International Journal of

Environmental Research
and Public Health

Article
An Evaluation of Policies Promoting Physical Activity among
Filipino Youth
Yves Y. Palad 1, * , Roselle M. Guisihan 1 , Maria Eliza R. Aguila 1 , Ralph Andrew A. Ramos 2
and Jonathan Y. Cagas 2

1 Department of Physical Therapy, College of Allied Medical Professions, University of the

Philippines Manila, Manila 1000, Philippines
2 Department of Sports Science, College of Human Kinetics, University of the Philippines Diliman,
Quezon 1101, Philippines
* Correspondence: [email protected]; Tel.: +63-2-8526-7125

Abstract: Government is key to promoting physical activity at the population level through policy.
The government was one of the physical activity indicators graded for the 2022 Philippine Physical
Activity Report Card based on ten physical activity-related policies. This study aimed to evaluate
the scope of the policies and to update these policies. Philippine government databases were
searched for policies using physical activity-related key terms. Policies found were evaluated
using the Wales Active Healthy Kids scoring rubric. The overall grade was converted to a letter
grade based on the Global Matrix 4.0 grading system. The authors analyzed the policies’ scope
and implications to practice and policy. Seven additional policies were found. Considering all 17
policies, the government indicator grade is now A- from the preliminary grade of B. The scope covers
promoting physical activity mainly through sports participation and active transport among students,
student-athletes, persons with disabilities, and the general population in school and community
settings. The gap between government and overall physical activity (F) scores suggests the need for
a comprehensive physical activity plan promoting various forms of physical activity and reducing
sedentary behavior among all Filipino youth and across various settings. Crucial to achieving change
is a well-coordinated, whole-of-systems approach to promoting active healthy lifestyles.
Citation: Palad, Y.Y.; Guisihan, R.M.;
Aguila, M.E.R.; Ramos, R.A.A.;
Keywords: active lifestyle; disease prevention; government indicator; health promotion; lower
Cagas, J.Y. An Evaluation of Policies middle-income country; sedentary behavior
Promoting Physical Activity among
Filipino Youth. Int. J. Environ. Res.
Public Health 2023, 20, 2865.
https://doi.org/10.3390/ 1. Introduction
ijerph20042865 An active healthy lifestyle among children and adolescents is vital to their overall
Academic Editor: Enrico Maria Clini development as it improves their physical functioning, mental and physical health, and
mitigates health risks [1]. Having an active healthy lifestyle includes engaging in recom-
Received: 13 December 2022 mended levels of physical activity and reducing sedentary times [1]. For children and
Revised: 26 January 2023
adolescents, the World Health Organization (WHO) recommends at least an average of
Accepted: 28 January 2023
60 min of moderate-to-vigorous physical activity per day and reduced sedentary behaviors,
Published: 6 February 2023
particularly recreational screen time use [1]. Early engagement in appropriate physical
activity levels is important as it is directly associated with physical activity [2] and better
perceptions of health in adulthood [3].
Copyright: © 2023 by the authors.
Such an active healthy lifestyle is essential in preventing non-communicable diseases
Licensee MDPI, Basel, Switzerland. (NCDs) [4]. They are chronic diseases resulting from a combination of genetic, physiological,
This article is an open access article environmental, and behavioral factors including physical inactivity, and are the leading
distributed under the terms and causes of death globally [5]. A recent report from the WHO revealed that globally, there
conditions of the Creative Commons will be about 500 million new NCD cases in the next ten years, costing the world around
Attribution (CC BY) license (https:// USD 27 billion if not managed [4]. Almost three-quarters of the new NCD cases will be
creativecommons.org/licenses/by/ in lower and upper middle-income countries [4]. Having a physically active populace is,
4.0/). therefore, beneficial in curbing the economic burden of NCDs [4].

Int. J. Environ. Res. Public Health 2023, 20, 2865. https://doi.org/10.3390/ijerph20042865 https://www.mdpi.com/journal/ijerph
Int. J. Environ. Res. Public Health 2023, 20, 2865 2 of 13

The Philippines, being a lower middle-income country, is one of these countries that
will bear much of the economic burden from rising NCD cases. The country, therefore,
needs to scale up its efforts to promote an active healthy lifestyle, especially since its youth
was found to be insufficiently physically active [6]. As of 2020, 10% of the Philippine
population, or 11 million, are children below 5 years, and 39%, or 42 million, are 5 to
24 years old [7]. Despite the importance of adopting an active healthy lifestyle, children
and adolescents were found to be less active than might be expected [4]. According to a
national survey conducted from January 2018 to February 2019, 82.7% of 10- to 17-year-old
Filipino adolescents were not meeting physical activity recommendations [6,8]. These data
were gathered from approximately 46,000 households across the country [8].
The national government is a key element in a coordinated, whole-of-systems approach
to scaling up physical activity promotion efforts at the population level [4,9,10]. The
WHO Global Action Plan on Physical Activity 2018–2030 (GAPPA) suggests that strong
commitment and leadership are needed to establish a national vision and direction that
prioritize the promotion of physical activity and reducing sedentary behaviors [10]. The
government is a key source of such leadership and commitment through policymaking
that promotes actions toward a more active and healthy population, and through resource
mobilization to support a coordinated, multi-sectoral policy implementation, monitoring,
evaluation, and reporting [10].
Government is also one of the ten indicators of success in the Global Matrix 4.0 (see
Table 1 for these ten indicators and their definitions). The Global Matrix 4.0 is an initiative
that aims to evaluate the status of countries in promoting physical activity participation
among the youth based on synthesized available data on each of the ten indicators. Each
indicator is assigned a letter grade (i.e., A to F, INC) based on how well a country performed
against the indicator’s benchmarks [11] Table 2 shows the Global Matrix 4.0 grading rubric.
Benchmarks for evaluating the government indicator include “evidence of leadership
and commitment in providing physical activity opportunities for all children and youth”,
“allocated funds and resources for the implementation of physical activity promotion
strategies and initiatives for all children and youth”, and “demonstrated progress through
the key stages of public policy making” [11]. Participating countries in the Global Matrix
4.0 were graded a C on average for their government efforts in influencing the physical
activity of children and adolescents [11].

Table 1. Global Matrix 4.0 indicators of success in promoting physical activity 1 .

Indicators Definition
Overall Physical Activity Any bodily movement produced by skeletal muscles that requires energy expenditure.
A subset of physical activity that is structured, goal-oriented, competitive, and
Organized Sports and Physical Activity
contest based.
May involve symbolic activity or games with or without clearly defined rules; the
activity may be unstructured/unorganized, social, or solitary, but the distinguishing
Active Play features are a playful context, combined with an activity that is significantly above
resting metabolic rate; tends to occur sporadically, with frequent rest periods, which
makes it difficult to record.
Any form of human-powered transportation—walking, cycling, using a wheelchair,
Active Transportation
in-line skating, or skateboarding.
Any waking behavior characterized by an energy expenditure 1.5 metabolic
Sedentary Behavior
equivalents, while in a sitting, reclining, or lying posture.
Characteristics that permit a good performance of a given physical task in a specified
Physical Fitness
physical, social, and psychological environment.
Any member within the family who can control or influence the physical activity
Family and Peers
opportunities and participation of children and adolescents in this environment.
Int. J. Environ. Res. Public Health 2023, 20, 2865 3 of 13

Table 1. Cont.

Indicators Definition
Any policies, organizational factors (e.g., infrastructure and accountability for policy
implementation), or student factors (e.g., PA options based on age, gender, or
School
ethnicity) in the school environment that can influence the physical activity
opportunities and participation of children and adolescents in this environment.
Any policies or organizational factors (e.g., infrastructure and accountability for policy
Community and Environment implementation) in the municipal environment that can influence the PA
opportunities and participation of children and adolescents in this environment.
Any governmental body with authority to influence physical activity opportunities or
Government
participation of children and adolescents through policy, legislation, or regulation.
1 Adapted with permission from Aubert et al., 2022, Global Matrix 4.0 Physical Activity Report Card Grades for
Children and Adolescents: Results and Analyses From 57 Countries, Journal of Physical Activity and Health
Volume 19, Issue 11, Pages 700–728, https://dx.doi.org/10.1123/jpah.2022-0456. © Human Kinetics, Inc. [11].

Table 2. Global Matrix 4.0 grading rubric 1 .

Grade Interpretation
A+ 94–100%
A Succeeding with a large majority of children and adolescents (87–93%)
A 80–86%
B+ 74–79%
B Succeeding with well over half of children and adolescents (67–73%)
B 60–66%
C+ 54–59%
C Succeeding with about half of children and adolescents (47–53%)
C 40–46%
D+ 34–39%
D Succeeding with less than half but some children and adolescents (27–33%)
D 20–26%
F Succeeding with very few children and adolescents (<20%)
INC Incomplete due to insufficient or inadequate information to assign a grade
1Adapted with permission from Aubert et al., 2022, Global Matrix 4.0 Physical Activity Report Card Grades for
Children and Adolescents: Results and Analyses From 57 Countries, Journal of Physical Activity and Health
Volume 19, Issue 11, Pages 700–728, https://dx.doi.org/10.1123/jpah.2022-0456. © Human Kinetics, Inc. [11].

The Philippines was one of the countries that participated in the Global Matrix 4.0
and produced its own physical activity country report card following the Global Matrix 4.0
recommended methodology [12]. A working research group was formed to work on the
Report Card. The group was composed of 25 academics and practitioners in the fields of
physical activity, sports science, physical therapy, physical education, and psychology [12].
Each member was assigned to an indicator and was responsible for searching databases for
documents on the physical activity of Filipino youth, extracting information from obtained
documents, evaluating the assigned indicator against its benchmarks, and drafting the
Report Card.
Two members of the research working group were assigned to lead the evaluation of
the government indicator. It was graded a B based on the assessment of ten (10) national
policies that promote any form of physical activity (e.g., organized sports, active trans-
port, recreational play, etc.). These were obtained from searching government websites
including those of the Congress and Senate of the Philippines, the Department of Health,
the Department of Education, the Philippine Sports Commission, the National Council for
Disability Affairs, the Department of Budget and Management, the Housing and Land Use
Regulatory Board, and the Official Gazette of the Republic of the Philippines.
The policy scoring rubric developed by the Wales Active Healthy Kids (AHK-Wales)
group [13] was used to quantitatively evaluate the policies. The rubric consists of six
criteria based on the second version of the Health-Enhancing Physical Activity Policy
Int. J. Environ. Res. Public Health 2023, 20, 2865 4 of 13

Audit Tool developed by the WHO Regional Office for Europe [13]. Table 3 outlines the
general description of each criterion. A full description of the AHK-Wales scoring system is
available in the article by Ward et al. [13]. The overall score was then converted to a letter
grade based on the Global Matrix 4.0 grading rubric [11]. Stakeholders from government
agencies, education institutions, professional organizations, and non-government organiza-
tions relevant to the physical activity of youth were consulted about preliminary results.
Government indicator scores were discussed and agreed on by the research working group
and were audited by external experts involved in the Global Matrix 4.0 [11,12].

Table 3. Evaluation of Philippine policies based on the AHK-Wales scoring rubric 1 .

Criterion Description/Scoring Score and Justification

7/10
Scored based on the number of
Number and 17 policies in total (4/5)
policies/strategies/action plans that reference
breadth of Forms of physical activity are mainly sports
physical activity, and the breadth of the policies, i.e.,
relevant participation and active transport; purposes are
the number of sectors covered in the included policies.
policies mainly for sports development and health and fitness;
Maximum 10 points: Number (5) + Breadth (5)
most policies do not specify the age group (3/5)
Identified Scored based on the number of policies with specific 20/20
supporting actions that promote physical activity. Each strategic There are more than 20 actions supporting physical
actions document is scored a point. (Maximum of 20 points). activity. (see Table 2)
Identified Scored based on the proportion of policies with 25/25
accountable specific organizations identified as responsible for Each policy has at least one specified accountable
organizations implementing actions. (Maximum 25 points) agency or organization.
Identifiable Scored based on the proportion of policies with 8/15
reporting explicit systems for reporting implementation of Only 9 out of the 17 policies (53%) have specified
structures policy actions. (Maximum 15 points) reporting structures.
15/20
Scored based on the proportion of policies that
Identified 76% or 13 out of 17 policies have explicit references to
explicitly identified funding sources to support
funding sources of funding to support the implementation of
delivery of actions. (Maximum 20 points)
the policy
8/10
Scored based on the proportion of policies with
Monitoring and 76% or 13 out of 17 policies have explicit references to
explicit systems for monitoring and evaluation of
evaluation plan plans for monitoring and evaluating the policy
policy progress and impact. (Maximum 10 points)
implementation.
Overall Score 83/100 or 83% = A
1Ward et al., The AHK-Wales Report Card 2018: Policy Measures - is it possible to ‘score’ qualitative data?,
Health Promotion International, 2020, Volume 36, Issue 4, Pages 1151–1159, by permission of Oxford University
Press [13].

The grade of B for the government indicator [12] implies that the country is performing
fairly well in promoting physical activity participation among Filipino youth through its
policies, leadership, and resource allocation. As government was one of only two indicators
wherein the country performed relatively well, it was seen as a potential actionable area to
better promote physical activity. A deeper look into the policies is, therefore, necessary to
better understand their breadth in terms of physical activity promotion. A previous study
mainly reported on the number of policies, their descriptions and rubric scores, and the
overall implications of the Report Card scores [12]. This current study aimed to do a deeper
evaluation of the scope of these policies, and in the process, check for updates in policies.

2. Materials and Methods

This current study followed the same procedures conducted to develop the Philippine
Physical Activity Report Card [11,12]. The two members originally assigned to evaluate
the government indicator were joined by three other collaborators in this current study to
update the evaluation of the government indicator. The five (5) investigators/authors are
academics and practitioners in the fields of physical therapy and sports science. Each of
Int. J. Environ. Res. Public Health 2023, 20, 2865 5 of 13

them took part in searching for relevant policies, extracting information, and evaluating
the policies.
To gather existing policies, the websites of the following government agencies were
searched in addition to the initially searched government databases: the Department of
Public Works and Highways, the Department of Transportation, the Bangsamoro Sports
Commission, and the Bangsamoro Autonomous Region in Muslim Mindanao’s (BARMM)
Ministry of Health and Ministry of Basic, Higher, and Technical Education. Keywords
used for searching policies were “physical activity”, “physical fitness”, “health promotion”,
“disease prevention”, “physical education”, “play”, “recreation”, “playground”, “public
space”, “recreational space”, “sports”, and “active transport”.
Similar to previous procedures, the obtained policies were evaluated using the AHK-
Wales grading system (Table 3). The authors analyzed the scope of the obtained policies
and discussed the implications to policy and practice. The overall numerical score was
converted to a letter grade using the Global Matrix 4.0 grading rubric (Table 2). The
resulting scores from the current study were discussed and agreed on by the authors of
this paper.

3. Results
Seven (7) were found in addition to the previously reported ten policies [12]. Table 4
shows a summary of all 17 policies, including the year they were enacted or issued, their
scope or purpose(s), and sample supporting actions. Scoring based on the AHK-Wales
criteria is shown in Table 3. Considering all 17 policies and their supporting actions, the
updated score for the government indicator based on the AHK-Wales scoring rubric is
83%, which is equivalent to a letter grade of A [11]. In terms of scope, these policies
were found to cover promoting physical activity mainly among students, student-athletes,
persons with disabilities, and the general population in school and community settings.
Sports participation and active transport are the main forms of physical activity promoted
by the policies. The succeeding subsections explain the results of each criterion.

Table 4. Summary of physical activity promoting policies in the Philippines 1 .

Year
Policy Title Enacted or Scope or Purpose Sample Supporting Actions
Issued
Previously reported
The Schools Physical
Integration of PE and sports development K to 12 Curriculum Guide:
Education and Sports 1969
programs in all schools in the Philippines [14] Physical Education [15]
Development Act of 1969
Provision of open spaces, roads, alleys, and
Guidelines on the Creation
sidewalks to create and maintain a healthy
Presidential Decree No. 1216 1977 and Use of Parks and Public
environment in human settlements to enhance
Open Spaces [17]
the quality of life of the residents [16]
Setting minimum requirements and standards to Accessibility Law
Accessibility Law 1983 make buildings, facilities, and utilities for public Implementing Rules and
use accessible to persons with disabilities [18] Regulations [18]
Batang Pinoy (Philippine
Creation of the Philippine Sports Commission to
Youth Games) [20]
promote PE and encourage and sustain the
Laro’t Saya sa Parke
The Philippine Sports development of sports in the country to foster
1990 (park-based and
Commission Act physical fitness, self-discipline, teamwork, and
family-oriented sports-for-all
excellence for the development of a healthy and
program) [21]
alert citizenry [19]
Pilipinas Para Games [22]
Int. J. Environ. Res. Public Health 2023, 20, 2865 6 of 13

Table 4. Cont.

Year
Policy Title Enacted or Scope or Purpose Sample Supporting Actions
Issued
Implementing Rules and
Granting of rights and privileges to persons with
Regulations [23]
disabilities by adopting policies to ensure the
Policy Guidelines on the
rehabilitation, self-development, and
Magna Carta for Provision of Educational
1991 self-reliance of persons with disabilities, and
Disabled Persons Programs and Services for
developing their skills and potentials to enable
Learners with Disabilities in
them to compete favorably for available
the K to 12 Basic Education
opportunities [23]
Program [24]
Institutionalization of the Palarong Pambansa
(National School Games) as the premier national
The Palarong Pambansa Act
2013 sporting event of the country as a venue for Palarong Pambansa [26]
of 2013
talent identification, selection, and recruitment of
student-athletes [25]
The promotion of excellence in sports by looking
after the welfare of national athletes and coaches
The National Athletes and
competing for the country and by providing Implementing Rules and
Coaches Benefits and 2015
benefits and incentives for national athletes and Regulations [27]
Incentives Act
other athletes who bring honor and recognition
to the country [27]
Creation of a Special Program in Sports to
Implementation of the Special
Implementing Guidelines on enhance the athletic potential of talented
2015 Program in Sports in a
the Special Program in Sports students in different sports disciplines, and
national high school [29]
achieve school-sport balance [28]
Establishment of the Philippine Sports Training
The Philippine Sports Center to promote and develop sports in the Philippine Sports Training
2019
Training Center Act country, and achieve excellence in international Center in Bataan [31]
sports competitions [30]
Establishment of the National Academy of
Sports System to develop the athletic skills and
The National Academy Implementing Rules and
2020 talents of students in world-class sports facilities
of Sports Regulations [32]
that are at par with international standards; the
school system will include para-athletes [32]
Newly obtained
Pilipinas Go4Health (national
Development and promotion of an integrated
The national policy on campaign on healthy lifestyle
and comprehensive program on the prevention
strengthening the prevention against non-communicable
and control of lifestyle-related diseases in the
and control of chronic 2011 diseases) [34]
country, wherein promoting physical activity is
lifestyle-related Wais Magpapawis (campaign
one of the strategies to prevent and control
non-communicable diseases on being active during the
non-communicable diseases [33]
pandemic) [35]
Arriving at a consensus and resolving and
providing practical guidance on family-related
Comprehensive Gender and
Fatwa on the Model Family issues, including problems related to health
2015 Health Education for Youth:
in Islam among youth, consistent with Shari’ah or Islamic
Instructional Modules [37]
Law to safeguard the wellbeing of individuals
and society [36]
The protection and promotion of the right to
health of all Filipinos, mandating agencies to
The Universal Health address public health problems by, among Health Promotion Framework
2019
Care Act others, promoting a healthy lifestyle through Strategy [39]
physical activity, proper nutrition, injury
prevention, etc [38]
Int. J. Environ. Res. Public Health 2023, 20, 2865 7 of 13

Table 4. Cont.

Year
Policy Title Enacted or Scope or Purpose Sample Supporting Actions
Issued
Incorporating physical fitness as an essential
The Revised Physical Fitness Physical Fitness Test Manual
2019 component of the physical education and school
Test Manual [40]
sports program from Grades 4 through 10 [40]
Guidelines and Protocols for
Guidelines on the Proper Use Active Transportation and
Provision of guidance for the promotion and safe
and Promotion of Active Light Mobility Vehicles [42]
2020 use of active transport during and after the
Transport During and After Prescribing Guidelines on the
pandemic [41]
the COVID-19 Pandemic Design of Bicycle Facilities
Along National Roads [43]
Institutionalizing sports development in the
BARMM by providing leadership and
camaraderie among the people of Bangsamoro,
formulating policies and setting the priorities
The Bangsamoro Sports Reviving indigenous games
2020 and direction of all regional sports promotion
Commission Act of 2020 [45]
activities, embarking on initiatives to develop
athletic programs, and providing adequate
facilities and support for Bangsamoro athletes
[44]
Health Promotion Playbook
Provision of the framework, direction, and
Modules [46]
strategies for the planning, development, and
Manual of Procedures for the
Health Promotion Framework implementation of health promotion policies,
2021 Operationalization of the
Strategy 2030 programs, plans, and activities, with physical
Health Promotion Framework
activity as one of the priority areas for health
Strategy in Province- and
promotion [39]
City-wide Health Systems [47]
1A portion of this table was adapted with permission from Cagas et al. (DOI:10.1016/j.jesf.2022.10.001) [12]. Note:
BARMM—Bangsamoro Autonomous Region in Muslim Mindanao and PE—physical education.

3.1. Number and Breadth of Policies

Based on the AHK-Wales scoring rubric [13], a total of 17 policies that reference PA
merits 4 out of 5 points. The breadth of these policies was scored based on the scope of
policy content including the settings and population groups the policies cover, as well as
the forms of physical activity promoted and the purposes of promoting physical activity.
Sports participation (47%, n = 8) [14,19,25,27,28,30,32,44] and active transportation
(23%, n = 4) [16,18,39,41] are the main forms of physical activity promoted by the policies.
Other policies only broadly suggest engaging in physical activity as a strategy for health
and fitness [23,33,36,38,40]. In terms of purpose, most of the policies promote physical
activity for sports development (47%, n = 8) [14,19,25,27,28,30,32,44] and health and fit-
ness (47%, n = 8) [14,23,33,36,38–41]. Others are toward improving social participation
and quality of life (18%, n = 3) [16,18,23]. Schools (53%, n = 9) [14,19,23,28,32,36,38–40]
and communities (41%, n = 7) [16,18,23,33,38,39,41] are the main settings where physical
activity is to be promoted. In terms of population groups, only five (5) policies (29%)
are specific to children and adolescents [14,28,32,36,40]. All others are not specific to any
age group, but these policies were still included in evaluating the government indicator,
as they did not explicitly exclude children and adolescents. Seven (7) policies (41%) tar-
get developing athletes [19,25,27,28,30,32,44], two (2) (12%) are particular to persons with
disabilities [18,23], and two (2) (12%) are specific to the people of BARMM [36,44].
Given the scope of the policies, which can still be improved by including more coverage
of other forms of physical activity and active lifestyle (e.g., informal play and reducing
sedentary behaviors), settings (e.g., homes and public spaces), and population groups (e.g.,
early childhood and out-of-school youth), this criterion was graded 3 out of 5 points.
Int. J. Environ. Res. Public Health 2023, 20, 2865 8 of 13

3.2. Supporting Actions

The number of existing physical activity-promoting actions exceeded 20. Examples
of these actions that arose from each policy are shown in Table 3. Supporting actions
range from implementing rules and regulations [18,23,27,32], national campaigns [34,35],
operation manuals and modules [37,40,46,47], guidelines [15,17,24,42,43], and sporting
programs or events [20–22,26,45].

3.3. Identified Accountable Organizations

This criterion was also assigned maximum points as each policy has identified gov-
ernment agencies responsible for its implementation. The Philippine Sports Commission
is the main responsible agency for sports-related policies [19,25,27,28,30,32], while the
Department of Education and Department of Health (DOH) are the main agencies for
education- [14,25,28,32,40] and health-related policies [33,38,39], respectively. Policies on
active transportation and open public spaces are jointly implemented by the DOH, the
Department of Transportation, the Department of Public Works and Highways, and the
Department of Interior and Local Government [16,18,42]. The National Council on Dis-
ability Affairs is the main agency in charge of ensuring the implementation of policies on
disability rights [18,23]. Policies on promoting an active healthy lifestyle in the BARMM are
spearheaded by agencies such as the Bangsamoro Sports Commission and the Commission
on Population and Development [36,44]. All policy implementations are in coordination
with local government units.

3.4. Identified Reporting Systems

Only nine out of the seventeen policies (53%) have identified structures for reporting
their implementation [19,25,27,28,38–41,44]. Actual reports of some implemented actions
are available on the responsible agency’s website (e.g., PSC, Palarong Pambansa) or in online
file storage services (e.g., HPFS [48]). However, no actual reports were found for the other
policies. This criterion was therefore graded 8 out of 15 based on the rubric.

3.5. Identified Funding Sources

Thirteen of the seventeen policies (76%) have identified sources for funding their
implementation [14,19,23,25,27,28,30,32,33,38,39,42,44]. This percentage is equal to a grade
of 15 out of 20. Funding sources are from the annual budget appropriated by the national
government to the responsible agencies and from the budget of local government units.

3.6. Identified Monitoring and Evaluation Plans

Thirteen policies (76%) have stipulated plans for monitoring and evaluating their
implementation [18,19,25,27,28,30,32,33,38–40,42,44], which is equal to 8 out of 10 for this
criterion. For most policies, the concerned agencies are responsible for monitoring and
evaluating their implementation, and some are subject to Congressional oversight (e.g., the
Universal Health Care Act [38] and the Philippine Sports Training Center Act [30]).

4. Discussion
The purpose of this study was to analyze, in depth, the scope of physical activity-
related policies and update the preliminary grade of the government indicator of the
2022 Philippine Physical Activity Report Card. Seven physical activity-related policies
were added to the initial ten policies. If these policies were included in the Report Card
government indicator grade, the grade would have been A- instead of B. This is largely
due to the additional policies expanding the scope of policy coverage and meeting most
of the criteria of the AHK-Wales scoring rubric. In terms of scope, aside from physical
activity for sports development, there is now greater emphasis on physical activity for
health, with the inclusion of policies that mention physical activity for the prevention of
non-communicable diseases, universal health care, health promotion, and physical fitness.
The promotion of active transportation is also highlighted with a number of guidelines on
Int. J. Environ. Res. Public Health 2023, 20, 2865 9 of 13

ensuring the safe use of different forms of active transport. The inclusion of policies for
BARMM and persons with disabilities is also evidence of the breadth of Philippine physical
activity policies in terms of the population covered. The provisions for funding and the
implementation, monitoring, and evaluation guides identified in these policies should be
maximized to ensure an active healthy Filipino youth.
However, some Filipino youth, such as non-athletes and out-of-school youth, could be
overlooked by these policies. In terms of scope, half of the evaluated policies are centered
on participation in organized or competitive sports. While they are valuable in promoting
physical activity through sports, only athletes or population groups who are sports-inclined
could be benefitting from them. Policies specific to children and adolescents are also set in
schools or training centers, potentially leaving behind out-of-school youth which comprises
5.5% of Filipinos aged 5 to 17 years [49]. There are also no policies for promoting physical
activity among children in the early years (i.e., younger than 5 years) despite physical
activity being crucial for their development [50,51]. As the rest of the policies are not
specific to any population group, it is difficult to determine the extent to which Filipino
youth may be benefitting from these policies. A nationally representative study that covers
all youth is necessary to help recognize and act on the differential impacts of these policies
on the members of Filipino youth.
Aside from meeting recommended physical activity levels, reducing sedentary be-
havior is also important in developing an active healthy lifestyle [1]. However, none of
the evaluated policies explicitly address the sedentary behaviors of Filipinos. The country
needs to expand the scope of its policies to include reducing sedentary behavior. Toward
this end, efforts could incorporate existing physical activity policies and guidelines at the
local and national government levels on reducing sedentary behaviors in various settings
such as home, school, transportation, healthcare, and non-home-based leisure [52]. How-
ever, consistent with a whole-of-systems approach in promoting an active lifestyle [10],
effective policies will require strong shifts in social norms and culture on sitting, such as how
classes are held. They will also need to emphasize the broader effects of sedentary behavior
not only on health, but also on productivity, learning, and community well-being [52].
The grade improvement from B to A- widened the gap between the government indi-
cator grade and the country’s overall physical activity score for children and adolescents,
which was F [12]. The overall physical activity score was based on an earlier mentioned
2018–2019 national survey [6,8] showing that the majority of Filipino adolescents are not
meeting the recommended PA levels. This implies that while there are several policies
advancing physical activity in the country, evidence of translation of these policies into ac-
tual engagement in physical activity is lacking. For example, despite the Accessibility Law
setting standards to ensure accessibility of infrastructures to people with disabilities [18],
a study showed that designs and options for public transportation vehicles in a province
in the Philippines were limited, and obstructions in sidewalks, pedestrian crossings, and
footbridges were common, making them unsafe for their active transport [53].
Reasons for the policy–practice gap need to be better understood to guide further
action. One of the reasons could be inadequate reporting on the implementation and
impact of policies and their supporting actions because data from these can be used
to inform physical activity status. For example, only one data set was comprehensive
enough to be of use as a basis for evaluating the overall physical activity status of Filipino
youth [12]. This points to the need to look into scaling up the monitoring and reporting of
the implementation of policies and supporting actions to generate data that could inform
evaluations of physical activity engagement and further actions. Reports also need to be
publicly available to benefit all sectors needing access to such information.
Another potential reason worth exploring is the extent to which all policies are aligned
in promoting physical activity to Filipino youth. The 17 policies were found to have no clear
alignment with an overarching framework to guide physical activity promotion. While the
Universal Health Care Law serves as an overarching health policy, this could be deemed
too broad to be effective in providing a framework specific for physical activity promotion.
Int. J. Environ. Res. Public Health 2023, 20, 2865 10 of 13

Additionally, the Health Promotion Framework Strategy 2030, another overarching policy,
is currently limited to promoting physical activity mainly through active transportation.
The country has national physical activity guidelines [54]; however, these guidelines need
to be updated and aligned with current global recommendations and standards [1,10]
to be able to inform national policy and action plans. These issues are pointing to the
need for a comprehensive physical activity plan that could provide guidance for well-
coordinated, multi-sectoral actions for better promotion of an active healthy lifestyle at the
population level [4,10]. Such a plan needs to advance various forms of physical activity
(e.g., active indoor or outdoor play, minimized sedentary behavior) across multiple settings,
and should be inclusive of all Filipino youth (e.g., early years, children with a disability,
and marginalized youth). A comprehensive physical activity plan with a multi-sectoral or
whole-of-systems approach could drive better-coordinated actions among relevant sectors,
which is crucial to achieving meaningful change in valuing physical activity at the societal
level [1,10].

5. Conclusions
Several policies promote an active healthy lifestyle among Filipino youth. However,
the scope of these policies suggests the need for them to be reinforced by emphasizing
other forms of physical activity aside from sports and active transport, incorporating
guidelines on reducing sedentary behavior, and including all members of Filipino youth.
The gap between the government indicator and the overall physical activity indicator scores
points to the need to better understand the reasons for the gap, including the extent of
efforts to monitor and report the implementation of policies, and extent of alignment of
all policies in promoting active healthy lifestyles. Effective monitoring and reporting of
the implementation of policies could help in better grasping the status of physical activity
and the impact of these policies on Filipino youth. A comprehensive physical activity plan
could also be beneficial for better promotion of physical activity engagement. Crucial to
such a plan is adopting a coordinated, multi-sectoral approach to ensure a meaningful
impact at the societal level.

Author Contributions: Conceptualization, J.Y.C. and Y.Y.P.; methodology, J.Y.C., Y.Y.P. and R.M.G.;
formal analysis, all authors; data curation, all authors; writing—original draft preparation, Y.Y.P.;
writing—review and editing, all authors. All authors have read and agreed to the published version
of the manuscript.
Funding: This research received no external funding.
Institutional Review Board Statement: Not applicable.
Informed Consent Statement: Not applicable.
Data Availability Statement: The data that support the findings of this study are available from the
corresponding author, Y.Y.P., upon reasonable request.
Acknowledgments: The 2022 Philippine physical activity report card was produced in partnership
with the Active Healthy Kids Global Alliance and the University of the Philippines Diliman College
of Human Kinetics with support from Sun Life Philippines as part of its purpose to help individuals
live healthier lives.
Conflicts of Interest: The authors declare no conflict of interest.

References
1. World Health Organization. WHO Guidelines on Physical Activity and Sedentary Behaviour. Available online: https://www.
who.int/publications-detail-redirect/9789240015128 (accessed on 1 November 2022).
2. Telama, R.; Yang, X.; Viikari, J.; Välimäki, I.; Wanne, O.; Raitakari, O. Physical Activity from Childhood to Adulthood: A 21-Year
Tracking Study. Am. J. Prev. Med. 2005, 28, 267–273. [CrossRef] [PubMed]
3. Ekblom-Bak, E.; Ekblom, Ö.; Andersson, G.; Wallin, P.; Ekblom, B. Physical Education and Leisure-Time Physical Activity in
Youth Are Both Important for Adulthood Activity, Physical Performance, and Health. J. Phys. Act. Health 2018, 15, 661–670.
[CrossRef] [PubMed]