By Vincent Siasoco, MD, MBA

“The Philippines is strategically located and blessed with the greatest resource: its people, who are hard-working, very loyal, and very adaptive.” - Benigno Aquino III, Former President of the Philippines

Philippines: Overview

A contrast in cultures, language, environment, and geography, Filipino culture is a rich blend of indigenous, Polynesian, Asian, Western, and Spanish influences in which the unifying factors are the hospitality, family values, and community spirit of its people. From the northernmost island of Luzon, where the capital of Manila is located, to the largest southernmost island of Mindanao, interspersed between the two are over 7,600 islands all consisting of different dialects and diverse cultures. From lush, green jungles and pristine white sand beaches leading up to crystal clear blue green waters to overrun rivers and urban overgrowth and population. From bustling, crowded, metropolitan cities to provincial areas of suburban life to old world, remote, villages consisting of nipa huts and countryside farms. In an archipelago that has a population of over 115 million people, the Philippines is one of the most densely populated countries in the Asia-Pacific region with almost 15 million living in its capital of Manila.

Data: What We Know

According to the World Health Organization, more than 700 million people in Asia and the Pacific live with some form of disability. (1) The Philippines Statistics Authority reported that approximately 1.44 million or 1.57% of its population had a disability as of 2010. (2) However, there are numerous and wide-ranging estimates of the prevalence of disability in the Philippines, ranging from 1.6% as estimated in the 2010 Census of Population and Housing, to 28.2% according to the World Report on Disability. (3) Approximately 1-3% of the global population has an intellectual disability – as many as 200 million people, as reported by Special Olympics. (4) It has been noted that globally, people with disabilities experience severe health inequities. Compared to those without disabilities, most are likely to die 20 years earlier, experience poorer health - having more than double the risk of developing conditions such as diabetes, stroke, or depression, and with limitations in function and inaccessible health facilities, up to 6 times more hindering for them. (5) The World Health Organization reports that 1 in 1000 births results in Down syndrome worldwide and 1 in 100 children are diagnosed with autism spectrum disorder. It has been noted that approximately 1 in 800 babies born in the Philippines have Down syndrome according to the Down syndrome Association of the Philippines, Inc. (6) 1 in 100 Filipinos is reported to be on the autism spectrum according to the Autism Society Philippines (7)

Intellectual and Developmental Disabilities

Intellectual disability, as defined by the Centers for Disease Control and Prevention (8), is a term used when there are limits to a person’s ability to learn at an expected level and function in daily life skills that starts before the age of 18 years old. Some examples of conditions under intellectual disability include Down syndrome, Fragile X Syndrome, and Fetal Alcohol Syndrome. Developmental Disabilities are a group of conditions due to impairment in physical, language, or behavior areas. Some conditions include autism spectrum disorders, cerebral palsy, spina bifida, ADHD, and intellectual disability.

Challenges and Barriers

-> Healthcare Access and Quality - Education/ Training

Access to healthcare has been an ongoing issue like in many parts of the world for those with intellectual and developmental disabilities (IDD). Unfortunately, in the Philippines, underreporting in rural areas due to limited access to proper diagnosis and subsequent intervention and care in children with IDD is a concern. In a 2022 report, it was noted that there were only 99 developmental pediatricians in the Philippines with over 50% of them practicing in the Metro Manila area. This results in underdiagnosing, lack of education, support, and overall poor access to care in other regions. (9) The lack of education and training on how to care for this population in medical, dental, and nursing schools further contributes to the poor quality of care and access to health. It has been reported that, “People with disabilities had significantly reduced access to health services, work, rehabilitation, education, government social welfare, and disaster management than people without a disability.” (3)

-> Economic Stability

In a country that has been noted to be one of the most dynamic economies in the East Asia and Pacific region, there still exist vast differences in regions when it comes to this. In 2023, the poverty rate was at 15.5% which accounted for about 17.5 million people according to the Philippine Statistics Authority (2). Although great strides have been made to lower this percentage since the pandemic, income inequality persists with the most rural areas being adversely affected the most. Poverty impacts on all the social determinants of health that include access to education, housing, food, and healthcare. Health inequities continue to exist due to poverty, steep health costs, and lack of access to healthcare constrained by inadequate health services, lack of financing, and a weak health information system.

The health expenditures of children with disabilities are 40% to 80% higher than other children without disabilities. Households with children with disabilities have poverty rates that are 50% higher than those of other households with children. (10) All Filipinos have the right to free healthcare through the Philippine Health Corporation (PhilHealth). Unfortunately, the quality and access to healthcare can vary depending on the location, with rural areas having the least access, and with many patients being required to still pay out of pocket.

-> Stigma, Social, and Community Support

Among families and culture, there is a lack of knowledge and awareness about individuals with disabilities. Cultural values and norms shape the support dynamics for female and male with disabilities. Compared to men and boys, women and girls with disabilities face a greater likelihood of exclusion from society, which can potentially lead to their limited income and reduced societal participation. Nevertheless, their male counterparts also face discrimination, given traditional gender roles and family expectations of being the “pillar of the home.” (11) (12) Some view disabilities as a curse and may reject the individual with a disability. “In the Philippines, as in many other countries, disability discrimination is entrenched and reinforced through superstition and misconceptions. Stigma can keep persons with disabilities at home and out of leadership positions.” (13).

In the Philippines, most children and adults with IDD live at home with parents and extended family members. Unlike in the U.S. where states provide group home for the more severe to profound end of disabilities, in the Philippines individuals with IDD and families have to fend for themselves. This becomes more of a challenge when the individual transitions into adulthood. (14) Day programs for adults are a rare find and are usually only for those who can afford.

Moving Mountains

Despite these challenges, there are many bright spots in the Philippines when it comes to advocacy and efforts for inclusion for those with intellectual and developmental disabilities.

Special Olympics Pilipinas provides year-round sports training and athletic events for children and adults with intellectual disabilities. Athletes can develop their physical and social skills, boost their self-confidence, and highlight their abilities. (15) This in turn fosters meaningful connections with their families, fellow athletes, and the community. Recently, Special Olympics Pilipinas joined the Special Olympics Global Coalition for Inclusion. As a result of this, Special Olympics Pilipinas developed a partnership with the Philippine Department of Education, with a goal to engage at least 50,000 students across five hundred schools throughout the Philippines through their Unified Sports program, where people with and without intellectual disabilities would play sports alongside each other. In addition, at least 2,000 educators will receive specialized training to ensure inclusive practices are effectively implemented in schools because of this partnership. (16)

The Autism Society Philippines (ASP) is a national non-profit organization in the Philippines that was established in 1989 where their goals are to see Filipinos on the spectrum, “become the best of their potentials-self-reliant, independent, productive, and socially accepted members” of society. They provide educational webinars for families across the country. Each year, ASP holds an “Angel’s Walk for Autism” event which brings thousands of individuals with autism, their families, and advocates together for a one-day event to show their collective support for those on the autism spectrum and raise awareness and promote advocacy. This year in May 2025, over 40,000 people showed up for this one-day ASP event held in 10 different cities throughout the Philippines.

The Down syndrome Association of the Philippines, Inc. is another non-profit organization that was established in 1991 by families and physicians to provide support to families of children with Down syndrome. Each year they hold a “Healthcare for Down” event in which over two hundred healthcare providers of different disciplines including family medicine, pediatrics, cardiology, dentistry, endocrinology, neurology, therapists, and nursing come together to provide free medical screenings and services for individuals with Down syndrome.

In 2024, the International School Manila held its first Neurodiversity Health Summit which brought together different disciplines that included family medicine, developmental pediatrics, and dentistry to educate families on the importance of healthcare. During this time, the University of the Santo Thomas Faculty of Medicine and Surgery held its first lecture on the Care of Intellectual and Developmental Disabilities for their residents in Physical Medicine and Rehabilitation, Family Medicine, and Pediatrics.

Summary - “Pag-asa” and “Kakayahan”

The Philippines still needs to make more strides to ensure the health and inclusion of their individuals with intellectual and developmental disabilities are addressed in society and that support is also provided to caregivers. “Disability results from the interaction between individuals with a health condition, such as cerebral palsy, Down syndrome, and depression, with personal and environmental factors including negative attitudes, inaccessible transportation and public buildings, and limited social support.” (5). However, through organizations fueled by families and advocates’ passions to ensure a better life for those with IDD and more government support and protections there is “Pag-asa” (Translated into “Hope”). Looking past the disabilities to focus on “Kakayahan” (Translated into “Abilities”) is what we should be striving for to ensure those with intellectual and developmental disabilities live life to the fullest and healthiest in an inclusive and supportive society.

*The author, Dr. Siasoco, being taught how to play bocce by a Special Olympics Pilipinas athlete leader.*

References:

1. World Health Organization, Global Report on Health Equity for Persons with Disabilities. https//www.who.int

2. Philippines Statistics Authority. Psa.gov.ph

3. Marella M, Devine A, Armecin GF, Zayas J, Marco MJ, Vaughan C. Rapid assessment of disability in the Philippines: understanding prevalence, well-being, and access to the community for people with disabilities to inform the W-DARE project. Popul Health Metr. 2016 Aug 2; 14:26. doi: 10.1186/s12963-016-0096-y. PMID: 27489509; PMCID: PMC4971707.

4. Special Olympics. Specialolympics.org

5. World Health Organization – Disability. https://www.who.int/health-topics/disability

6. Understanding Down Syndrome. Special Olympics Pilipinas. www.specialolympicspilipinas

7. Autism Society Philippines. www.autismsocietyphillipines.org

8. Centers for Disease Control and Prevention. https://www.cdc.gov

9. Challenges in Philippine Developmental Paediatric Care. https://doi.org/10.1111/jpc.16055

10. Carraro L, Robinson A, Hakeem B, Manlapaz A, Agcaoili R. Disability-Related Costs of Children with Disabilities in the Philippines. Int J Environ Res Public Health. 2023 Jul 6;20(13):6304. doi: 10.3390/ ijerph20136304. PMID: 37444151; PMCID: PMC10341990.

11. Socioeconomic Research Portal for the Philippines. https://serp-p.pids.gov.ph/feature/public

12. Thatcher, B. 2023. Value Fragmentation for Persons with Disabilities in the Family: A Case Study in Valenzuela City, Philippines. Philippine Journal of Development Volume 47(Number 1):20.

13. Conciliation Resources. https://www.c-r.org/news-and-insight/including-persons-disabilities-peacebuilding-philippines

14. Rotas, E. E., & Cahapay, M. (2021). Managing the Mental Health of Persons with Disabilities amid the COVID-19 Pandemic in the Philippines: Specific Factors and Key Actions. European Journal of Environment and Public Health, 5(2), em0077. https://doi.org/10.21601/ejeph/10954

15. Cordero DA. Children With Intellectual and Developmental Disabilities in the Philippines: Challenges and Interventions. Global Pediatric Health. 2024;11. doi:10.1177/2333794X241240955

16. Special Olympics Pilipinas. Specialolympicspilipinas.org

About the Author

Moving Mountains in Manila and Beyond

Sharing Inclusive Healthcare Messages with the American Public Health Association