Education
Sectors, 1992-1995," 1998. Unpublished PIDS paper; National Statistical Coordination
Board; Naga City Nutrition Office; DOH Nutrition Service.
The ERN was therefore created "to serve so that others may
live." Its objectives are:
1.To minimize mortality and morbidity in cases of natural and

manmade disasters, and
2.To establish protective measures at the earliest possible time
to mitigate damages to lives and properties.
ERN Structure, Functions and Responsibilities

Housed at the LGU-owned Nagra City Hospital, the ERN Unit
staffis directly under the supervision of the Chief of Hospital (Figure
1). Its core staff includes one paramedic personnel, a driver, and
volunteers. Regular hospital staff, numbering 40, are on call.
Aside from the medical personnel/paramedics, ERN also has
400 trained first responders and emergency medical technician
volunteers who serve without pay because the ERN is for a _ood cause.
340 nizationUndera DecentralizedGovernanceFramework
Figure 1. Organizational Structure of the Emergency Rescue Naga
Chiefof Hospital l
1
Emergency Rescue]
" Naga _-'-
Unit
l Transport
1
Services Services Services
concerned local officials, the role of the evacuation centers, and the
action plans that will be implemented.
ERN has the following mandated fianctions:
1. Training of volunteers as First Responders and Emergency

Medical Technicians, as well as training in conducting Water
Rescue and Survival;
2. Advising the city mayor on rescue operations and evacuation
plans and options prior to the expected disaster;
3. Coordinating with the City Engineer's Office (CEO), Bureau
of Fire Protection (BFP), Philippine National Police (PNP),
City Social Welfare and Development Office (CSWDO), and
Office of the City Mayor on all disaster operations;
4. Coordinating with the Camarines Sur Medical Society; and
5. Checking "allmedical emergency kits of BHS as well as vehicle
and equipment to be used in emergency situation.
ERNs' standard operating procedures for emergency and rescue

The usual procedure isto ask for the patient's name, address
and case once a call is received. An ambulance is sent to the patient
with the assigned personnel taking note of the patient's vital signs,
providing eme,gency treatment, assessing the patient's condition and
transporting him to the nearest or desired hospital. Vohmteers are
notified, in cases of big operations, through their beepers and
handheld radios.
Case Study: EmergencyRescueNaga 34]
ERN's notable accompllshnwnts

In 1994, ERN earned the Galing Pook Award as one of the
country's 20 most outstanding local government programs. In 1995,
it won the National Disaster Coordinating Council's Recognition
Award as Bicol's and the country's best institutional outfit on disaster
preparedness and mitigation. Among its notable achievements are:
1.Rescue operations of stranded mountaineers in Mt. Isarog;

2.Rescue operations of residents trapped by floodwater at the
height of super typhoons Monang and Rosing;
3.Rescue operation for a barangay during a tornado;
4.Transfer of patients across the Bicol River after the collapse of
the Mabulo Bridge in Naga City;
5. Medical assistance during the PalarongPambansa held in Bicol
in April 1997; and
6. Conduct of regular trainings on Disaster Preparedness and
Management to ERN volunteers, civic and religious groups.
Supporters of the project take note of ERN's quick response to

an average of 6.2 emergency calls pe r day in 1996 from only a third of
this total in 1991. For 1996, the ERN responded to a total of 2,259
emergency and transport cases.
Prob/ems encountered
The ERN problems relate to inadequate facilities such as lack
of training area for emergency medical technicians and storage room
for supplies. To address these needs, additional funding will be
obtained from the city government.
The ERN also receives prank calls. The ambulance crew finds
out when they go to the location specified that no accident or
emergency actually took place. False calls may be discouraged by
asking for the telephone number and calling the same number after
a few moments to check if it really exists. Calls may also be coursed
through the barangay captains or BHWs who can confirm the need
for emergency and transport assistance. The city could also
disseminate more information to instill proper regard for ERN and
devise ways to catch prank callers and penalize them.
Except for occasions or events when volunteers are enjoined
to assist, the ERN stafffinds it difficult to gather most of the volunteers.
TO solve this problem, the ERN Volunteers Group has drawn up a

program of activities meant to sustain active membership.
Spirit of volunteerism
The ERN's noble cause and the recruiters' motivation draw in
more volunteers. A clear indication of popular support for the ERN is
its 400 volunteers consisting of students and youth, nurses and other
medical personnel. This means substantial manpower supply at
minimal cost since the city does not give compensation to volunteers.
It only provides them food (while on duty), uniform and group
insurance.
ERN volunteers have also organized themselves. They have their
own set of officers who draw up a program of activities to sustain
membership and who conduct training sessions.
Capability-building
Under the leadership of the chief of the Naga City Hospital, Dr.
Vito Borja, the ERN staff and volunteers were trained on areas such
as Emergency Case Management, First Aid, and Disaster Management
Workshop for Water Rescue. Informal trainings actually took off from
the initiative of a vacationing overseas contract worker who
volunteered to conduct emergency management trainings for the
ERN staff. These were followed up by Dr. Borja, who has been trained
on Rescue 911 's Operation Medical Technician Course. News of such
trainings spread to other municipalities and various groups, which in
turn volunteered to be trained by ERN. These groups included
government and private organizations, the Bureau of Fire Protection
(BFP), Philippine National Police (PNP), BAYANTEL, youth
associations, people from the mass media (CARE), and ambulance
staffand medical personnel from neighboring municipalities. A total
of 827 individuals have been reportedly trained.
Administrative mobilization by the City Government of Naga

The ERN is the fulfillment of Mayor Jesse M. Robredo's vision
of having Naga's own emergency rescue services. It became
operational as funds were allocated for its operation. The ERN group
also persisted despite the limited resources at the start.
At present, the ERN has spawned the Metro Naga Emergency

Rescue Network, with the institutionalization of a partnership among
the rescue and disaster services of Naga City and its neighboring
municipalities. Hence, municipalities under Metro Naga share their
ambulances, fire trucks, and other facilities.
supportfrom other ent/t/esand nong

o,izaions (N6Os)
The ERN enjoys the support of other government entities such
as the PNP, BFP, City Disaster Coordinating Council (CDCC),
Camarines Sur II Electric Cooperative (CASURECO II), Metro Naga
Water District, CSWD and CEO, At the barangay level, ERN also has
the support of the B_trangay Emergency Disaster Brigade.
NGOs and service organizations, civic organizations, and busi-
ness establishments also offer services in kind or cash during rescue
operations and big events through the ERN.
Effectivewnmmnica6onchannelsand networking
The ERN has two telephone hodines. Bayantel's 168 and
Digitel's 169. These are complemented by two VHF controls (148.5
and 147.90). Volunteers are equipped with beepers. Calls to ERN come
not only from Naga City but also from neighboring municipalities
owing to ERN's lead role (as a control center) in the Metro Naga
Emergency Rescue Network. Within Metro Naga, an extensive radio
network was set up linking all offices of the mayor, the ambulances,
and the police and fire stations. Handheld radios were also distrib-
uted to key personnel of each LGU. Of the 15 LGUs comprising Metro
Naga, only four have fire protection bureaus and five have ambu-
lances. Therefore, making the ERN metrowide enabled sharing of
these limited facilities and magnified their benefits.
Applicability and Replication

The ERN is applicable to cities that are prone to disasters and
accidents and where emergency rescue and medical assistance are
lacking or inadequate. It facilitates health service delivery and serves
as referral of patients to hospitals. More importandy, it saves lives and
stops or minimizes deterioration of patients' condition. Any city in-
tending to have its own emergency rescue and medical services can
follow Naga City's example, as discussed in the following subsections:
Facili_
Just like Naga, other cities can start even with one ambulance.
They may be able to request a unit fi_om donor agencies such as the
Philippine Charity Sweepstakes Office (PCSO) or the Philippine
Amusement and Gaming Corporation (PAGCOR). One or more
telephone hodines may be used for emergency calls. These can be
supplemented by VHF radios distributed to key LGU officials and to
police and fire stations involved as participating partners. Beepers
may be supplied by the city or by the volunteers themselves.
Volunteers and trainings

Cities would need recruiters who can present emergency and
rescue services as worthy undertaking as well as inspire volunteerism
among the people. Initially, they may request Naga's assistance in
training recruiters and volunteers. They may also ask help from the
Emergency Rescue Unit Foundation (Philippines) Inc. or ERUE an
NGO based in Cebu City. This organization is willing to share its
experiences in planning and running an emergency rescue program
to interested LGUs and NGOs.
Guidelines on disaster preparedness, management

and rehabilitation
To ensure orderly implementation of activities on disaster
preparedness, management and rehabilitation, other cities could
prepare guidelines specifying the duties and responsibilities of the
concerned local officials, the evacuation centers, and the action plans
that will be implemented during emergencies or disasters. They may
also adopt the guidelines of Naga City, modifying such accordingly to
suit their own conditions and facilities.
Naga City provides free emergency rescue and medical services
to the people but such services have costs. For 1997, it spent P150,000
for the ERN. To recover costs, even partially, Naga and other cities
could charge service fee to persons servedwho can afford to pay. They
can also generate funds by conducting trainings and seminars to
organizations for a fee. Financing from such sources may enable the
cities to increase and improve their emergency facilities and services.
Conclusion
Frorh a mere vision, the ERN has become a reality as a result of
the city leaders' and health personnel's drive to proceed with the
project even with very limited resources, together with the people's
readiness to give voluntary services for a worthy cause. Following Naga
City's example, other cities can also provide emergency rescue services
to their constituents.
The ERN is a good model not only _br cities but for metropolitan
arrangements as well. Just like in Metro Naga, other metropolitan
arrangements can also pool their resources and jointly provide
emergency rescue services on a metro-wide basis so as to extend the
benefits to more people.
expenditures dropped to 6 percent. Since the city does not own a

hospital, its health expenditures are mainly on basic health.
Surigao City's budget for the CHO was P10.4 million in 1995,
P10 million in 1996, and P10.9 million in 1997. The city health budget
constituted about 5 percent of the total city budget.
Health Performance
From 1990 to 1995, Surigao City's infant mortality rate declined
•44.3 to 36.3 while child mortality rate dropped from 61.8 to 50.8
le 1). These were lower than the national average for the same
years. In contrast, the city's maternal mortality rates were higher than
the average for the country. However, the reduction in maternal
mortality rates in Surigao City (42.8) was greater than that for the
whole Philippines (29.3) between 1990 and 1995.
In 1990, Surigao's malnutrition rate at 69 percent was higher
than the national average of 59 percent. It fell significantly to 38
percent in •1995, which was even lower than the average of 40 percent
for the whole Philippines.
Table 1. Mortalityand Nutrition Indicators, 1990 and 1995

.1990 1995
Indicator Surigao Surigao

City Philippines City Philippines
Mortality Rates:
Infant 44.B 56.7 36.3 48.9
Child 61.8 79.6 50.8 66.8
Maternal 237.7 209.0 194.9 179.7
Mild 47.0 41.3 29.9 30.7
Moderate 19.2 15.5 7.1 8.4
Severe 3.1 2.B 0.9 1.2
Total 69.3 59.1 37.9 40.3
infant mortality: infant deaths per 1,000 live births.

3hild mortality: number of deaths among children less than 5 years of age per ] ,000 children
)f the same age range.
Vlaternal mortality: number of maternal deaths per 100,000 live births.
_ottrces: Herrin (1998); National Statistical Coordination Board: Surigao City Health Office;
Department of Health Nutrition Service.
Case Study:SurigaoCity'sPHC FederatedWomen's Club 349
The PHC-City Government Partnership 1

Health service delivery has always been a challenge to the city
because of limited resources. For example, in 1987, it only has 16
BHSs and four hospitals. Considering the city population of 94,453
persons at that time, the ratio of health facilities is one BHS for 5,903
persons. While the hospitals are physically situated in Surigao City,
they also served areas outside the city.
Another problem with health service delivery is the
inaccessibility of some barangays. Thirty-two barangays are in the
mainland while 22 are island-barangays separated from the mainland
by the Surigao Strait. There are barangays that are inaccessible during
the typhoon months from November to January and are difficult to
reach by public transportation.
To overcome the constraints to efficient health service delivery,
Surigao City put into practice the Department of Health's vision of
placing health in the hands of the people. It mobilized mothers, and
later, whole families in health care service and delivery. This was made
possible through the Primary Health Care (PHC) Women's Club, a
people's organization initiated by a CHO midwife.
The PHC's stated objective is to develop skills among mothers,
their families and other individuals in the community and enable
them to achieve an acceptable level of health and well-being in a self-
reliant way. With membership covering all the barangays, the PHC
enabled delivery of health care services even in the socially and
geographically disadvantaged areas of the city.
The Primary Health Care Women's Club

The PHC began in 1986 in Barangay Taft as a project of Mrs.
Zenaida Arana, the midwife assigned to the barangay. Mrs. Arana's
workload was heavy since aside from being in-charge of Barangay Taft's
population of more than 18,000 persons, she was also assigned to
Barangays Washington and San Juan. Realizing the difficulty of
delivering health services to three barangays without assistance, she
turned to mothers. Initially, several mothers helped in scheduling
the children or bringing them to the center for immunization. The
opportunity to serve their community inspired them to move on to
Information and data on the PHC were sourced from interviews with its members and
,from a paper by Asis (1994).
other tasks. Mrs. Arana trained this core group of volunteers and
reached out to other mothers in Barangay Taft and her other assigned
barangays. She conducted three-day seminars on health and health-
related matters and formed the PHC Women's Club. Those who
completed the seminar became members of the Organization. Given
definite roles in the program, the members gained a sense of
responsibility and became committed to support and promote health
in the communities.
The CHO noticed Mrs. Arana's work in Barangay Taft. At the
same time, it also realized the need to strengthen the primary health
care strategy by implementing it on a large scale. Hence, in 1988, it
established a PHC office in the City and appointed Mrs. Arana as
PHC coordinator. Her task was to launch similar clubs in the city. In
1991, the PHC was registered with the Securities and Exchange
Commission (SEC) so it can have legal personality.
The CHO adapted and expanded the program all over the city.
It provides the training package and resource persons for PHC classes.
Classes cover family life, the roles of men and women in the home
and in the community, responsible parenthood, nutrition, sanitation,
and topics related to primary health care. Some of the participants
can eventually become barangay health workers or barangay nutrition
scholars. Upon completing the course, participants form a PHC
chapter and elect a set of officers.
The PHC has mobilized all family members in working for health
and other programs in the community. It gave rise to other
organizations, namely, the Barangay Environmental and Sanitation
Implementation Group or BESIG for the menfolk in 1989, the PHC
Youth (12-21 years old), and the Mini-Youth (7-12 years old) in 1990-
1991. From 300 mothers in 1986, the PHC and its offspring
organizations' membership has grown to over 12,000 members in
1996, representing about 63 percent of the city's total households.
All the members work on a voluntary basis. For the CHO, this means
considerable savings on salaries as well as having a pool of thousands
of health workers.
The scope of PHC activities has already gone beyond purely
health concerns and into livelihood and community development,
particularly after winning the HAMIS (Health and Management
Information System) Gold Award and Diamond Award in 1992 and
1993, respectively.
Case Study: Surigao City's PHC Federated Women's Club 35 ]
PHC Health Activities

The PHC actively participates in the implementation of
programs of the Department of Health (DOH) and the local
government unit. These programs include maternal and child health
care, expanded program of immunization, nutrition, family planning,
environmental sanitation, national tuberculosis program, disease
surveillance, and disaster management. As health volunteers, the PHC
members are involved in the operation and maintenance of the main
health center and 45 BHSs as well as 140 feeding centers. They handle
recording of immunization, bring the pregnant women for pre-natal
checkup, and assist in feeding the children. They conduct health
education activities by giving speeches and encouraging mothers to
attend trainings and seminars, handling the PHC radio program, and
organizing and mobilizing other people in the community. Because
of these health education activities, the mothers who used to hide
their children to avoid immunization now bring them to the health
station.
The PHC also helps generate health information data and
monitor health status through the community data board system. Its
members assist the barangay health workers in conducting the survey
and in processing the data. The PHC mothers also do the necessary
followups, such as on those whose homes do not have toilets and on
children who have not been immunized. They encourage and teach
plant propagation to those who do not have herbal or vegetable
gardens.
The CHO supervises and monitors the activities of the PHC, its
officers and members. Every quarter, it conducts a formal evaluation
of PHC chapters. CHO representatives do not need to go to the
barangays because PHC members themselves go to the PHC office to
submit reports, and sometimes, just to meet and mingle with other
PHC members.
As the mothers and other volunteer health workers focus on
preventive health care, demands on the curative aspects of health
care are lessened. This can be seen in the lower bed capacity of private
hospitals, from 150 in 1986 to 65 in 1995, which reflects a reduction
in hospital admissions. The strategy that focuses on promotive and
preventive health care has been proven to be relatively cost-effective.
Existing estimates of cost-effectiveness of alternative types of health
interventions indicate that cost per life saved is much higher (at least
two to five times as much) in curative care than in preventive care

(The World Bank 1987 as cited in Manasan et al. 1996).
PHC souca_ and funding

The basic unit of the organization is the PHC Chapter, which is
organized at the purok level. The next higher level is the PHC
Integrated Club at the barangay level. The barangays are further
grouped into seven districts. Each district has a board of directors. At
the top of the PHC organizational chart is the city-level Federated
Women's Club, the umbrella organization. Each PHC level has its
own set of officers and representative to the higher levels. The PHC
is under the Surigao City Health Office, which supervises, monitors
and evaluates the former's activities.
Financial sources for PHC activities include membership dues
(each member pays a yearly membership fee of P10.00), the mortuary
fund (contributions used for funeral expenses), fund raising
campaigns for special projects, the cash award (a total of P450,000)
from HAMIS, and interest on income generating project (IGP) loans
and medical health loans.
The city government provides support to the federation in the
form of honorarium for health workers. It helped set up the mortuary"
fund by giving a counterpart contribution. The city also pays for the
services of the PHC bookkeeper. At the chapter levels, it finances
the construction of health and feeding centers and other
infrastructure projects. The local PHC/BESIG chapters' counterpart
consists of materials or labor.
For the construction of the federation's concrete two-storey
Primary Health Care Training Center, the city government has
allocated P1.5 million while a senator committed another P1.5 million
from his Countrywide Development Fund (CDF).
Some prob/ems encountered

Whenever a club is formed, the differences in the members'
educational attainment constrain participation. That is, those with
low-level education feel inferior. The PHC experience shows that such
attitude can be overcome by leadership trainings that enable the
mothers to be confident and more active. This is an indication that
leadership trainings should really be an integral part of the training
package.
Case Study: Surigao City's PHC Federated Women's Club 353
The wives' involvement in PHC and community activities caused

conflicts with their husbands. However, the PHC turned such problem
into an opportunity by forming the BESIG, enabling husbands to have
their own tasks and thus contribute to PHC activities.
The PHC used to contend with delinquent borrowers. In 1991,
it ri_corded a low repayment rate of about 30 percent. As a solution,
the PHC required the chapter president to act as guarantor of
members' loans. Moreover, if one barangay member has an unpaid
loan, other members from the same barangay will not be allowed to
borrow. With these strategies, repayment rate rose to more than 80
percent.
PHC Health Initiatives

Aside from its implementation of DOH impact programs, the
PHC has made the following health initiatives.
Setting up of heodth _ fund

Members can borrow from this fund for their hospitalization or
medical expenses. With a contribution of P10 per year, a member
can avail of a P500 loan without interest for hospitalization or a PS00
loan with 2 percent monthly interest for outpatient consultations.
The loans are payable in three months. Additional financing for the
health fund comes from the mortuary fund. In the mortuary fund
scheme, members pay an annual due of P30. In the event of death,
the member's family will be given P1,000. Any unused money from
the mortuary fund at yearend automatically goes to the organization's
health emergency fund.
Mobilization of men for environment and sanitation activities

In 1989, the PHC BESIG for the adult males in the community
was organized. With BESIG, the men became active partners of the
PHC. Members set up the feeding center while the PHC women take
care of feeding the children. The PHC women survey the households
in the community and encourage them to install toilets while BESIG
men offer labor in installing toilets. These are some examples of PHC-
BESIG cooperation.
Dissemination of health infornmaon

The PHC provides health updates, PHC-related news, and
interviews with resource persons through a weekly radio program
("PHC on the Air") and a weekly TV show ("AKO: Ang Katawang

Okay").
Promotion of herbal medicines

The PHC has a wide collection of herbal plants and extensive
experience on herbal medicines. Each chapter has herbal gardens.
Mothers make herbal medicines such as LSKsyrup (luya, sambong or
sampalok, and kalamansi for cough) and liniments. These
medications are distributed either directly to the people or through
the herbal clinic or Botika sa BinhL Currently, a big herbal garden
project is being planned by the Surigao City Rotary Club and the
Makad Rotary Club. Under their memorandum ofagreeement signed
in 1997, the Makati Rotary will buy a five-hectare land in Surigao City
and convert such into a herbal garden while the Surigao City Rotary
will monitor the project.
Key Elements for PHC Success

Women are often too preoccupied with attending to both their
household chores and the family's needs while their husbands are
equally busy ekking out a living. Any spare time they may have is
expected to be spent for rest or recreation. Nevertheless, the PHC
was able to mobilize men and women to contributing their time and
labor to the community. How then did the PHC get such commitment
and ensure their continued cooperation?
The members attribute the success of the PHC to Jesus Christ.
Their slogan is '_esus Christ + PHC." Before they proceedwith any of
their activity, they first spend 30 minutes to one hour for praying and
Bible sharing. They believe that this will guide them in everything
they do.
On the other hand, in the context of local governance, the key
success elements of the PHC in empowering people are as follows:
Giving importance to people and equipping them

with the necessary skills
In organizing the PHC chapters, the resource persons motivate,
exhort and challenge the mothers..As a result, mothers feel that they
are needed and that they have a crucial role in improving the standard
of life in the community. Through trainings and seminars (leadership
topics included), the CHO gives them the capability to perform health-
care related tasks.
Case Study:Surigao City'sPHC Federated Women's Club 35 5
The city government likewise provides support by funding PHC/

BESIG projects.
The PHC transformed women from plain housewives to
community leaders. With their acquired knowledge and skills, mothers
have become more active in the community. They give speeches and
even handle radio programs. Several of them were even elected as
kagawads or barangay officials. The mayor likewise recognizes the
mothers' crucial role to the community by occasionally attending PHC
meetings.
Promotion of cama_ and sense of belonging

PHC strengthens friendship and unity among members through
the celebration of important milestones in the organization's life (e.g.,
graduations, inductions, anniversaries and recognition days) and
holding of various contests (such as choral singing competition on
PHC activities).
Encouraging people participation in planning

and decisionmaking
One way to enable people participation is through the sustaitaed
implementation of the community data board (Figure 1). Here, the
health status of each household is known and their needs identified
through a quarterly survey. The smwey tackles the community's health
concerns such as pregnancies (pre/post-natal), immunization and
nutrition status of children, garbage disposal, water source, occurrence
of diseases, PHC health insurance membership, and availability of
toilet and herbal or vegetable garden.
In the community data board, each household is graphically
represented by a small hut. For exampie, if there are 60 households
in the pur0k (subvillage), there will be 60 huts. The hut shows the
house number, the name of the family head, the health concerns,
and the period covered (i.e., first to fourth quarter). For comparison
purposes, the previous year's quarterly performance is included as
baseline datum.
For each health concern, the health worker and the assisting
mothers assign a colored circle to indicate health status. The colors,
their meanings, and some examples of their application in different
health concerns are as follows:
356 ManagingUrbanizationUndera DecentralizedGovernanceFramework "
Figure 1. The Community Data Board
House No.
Name of household
Pre/Post-natal
Family planning
Nutrition
Immunization
Garbage disposal
Water source
Herbal/Vegetable garden
Toilet
Disease
Health insurance
Current year
Previous year
- -- __1
Quarter Q1 Q2 Q3 Q4
Case Study:SurigaoCity'sPHC FederatedWomen's Club 3 57

Blue Not applicable Nobody is pregnant in the household.
Yellow Improving Malnutrition changed from severe to mild.
Green Safe Children are fully immunized.
Red Danger No PHC health insurance.
By looking at the red circles, the health personnel are alerted

on the needs of each household. The concerns of the purok can also
be prioritized according to the number of red circles. The top problem
is that of health concern with the most number of red circles.
Comparison with the previous quarter will also show where
performance has improved or deteriorated.
The community boards of the different pur0ks are consolidated
at the barangay level. A small hut is also used to represent a pur0k.
For each health concern, the applicable numbers are entered for
each purok (such as how many children were not immunized, how
many households do not have toilets). These are then aggregated at
the barangay level. Again, comparison of data with those of the
previous quarter indicates in which area and health concern
performance has become better or worse off.
The PHC chapter monthly meetings provide the venue for
further identification and discussion of community needs and
problems, solutions, development projects, and plans at the purok
level. To ensure prompt action and accountability at the
implementation stage, the PHC uses a monitoring chart on the
problems or needs, the steps required, the persons responsible for
each step, the target completion date and what has been accomplish.
During monthly meeting with larger units, chapter presidents
report the activities and discuss the plans of their respective units.
The meetings also serve as fora for sharing experiences, including
problems and innovative strategies adopted by local chapters. The
chapter presidents then report back to their members what had been
discussed in these meetings. Thus, there is two-way communication
between the small and the larger units. Even as the local chapters
have the flexibility to make their own decisions, they also benefit from
the monitoring and supervision provided by the larger units.
Recognition of outstanding perfornmnce

Members look forward to August (designated as the PHC
month) and September for the PHC Annual General Assembly.
During this period, annual evaluation of each chapter is done.
Outstanding performances are recognized based on how the chapters
or members conduct healthcare-related programs, projects and
activities such as:
1. most number of babies immunized;

2. most number of sanitary toilets constructed and maintained;
3. least number of malnourished children;
4. community data board;
5. submission of reports;
6. participation in the radio program;
7. success of livelihood and income-generating projects;
8. attendance to meetings and related activities;
9. fund raising; and
10. other community development projects.
Among the highlights of the September convention are the

recognition of the Ten OutstandingPHC Chapters, Most Outstanding
President/Member, Five Outstanding Workers, and Outstanding
Couple. The awardees receive prizes in cash and in kind,
In_lenwntation of b_ projects
The PHC continues to flourish because it benefits people. It
enabled greater access to health services and medications. With many
health services provided within the barangay level, people do not
need to go to Surigao City. In addition, mothers have also learned to
treat common illnesses and make herbal cough preparations and
liniments. To reduce the cost of medicines, the PHC has put up several
barangay pharmacies and buys direct from drug manufacturers. As a
result, the medicines in PHC boticas are 30 percent cheaper than
commercial pharmacies.
Other benefits the PHC provides its members include medical
loans, mortuary assistance, 10 percent discount on drugs bought from
Botika sa Binhi, and 2-10 percent discount from participating
coinmercial establishments for PHC cardholders. Members can also
avail of loans for income-generating projects (such as retail stores,
credit financing, poultry/piggery, food catering).
Case Study: SurigaoCity's PHC.FederatedWomen's Club 359
The health awareness activities of PHC and BESIG members

resulted in better sanitation and nutrition in the barangays. Houses
are kept clean, with most having individual toilets. There are vegetable
and herbal gardens. Garbage is disposed of properly. Because of such
improvements in the living conditions in the community, the PHC
has gained the support and cooperation of the people.
Still, the PHC members continue to explore other possibilities.
They are now preparing to open a banking institution that will cater
to the credit needs not only of the members but also of the rest of the
city population.
How to Replicate
Many strategies can be replicated from the PHC program.
Foremost of these is the organization of mothers' and fathers' clubs.
Prior to organizing, the city or any other local government unit should
identify or select the following:
O_ganir.,erlcoordinator
This could be an individual or a group that has the ability to
motivate and mobilize people and is involved in health activities. The
services of nongovemment organizations (NGOs) may be tapped since
they pioneered people participation. The Surigao PHC coordinator,
Mrs. Arana, may be invited to give pointers or suggestions.
Remu_e persons to conduct c/o_es

City personnel involved in health education may be assigned
to teach specific clams. If this is not possible, the city can select other
health personnel or recruit other persons who can be trained to
eventually conduct health classes. Initially, the city may also invite
resource persons from the DOH or Surigao City.
Training package
The city may be able to get training materials from the DOH
or request Surigao City to share its own training package. In addition
to health concerns, the training should include leadership topics,
implementation of the community data board, orientation on the
PHC program and the important role of mothers, and the plan to
adopt the program in the city. Aside from basic trainings,
enhancement trainings should be a continuing activity of the CHO.
Case Study:Surigao City's PHC Federated Women's Club 361
Botika sa Binhi
The members set up a main pharmacy and buy medicines
directly from manufacturers. Smaller pharmacies may also be put up
in barangays or even in pur0ks.
Mortuary fund and reed/ca//oan fund

Members pay a fixed annual contribution. In return, they can
avail of mortuary assistance and borrow for hospitalization and
outpatient needs. Any excess from the mortuary fund at yearend would
be added to the medical loan fund.
Annual awards for outstanding clubs and members

The criteria used by the Surigao PHC may be adopted while
prizes would depend on the city's financial capability.
A replicating city should guard the program against any form
of politics. This is another lesson from the Surigao City experience.
When the city first organized a mothers' club in 1976, it was meant to
help promote proper health practices at the barangay level.
Unfortunately, the CHO lost its control over the program when some
politicians started using it for their own political agenda.
Conclusion
"Health in the hands of the people" is the PHC members'
battlecry. They believe that the health of the people and of the nation
is possible onlywhen everybody works for it. Thus, through the PHC,
Surigao City succeeded in making health everybody's concern. Starting
initially with an activity that involved mothers only, the PHC now taps
the contribution of all members of the family. In turn, it benefits not
only its members but the whole population of Surigao City as well.
The Federated Primary Health Care project of Surigao City is
something that the Surigaonons are proud of. According to the PHC
members, the program has been adopted in Quezon province, La
Union, and neighboring provinces in Region 10. A similar project in
the province of Surigao Norte called the Partnership for Community
Health Development (PCHD) was also started in 1991. All these prove
that the PHC program can indeed be replicated in other cities and
LGUs.
References
Asis, M. 1994. Community-Based Initiatives in Health: Development,

Growth and Transformation. Department of' Health (DOH)-
Health and Management Information System (HAMIS)
Occasional Paper No. 8. Manila: DOH-HAMIS.

and Education Sectors, 1992-1996. Paper submitted to the
Philippine Institute for Development Studies. Unpublished.
Manasan, R., G. Llanto and W. Nuqui. 1996. Financing Social Programs

in the Philippines. Makati City: Philippine Institute for
Development Studies.
Case Study 5
Financing and Delivery of

Health and Sanitation Services:
A CaseStudy of Cotabato City
Virginia S. Pineda and Ma. Lourdes D. Lim
he city of Cotabato, located at the northwest portion of

Maguindanao Province in Central Mindanao, was created
under Republic Act No. 2364 on June 20, 1959. Under this
charter, the city covered a total land area of 17,599 hectares and was
politically subdivided into five barangays. At present, 32 more
barangays have been created, giving the city a total of 37 barangays.
The city is around 689.9 nautical miles southeast of Manila and
is more or less 220 kilometers from Davao City. On its north is the
municipality of Sultan Kudarat, with the Rio Grande de Mindanao as
the boundary; on the east, it is bounded by the municipality of
Kabuntalan; on the south by the municipality of Dinaig (all
municipalities of Maguindanao Province); and on the west by Illana
Bay. Presently, Cotabato City is the seat of two regional governments:
Region XII and Autonomous Region in Muslim Mindanao (ARMM).
Vital Facts and Figures

Between 1990 and 1995, Cotabato City's population increased
from 127,065 to 146,779 persons or by 16 percent. Likewise, population
density per square kilometer rose from 722 in 1990 to 834 in 1995. Of
its 37 barangays, 29 are urban and eight are rural. The city has about
26,900 households.
Currently, about 60 percent of the population live within the
poverty level (i.e., with average gross family income of P6,000 and
below per month). The middle-income group, earning an average
gross family income of P6,001 to P40,000 monthly, constitutes 30
percent while the high-income group (over P40,000 monthly) makes
up the remaining 10 percent.
The city's health facilities consist of one main health center, 37

barangay health stations (BHSs) with seven extensions, one
government hospital, and four private hospitals. The Cotabato
Regional and Medical Center (CRMC) has a capacity of 240 beds while
the private hospitals have a combined capacity of 474 beds. As a
regional hospital, the CRMC serves not only Cotabato City but the
provinces of Cotabato, Maguindanao, and Sultan Kudarat as well.
In 1991, before the devolution, the city's health expenditure
was P3.0 million, which was 7 percent of its total expenditures. Of
this amount, 75 percent was for basic health services and the rest for
hospital expenditures. In 1994, after the devolution of functions,
health expenditures rose to P8.5 million, which was 5 percent of the
city's total expenditures. About 98 percent of the amount was spent
for basic health and nutrition while the rest was for other health
expenditures such as operation and maintenance of facilities.
In 1996, the budget for health services oecame P7.5 million. Of
this amount, 90 percent was for primary health and 10 percent for
curative services. City health budget constituted 8 percent of the total
budget. For 1997, the city health budget was 6.5 million, about 9
percent of the total city budget.
Problems/Constraints to Effective Health Service Delivery

The implementation of the 1991 Local Government Code
(LGC) in 1992 provided the impetus for local government units
(LGUs) to assume greater roles and responsibilities in bringing about
socioeconomic development. This is in view of the devolution in the
provision of basic services such as health, social welfare, socialized
housing, agricultural extension and tourism development, from the
national to local governments.
The devolution of health services from the Department of
Health (DOH) to LGUs was in consonance with the national goal of
"Health for All" by the year 2000 and the "Health in the Hands of the
People" goal by the year 2020. The national vision signals local
constituents to actively participate in the delivery of basic health
services in their communities and also provides an opportunity for
the LGUs to manage their respective health services eflectively and
efficiently: However, despite these meritorious national objectives, the
devolution process also posed problems for the DOH and the LGUs
particularly because of inadequate financial resources to undertake
vigorous health service delivery programs.
Case Study: Financing and Delivery of Services in Cotabato City 365
In Cotabato City, the insufficiency of budgetary resources was

only one of the problems faced by the LGU. Other problems
encountered included adverse geographic location of its barangays,
low economic status of its population, and inadequate health
manpower and facilities.
Economic status of the population

People of various ethnic origins coming from as far as Aparri to
Tawi-tawi populate the city of Cotabato. Majority are from the
Maguindanaoan tribe and the Visayan regions.
About 60 percent of the population is composed of marginal
farmers and fisherfolk, seasonal job workers, unskilled laborers, and
jobless individuals. Those belonging to this group live within the
poverty threshold level, earning an average gross family income of
P6,000 and below per month. Tile remaining 40 percent accounts
for the middle- and high-income groups. This implies that majority
of the city's population are poor and disadvantaged and, therefore,
most wanting of health care and other basic services from the
government.
Accessibility and tran.vportation constraints

The city's geographical feature makes delivery of health services
a major challenge to the local government. Brooks, rivulets and creeks
of various sizes criss-cross and traverse the city in all directions. Eight
barangays can only be reached by water vessels. Three other barangays
are not easily accessible by public transportation.
Before its special project on health and sanitation (see next
section), the city has been providing health care at the main health
center and 11 satellite stations. However, people in remote areas could
not avail of these services because of transportation problems.
Inadequate financial and budgetary resources

The Office of Health Services (OHS) had very limited financial
resources. Its regular budget (P4.5 million in 1992) was just sufficient
to cover personal services, and maintenance and operating expenses.
Inadequate health manpower and facilities

Due to its financial constraints, the OHS could not put up
additional health facilities and employ additional health personnel.
Prior to its special project on health and sanitation, the city had only
11 health stations while the OHS had only 39 regular personnel. The
OHS staff consisted of four doctors, six nurses, 11 midwives, one
dentist, one medical technologist, eight sanitary inspectors, and eight
nontechnical and administrative personnel. Such health fhcilities and
manpower have been inadequate to cover all the households in the
city.
Adverse We-implementation health situation

Until 1993, major health statistics and conditions showed that
there was a need to focus more on the delivery of basic preventive
health services, particularly to the disadvantaged groups living in the
remote barangays. Based on the National Statistical Coordination
Board (NSCB) data for 1990, the city's infant mortality rate was 44.0
per 1,000 live births while maternal mortality rate was 182.8 per
100,000 live births.
The Special Project on Health and Sanitation

The Special Project on Health and Sanitation proposed to make
basic health services accessible to people in the far-flung barangays
of Cotabato City. Its main objective was to improve and sustain the
yearly delivmy of basic health services to all the barangays in the city.
It developed into a P3 million peso project, which was financed from
the 20-percent Community Development Fund of the Cotabato city
governmen t.
The project was conceived in 1992 during the conduct of the
City Planning Workshop. This OHS initiative, with support of the
private sector, later became the initial response to Cotabato's health
care problem. It has two components, namely: (1) establishment of
at least one health station for each of the 37 barangays of the city as
well as the hiring of casual personnel to man the health stations all
year round and (2) provision of minimal but highly significant funding
support to health-focused activities such as advocacy to national and
special locally implemented programs and projects.
Project ma_t and organization

The main health center under the City Health Office exercises
the overall supervision of the Barangay Health Services Extension
component of the project through the area/cluster supervisors while
one BHS was established in each of the 37 barangays in the city. Seven
Case Study; Financing and Delivery of Services in Cotabato City 367
other extensions were set up for catchment areas in larger or heavily

populated barangays.
For more effective supervision and monitoring, the BHSs are
grouped into seven clusters. These clusters are in accordance with
the subcity clusters or barangay groupings organized for facilitating
administrative concerns of th e city government. A coordinator, who
is a permanent nurse or midwife with extensive training and
experience in city health programs, heads each cluster.
All barangay health midwives (BHMs), now barangay health
aides (BHAs), are directly under the supervision of the coordinators.
The barangay chairpersons assist in the monitoring of the
administrative performance functions of the BHAs.
Addressing constraints to effec6ve health service delivery
_£_BHS and midwife in each barangay

While affluent cities could easily provide their respective
barangay with its own health station and midwife, it is a formidable
task to those that lack financial resources. Cotabato City serves as a
model for cities that intend to provide a BHS and midwife for each
barangay despite the lack of fun&s.
In the city's experience, the building cost of a concrete BHS
structure is about P100,000. At most, the city could construct only
three concrete BHS per year. The OHS managed to overcome the
lack of permanent BHS structures by utilizing barangay halls, and
rooms or spaces in private homes of concerned citizens as health
stations free-of-charge.
Although the plan was to provide one BHS per barangay, the
city went beyor, d the standard. Recognizing the differences in each
barangay's size and population, the OHS also set up seven other
stations for catchment areas in larger or heavily populated barangays.
As of 1996, the city has 37 BHS and seven BHS extensions. Of these,
23 are permanent structures constructed by the citywhile the rest are
temporarily located in barangay halls or private homes.
Another target of the OHS was to provide one midwife in every
barangay. However, the OHS regular budget could not meet the salary
requirements for additional permanent personnel. To solve this
problem, the strategy was to hire casual midwives and finance their
salary from the 20-percent Community Development Fund.
Mo_bilizati.on__le..J'e sou rce s

Unable to hire health workers, the OHS identified the
alternative manpower resources that can be tapped for delivery of
health services. It sought out some 100 volunteers, mosdy trained
hil_ts (traditional midwives), to assist the midwives in the BHS. These
volunteers provide maternal delivery services and promote other basic
health care services at the purok levels. In appreciation of their
volunteerism, the city gives each of them a cash gift of P500 every
December.
The city likewise mobilized health services-related educational
institutions, nongovernmental organizations, private companies, and
civic-minded citizens. These groups provide volunteers, medicines,
refreshment, vehicles, and financial support during advocacy activities.
The OHS also obtained support from barangay officials. Funds
for medicines come from the barangays. In case of problems, the
midwives coordinate with the barangay officials and discuss any
proposals or recommendadons. Health concerns are among the topics
discussed during the pulongpulongor barangay meetings that are held
about once a month. Barangay captains also help in advocacy programs
by presiding over meedngs to plan the activities and mobilize the
support and participation of local residents.
Barangay clustering
For more effective supervision and monitoring, the OHS
grouped the 37 barangays into seven clusters. This is in accordance
with the subcity cluster system adopted by the city government for
facilitating local administration and management. A cluster coordi-
nator supervises and monitors the activities of his/her BHS and the
barangay midwives.
Dividing the work of supervision and monitoring of the 37
barangays among seven coordinators facilitated these tasks. Focusing
on only a few barangays enabled the coordinators to immediately
respond to the problems and needs of the barangays within their
clusters.
Activities under the special project on health and sanitation

Project activities fall under three categories: (i) DOH regular
programs implemented at the barangay level; (ii) locally initiated
health activities; and (iii) advocacy activities for periodic national and
global health programs.
Case Study:Financingand DeliveringServices in Cotabato City 371
the OHS radio program and distribution of IEC materials;

and holding of the yearly "healthy baby contest" with the
support of NGOs, drug companies, and other government
agencies. Cotabato City was also commended for its
achievements during the nutrition months.
With funds from the project, the OHS was able to provide
free dental services, toothpastes and toothbrushes during the
National Dental Health Week (February), medical testing
services during the Women's Health Month (March) and STD-
AIDS Awareness Month (December). It also conducted
information campaigns through slogan and poster-making
contests, parades and symposia. All these advocacy activities
were done in collaboration with NGOs and other government
agencies such as the Cotabato Regional and Medical Center,
Philippine National Red Cross, and City Social Welfare and
Development Office.
Imp oft p,w'oa

In 1992, Cotabato City has been reported as one of the areas in
the country with the highest incidence of denguema total of 213 cases.
Dengue incidence dropped significantly to 39 cases in 1996. Since
the project's implementation, no epidemic has occurred in the city.
While the city's adjacent municipalities and provinces suffered
from measles epidemic in 1996, Cotabato City was able to control the
spread of the disease. Its measles cases during the year were at a
manageable count of 214.
The prevention of epidemics is attributed to the presence in
each barangay ofa BHS midwife and volunteer workers who conduct
disease surveillance and information campaign on proper health care
and sanitation. The project also enabled the OHS to intensify its
environmental sanitation drive with the hiring of utility personnel to
handle fogging and spraying operations.
With the implementation of the project, health conditions in
the city have improved as reflected in the reduction from 1990 to
1995 of infant mortality rate from 44 to 36 (per 1,000 live births);
child mortality rate from 61 to 50 (per 1,000 children below age 5);
and maternal mortality rate from 183 to 150 (per 100,000 live births).
These were even lower than the average for the Philippines (Table
1).
• 372 ManagingUrbanizationUndera DecentralizedGovernanceFramework
Table 1. Comparative MortalityRates, 1990 and 1995

1990 1995
Mortality rates Cotabato City Philippines Cotabato City Philippines
Infant 44.0 56_7 36.1 48.9
Child 60.9 79.6 50_0 66.8
Maternal 182.8 209.0 149.9 179.7

Child mortality: number of deaths among children less than 5 years of age per 1,000
children of the same age range.
Maternal mortality: number of maternal deaths per 1O0,00O live births.
Sources: Herrin, A. 1998 - "Beyond 2000: An Assessment of Health, Nutrition and

Education Sectors, 1992-1996" (Unpublished PIDS Report); National Statistical
Coordination Board.
Key Contributors to the Project's Success
Interg_ernmenta/coordinat/on and co//aborat/on

The city government, through the OHS, successfully established
strong coordinative and collaboration linkages with the executive and
legislative branches of the local government though the City
Development Council. This was manifested in the support provided
by the barangay officials, NGOs, and the private sector in the
conceptualization, development, •and implementation stages of the
project. The ability of the city government to provide these basic health
services to the disadvantaged people in the far-flung areas by
harnessing the support of various development actors shows the extent
of its coordination and collaboration efforts. This is illustrated by the
government's success story in providing a BHS in each barangay and
additional seven BHS extensions. Barangay officials and concerned
private citizens supported the project by allowing the free use of
barangay halls and private homes as health stations.
Mobillxaaon of local financial resources

The city government was able to overcome its limited financial
resources by resorting to its 20-percent Community Development
Fund in financing its health care projects. Had the OHS depended
on the regular budgetary source alone and did not explore other
sources of funds, the delivery of effective and efficient health services
may not have been brought down to the barangay level. The ingenious
approach to the health service delivery problem, particularly in its
Financing and DeliveringServices in Cotabato City 373
financing, aftbrded the implementation of a meaningful project

attuned to the needs of the population.
Presence of health facilities and personal in the barangays

Since there is a health station serving each barangay, people
have a place to go for their immediate health needs. Health conditions
also improved because there is enough manpower to deliver health
care services. There are midwife and volunteers in every barangay
who implement regular health and sanitation programs, advocacy
activities for periodic health-focused programs, and locally initiated
health activities. Through their house-to-house visits and community
classes, they promote health awareness, proper nutrition, and
sanitation. By monitoring any outbreak of a disease, they prevent
epidemics. The availability of a utility worker to handle spraying and
fogging operations also helps reduce dengue cases.
Mobilization of people for volunteer work

The mobilization of approximately 100 volunteers in assisting
the 37 midwives facilitated the delivery of health services to more
people at minimum cost. The city in turn recognizes the outstanding
performance of BHWs through annual awards and token gifts. For
the government, these volunteer workers are one of the key
contributors to the remarkable performance of the city in the
implementation and advocacy of annual health programs.
Barang_y e/uaer/ng
Clustering the barangays into seven subcity areas facilitated the
implementation and monitoring of the project. Moreover, the
designation of a cluster coordinator for each area provided focus in
the supervision and monitoring of health activities in the barangays.
Clear goals/plans/programs
Because primary health was one of the local administration's
priorities, the city leaders have set a specific goal: to provide a BHS
and midwife in every barangay. Accordingly, they devised plans and
financing scheme to achieve this goal. The OHS then prepared a
project proposal, which was discussed thoroughly in the Annual City
Planning Workshop participated by government agencies and
nongovernment organizations. With its concrete measures, the
proposal was subsequently implemented as the Special Project on

Health and Sanitation.
Strategies That Can Be Replicated by Other Cities

Given the experiences and lessons from Cotabato City's
financing and delivery of health and sanitation services, the following
strategies may be replicated by other cities.
Use of barangay halls and private homes as BHS

Cotabato City's experience shows that there is a need for a
physical structure or facility to house a BHS so that the people will
know where to go for their health needs. In addition, it presents
possibilities of substitution or sharing in the use of facilities. A certain
venue does not have to be utilized solely for the BHS. It can serve as
BHS on certain days of the week and have other uses during other
days.
Another important lesson that can be derived from the Cotabato
City experience is its persistence in pursuing its goal of providing a
BHS for each barangay despite the budgetary support. Through
effective coordination and collaboration with barangay officials and
private citizens, the city government was able to set up the health
stations using barangay halls and private homes for free. Since the
barangay residents directly benefit from the BHS, it is enough
incentive for them to help the city government through free
accommodation in their respective barangay halls or private homes.
Of course, other government units may also consider renting these
facilities instead.
Provision of midwife for each barangay

Without the health personnel, the presence of health facilities
in the barangays does not guarantee the delivery of health services to
the community at any given time. This is the rationale for the provision
of barangay health midwives for each BHS who were hired even on a
casual basis.
Intensive planning and coordination

The case of the Cotabato OHS imparts to other LGUs that to be
able to implement meaningful projects, thorough planning and
extensive coordination work must be done. The LGU attained its
objectives for its development projects because its planning staff was
Case Study: Financing and Delivering Services in Cotabato City 375
able to articulate these needs, identify viable measures to address the

problems, coordinate with beneficiaries, local officials and NGOs,
and explore local financial resources.
Mobi_ of local resources

Based on Cotabato City's example, other cities can also tap
trained hilots to assist midwives in the health stations. The barangay
officials and midwives may approach the trained h//0ts individually or
organize a meeting meant to encourage the latter's participation in
health service delivery.
Other cities could also request the assistance of health service-
related educational institutions, NGOs, private companies, and civic-
minded citizens in conducting health-related activities for periodic
advocacy programs as well as during the celebration of the cities'
respective foundation days. City officials or representatives may
approach them directly or call a meeting with them to plan the
activities and specify their participation or contribution (such as
manpower, refreshments, and financial support).
Bam_ry clmt_ng
In Cotabato City, the clusters matched the delineation of the
subcities identified by the city government for its administration.
Other cities could also follow their own government's delineation as
basis for the barangay grouping or they could devise other schemes
such as grouping the barangays based on their proximity with each
other.
Anmud program rev/ew and evahaz6on

Other cities could also conduct an annual workshop or general
meeting among their health workers, as being practiced by Cotabato
City, to serve as a forum for assessment of perfolTnance, exchange of
information, and social interaction. In this activity, health workers
can provide information on their respective projects, share ideas and
interact with one another, thereby promoting camaraderie and
smooth working relationships.
Conclusion
Cotabato City is a good example for other cities to follow. If the
OHS just relied on the regular budget for the construction of the
BHS, it would not have accomplished its objective of providing one
BHS per barangay. At present, the city has only 23 concrete BHS.
Based on the construction rate of three BHS per year, it will take
about five more years to build additional 14 concrete BHS to com-
plete its target of 37 BHS (or one BHS for each barangay). Likewise,
if the OHS depended only on its regular budget, it would not have
been able to provide a midwife for each barangay. Its resourcefulness
and initiative in looking for funds and alternative setups for BHS and
hiring of midwives enabled the city to bring health services to each
barangay starting 1993.
The same arrangement may be explored to facilitate the imme-
diate realization of another OHS goal--the establishment of seven
subcity District Heakh Offices (DHO), each manned by one doctor
and one nurse. This project is planned for implementation in 2003-
20O8.
The city government may also hire the DHO personnel on tem-
porary basis. To reduce costs further, it could allow doctors to work on
a part-time basis. This is based on Puerto Princesa City's example.
The city was able to provide doctors to satellite clinics on part-time-
arrangement. Puerto Princesa City has five strategic satellite clinics,
each with a catchment area of four to eight barangays. Doctors (one
for each clinic), who are hired on contractual basis, attend to the
patients for two days a week and in the remaining days, engage in
private practice. The city pays each doctor a monthly salary of P10,000.
Cotabato City can explore the arrangement made by Puerto
Princesa City in the provision of doctors and other health personnel
in the subcity clusters. The city and barangay governments may share
in the payment of salaries to these health personnel.
In the final analysis, the implementation of the 1991 Local
Government Code provided the LGUs the opportunity to examine
the mandate given to them as well as their human and physical re-
sources in the delivery of basic services to their respective constitu-
ents. The decentralized local governance policy encouraged LGUs
to be resourceful and to take the initiative in planning, developing,
and implementing programs and projects in their localities. The Spe-
cial Project on Health and Sanitation of Cotabato City has exempli-
fied that with creativity, political will and determination, and dedica-
tion to public welfare, the delivery of health services to the people
can be ensured and sustained.
Case Study 6
Lapu-lapu City's
Partnership,for Health
Virginla S.Pi_d.a
apu-lapu City, the prime tourist destination in Cebu, is located

in Mactan Island, about 13 kilometers away from the Port of
Cebu. It is bounded on the north and west by Mactan Chan-
nel, on the east by Bohol Strait, and on the south by the Municipality
of Cordova and Bohol Strait.
composed of 30 barangays and has about 30,838 households.
Lapu-lapu City has 100 percent urban population. In just 15
years, its population almost doubled. From 98,723 persons in 1980,
its population increased to 146,194 in 1990 and 173,744 in 199.5.
Accordingly, population density per square kilometer rose from 1,699
in 1980 to 2,459 in 1990 and 2,933 in 1995.
Health Facilities
The city has 41 barangay health centers/stations (BHCs/BHSs),
one government primary (community) hospital, two private primary
hospitals, and one private tertiary hospital. The hospitals have a
combined capacity of 130 beds, consisting of 10 beds in the
government community hospital and 120 beds in private hospitals.
The BHCs and BHSs are clustered into eight health districts. These
hospitals and the health districts cover certain barangays and
population, as presented in Table 1.
Health Expenditures/Budget
In 1991, prior to devolution, Lapu-lapu City's health
expenditures totaled 2.8 million (7 percent of its total expenditures).
After devolution, health expenditure rose to P6.1 million in 1994
and 8.9 million in 1995 but its ratio to total expenditures declined to
4 percent for both years. These amounts were spent for basic health
services and other health-related expenditures such as construction
and maintenance/operation of facilities.
Table 1. Catchment Areas of Hospitals and BarangayHealth Stations,in

Lapu-lapu City
Hospital/Health Districts No. of Beds/BHSs No. of Barangays Poptdation
Sta. Rosa Community l 0-beds 8 island 18,796

]:tospital barangays
22 mainland 127,398
Our Lady of Rule Maternity
Tojong
}General Matemity
Hospital
and General Clinic and
Hospital 10
16 beds
beds ) barangays
Mactan Community Hospital 94 beds

District 1 5 BHSs 4 24,423
Note: Population data corresponding to the catchment area of the hospitals were based on
the 1990 Census of the National Statistics Office while data at health district level were
based on 1997 population.
Sources: Lapuqapu City Health Office; National Statistics Office.
Lapu-lapu City's budget for health for 1997 was P14.6 million.
About 25 percent of this was for the city government's counterpart
for Urban Health Nutrition Project (UHNP)-initiated activities while
the remaining 75 percent was for the City Health Office (CHO). The
percentage of the health budget to total city budget is 5 percent. For
1998, the city allocated P4.3 million as counterpart for UHNP
programs and P13.3 million for the CHO. Its health budget amounted
to P17.6 million and constituted 6 percent of the total city budget.
Lapu-lapu City provides flee services and medicines in its BHCs/BHSs.
Health Performance
Lapu-lapu City used to perform poorlyin the Expanded Program
of Immunization (EPI). In 1988, it ranked second lowest among the
provinces and cities in the Philippines as the proportion of its Fully
Immunized Children (FIC) to the target population was only 30
percent. Its FIC rate increased substantially in the subsequent years:
80 percent in 1989 and 90 percent in 1990. In 1991, Lapu-lapu City
Case Study:Lapu-lapuCity'sPartnershipfor Health 379
even won the Most Accelerated City in EPI Award as its FIC reached
95 percent. As of 1995, its FIC rate was 104.5 percent of the target
population.
With better EPI performance, the city's infant and child
mortality rates as well as maternal mortality rates declined from 1990
to 1995 and were even lower than the average for the whole country
(Table 2). Lapu-lapu City was also performing very well in nutrition.
In 1990, its malnutrition rate at 59 percentwas the same as the national
average. By 1995, it was able to decrease substantially its malnutrition
rate to 22 percent, which was much lower than the average rate of 40
percent for the Philippines.
Strategies to Promote Health

To promote efficient delivery of health services, the Lapu-lapu
CHO employed the following strategies:
Regular barangay visitation and assembly

When the city health officer assumed office in 1989, he toured
all the barangays for one month to know the people's health needs
and identify ways of improving their access to health and sanitation.
He traced the low EPI performance to the absence of a specific
schedule for immunization and the people's lack of interest or
awareness. Access to other health services has also been limited since
doctors did not have a fixed schedule of visits to the barangays. The
city health officer therefore set a permanent schedule for EPI every
week and ensured that a doctor will visit a barangay at least once a
month on a specific date. At that time, there were only two doctors.
Now, there are 10 doctors, each of whom is assigned to four barangays.
As the city health officer went around all the barangays, he encouraged
the people to go to the health centers. He goes to the barangays three
to four times a week to check on the status of programs being
implemented. The mayor would also come along with the city health
officer three to four times a month.
Every quarter, the CHO conducts barangay assembly to present
the current health programs and projects of the government and to
solicit feedback on the community's health problems and priorities.
The community also participates in drawing up solutions to their
problems.
Table 2. Mortafity and Nutrition Indicators, 1990 and 1995

Indicator 1990 1995
Lapu-lapu Philippines Lapu-lapu Philippines
Mortality Rates:
Infant 42.0 56.7 32.8 48.9
Child 55.1 79.6 43.0 66_8
Maternal 167_7 209_0 130 _8 179 _7
Mild 32.1 41.3 19.5 30.7
Moderate 23.9 15_5 2_8 8.4
Severe 3.4 2.3 0.1 1.2
Total 59.4 59.1 22.4 40.3
of" the same age range.
Sources: "Beyond 2000: An Assessment of the Health, Nutrition and Education Sectors, 1992-
1996", 1998 (Unpublished PIDS paper); National Statistical Coordination Board;
1996 Department of Health (DOH) Annual Accomplishment Report; DOH
Nutrition Service; 1997 Lapudapu City CHO Statistical Report.
Regular interaction with officials, concerned groups and staff

Aside from submitting reports, the city health officer gives
feedback to the mayor every morning concerning the past day's
activities. He joins the Association of Barangay Captains (ABC)
meedngs once a month. During the meedngs, the city health officer
is able to promote health concerns such as the importance of having
a BHS in every barangay. In 1989, there were only five BHCs/BHSs.
Currendy, there are 41 BHCs/BHSs for the city's 30 barangays.
Recognizing the usefulness of an integrated approach in
addressing needs, the city health officer formed an interagency
committee composed of"government, nongovernment, and civic and
religious groups. The committee meets every first Thursday of the
month to discuss health, education, and social welfare issues and
concerns. One example where the involvement of the religious sector
proved beneficial relates to the tetanus toxoid controversy. A parish
priest opposed the immunization of pregnant women with tetanus
toxoid because it allegedly caused abortion. The committee's member
from the religious sector helped to convince the parish priest on the
effectiveness of tetanus toxoid as a preventive medicine and corrected
the latter's misconception.
Case Study: Lapu-lapu City's Partnership for Health 381
Ever), Monday, the city health officer conducts staff meetings

with all health personnel to discuss issues and concerns related to
delivery of t/ealth services as well as CHO operations. In addition,
there is also a monthly meeting per district among the health
personnel and workers. These meetings provide a venue for
identifying problems and solutions, and other strategies for further
improving performance in the health sector.
Adopt,.a-Barangay Program for private companies

Under this program, private companies and educational
institutions adopt barangays and assist on health needs. They help
through their doctors (retainers) who conduct regular monthly free
clinic in the adopted barangays and by donating facilities or supplies
such as used toilets. At present, 10 private companies and five
educational institutions have adopted eight barangays. On top of the
health assistance, the institutions and firms also plant trees to maintain
the greener areas of the adopted barangays.
Private companies and congressmen also contribute for the milk
feeding of preschoolers and Grade I pupils while a food manufacturer
regularly donates noodles to feed children. One company even
handled the fogging activities for the entire Lapu-lapu City.
Mobilization of pr_vate medical practltione_ and other groups

For the immunization program, the CHO has involved 50 private
medical practitioners from the Mactan Doctors Organization, a civic
organization, and nurse-volunteers from the Mactan Community
Hospital. It provides vaccines for the group during their collaborated
immunization program. Moreover, it also requests the group to set
aside time for rendering free services to the barangays. At presents,
50 doctors and 100 nurse-volunteers give free services to the barangay
people.
The hilots and midwives who are private practitioners are
considered as part of the CHO even if they are not employed by the
government. The CHO provides them trainings and asks them to
participate in meetings so they could enhance their skills and service
to their clients. The h//ots and trained birth attendants (TBAs) are
required to report to the CHO every last Monday of the month to
discuss health issues and concerns.
To encourage entertainment club owners and managers to
monitor the health status of their club workers, the CHO organized
the Lapu-lapu City Club Owners and Managers Association

(LACOMA). The club owners and managers are responsible for
ensuring that their workers undergo hygiene checkup everyweek and
conduct peer counseling sessions on sexually transmitted diseases/
human immunodeficiency virus monitoring, detection and
surveillance (STD/HIV/MDS), fertility and birth control.
The CHO also formed mothers' support groups to assist the
health workers. The mothers do information-education-
communication (IEC) dissemination in their respective barangays.
They help health personnel during advocacy activities such as in
feeding the children during the nutrition month. The groups
currently have 410 members.
Funding from the barang_s

Allowances given to barangay health workers (BHWs) come from
the barangays. This arrangement encourages barangay officials to be
more involved in health matters and to monitor the activities of BHWs.
Depending on the barangay budget, the allowances range from P400
to P!,500 per month. The city, on the other hand, provides free
hospitalization to the BHWs and their families.
Use of biological toilet for barangays short of water

Lapu-lapu City has nine biological toilets in two barangays.
These toilets are useful in areas experiencing shortage of water.
Instead of utilizing water for waste disposal, ash is used to cover the
waste. The toilets are made of hollow blocks and cement. Galvanized
iron is installed to facilitate the drying up of the waste matter via the
heat of the sun. The dried waste matter has been tested to be free of
coliform and is used as fertilizer after one year. A biological toilet
costs P10,000 and is good for five to 10 households.
Leadership and i_ of the city health officer

To know the people's health needs, the city health officer went
to the barangays regularly. After studying the causes of Lapu-lapu City's
low performance in EPI, he implemented corrective measures that
helped turn the city from the second lowest performer in 1989 to the
most accelerated city in EPI implementation in 1991. The solutions
Case Study:Lapu-lapu City'sPartnershipfor Health 383
were quite simple: fixing a schedule for EPI, encouraging the people
to go to the BHSs and ensuring that there are health personnel who
will attend to them. He initiated the organization of an interagency
committee that discusses health and other concerns and instituted
regular meetings among health personnel and workers. His regular
presence and monitoring work in the barangays encouraged health
personnel and workers to do their tasks well.
Interaction with the mayor and baranguy captains

The city health officer was able to push for health concerns
during his interactions with the mayor and the barangay captains.
He always stressed the need for health to be a priority inasmuch as
their constituents will not be productive if they are not healthy. By
communicating to the city/barangay leaders the health problems and
needs in the barangays, he was able to get financing for the
construction of BHSs and funds from the barangays for the health
workers' allowances.
Good networking, proper linkages and coordina6_

Through networking and identifying specific ways by which
private companies, medical practitioners and mothers can assist in
health service delivery, the CHO was able to get the involvement and
support of these groups.

Lapu-lapu City's health-promoting strategies that other cities
may replicate are the following:
Regular barangtty visitation and assembly

The city health officer could schedule regular visits to the
barangays to see actual implementation of health activities and
interactwith the people concerning their health needs and problems.
He could also conduct barangay assembly meetings every quarter to
present health programs and projects and discuss with the community
its health priorities, problems, and solutions.
Interaction with city/barangay officials, concerned groups and
staff. Besides submitting reports, a dialogue or meeting with the mayor
may be done regularly. To interact with barang_ay captains and promote
health concerns, the city health officer may also attend ABC meetings.
He may also initiate the creation of an interagency committee to

discuss health and other concerns. Regular meetings (e.g., monthly
or weekly) among the health personnel/workers may be conducted
as part of the planning, monitoring and evaluation process.
Adop_-Baran_y program for pr/vate cannpan/es

Similar to Lapu-lapu City, other cities could also ask private
companies to adopt barangays. The city health officer may present
the needs of the barangays and identify the specific assistance the
companies could provide such as holding of regular free medical
clinics or milk or food contributions to the nutrition program.
Mobitixaaionofpra,at, pmeation and mothers

The CHO may request private practitioners (doctors, nurses,
midwives) in the barangays to render free services regularly (e.g.,
once or twice a month). The BHWs can assist by identifying the private
practitioners who may be able to give such services.
Health personnel could organize mothers' support groups in
cities where these are nonexistent. Following such groups'
organization, CHO resource persons can train mothers on health and
sanitation concerns and identify specific ways by which they can assist,
in health service delivery.
Bara_ funding
Just like in Lapu-lapu City, the barangays could give BHWs an
allowance. The amount may depend on their financial capability. If
the barangays can _afl_ordit, the allowance may be standardized.
Cities that lack water or would like to save on water can try using
biological toilets. They can request Norfil Foundation, a
nongovernmental organization that handled the setting up of
biological toilets in Lapudapu City, to construct a similar facility or to
teach how these units are made and maintained.
Conclusion
Having been awarded as the most accelerated city in EPI
implementation in 1991, Lapu-lapu City is a good example to follow
for low-ranking EPI performers. Like the former, they could examine
Case Study: Lapu-lapu City's Partnership for Health 385
the causes of their low performance and apply corrective measures.

In the case of Lapu-lapu City, it fixed a regular schedule for EPI and
doctors' visits, and encouraged the people to go to the BHSs. Causes
of low performance may differ per locality but the first step is to
identify them so that appropriate actions can be taken.
Following Lapu-lapu City's example, health officers in other
cities and local government units could achieve efficient and effective
delivery of health services at minimum cost by knowing the people's
needs through their interaction with them, as well as by
communicating these needs to concerned city and barangay officials
and by mobilizing various groups to provide material and manpower
resources,
Case Study7

Virginia S. Pineda and Aurora M.Joson
,Zambales. It is about 127 kilometers north of Metro Manila.

O longapo
It City isonlocated
is bordered at the
the north by southernmost
the Municipality portion of
of Subic
(Zambales), on the south by Dinalupihan (Bataan), on the southeast
by Morong (Bataan), and on the southwest by Subic Bay.
composed of 17 barangays, all of which are urban. As of 1995, it has
about 38,983 households.
The population decreased from 193,327 in 1990 to 179,754 in
1995 or by 7 percent. Accordingly, population density per square
kilometer fell from 1,872 persons in 1990 to 1,740 persons in 1995.
The population decline may be due to out-migration resulting from
the US Navy's withdrawal from Subic and the Mt. Pinatubo eruption.
As of 1994, about 28 percent of the population lived below the poverty
threshold level.

The city has one main health center, one government hospital,
and eight private hospitals. It has 18 barangay health stadons (BHSs):
two for Sta. Rita and one each for the remaining 16 barangays. Each
barangay has a doctor, nurse and midwife. Large barangays even have
three midwives. A dentist comes to the barangays once a week.
The city government owns and operates the James Gordon
Memorial Hospital (formerly the Olongapo City General Hospital).
It has a capacity of 155 beds and serves not only patients from the city
but also those from the neighboring municipalities and provinces.
The private hospitals have a combined capacity of 156 beds.
All services and medicines are free in the health center and
stations. For those who want to give contribution, a donation box is
placed in each site. in the hospital, most of the patients are service
(charity) patients. Of the 7,438 patients admitted in 1995, the service
patients comprised 76 percent, while medicare and pay patients
constituted 11 and 13 percent, respectively.
Case Study: Olongapo - A Health City 389

1990 1-_5
Indicator Olon_apo Pbillpplne_ Olongapo Philippines
Mortality Rates:
Infant 41.2 56.7 30.9 48.9
Child 54.0 79.6 40.2 66.8
Maternal 184.0 209.0 138.0 179.7
Mild 33.9 41.3 28.1 30.7
Moderate 9.9 15.5 8.3 8.4
Severe 1.1 2.3 1.4 1.2
Total 44.9 59.1 37.8 40.3

Child mortality: number of deaths among children less than 5years of age per 1,000 children
Sources: Herrin, A. "Beyond 2000: An Assessment of the Health, Nutrition and Education
Sectors, 1992-1996," 1998 ('Unpublished PIDS Paper); National Statistical
Coordination Board; Olongapo City Health Office; Department of Health Nutrition
Service.
Disease prevention through cleanliness

Olongapo's city leaders believe that diseases can be avoided or
minimized through cleanliness. After the city launched its solid waste
management project in September 1989, sanitation-related diseases
were remarkably reduced. For instance, morbidity rates (per 100,000
population) for typhoid, paratyphoid and other salmonella infections
declined from 75.2 in 1988 to 59.8 in 1990 and 9.3 in 1995, and for
malaria from 345.3 in 1988 to 183.9 in 1990 and 68.5 in 1995.
Olongapo City's solid waste management project is discussed
in more detail as a case study in the environmental management
sector. Briefly, it involves enforcement of the tbllowing: putting
garbage in plastic bags, strict collection schedule, service fee for
garbage collection, incorporation of said fee in the electricity bill,
and imposition of fines for violators of sanitation ordinances. Plastic
bags are required to make garbage collection faster and neater.
Likewise, the inclusion of a garbage fee in the electricity bill facilitates
and ensures garbage collection.
The. CHO plays a major role in the solid waste management
project. Its sanitary inspectors regularly inspect their assigned areas
and issue citation tickets to residents and owners of business
establishments who violate sanitation ordinances (such as having
unclean premises and putting out garbage outside of the scheduled

collection time). The tickets impose fmes ranging from PS00 to P5,000
(or imprisonment), depending on the number of offenses or
violations.
Olongapo has a city ordinance, passed on 24 January 1996,

requiting barangays to allocate 5 percent of their internal revenue
allotment (IRA) to health and welfare. Drug allocation to the
barangays are sourced from this fund, thus reducing the financial
burden on the city. This arrangement also increases the involvement
of barangay leaders in health service delivery.
Mobilization of volunteers
Olongapo is known for the volunteerism of its people. It even
won a Galing Pook Award in 1997 (Top Twenty) for its volunteer
program. One of the city's volunteer groups is the Balikatan Ladies
of Olongapo Movement (BLOOM), which was organized by Mayor
Kate Gordon in 1980. BLOOM is composed mosdyof housewives in
the community. At present, it has more than 6,000 members. It
participates in the city's cleanliness drive and undertakes various
barangay projects. Its members who also serve as health volunteers
work without pay as nursing aides in the city hospital, assist the health
workers in immunization drive and in organizing and conducting
health classes. Olongapo City's health volunteers, including non-
BLOOM members, are about 300. They do not receive allowance but
are provided with hospitalization benefits.
Perforn_nce monitoring through meetings

In addition to reports, monthly staffmeetings and semi-annual
review of accomplishments are conducted to monitor and evaluate
the barangays' performance. Here, causes of low accomplishments
and appropriate solutions are identified. For example, if a barangay
has many dropouts in immunization, follow-ups through letters or
house visits are recommended.
Baran_uy con.ridtat/on w/th the mayor and department heads

Mayo r Kate Gordon does not spend most of her time in her
office because she believes that not all people can go to the city hall.
To actually see their situation and needs, the mayor goes to the
Case Study:Olongapo- A Health City 3 91
harangays with all the department heads. All the 17 barangays are
visited within one quarter. During the barangay consultations, the
people tell the mayor their problems and needs. The department
head concerned is then tasked to take action and start working on
these issues the following day: The people then report back to the
mayor in case the problems remain unsolved.
Effea/veten.t/on anataw
The barangays' financial contribution to health (5 percent of
their IRA) was made compulsory through a city ordinance. The city
government also enacted sanitation ordinances and used both
negative and positive reinforcements to ensure the people's
compliance with its regulations. To promote cleanliness, sanitary
inspectors do their rounds everyday and impose fines on violators of
sanitation ordinances. Garbage is not coUected unless iris putin plastic
hags. Payment of garbage fees is guaranteed by incorporating them
in the electricity bill. Positive reinforcements include posting of _Keep
Olongapo City Clean" slogans and implementation of a regular, fixed
garbage collection schedule.
0r/p's $or po#U's

Volunteerism is encouraged by giving the volunteers (or their
qualified relatives) priority in job placement. To a large extent, the
city officials were able to gain the people's cooperation as well as
know their needs and problems by reaching out to them--through
regular barangay visitations and interaction.
I_ among concerned of[w/a/s and staff

Monthly and semi-annual meetings to review and compare
accomplishments among the barangays enable them to identify low
performers, discuss and analyze problems, and devise solutions and
strategies.
Disease prevention through cleanliness

Specific practices of Olongapo City that can be emulated by
other cities include requiring residents to put their garbage in plastic
bags, incorporating the garbage fee in the electricity bill, regular

monitoring of residential and business premises by sanitary inspectors,
and imposing fines for violators of"sanitation ordinances.
Barangay funds for health

Other cities may also require barangays to allocate a certain
percentage of their IRA for health and welfare concerns. The
percentage may be set in consultation with the barangays.
Performance monitoring and evaluation

Regular monthly and semi-annual meetings may be scheduled
to review and compare accomplishments among the barangays and
the whole city. Meetings, in addition to submission of reports, have
benefits. Through them, the officials and staff concerned could
analyze the problems, exchange views, generate ideas, and devise
solutions and strategies to further improve performance.
Mobilization of health volunteers

If there are no existing health volunteer groups, the cities could
form an organization similar to Olongapo's BLOOM. They could
assign people who can motivate and undertake the recruitment and
training of health volunteers.
Barangay consultation with city officials

The mayor and other city officials could make it their policy to
visit each barangay regularly. During the visits, they could discuss with
the people the latter's problems and needs. The mayor can then assign
the officials concerned to take appropriate action or work out with
the people the solution to the problems.
Conclusion
Olongapo City made the link between health and sanitation
stronger by integrating its environmental program with health
activities. It hasbecome a healthy city as a result of its leaders' political
will and commitment to good health and sanitation, the dedication
of its staff, and the cooperation of its people. Its health-promoting
strategies also serve as lessons on good governance that other cities
could follow. These include the need for city leaders to interact
regularly with their constituents, the use of positive and negative
reinforcements to instill discipline and proper values to people, and
regular monitoring and evaluation to ensure sustained and successful
implementation of programs and activities.
Case Study 8
Butuan City: A Consistent

Regional Outstanding
Winner in Nutrition
Virginia S. Pineda andJazmin D. Berido
uman City is located at the central portion of the province o:

Agusan del Norte in northern Mindanao. It is bounded oi
the north by the Butuan Bay and the municipality o
Cabadbaran, on the east by the municipality of Sibagat, on the wes
by Buenavista and on the south by Las Nieves.
The city has a total land area of 526.3 square kilometers. It i..
composed of 86 barangays, of which 27 are urban and 59 are rural. P_
of 1995, it has about 46,596 households.
In 1990, the city population was estimated at 227,829 persons
Of these, 40 percent live in the urban areas while 60 percent resid_
in the rural barangays. By 1995, the population increased to 247,07_
persons orby 8 percent (National Statistics Office Census). Populatioi
density per square kilometer also went up from 433 in 1990 to 470 il
1995. The proportion of population living in urban areas decreasec
slightly to 38 percent while that in rural areas rose to 62 percent.

Butuan City has three main health centers, 27 urban baranga,
health stations (BHSs) and 59 rural BHSs. It has two governmen
hospitals and six private hospitals. The city owns and operates thq
City General Hospital and Medical Center, which has a capacity o
150 beds. The other government hospital, the Provincial Hospital o
Agusan del Norte, has a capacity of 100 beds. In addition, the city'..
six private hospitals have a combined capacity of 521 beds. Th_
hospitals serve not only patients from Butuan City but also those fron
other municipalities.
In 1991, prior to devolution, Butuan City's health expenditure_
amounted to P12.3 million, which constituted 10 percent of its tom
expenditures. Of this, about 34 percent was spent for basic healtt
and 66 percent ibr hospital. In 1994, after the devolution of functions,

health expenditures increased to P27.5 million, which was 10 percent
of the city's total expenditures. The proportion spent for basic health
increased to 43 percent while that for hospital declined to 55 percent.
The city government's budget for health in 1995 was P29.1
million (or 8 percent of the total city budget). About 54 percent of
the health budget was allocated for hospital and 46 percent for basic
health, nutrition, and miscellaneous health services.
Health Performance
Butuan City's infant and child mortality rates have been
declining and are lower than the average for the whole country in
1990 and 1995. Its maternal mortality rates, although decreasing, have
been higher than the national average for the same years (Table 1).
Nevertheless, the reduction in the city's maternal mortality rates (50
per 100,000 live births) was greater than the average for the
Philippines (29 per 100,000 live births) from 1990 to 1995. Similarly,
the percentage of the city's malnourished children fell significantly
from 58 percent in 1990 to 32 percent in 1995, both lower than the
national average for the same years.
Table 1. Mortalityand Nutrition indicators, 1990 and 1995

1990 1995
Indicator
Butuan City Philippines Butuan City Philippines
Mortality Rates:
Infant 45.9 56.7 36.7 48.9
Child 65.0 79.6 52.2 66,8
Maternal 251.3 209.0 201.0 179.7
Children (0-83 years old)
Mild 43.6 41.3 26.5 30.7
Moderate 13.7 15.5 5.0 8.4
Severe 1.1 2.3 0.4 1.2
Total 58.4 59.1 31.9 40.3

Child mortality: number of deaths among children less than 5 years of age per 1,0OO children
Sources: Herrin, A. 1998. Beyond 2000: An Assessment of the Health, Nutritional and Education
Sectors, 1992-1996 (Unpublished PIDS paper); National Statistical Coordination
Board; Butuan City Nutrition Office; Department of Health Nutrition Service.
Case Study:Butuan City - A ConsistentWinner in Nutrition 395
Nutrition Activities
The Philippine government's measures to address the malnu-
trition problem include food assistance, micronutrient supplemen-
tation and ibrtification, growth monitoring and promotion, nutrition
education, home and community food production, and credit assis-
tance for livelihood. Butuan's Nutrition Committee is in-charge of
these activities for the city. It is chaired by the mayor and members
meet once every quarter. Its composition and the tasks per member
are presented in Table 2.
Table 2. Composition of the Butuan City Nutrition Committee
Agency Activlty/responsibillty
Department of Interior and Reactivation of Barangay Nutrition Committees (the

Local Government (DILG) Committees are funded by the barangays)
City Health Office (CHO) Rehabilitation of malnourished children; In-charge of

micronuu_ient supplementation
City Social Welfare and Livelihood funding for family with malnourished
Development child/children (poverty cases) ; Supplemental feeding
Office of the City Agriculturist Food production/food security
Department of Education, Nutrition education using TCP (Teacher, Child,

Culture and Sports (DECS) Parent) approach. The teacher imparts nutrition
information in class, which the children echo to the
parents.
Food assistance program for children, e.g., hot lunch
Food production in schools
City Budget Office Allocation of funding for nutrition
Philippine Information Assistance in nutrition information dissemination

Agency through the tri-media
City Population Office Population control and population education
Butuan Host Lions Club Food assistance through feeding in the bm-angays and
distribution of food commodities
Responsible for training the Barangay Nutrition
Scholars in Vitamin A deficiency and eye cataract
detection
Catholic Women's League Feeding activities for disabled persons, prisoners and
hospitalized children
Source; Butuan City Nutrition Office.
Butuan City has a separate City Nutrition Office (CNO). Headed

by the City Nutrition Officer, the CNO acts as the Secretariat to the
Butuan Nutrition Committee and serves as the coordinating office
for all nutrition program activities. The CNO has two assistant
nutritionists, each of whom is assigned to 43 barangays. In every
barangay, there is a feeding center and a barangay nutrition scholar
(BNS). Each BNS receives a monthly amount of P400 from the city
plus allowance from the barangay (the amount varies per barangay).
The barangays are grouped into 10 clusters. Each cluster's members
meet once a month. All 10 clusters also hold a monthly general
meeting wherein the BNSs discuss plans, problems, and program
implementation.
The BNSs serve as contact persons for almost all city activities
on nutrition, agriculture, social welfare, health, education, and
population. The CNO and the Department of Interior and Local
Government (DILG) provide at least two training/seminars per year
to BNSs to equip them with necessary skills in program management
and basic information on nutrition program planning and
implementation in the barangays.
With the supervision of Barangay Nutrition Committee
members, the BNSs hold nutrition seminars in the barangays. Aside
from teaching proper nutrition, the seminars also deal with
responsible parenthood. Because malnutrition is most likely present
when there are many children to feed and family income is low, the
parents are advised to limit the number of their children. Otherwise,
the share of each child in the food and other provisions gets smaller
as the number of children increases. Mothers of malnourished
children are required to attend nutrition seminars at least twice a
year. If they fail to do so, their children are not given milk.
Every month, the BNSs weigh the children. Simultaneously, they
provide information on proper nutrition to mothers. The BNS also
conduct regular home visits once a month. During their visits, they
hold a dialogue with residents regarding the different programs and
projects offered by the city government.
The BNSs campaign fbr food production through barangay
assemblies, meetings and mothers' classes. They encourage backyard
gardening or even planting in the mountains if backyard space is not
available. In every barangay, an agricultural officer is assigned to assist
farmers. To enable farmers to buy pre- and post-harvest equipment
(power tillers and threshers), the mayor provides interest-free loans.
Case Study:ButuanCity - A ConsistentWinnerin Nutrition 397
Table $. Malnutrition in Butuan City and in the Philippines

Percentage of Malnou_dled 1_6 1997
Children
(0-83 months old) Butmm City Philippics Butuau Phifipplnes

cat,/
Mild 24.0 28.5 22.5 26.2
Moderate 4.4 8.3 3.6 6.6
Severe 0.4 1.3 0.3 0.9
Total 28.8 38.1 26.4 35.7
Sources: Butuan City Nutrition Office and Department of Health Nutrition Office
To monitor performance, the BNSs use a spot map and

nutritional status table. The spot map indicates which barangays have
many moderately, mildly, or severely malnourished children. The
nutritional status table presents a yearly comparison of the number
and percentage of children with severe, mild, and moderate
malnutrition.
Butuan City was a CROWN (Consistent Regional Outstanding
Winner in Nutrition) Awardee in 1996 and 1997. The city showed
outstanding performance, having lowered the malnutrition incidence
among children from 29 percent in 1996 to 26 percent in 1997 as
compared with the national averages of 38 and 34 percent, respectively
(Table 3).
Butuan City's budget for nutrition (including milk) amounted
to P2.3 million in 1997, which constituted 0.46 percent of the total
city budget.
For its livelihood program, Butuan City has allotted P4 million.
Furthermore, its P50,000 CROWN prize was loaned to 25 families
coming from the top 20 barangays with the highest malnutrition
incidence and from the top five nutrition program implementors.
The loans are used for livelihood projects, such as sari-sari stores and
mushroom/bromeliad growing. These loans are interest-free and
payable after two years.
Strategies to Overcome Malnutrition

The city is actively implementing the government's :holistic
approach to the malnutrition problem. In addition, it has its own
local strategies that contributed to its outstanding performance in
nutrition:
398 ManagingUrbanizationUndera DecentralizedGoverna_
Use of fresh milk

Butuan City uses milk instead of Nutripak for feeding. According
to the city nutrition officer, milk is more convenient since it is ready
to drink and can be taken on-site. In contrast, Nutripak, which contains
mongo and d//_ (anchovies), has to be cooked at home. It is also
hard to monitor if Nutripak was fed to the malnourished child only
or served as food for the whole family.
Malnourished children are weighed every month and fed milk
everyday until the normal weights are achieved. The BNSs distribute
to pur0h leaders a specified quantity of milk based on the number of
malnourished children. As a control measure, the parents' signatures
are required to certify that their children drank the milk.
Butuan City began to use fresh milk for feeding in 1993 after
the phase out of the United States' food commodity provision under
Public Law 480. Initially, it sourced fresh milk from a farmers'
cooperative in another city. However, there were problems
encountered in this arrangement. The milk had to be consumed
immediately to avoid spoilage. Storing it in the freezer extended its
shelf life but many complained that it was too cold to drink. Children
also got diarrhea from drinking the milk. The city nutrition office
was able to solve this problem by shifting to liquid milk from Australia.
Such milk can be stored up to nine months and was cheaper than
local milk by 10 percent.
The city spent P1.4 million for milk in 1997. For 1998, its
approved budget for milk was P1.5 million. But since milk provision
was a temporary project, the BNSs told mothers not to depend on it.
Rather, the mothers were reminded to apply what they have learned
from nutrition seminars on the right kind of food to feed their
children.
Barangay Nutrition Committee program planning seminars

Butuan City Nutrition personnel and DILG staff conduct
nutrition program planning seminars with barangay leaders. They
compare the nutritional status of the purok in the barangay and guide
the leaders in making their own plans for each quarter by asking them
to identify problems, think of solutions, look for funding sources if
needed, assign people to handle problems, and make a timetable of
activities.
Case Study:ButuanCity -.A ConsistentWinner in Nutrition 399
Searchfor Bulawanong (Golden) Bamngay

Butuan City conducts an annual "Search for Bulawanong
(Golden) Barangay." Every quarter, the performance of the barangays
is evaluated using the following criteria: food production, clean and
green, barangay record keeping, decrease in malnutrition, presence
of herbal and communal garden, livelihood program, primary health
care activities, barangay nutrition projects, presence of garbage
receptacles, sports facilities, availability of a drug abuse prevention
program, parents-teachers assembly, maintenance of barangay
facilities (such as health stations), and awards and citations for the
past two years. Awards for each winner (an urban barangay and a
rural barangay for each prize) amount to P100,000 for the first prize,
P75,000 for the second prize, and P50,000 for the third prize.
and ofworst
The barangays are ranked based on the number of malnourished
children. During Association of Barangay Captains meetings, the
names of the barangays that topped the list in terms of malnutrition
are announced. The problems of these worst-performing barangays
and appropriate actions to deal with them are discussed accordingly.
_are-Food Project
Under the Share-Food Project of Barangay Golden Ribbon, well-
off families sponsor malnourished children by feeding the latter for
three months. As a result, the problem of severe malnutrition was
eradicated. At present, the project concentrates on moderately and
mildly malnourished children. The other four barangays in the city
are likewise replicating the project to help overcome their own
malnutrition problems.
A_l_ of holistic apprm_h

The city nutrition office realizes that the feeding project
provides only immediate and temporary solution to malnutrition. The
problem will remain and even worsen if its underlying causes are not
addressed. Butuan City has identified the root causes as poverty/
unemployment, mothers' lack of knowledge, and the large number
of children per family. It addressed these problems through livelihood
projects, food production, nutrition seminars, and dissemination of
400 ManagingUrbanization
Undera DecentralizedGovernanceFramework
the advantages of responsible parenthood. Furthermore, its "Search

for the Golden Barangay" covers a wide range of concerns, thereby
promoting cooperation from barangay leaders and their constituents
in the implementation of nutrition, health, cleanliness programs, and
other projects.
Planning
During program planning seminars and meetings between
nutrition personnel and barangay leaders, problems and causes of
low performance are identified. Thereafter, specific plans and
measures to deal with such problems are brought up to help improve
the barangay performance for succeeding periods.
o/te f00al.g
When food for malnourished children has to be cooked at home,
as in the case of Nutripak, it is possible that the food is not. taken
exclusively by the malnourished children but instead, is shared with
other family members with no nutrition problems. Use of ready-to-
drink milk enables on-site feeding, which ensures that the target
beneficiaries are the ones fed.
Rg,,iti ofout nding ,,ndwontp,-fonn

Competition for the Golden BarangayAward motivates barangay
leaders and constituents to give their best performance. Likewise,
because ranking and announcing the names of worst performers are
embarrassing, leaders and their constituents are prompted to do better
next time.
_hip and _ of city officials

The leadership provided by the mayor and the rest of the Butuan
City Nutrition Committee, together with the active and sustained
implementation of activities by the officials and staff of the City Nu-
trition Office, resulted in the city's outstanding nutrition performance.
The city officials' commitment to overcome the malnutrition prob-
lem is likewise reflected in the funds allocated for nutrition-related
activities, such as milk feeding and livelihood projects.
Case Study:ButuanCity- A ConsistentWinner in Nutrition 401
Barangccy Nutrition Progrmn planning seminars

The Nutrition Office and DILG personnel could initiate
nutrition program planning seminars in every barangay. Initially, they
could assist the barangay leaders in making quarterly nutrition plans
and reviewing the accomplishments. This may be done by asking the
leaders to.identify problems, devise solutions, specify funding sources
if necessary, assign people to handle the problems, and make a
timetable for accomplishing tasks.
I_ of outstanding performers and worst performers

Other cities may also launch their own contest for the most
outstanding barangay. Cash prizes for winners will have to depend
on the financial capability of the city. Buman City's criteria for "Golden
Barangay" may also be used or modified by these cities.
Barangays with the most number of malnourished children may
also be identified and ranked. Meetings with these barangays may be
set up to discuss problems, identify solutions, and come up with ways
to improve their performance.
Share-Food Project
Barangay officials can request well-off families to sponsor the
meals of malnourished children for a certain period.
Useof or food
On-site feeding may be done using milk or other ready-to-eat
food. Instead of allowing the food to be taken home, the barangay
can opt to cook the food collectively in feeding centers, with mothers
taking turns in cooking.
Some cities may not have the resources to provide credit for
livelihood projects. They could search for possible loan sources such
as nongovernment organizations (e.g., Tulay sa Pag-Unlad, Technology
and Livelihood Resource Center or TLRC conduits) and disseminate
these information to the people. Moreover, they could also encourage
people interested in livelihood projects to pool their resources
together: In such system called "paluwagan," the participants regularly
402. ManagingUrbanizationUndera DecentralizedGovernanceFramework
contribute money into a common fund, and then take turns receiving
the total collection for a specified period. To discourage delinquency
and fund misuse, initiators could impose a punishment to members
who remissed on their payment or used the money for other purposes.
Conclusion
In dealing with the malnutrition problem, the Philippine
government has adopted a holisdc approach through food assistance,
micronutrien t supplementation and fortification, nutrition education,
food production, and credit assistance for livelihood programs. The
extent of the implementation of such method, however, differs for
each local government unit (LGU). Butuan City can be considered a
model city as it actively applied the holistic approach and even
initiated additional strategies to address its own malnutrition problem.
Its CROWN Award is proof of its outstanding nutrition performance.
Following Butuan City's example and replicating its relevant strategies
would help improve the nutrition performance of other cities and
LGUs in the country.
About
theAuthors
Raul S.Anlocotan is Supervising Economic Development Specialist of

National Economic and Development Authority (NEDA) Regional Office
VI (Western Visayas). Amaster's degree holder in business management
from the University of the Philippines, his expertise is project
development. He is also a faculty member of the Graduate School of the
University of San Agustin in Iloilo City where he teaches economics,
business administration and strategic planning.
Casimira V. Balandra is the Regional Director of NEDA Regional Of-

rice X (Northern Mindanao). She holds a master's degree in Economics
from the Notre Dame University and a Graduate Diploma in Integrated
Regional/Rural Development Planning from the Development Study
Center, Israel. She has written guides on population development inte-
gration in land use planning and on the integration of gender concerns
in regional and local planning. She has likewise authored a number of
papers on the competitiveness of Cagayan de Oro City.
Jazmin D. Berido is Economic Development Specialist II of NEDA Re-

gional Office XIII (Caraga). She is especially involved in information
and advocacy activities, being her office's information officer-designate.
She has a bachelor's degree in Development Communication from Xavier
University, Ateneo de Cagayan.
Rosemarie O. Buan is Supervising Economic Development Specialist

of NEDA Regional Office V (Bicol). She finished AB Sociology from the
University of the Philippines. Her interests include social development
planning including population/women and development, and social
mob'dization work.
Carmel P. Chammag is Senior Economic Development Specialist of

NEDA-CAR (Cordillera Administrative Region) office. She has a
bachelor's degree in Economics from the University of the Philippines
(UP) School of Economics and a master's degree in Social and Develop-
ment Studies from UP CoUege-Baguio. She spedalizes in socioeconomic
and physical planning.
Clark Y. Clarete is formerly the regional development coordinator of
the health subsector for Region X (Northern Mindanao). H_efinished
Master of Engineering in Natural Resources DeVelopment and Manage-
ment at the Asian Institute of Technology, Bangkok. Currently, he is the
Chief Economic Development Specialist of the Macro Inter-sectoral
Coordination and Assistance Division of NEDA Regional Office X.
Aurora M. Joson is Chief Economic Development Specialist of NEDA

Regional Office III (Central Luzon) where she heads the Social Devel-
opment Division. She has a master's degree in Urban and Regional Plan-
ning from the University of the Philippines. Her expertise is regional
planning.
John ny T. Lim is the Chief of the Technical Division of NEDA Regional

Office XIII (Caraga). He holds a master's degree in Economics from
the University of Wales, United Kingdom. He specializes in social plan-
ning and epidemiology.
Mal Lourdes (Sittie Mariam) D. Lira, A1Haj is the Regional Director of

NEDA Regional Office XII (Southern Mindanao). She is a Ph.D. candi-
date in Economics at the University of the Philippines. She has been
involved in regional socioeconomic development as well as in physical
planning, investment programming, monitoring and eyaluation, and in
peace and development efforts in conflict areas of Southern Philippines.
She is the Vice-Chairperson of the Regional Development Council for
Southern Mindanao.
Rosario G. Manasan is a Senior Research Fellow at the Philippine Insti-

tute for Development Studies (PIDS). She holds a Ph.D. in Economics
from the UP School of Economics and pursued postdoctoral studies at
the Massachusetts Institute of Technology. She specializes in public fi-
nance and fiscal policy and has written and published numerous studies
on these areas. She has also served as adviser andconsultant to many
government, international and private institutions.
Ruben G. Mercado, a Research Associate at PIDS, has written and pub-

lished studies on regional and urban development, public ,finance, and
population and development. He has a master's degree in Policy Analy-
sis from Saitama University, Japan, as well as in Demography from the
University of the Philippines. He also received a Post-Graduate Diploma
in Development Economics at the Institute of Developing Economies
Advanced Schoc
Virginia S. Pineda was formerly a Research Associate at PIDS. She has a
master's degree in Economics from the UP School of Economics. She
has written studies on international trade, health economics, public fi-
nance and governance.
Ross O_ Quisao ¢urrendy works with the International Labor Affairs

Service, Department of Labor and Employment as Senior Labor and
Employment Officer. Previously, he worked as Research Analyst at PIDS.
His research interests include the role of the Catholic Church and other
nongovernment organizations in Philippine society, decentralization and
Philippine foreign policy. He has masteral units in Philippine Studies
(major in Development Studies) from the College of Liberal Arts, De La
Salle University-Taft.
Anicia C. Sagos was formerly Senior Research Specialist at PIDS. Cur-

rendy, she works at the Asian Development Bank as Technical Consult-
anL She finished BS Social Science at the University of the Philippines
and also took up the Program in Development Economics at the UP
School of Economics. She is finishing her M.A in Urban and Regional
Planning also at UP.
Victor R. Ubaldo, a licensed engineer, is Chief Economic Development

Specialist at NEDA Regional Office III (Central Luzon) and formerly at
NEDA Regional Office V (Bicol). He has a master's degree in Rural Re-
sources and Environmental Policy from the University of London, and a
bachelor's degree in Agricultural Engineering from the University of
the Philippines-Los Bafios. His areas of expertise include environmen-
tal impact assessments, strategic planning, and physical and land use
planning.

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ManagingUrbanization

Edited by Rosario G. Manasan

Demographic Researchand Development Foundation, Inc.

Philippine Institute for Development Studies

Printed in the Philippines. All rights reserved.

The findings, interpretations and conclusions in this volume are

Please address all inquiries to:

PHILIPPINEINSTITUTE FOR DEVELOPMENTSTUDIES

Chapter I Financing and Delivery of Urban Services

Urbanization vis-_t-visExpenditures and Revenues ..................... 5

Chapter 2 Metropolitan Arrangements in the Philippines:

Context of Inquiry. ......................................................................... 34

Chapter 3 Environment and Natural Resources Management:

Chapter 4 Health Management: Strategies

Health Services Provided by Cities

Chapter 5 Local Efforts in Housing Provision ............................... 127

Introduction ............................................... :................................... 127

PART II CASE STUDIES

Chapter 1 Closing the Urban Fiscal Gap: An Overview ................. 155

Introduction ................................................................................... 155

Development Trends in Metro BLIST.......................................... 174

Setting an Institutional Framework for Metropolitan

Composition and Management of Metro Cebu .......................... 193

Providing a Metropolitan Perspective to Development

Metro CDO Current Development and Prospects ...................... 204

Metro Naga: A Continuing Challenge of Local

Management of the Metropolis .................................................... 221

Melro Iloilo: A Struggle for Acceptance and Organization .............. 235

Demographic and Land Characteristics ............................ i......... 237

Metro Davao: In Search of Metropolitan Def'mitions ....................... 247

The Three Definitional Models of Metro Davao ......................... 248

Governance and Urban Development: Case Study

Introduction .................................................................................... 255

Chapter 3 Health Management Strategies of Selected Cities .......... 299

C_e Studies_of Health Management Strate_es

Reaching Out: Gingoog City's Total Integrated

Health Facilities and Expenditure/Budget ................................. 315

Puerto Princesa City's Satellite Clinics:

Health Facilities and Expenditure/Budget ................................. 327

Emergency Rescue Naga: An LGU-Managed Emergency

Health Facilities, Welfare and Expenditures ................................ 337

People Power at Work: The Case of Surigao City's Primary

Health Facilities and Expenditures ............................................... 347

Financing and Delivery of Health and Sanitation Services:

Vital Facts and Figures .................................................................... 363

Olongapo: A Health City ...................................................................... 387

Health Facilities and Expenditure/Budget ................................. 387

Butuan City: A Consistent Regional W_nner in Nutrition ................. 393

Health Facilities and Expenditure/Budget ................................. 393

About the Authors .............................................................................. 403

Figure I Share of CLGUs in Total General Government

Figure 1 City, Non-city and Total Metropolitan Land Area ......... 40

Figure 1 Structure of the Clean Effort ............................... :........... 85

Figure 1 Organizational Chart of the Lote Para sa

Case Studies of Melropolitan Arrangements

Figure 1 Proposed Organization for Metro BLIST

Figure 1 Major Road Network of Metro Manila ........................... 262

Case Studies of Health Management Su'atet_ies

Emergency Rescue Naga

Figure ] Organizational Structure of the Emergency

Surigao City's PHC Federated Women's Club

Figure ] The Community Dam Board ....................................... ....356

Table ] Linear Regression of Per Capita Tax Revenue