International Journal of Health Policy and Management

International Journal of Health Policy and Management

“Pundits Are Saying This Is ‘Anti-poor’”: Competing Framing Strategies for Child Road Safety Policy in the Philippines

Document Type : Original Article

Authors
Sarah N. Champagne 1
Adam D. Koon 1, 2
Allan R. Ulitin 3
Haidee A. Valverde 3
Lamisa Ashraf 1
Ma-Ann M. Zarsuelo 3
Connie Hoe 1, 4
Hilton Y. Lam 3
Abdulgafoor M. Bachani 1
1 Johns Hopkins International Injury Research Unit, Health Systems Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
2 Department of Global Health, School of Health, Georgetown University, Washington, DC, USA
3 Institute of Health Policy and Development Studies, National Institutes of Health, University of the Philippines Manila, Manila, Philippines
4 Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
10.34172/ijhpm.8585
Abstract
Background 
Child restraint systems (CRS) can lead to a 60% reduction in child deaths, yet few low- and middle-income countries (LMICs) have comprehensive policies to enforce best practice standards. In 2019, the Philippines established such a policy: the Child Safety in Motor Vehicles (CSMV) Act.
 
Methods 
Drawing on framing theory, this study aims to understand the social dimensions of policy change to identify the Act’s origins, design, and implementation. Three sources of data – 25 articles, 27 key-informant interviews, and field notes – were collected and thematically analysed.
 
Results 
We present the findings according to two features of the framing process: storytelling and naming. The policy process can be sharply distinguished into two sections: the Act’s passage into law (which was swift and successful) and its implementation (which to date has not been). The Act’s implementation was stymied by three overarching frames – that it is “anti-poor,” “unnecessary,” and a “strategic political distraction.” A media backlash at the time of implementation solidified these frames, leading President Duterte to indefinitely defer enforcement of the Act.
 
Conclusion 
The CSMV Act emphasises that passing a law is insufficient. The trajectory of the act highlights the combined importance of (a) the framing of policy, (b) framing processes operate throughout a policy’s lifecycle, and (c) the media in creating a narrative. Our findings offer valuable insights for other LMICs implementing evidence-based road safety measures, suggesting that successful implementation requires not only strong legislation but also strategic communication and frame management throughout the policy process. Understanding framing dynamics can help policy-makers anticipate and address potential resistance to life-saving public health interventions.
Keywords
Framing Theory
Policy Analysis
Child Health
Injury
Child Restraint Systems
Philippines
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International Journal of Health Policy and Management
Volume 14, Issue 1
2025
Pages 1-11

  • Received Date 11 May 2024
  • Revised Date 05 April 2025
  • Accepted Date 11 June 2025
  • First Published Date 16 June 2025
  • Published Date 01 December 2025