Professional Documents
Culture Documents
Doh Programs
Doh Programs
Programs A-z, Monthly Health Events, Top 10 Causes of mortality and morbidity in the Philippines
SUBMITTED BY:
JOYCE P. DELA CRUZ
BS-PHARMACY I-B
Source:http://www.doh.gov.ph/health_programs_glossary
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Table of Contents
A
Adolescent and Youth Health Program (AYHP) 6
B
Botika Ng Barangay (BnB) 14
Breastfeeding TSEK 16
Blood Donation Program 16
C
Child Health and Development Strategic Plan Year 2001-2004 18
CHD Scorecard 22
Committee of Examiners for Undertakers and Embalmers 22
Committee of Examiners for Massage Therapy (CEMT) 24
Chronic Obstructive Pulmonary Disease Program 26
Cardiovascular Disease Program 30
D
Dental Health Program 34
Diabetes Mellitus Prevention and Control Program 40
E
Emerging and Re-emerging Infectious Disease Program 44
Environmental Health 46
Expanded Program on Immunization 47
Essential Newborn Care 52
F
Family Planning 55
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Food and Waterborne Diseases Prevention and Control Program 59
Food Fortification Program 61
G
Garantisadong Pambata 65
H
Human Resource for Health Network
Health Development Program for Older Persons - (Bureau or Office: National Center for Disease Prevention and
Control )
Health Development Program for Older Persons - R.A. 7876 (Senior Citizens Center Act of the Philippines)
Health Development Program for Older Persons (Global Movement for Active Ageing (Global Embrace 1999))
Health Development Program for Older Persons - R.A. 7432 (An Act to Maximize the Contribution of Senior Citizens to
Nation Building, Grant Benefits and Special Privileges)
Health and Well-being of Older Persons
Healthy Lifestyle Program
I
Infant and Young Child Feeding (IYCF)
Iligtas sa Tigdas ang Pinas
Inter Local Health Zone
Integrated Management of Childhood Illness (IMCI)
K
Knock Out Tigdas 2007
L
Leprosy Control Program
LGU Scorecard
4
Licensure Examinations for Paraprofessionals Undertaken by the Department of Health
M
Malaria Control Program
Measles Elimination Campaign (Ligtas Tigdas)
N
National Tuberculosis Control Program
Natural Family Planning
National Filariasis Elimination Program
National Rabies Prevention and Control Program
Newborn Screening
National HIV/STI Prevention Program
National Mental Health Program
National Dengue Prevention and Control Program
National Prevention of Blindness Program
O
Occupational Health Program
P
Persons with Disabilities
Pinoy MD Program
Philippine Cancer Control Program
Province-wide Investment Plan for Health (PIPH)
Philippine Medical Tourism Program
Prevention and Control of Chronic Lifestyle Related Non Communicable Diseases
Provision of Potable Water Program (SALINTUBIG Program - Sagana at Ligtas na Tubig Para sa Lahat)
R
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Rural Health Midwives Placement Program (RHMPP) / Midwifery Scholarship Program of the Philippines (MSPP)
S
Schistosomiasis Control Program
Soil Transmitted Helminth Control Program
Smoking Cessation Program
U
Urban Health System Development (UHSD) Program
Unang Yakap (Essential Newborn Care: Protocol for New Life)
V
Violence and Injury Prevention Program
W
Women's Health and Safe Motherhood Project
Women and Children Protection Program
6
Adolescent and Youth Health Program (AYHP)
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cases to 110 per year, which is substantial cause for alarm. In 2009, 15-24 year olds
make 29% of all new infections; in 2009, the number of new infections among 20-24
equals the number of new infections among 25-29; with 10 cases see July DOH AIDS
Registry Report. The substantial increase from the past year can be traced from
the adolescents’ early engagement in health risk behavior, due to serious gaps of
the knowledge on the dangers of drugs, as well as the cause as well as causes
on the transmission of STD and HIV AIDS , dangers of indiscriminate tattooing
and body- piercing and inadequate population education. Under this threat,
young males are prone to engaging in health risk behavior and more young
females are also doing the same without protection and are prone to aggressive
or coercive behaviors of others in the community such that it often results to
significant number of unwanted pregnancies,septic abortion and poor self-care
practices.
In addition, there are also other less common but significant causes of disease and
deaths namely;
Intentional self- harm –the 9th leading cause of death among 20-24 years old. In
this age group, seven out of 10 who died of suicide were males. In age group of 10-
24 years old took up 34% of all deaths from suicide in 2003
Substance Abuse - 15-19 years old group has the claim of drug use; more
males than females who are drug users and drug rehabilitation centers claim that
majority of clients belong to age group of 25-29 years old. According to the SWS
survey, 1996- 1.5M youth Filipinos and 1997- grew into 2.1M youth Filipinos are
into substance abuse
Nutritional Deficiencies –there are no specific rates for adolescent and youth, but
there is the prevalence of anemia and vitamin A deficiency which may be also
high for the adolescents and youth as those known for the younger and pregnant
women.
Disability – Filipinos aged 10-24 years old has an overall disability prevalence of 4%.
The most common disability among this age group affected are speaking (35%),
hearing (33%) and moving and mobility (22%)
There are also vulnerable Filipino adolescents which can be classified in
their respective areas of vulnerability
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Botika Ng Barangay (BnB)
II. Objectives
The objectives of this Order are as follows:
1. To promote equity in health by ensuring the availability and accessibility of
affordable, safe and effective, quality essential drugs to all, with priority for
marginalized, underserved, critical and hard to reach areas.
2. To integrate all related issuances of the DOH that provides rules and
regulations in the establishment and operations of BnBs; and
3. To define the roles and responsibilities of the different units of the DOH and
other partners from the different sectors in facilitating and regulating the
establishment of BnBs.
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Breastfeeding TSEK
On February 23, 2011, the Department of Health (DOH) launched the exclusive
breastfeeding campaign dubbed “Breastfeeding TSEK: (Tama, Sapat, Eksklusibo)”.
The primary target of this campaign is the new and expectant mothers in urban
areas.
This campaign encourages mothers to exclusively breastfeed their babies from
birth up to 6 months. Exclusive breastfeeding means that for the first six months
from birth, nothing except breast milk will be given to babies.
Moreover, the campaign aims to establish a supportive community, as well
as to promote public consciousness on the health benefits of breastfeeding. Among
the many health benefits of breastfeeding are lower risk of diarrhea, pneumonia, and
chronic illnesses.
Republic Act No. 7719, also known as the National Blood Services Act of 1994,
promotes voluntary blood donation to provide sufficient supply of safe blood and to
regulate blood banks. This act aims to inculcate public awareness that blood
donation is a humanitarian act.
The National Voluntary Blood Services Program (NVBSP) of the Department
of Health is targeting the youth as volunteers in its blood donation program this year.
In accordance with RA No. 7719, it aims to create public consciousness on the
importance of blood donation in saving the lives of millions of Filipinos.
Based from the data from the National Voluntary Blood Services Program, a
total of 654,763 blood units were collected in 2009. Fifty-eight percent of which was
from voluntary blood donation and the remaining from replacement donation. This
year, particular provinces have already achieved 100% voluntary blood donation. The
DOH is hoping that many individuals will become regular voluntary unpaid donors to
guarantee sufficient supply of safe blood and to meet national blood necessities.
Mission:
Blood Safety
Blood Adequacy
Rational Blood Use
Efficiency of Blood Services
Goals:
The National Voluntary Blood Services Program (NVBSP) aims to achieve the
following:
1. Development of a fully voluntary blood donation system;
2. Strengthening of a nationally coordinated network of BSF to increase
efficiency by centralized testing and processing of blood;
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3. Implementation of a quality management system including of Good
Manufacturing Practice GMP and Management Information System (MIS);
4. Attainment of maximum utilization of blood through rational use of blood
products and component therapy; and
5. Development of a sound, viable sustainable management and funding for
the nationally coordinated blood network.
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Child Health and Development Strategic Plan Year 2001-2004
Introduction
The Philippine National Strategic Framework for land Development for Children or
CHILD 21 is a strategic framework for planning programs and interventions that
promote and safeguard the rights of Filipino children. Covering the period 2000-
2005, it paints in broad strokes a vision for the quality of life of Filipino children in
2025 and a roadmap to achieve the vision.
Children's Health 2025, a subdocument of CHILD 21, realizes that health is
a critical and fundamental element in children's welfare. However, health programs
cannot be implemented in isolation from the other component that determines the
safety and well being of children in society. Children's Health 2025, therefore, should
be able to integrate the strategies and interventions into the overall plan for
children's development.
Children's Health 2025 contains both mid-term strategies, which is targeted
towards the year 2004, while long-term strategies are targeted by the year 2025. It
utilizes a life cycle approach and weaves in the rights of children. The life cycle
approach ensures that the issues, needs and gaps are addressed at the different
stages of the child's growth and development.
The period year 2002 to 2004 will put emphasis on timely diagnosis and
management of common diseases of childhood as well as disease prevention and
health promotion, particularly in the fields of immunization, nutrition and the
acquisition of health lifestyles. Also critical for effective planning and implementation
would be addressing the components of the health infrastructure such as human
resource development, quality assurance, monitoring and disease surveillance, and
health information and education.
The successful implementation of these strategies will require collaborative
efforts with the other stakeholders and also implies integration with the other
developmental plan of action for children.
Vision
A healthy Filipino child is:
Wanted, planned and conceived by healthy parents carried to term by healthy
mother born into a loving, caring, stable family capable of providing for his or her
basic needs, delivered safely by a trained attendant
Screened for congenital defects shortly after birth; if defects are found,
interventions to correct these defects are implemented at the appropriate time
Exclusively breastfed for at least six months of age, and continued
breastfeeding up to two years, introduced to complementary foods at about six
months of age, and gradually to a balanced, nutritious diet, protected from the
consequences of protein-calorie and micronutrient deficiencies through good
nutrition and access to fortified foods and iodized salt
Provided with safe, clean and hygienic surroundings and protected from
accident, properly cared for at home when sick and brought timely to a health
facility for appropriate management when needed. Offered equal access to good
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quality curative, preventive and promotive health care services and health
education as members of the Filipino society
Regularly monitored for proper growth and development, and provided with
adequate psychosocial and mental stimulation, screened for disabilities and
developmental delays in early childhood; if disabilities are found, interventions
are implemented to enabled the child to enjoy a life of dignity at the highest level
of function attainable
Protected from discrimination, exploitation and abuse
Empowered and enabled to make decisions regarding healthy lifestyle and
behaviors and included in the formulation health policies and programs, afforded
the opportunity to reach his or her full potential as adult
Current Situation
Deaths among children have significantly decreased from previous years. In
the 1998 NDHS, the infant mortality rate was 35 per 1000 live births, while neonatal
death rate was 18 deaths per 1000 live births. Among regions IMR is highest in
Eastern Visayas and lowest in Metro Manila and Central Visayas. Death is much
higher among infants whose mothers had no antenatal care or medical assistance at
the time of delivery. Top causes of illness among infants are infectious diseases
(pneumonia, measles, diarrhea, meningitis, and septicemia), nutritional deficiencies
and birth-related complications.
The probability of dying between birth and five years of age is 48 deaths per
1000 live births. The top five leading causes of deaths (which make up about 70%) of
deaths in this age group) are pneumonia, diarrhea, measles, meningitis and
malnutrition. About 6% die of accidents i.e. submersion, foreign bodies, and
vehicular accidents.
The decline in mortality rates may be attributed partly to the Expanded
Program of Immunization (EPI), aimed to reduce infant and child mortality due to
seven immunizable diseases (tuberculosis, diptheria, tetanus, pertusis, poliomyelitis,
Hepatitis B and measles).
The Philippines has been declared as polio-free during the Kyoto Meeting on
Poliomyelitis Eradication in the Western Pacific Region last October 2000. This
however, is not a reason to be complacent. The risk of importing the poliovirus from
neighboring countries remains high until global certification of polio eradication.
There is an urgent need for sustained vigilance, which includes strengthening the
surveillance system, the capacity for rapid response to importation of wild poliovirus,
adequate laboratory containment of wild poliovirus materials, and maintaining high
routine immunization until global certification has been achieved.
Malnutrition is common among children. The 1998 FNRI survey show that
three to four out of ten children 0-10 years old are underweight and stunted. The
prevalence of low vitamin A serum levels and vitamin A deficiency even increased in
1998 compared to 1996 levels as reported by FNRI. Vitamin A supplementation
coverage reached to more than 90%, however, a downward trend was evident in the
succeeding years from as high as 97% in 1993 to 78% in 1997.
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Breastfeeding rate is 88% (NSO 2000 MCH Survey), with percentage higher
in rural areas (92%) than in urban areas (84%). Exclusive breastfeeding increased
from 13.2% to 20% among children 4-5 mos. of age (NDHS).
Several strategies were utilized to improve child health. The Integrated
Management of Childhood Illness aims at reducing morbidity and deaths due to
common childhood illness. The IMCI strategy has been adopted nationwide and the
process of integration into the medical, nursing, and midwifery curriculum is now
underway.
The Enhanced Child Growth strategy is a community-based intervention
that aims to improve the health and nutritional status of children through improved
caring and seeking behaviors. It operates through health and nutrition posts
established throughout the country.
Gaps and Challenges
Many Local Health Units were not adequately informed about the Framework
for Children's Health as well as the policies. There is a need to disseminate the two
documents, CHILD 21 and Children's Health 2025 to serve as the template for local
planning for children’s health. There is also the need to update and reiterate the
policies on children's health particularly on immunization, micronutrient
supplementation and IMCI.
LGUs experienced problems in the availability of vaccines and essential drugs
and micronutrients due to weakness in the procurement, allocation and distribution.
Pockets of low immunization coverage are attributed largely to the irregular
supply of vaccines due to inadequate funds. Moreover, there is a need to revitalize the
promotion of immunization.
Goal
The ultimate goal of Children's Health 2025 is to achieve good health for all Filipino
children by the year 2025.
Medium-term Objectives for year 2001-2004
Health Status Objectives
1. Reduce infant mortality rate to 17 deaths per 1,000 live births
2. Reduce mortality rate among children 1-4 years old to 33.6% per 1000 live
births
3. Reduce the mortality rate among adolescents and youths by 50%
Risk Reduction Objectives
1. Increase the percentage of fully immunized children to 90%
2. Increase the percentage of infants exclusively breastfed up to six months to
30%
3. Increase the percentage of infants given timely and proper complementary
feeding at six months to 70%
4. Increase the percentage of mothers and caregivers who know and practice
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home management of childhood illness to 80%
5. Reduce the prevalence of protein-energy malnutrition among school-age
children
6. Increase the health care-seeking behavior of adolescents to 50%
Services and Protection Objectives
1. Ensure 90% of infants and children are provided with essential health care
package
2. Increase the percentage of health facilities with available stocks of vaccines
and essential drugs and micronutrients to 80%
3. Increase the percentage of schools implementing school-based health and
nutrition programs to 80%
4. Increase the percentage of health facilities providing basic health services
including counseling for adolescents and youth to 70%
Strategies and Activities
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Development of comprehensive monitoring and evaluation system for child
health programs and projects
CHD Scorecard
CHD Scorecard shall reflect performance of the CHD as extension producers of the
DOH in its mandate and function of steering and leading the national health system.
Performance indicators shall include extent and quality of goods and services desired
by the local health systems in the regional coverage area, and prescribed by DOH
management, along the 4 main strategies of F1. Performance indicators shall also
include satisfaction of clients with CHD services and products.
Rationale
Embalming is the funeral custom of cleaning and disinfecting bodies after death. It
has been part of the funeral parlors so with our lives. For the past decades,
embalming has been undergoing profound transformational events, not only in the
Philippines but worldwide. Today, embalming is also considered an art. It is done to
preserve the dead body from natural decomposition and for restoration for a more
pleasing appearance. Likewise, the procedure is significant for restoration of
evidences such as in medico-legal cases.
These changes were made possible by the multitudes of forces converging in the
national as well as the local levels, which is impacting on the quality of embalming
practice in the country. Embalmers today should therefore, be looked up to, because
of the significant manifold tasks they are rendering including the counseling
assistance they are providing the bereaved parties.
Objective:
The Department of Health (DOH) created the CEUE to regulate embalming practice
in the country. The creation was made possible by Presidential Decree (PD) No. 856
"Code of Sanitation of the Philippines" Chapter XXI "Disposal of Dead Persons" and
Executive Order No. 102 s. 1999 "Rationalization and Streamlining Plan of the DOH".
Strategies:
To ensure that only qualified individuals enter the regulated profession and that the
care and services which the embalmers provide are within the standards of practice,
the DOH-CEUE created:
1. CEUE Resolution No. 2011-001 - Three Year Transition Period for Compliance of
Administrative Order No. 2010-0033.
2. Memorandum dated August 10, 2010 - to the Centers for Health Development
(CHDs) Human Resource Development Units (HRDUs) regarding Updates on the
Committee of Examiners for Undertakers and Embalmers (CEUE) Program.
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3. Administrative Order No. 2010-0033 - Revised Implementing Rules and
Regulations of PD 856 Chapter XXI Governing Disposal of Dead Persons
4. CEUE Resolution No. 2010-001 - Adoption of the Code of Ethics for Embalmers in
the Philippines
5. CEUE Resolution No. 2009-001 - Creation of the Committee for Continuing
Embalmers Education Council (CEEC)
6. CEUE Resolution No. 2008-001 - Conduct of Licensure Examination for
Embalmers in Centers for Health Development (CHDs) to conduct a simultaneous
licensure examination in the Central Office and the CHDs with a minimum of 50
examinees for cost effectiveness.
7. Department Memorandum No. 2008-0009 - Designation of DOH Human Resource
Development Units (DOH-HRDUs) as Coordinators for Embalmers Program" to
facilitate immediate response to queries and complaints regarding the embalming
practice.
8. CEUE Resolution No. 2008-001 - Accredited Training Institutions and Training
Providers for Embalmers for CY 2008-2011 to regulate existing and potential training
providers and training institutions for embalmers for the enhancement and
maintenance of its professional standards.
9. CEUE Resolution No. 2008-002 - Extension of Moratorium as per CEUE
Resolution No. 2007-001.
10. CEUE Resolution No. 2007-001 - Moratorium on the Non-renewal of Licenses of
Embalmers for the past five (5) years and over with the aim of providing chance to
licensed embalmers who were unable tio renew their licenses for the past five years
and over.
11. Administrative Order No. 2007-0020 - Policies and Guidelines for the
Accreditation of Training Institutions, Training Programs and Training Providers for
Embalmers in the Philippines with the aim of institutionalizing the continuing
education program for embalmers in the country. Hence, to ensure the maintenance
of efficient, ethical and technical, moral and professional standards in its practice,
taking into account the quality of care to be rendered to respective clientele. At the
same time, the regulation ensures the global competitiveness of the Filipino
embalmers.
12. Department Circular No. 2007-0139 - Reiteration on the observance of
precautionary measures in the disposal of dead persons.
Chapter XXI "Disposal of Dead Persons" mandate the CEUE to monitor and
enforce quality standards of embalming practice in the Philippines and exercise the
powers necessary to ensure the maintenance of efficient, ethical and technical, moral
and professional standards in its practice, taking into account the quality of care to
be rendered to respective clientele. At the same time, the regulations ensure the
global competitiveness of the Filipino embalmers.
Program Status
Nationwide information dissemination of the following:
Administrative Order No. 2010 - 0033 (Disposal of Dead Persons)
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Curriculum for licensure examinations
Manuals for Licensure Examinations
Code of Ethics
1. March 25, 2011 - National Capital Region
2. May 3, 2011 - Visayas Region (Iloilo City)
3. May 13, 2011 - Mindanao Regions (Cagayan de Oro City)
4. June 30, 2011 - Butuan City (upon request)
5. August 25, 2011 - Aklan (upon request)
Rationale
Traditional medicine throughout the world recognizes the significance of therapeutic
massage in managing stress, illness or chronic ailments. Massage therapy is
considered the oldest method of healing that applies various techniques like fixed or
movable pressure, holding, vibration, rocking, friction, kneading and compression
using primarily the hands and other areas of the body such as the forearms, elbows
or feet to the mascular structure and soft tissues of the body.
Massage therapy can lead to significant biochemical, physical, behavioral and clinical
changes in massage as well as the person giving the massage. It contributes to a
higher sense of general well-being. Recognizing this, many healthcare professionals
have begun to incorporate massage therapy as a complement to their routine clinical
care. Efficacy of massage therapy in patient ranges from pretern neonates to senior
citizens. Although the country has the training standards and regulations through
the Technical Education and Skills Development Authority (TESDA), it lacks control /
regulations over the training institutions, thus, anyone who calls himself/herself a
massage therapist is one, regardless of training or experience.
Objective:
The Department of Health created the Committee of Examiners for Massage Therapy
(CEMT) to regulate the practice of massage therapy in accordance to the provisions of
the Sanitation Code of the Philippines (PD 856) and Executive Order No. 102 s. 1999,
Reorganization and Streamlining of the Department of Health. It provides the CEMT
the function to ensure that only qualified individuals enter the regulated profession
and that the care and services which the massage therapists provide are within the
standards of practice.
Strategies:
To ensure that only qualified individuals enter the regulated profession and that the
care and services which the massage therapists provide are within the standards of
practice, the DOH-CEMT created:
1. CEMT Resolution No. 2011-001 - Three-Year Transition Period for
Compliance to Administrative Order No. 2010-0034.
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2. Memorandum dated August 10, 2010 - to the Centers of Health Development
(CHDs) Human Resource Development Units (HRDUs) regarding Updates on the
Committee of Examiners for Massage Therapy (CEMT) Program
3. Administrative Order No. 2010-0034 - Revised Implementing Rules and
Regulations of PD 856 Chapter XIII Governing Massage Clinics and Sauna
Establishments
4. CEMT Resolution No. 2010-001 - Adoption of the Code of Ethics for Massage
Therapists in the Philippines.
5. CEMT Resolution No. 2009-001 - Creation of Committee for Continuing
Massage Therapy Education Council (CMTEC)
6. CEMT Resolution No. 2008-001 - Conduct of Licensure Examination for
Massage Therapists in Centers for Health Development (CHDs) to conduct a
simultaneous licensure examination in the Central Office and the CHDs with a
minimum of 50 examinees for cost effectiveness.
7. Department Memorandum No. 2008-0009 - Designation of DOH Human
Resource Development Units (DOH-HRDUs) as Coordinators for Massage Therapy
Program to facilitate immediate response to queries and complaints regarding the
massage therapy practice.
8. CEMT Resolution No. 2008-001 - Accredited training institutions and
training providers for massage therapists for CY 2008-2011 to regulate existing
and potential training providers and training institutions for massage therapists
for the enhancement and maintenance of its professional standards.
9. CEMT Resolution No. 2008-002 - Extension of Moratorium as per CEMT
Resolution No. 2008-001
10. CEMT Resolution No. 2008-001 - Moratorium on the Non-Renewal of
Licenses for Embalmers for the past five (5) years and over with the aim of
providing chance to licensed embalmers who were unable to renew their licenses
for the past five years and over
11. Administrative Order No. 2008-0031 - Policies and Guidelines for the
Accreditation of Training Institutions, Training Programs and Trainining
Providers for Massage Therapists in the Philippines with the aim of
institutionalizing the continuing education program for massage therapists in the
country. Hence, to ensure the maintenance of efficient, ethical and technical,
moral and professional standards in its practice, taking into account the quality
of care to be rendered to respective clientele. At the same time, the regulation
ensures the global competitiveness of the massage therapists.
Chapter XIII "Massage Clinics and Sauna Establishments mandate the CEMT to
monitor and enforce quality standards of massage therapy practice in the Philippines
and exercise the powers necessary to ensure the maintenance of efficient, ethical and
technical, moral and professional standards in its practice, taking into account the
quality of care to be rendered to respective clientele. At the same time, the
regulations ensure the global competitiveness of the Filipino massage therapists.
Program Status
Nationwide information dissemination of the following:
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Administrative Order No. 2010-0034 (Massage Clinics and Sauna
Establishments)
Curriculum for Licensure Examinations
Manuals for Licensure Examinations
Code of Ethics
1. March 25, 2011 - National Capital Region
2. May 3, 2011 - Visayas Regions (Iloilo City)
3. May 13, 2011 - Mindanao Region (Cagayan de Oro City)
4. June 30, 2011 - Butuan City(upon request)
5. August 25, 2011 - Aklan (upon request)
I. Rationale:
No large local study has been done to determine the prevalence of COPD in the
Philippines. So far, estimates have been based primarily on morality statistics. These
provide misleading figures because COPD is underdiagnosed and often not listed
either as primary or contributory cause of death. A spirometry based study in 1997
in a rural community found irreversible airway obstruction in 3.7% of the population.
Proceeding from an Asia-Pacific regional workshop in 2000 cited the prevalence of
COPD in the Philippines as 6.3%.
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adults did not report prior knowledge of Doctor-diagnosed asthma to explain their
symptoms. Prevalence and occurrence of Chronic respiratory diseases is likely to
increase and the extent of mortalities and financial cost necessitates a decisive plan
of action-both preventive and therapeutic. A national program supported by the
government, the scientific community, non-government organizations and people’s
organization is probably the optimal strategic approach to achieve a control of the
rising prevalence of CRDs.
A. Policy Statement:
The prevention and control of chronic lifestyle related non communicable diseases
shall be guided by the following policy statements.
B. Objectives:
Mission: To ensure that quality prevention and control and LRD services are
accessible to all, especially to the vulnerable and at-risk population.
II. Scenario
A. Global Situation
The leading causes of NCD deaths in 2008 were: cardiovascular diseases (17
million deaths, or 48% of NCD deaths); cancers (7.6 million, or 21% of NCD deaths);
and respiratory diseases, including asthma and chronic obstructive pulmonary
disease (COPD), (4.2 million). Diabetes caused an additional 1.3 million deaths.
Over 80% of cardiovascular and diabetes deaths, and almost 90% of deaths
from COPD, occurred in low- and middle-income countries. Behavioral risk factors,
including tobacco use, physical inactivity, and unhealthy diet, are responsible for
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about 80% of coronary heart disease and cerebrovascular disease. These important
behavioral risk factors of heart disease and stroke are discussed in detail later in this
chapter.
B. Local Situation:
Adopted in the context of health promotion in order to decrease the chances of the
targeted population to adopt high risk behaviors and habits that may lead to the
development of COPD.
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Trained Hospitals for the Registry System entitled “Users’ training for the
Unified Registry System”.
Trained CHDs for the Registry System entitled “Users’ training for the Unified
Registry System” (Non-Communicable Diseases).
Establishment of Philippine Coalition on the Prevention and Control of NCD.
A Training Manual for Health Workers on Promoting Healthy Lifestyle. (Non-
Communicable Diseases).
Twenty Years of Non-communicable Diseases (NCD) Prevention and Control in
the Philippines (1968-2006).
Healthy Lifestyle Advocacy Campaign.
Manual of Operations on the Prevention and Control Lifestyle-Related Non-
Communicable Diseases in the Philippines.
Training Manual for Health Workers: WHO/DOH Smoking Cessation Clinic:
Helping Smokers Quit.
V. Future Plan/Action:
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Cardiovascular Disease Program
I. Rationale:
The risk factors involved are tobacco use, unhealthy diet, physical inactivity
and alcohol use. The Food and Nutrition Research Institute (FNRD National
Nutrition and Health Surveys in 1998 to 2008 (Acuin and Duante, 2010) showed
that there is increasing prevalence in the associated risk factors between 1998 to
2008: hypertension from 2l%o to 25.3 %; diabetes from 3.9%o to 4.8%; among adults
who are overweight, there has been a significant increase from 24.2% to 26.60/o;
and those with high blood cholesterol levels had increased from 4Yo to 10.2%.
Furthermore, the study found out that the following groups are at risk for NCDs: age
group from the 40's onwards and those with Body Mass Index (BMI) > 23,
dyslipidemia, high waist circumference and waist hip ratios. Moreover, dietary intake
trends show increasing consumption of energy dense foods high in fats and sugars,
while almost the entire adult population has low levels of physical activity in all
domains: occupation, non-occupation, leisure, transportation.
Children and adolescents are also exposed to the above-mentioned risks. Latest
data from the Global Adult Tobacco Survey in 2009 shows prevalence of tobacco use
(current smokers) among population 15 years old and above tobe28.3%o (17.3 million
Filipinos); 47.7% of these are men (14.6 million) and 9%o are women (2.8 million). On
the other hand, the prevalence of overweight among adolescents 9-11 years old has
increased two folds from 2.4oh in 1993 to 4.8%;oin2005. Similarly, the prevalence
rate of overweight for children 6-10 years old doubled from 0.8% in 2001 to 1.6%o in
2005. (Source: Philippine Nutrition Facts and Figures 2005). About 30Yo of teenage
students are physically inactive, spending three or more hours per day sitting and
watching television, playing computer games, talking with friends, or doing other
sitting activities. (Source: Philippines Global School-based Student Health Survey,
2007). And, data shows that in 2008 hazardous alcohol intake stands at26.90/o
(FNRI-NNHeS 2008).
The Philippine Renal Disease Registry (PRDR) illustrates that for 2009,
diabetic nephropathy, a complication of diabetes remained the most common
etiology of end stage renal disease while clinical hypertensive nephrosclerosis, a
complication of hypertension ranked as the second most common etiology of end
stage renal disease. Unless something is done to control these non-communicable
diseases, renal complications will escalate to a degree that will compromise the
current capacity to care for these types of patients.
32
The cost of care of lifestyle-related non-communicable diseases may cause
people to fall into poverty and create a downward spiral of worsening poverty and
illness. They also undermine the country's economic development. In response to the
increasing prevalence of lifestyle related diseases in the country, vertical programs on
the prevention and control of cardiovascular diseases, cancers and diabetes were put
in place in the mid 1990's. The individual programs however, were focused on
treatment and management of those who were already sick and thus were competing
with each other for resources and for attention upon field implementation.
A. Policy Statement:
B. Objectives:
Mission: To ensure that quality prevention and control and LRD services are
accessible to all, especially to the vulnerable and at-risk population.
Vision: A nation of Filipinos with Healthy Lifestyle and habits, living and working
in clean and safe environment and with access to adequate medical care for CVD.
33
II. Scenario
A. Global Situation
The leading causes of NCD deaths in 2008 were: cardiovascular diseases (17
million deaths, or 48% of NCD deaths); cancers (7.6 million, or 21% of NCD deaths);
and respiratory diseases, including asthma and chronic obstructive pulmonary
disease (COPD), (4.2 million). Diabetes caused an additional 1.3 million deaths.
Over 80% of cardiovascular and diabetes deaths, and almost 90% of deaths
from COPD, occurred in low- and middle-income countries. Behavioral risk factors,
including tobacco use, physical inactivity, and unhealthy diet, are responsible for
about 80% of coronary heart disease and cerebrovascular disease. These important
behavioral risk factors of heart disease and stroke are discussed in detail later in this
chapter.
B. Local Situation:
34
III. Strategies implemented by DOH
35
Development of Strategic Framework and a five Year Strategic Plan for
Cardiovascular Disease (2012-2016).
Table 1: Prevalence of the Two Most Common Oral Diseases by Year, Philippines
Prevalence
YEAR
Dental Caries Peridontal Disease
1987 93.9% 65.5%
1992 96.3% 48.1%
1998 92.4% 78.3%
The oral health status of Filipino children is alarming. The 2006 National Oral
Health Survey (Monse B. et al, NOHS 2006) investigated the oral health status of
Philippine public elementary school students. It revealed that 97.1% of six-year-old
children suffer from tooth decay. More than four out of every five children of this
subgroup manifested symptoms of dentinogenic infection. In addition, 78.4% of
twelve-year-old children suffer from dental caries and 49.7% of the same age group
manifested symptoms of dentinogenic infections. The severity of dental caries,
expressed as the average number of decayed teeth indicated for filling/extraction or
filled permanent teeth (DMFT) or temporary teeth (dmft), was 8.4 dmft for the six-
year-old age group and 2.9 DMFT for the twelve-year-old age group (NOHS 2006).
Table 2 - Dental caries Experience (Mean DMFT/dmft), per age groups, Philippines
Age in NMEDS NMEDS NMEDS NMEDS NMEDS
Years 1982 1987 1992 1998 2006
6 8.4 dmft
12 6.39 5.52 5.43 4.58 2.9
15-19 8.51 8.25 6.3
35-44 14.18 14.82 14.42 15.04
Filipinos bear the burden of gum diseases early in their childhood. According to
NOHS, 74% of twelve-year-old children suffer from gingivitis. If not treated early,
36
these children become susceptible to irreversible periodontal disease as they enter
adolescence and approach adulthood.
In general, tooth decay and gum diseases do not directly cause disability or
death. However, these conditions can weaken bodily defenses and serve as portals of
entry to other more serious and potentially dangerous systemic diseases and
infections. Serious conditions include arthritis, heart disease, endocarditis, gastro-
intestinal diseases, and ocular-skin-renal diseases. Aside from physical deformity,
these two oral diseases may also cause disturbance of speechsignificant enough to
affect work performance, nutrition, social interactions, income, and self-esteem.
Poor oral health poses detrimental effects on school performance and mars success
in later life. In fact, children who suffer from poor oral health are 12 times more likely
to have restricted-activity days (USGAO 2000). In the Philippines, toothache is a
common ailment among schoolchildren, and is the primary cause of absenteeism
from school (Araojo 2003, 103-110). Indeed, dental and oral diseases create a silent
epidemic, placing a heavy burden on Filipino schoolchildren.
VISION: Empowered and responsible Filipino citizens taking care of their own
personal oral health for anenhanced quality of life
MISSION: The state shall ensure quality, affordable, accessible and available oral
health care delivery.
GOAL: Attainment of improved quality of life through promotion of oral health
and quality oral health care.
37
continuum of quality care by establishing a package of essential basic oral health
care (BOHC) for every lifecycle stage, starting from infancy to old age.
The following are the basic package of essential oral health services/care for
every lifecycle group to be provided either in health facilities, schools or at home.
TYPES OF SERVICE
LIFECYCLE
(Basic Oral Health Care Package)
Oral Examination
Oral Prophylaxis (scaling)
Mother(Pregnant Women) ** Permanent fillings
Gum treatment
Health instruction
Dental check-up as soon as the first tooth erupts
Neonatal and Infants under 1
Health instructions on infant oral health care
year old** and advise on exclusive breastfeeding
Dental check-up as soon as the first tooth
appears and every 6 months thereafter
Supervised tooth brushing drills
Oral Urgent Treatment (OUT)
- removal of unsavable teeth
Children 12-71 months old **
- referral of complicated cases
- treatment of post extraction complications
- drainage of localized oral abscess
Application of Atraumatic Restorative
Treatment (ART)
Oral Examination
Supervising tooth brushing drills
Topical fluoride theraphy
School Children (6-12 years old)
Pits and Fissure Sealant Application
Oral Prophylaxis
Permanent Fillings
Oral Examination
Adolescent and Youth (10-24 Health promotion and education on oral hygiene,
years old)** and adverse effect on consumption of sweets and
sugary beverages, tobacco and alcohol
Oral Examination
Emergency dental treatment
Other Adults (25-59 years old)
Health instruction and advice
Referrals
Oral Examination
Extraction of unsavable tooth
Older Person (60 years old and
Gum treatment
above)** Relief of Pain
Health instruction and advice
38
STRATEGIES AND ACTION POINTS:
a. Establishment of effective networking system (DepEd, DSWD, LGU, PDA, Fit for
School, Academe and others)
- Fluoride Use
- Tooth brushing
2. Ensure financial access to essential public and personal oral health services
a. Develop an outpatient benefit package for oral health under the NHIP of the
government
b. Develop financing schemes for oral health applicable to other levels of care
( Fee for service, Cooperatives, Network with HMOS)
c. Restoration of oral health budget line item in the GAA of DOH Central Office
3. Provide relevant, timely and accurate information management system for oral
Health.
39
b. Develop packages of essential care/services for different groups (children,
mothers and marginalized groups)
c. Design and implement grant assistance mechanism for high performing LGUs
a) Orally Fit Child (OFC)– Proportion of children 12-71 months old and are orally
fit during a given point of time. Is defined as a child who meets the following
conditions upon oral examination and/or completion of treatment a) caries-
free or carious tooth/teeth filled either with temporary or permanent filling
materials, b) have healthy gums, c) has no oral debris, and d) No handicapping
dento-facial anomaly or no dento-facial anomaly that limits normal function of
the oral cavity
b) Children 12-71 months old provided with Basic Oral Health Care (BOHC)
c) Adolescent and Youth (10-24 years old) provided with Basic Oral Health care
(BOHC)
d) Pregnant Women provided with Basic oral Health Care (BOHC)
e) Older Persons 60 years old and above provided with Basic Oral Health Care
(BOHC)
Policy/Standards/Guidelines formulated/developed:
a. AO. 101 s. 2003 dated Oct. 14, 2003 – National Policy on Oral Health
b. AO 2007-0007 – Dated January 3, 2007 Guidelines In The Implementation Of
Oral Health Program For Public Health Services In The Philippines
40
c. AO 4-s.1998 – Revised Rules and Regulations and Standard Requirements for
Private School Dental services in the Philippines
d. AO 11-D s. 1998 – Revised Standard Requirements for Hospital Dental
services in the Philippines
e. AO 3 s. 1998 - Revised Rules and Regulations and Standard Requirements for
Occupational Dental services in the Philippines
f. AO 4-A s. 1998 – Infection Control Measures for Dental Health Services
The training program was designed with the Public Health Dentists (PHDs) as the
main recipients of the Basic Course on the Management of Oral Health Program. The
training is expected to provide an in-depth understanding of the different roles and
functions of the PHDs in the management and delivery of Public Health Services. A
training module was developed for the basic course.
Researches:
Member Agencies:
Department of Health (NCDPC, HHRDB, NCHP)
DOH- Center for Health Development for NCR, Central Luzon and
CALABARZON
Philippine Dental Association
Department of Education
UP- College of Public Health
Department of Interior and Local Government
41
Print materials:
Leaflets (Malakas ang dating Buo ang Ngipin) for Children, Adolescent,
Pregnant Women and Older Person
Training Module on Basic Course on Management of Oral Health Program
I. Rationale
However, with recent evidences showing that diabetes and other chronic
lifestyle related non-communicable diseases (cardiovascular diseases, cancers and
chronic respiratory diseases) sharing common risk factors (unhealthy diet, physical
inactivity, smoking and alcohol use) should be addressed the most cost-effective way
through prevention of the emergence of the risk factors in an integrated manner,
employing health promotion strategies across the life course and intervening at the
level of family and community.
This is essential because the causal risk factors causing these illnesses are
deeply entrenched in the social and cultural framework of the society. Thus, an
integrated comprehensive program for the prevention and control of these non-
communicable lifestyle related diseases has to be put in place, hence, the signing of
the Administrative Order No. 2011 – 0003, National Policy on Strengthening the
Prevention and Control of Chronic Lifestyle Related Non-Communicable Diseases on
April 14, 2011.
42
Goal:
Objectives:
1. To develop and promote an integrated and comprehensive program on the
prevention and control of lifestyle related diseases in the country.
2. To engage all province-wide or city-wide health systems to adopt an integrated
and comprehensive program on the prevention and control of lifestyle related
diseases.
3. To achieve improvement in the following Key Performance Indicators from
2011-2016:
Disease Control
II. Scenario
The estimated number of adults living with diabetes has soared to 366 million,
representing 8.3% of the global adult population. This number is projected to
increase to 552 million people by 2030, or 9.9% of adults which equates to
43
approximately three more people with diabetes every 10 seconds(Diabetes Atlas 5th
Edition, 2011).
The Action Framework for the National Program on the Prevention and Control
of Chronic Lifestyle Related Non-Communicable Diseases is based on the Causation
Pathway Model for Major Chronic Diseases as contained in the World Health
Organization Western Pacific Regional Action Plan for Addressing Non-Communicable
Diseases, where the underlying determinants, common risk and intermediate risk
factors that would lead to lifestyle-related diseases are identified.
The Action Framework has seven action areas as follows: (1) Environmental
interventions; (2) Lifestyle interventions; (3) Clinical interventions; (4) Advocacy; (5)
Research, Surveillance, Monitoring and Evaluation; (6) Networking and Coalition
building; and (7) Health System Strengthening.
It draws primarily from the WHO Western Pacific Regional Framework for
addressing Non-communicable Diseases and emphasizes the requirement for
integrated comprehensive approaches that encompass and address the various levels
of determinants and risks for non-communicable lifestyle related diseases.
2) Lifestyle interventions address the common risk factors and intermediate risk
factors by providing population based lifestyle interventions (for example, information
and education and behavioral interventions for those who are already at risk).
44
and society, and health system strengthening through primary health care to make it
more responsive to chronic care.
The framework highlights the balance between “healthy choices” and “healthy
environments” because it recognizes that supportive environments are needed to
empower healthy choices. It also redistributes responsibility across the whole of
society, with government, the health sector, the private sector, non-governmental
organizations, communities, families and individuals all sharing accountability for
putting in place the necessary elements that promote healthy lifestyle and quality
care for non-communicable lifestyle related diseases.
Policy/Standard/Guidelines Development
Development of Clinical Practice Guidelines on diabetes and other NCDs are on-
going.
This brings the problem of NCDs including diabetes high in the consciousness of
all sectors and the Filipino public. This advocacy focuses on clear health priorities
such as consumption of healthy diet, promoting physical activity, curbing the use of
tobacco, alcohol, and illegal drugs, proper weight and stress management, early
detection and control of hypertension.
Coalition Building
Together with other partners in the Phil. Coalition for the Prevention and Control
of Non-Communicable Diseases, also known as Healthy Lifestyle Coalition, the
DOH also encourages the Fast Food Establishments to offer healthier food choices by
reducing the fat, sugar and salt content as well as trans-fatty acids in the food they
serve. Serving of fresh fruits and vegetables and other sources of fiber are encouraged
as well.
Surveillance
A national and integrated registry system for chronic non-communicable
diseases has been developed where health facilities like hospitals can report new
cases of diabetes, cancer, stroke and chronic obstructive pulmonary diseases and
statistics concerning incidence, mortality and survival can be generated. An
45
Administrative Order re: National Implementation of the Integrated Chronic Non-
Communicable Disease Registry System has been drafted for approval.
V. Future Plan/Action
Goal: Prevention and control of emerging and re-emerging infectious disease from
becoming public health problems.
Objectives:
46
The program aims to:
1. Reduce public health impact of emerging and re-emerging infectious diseases;
and
2. Strengthen surveillance, preparedness, and response to emerging and re-
emerging infectious diseases.
Program Strategies:
The DOH, in collaboration with its partner organizations/agencies, employs the key
strategies:
Partner Organizations/Agencies:
The following organizations/agencies take part in achieving the goal of the program:
47
Environmental Health
Strategic Objectives
48
Components
I. Rationale
II. Scenario
Global Situation
The burden.
In 2002, WHO estimated that 1.4 million of deaths among children under 5
years due to diseases that could have been prevented by routine vaccination. This
represents 14% of global total mortality in children under 5 years of age.
Burden of Diseases
The immunization coverage of all individual vaccines has improved as shown in
Figure 1: (Demographic Health Survey 2003 and 2008). Fully Immunized Child (FIC)
coverage improved by 10% and the Child Protected at Birth (CPAB) against Tetanus
improved by 13% compared to any prior period. Thus, the Philippines has now
historically the highest coverage for these two major indicators.
49
III. Interventions/ Strategies
Program Objectives/Goals:
Over-all Goal:
To reduce the morbidity and mortality among children against the most common
vaccine-preventable diseases.
Specific Goals:
Mandates:
Strategies:
50
IV. Status of implementation/ Accomplishment
All health facilities (health centers and barangay health stations) have at least one
(1) health staff trained on REB.
Polio Eradication:
The Philippines has sustained its polio-free status since October 2000.
Declining Oral Polio Vaccine (OPV) third dose coverage since 2008 from 91% to
83%. A least 95% OPV3 coverage need to be achieved to produce the required
herd immunity for protection.
There is an on-going polio mass immunization to all children ages 6 weeks up to
59 months old in the 10 highest risk areas for neonatal tetanus. These areas
are the following: Abra, Banguet, Isabela City and Basilan, Lanao Norte,
Cotabato City, Maguindanao, Lanao Sur, Marawi City and Sulu.
Acute Flaccid Paralysis (AFP) reporting rate has decreased from 1.44 in 2010 to
1.38 in 2011. Only regions III, V and VIII have achieved the AFP rate of
2/100,000 children below 15 years old. (Source: NEC, DOH). A decreasing AFP
rate means we may not be able to find true cases of polio and may experience
resurgence of polio cases
Measles Elimination
Conducted 4 rounds of mass measles campaign: 1998, 2004, 2007 and 2011.
Implemented the 2-dose measles-containing vaccine (MCV) in 2009
MCV1 (monovalent measles) at 9-11 months old
MCV2 (MMR) at 12-15 months old.
10 areas were classified as highest risk for neonatal tetanus (NT). Figure 3
shows the areas categorized as low risk, at risk and highest risk based on the
NT surveillance, skilled birth attendants and facility based delivery and the
tetanus toxoid 2+ (TT 2+) vaccination.
Three (3) rounds of TT vaccination are currently on-going in the 10 highest risk
areas. An estimated 1,010,751 women age 15 - 40 year old women regardless
of their TT immunization will receive the vaccine during these rounds. This is
funded by the Kiwanis International through UNICEF and World Health
Organization.
Control of other common vaccine-preventable diseases (Diphtheria, Pertussis,
Hepatitis B and Meningitis/Encephalitis secondary to H. influenzae type B)
Continuous vaccination for infants and children with the DPT or the
combination DPT-HepB-HiB Type B. Annex1 EPI Annual Accomplishment
Report. DOH procures all the vaccines and needles and syringes for the
immunization activities targeted to infants/children/mothers.
Hepatitis B Control
Republic Act No. 10152 has been signed. It is otherwise known as the
“Mandatory Infants and Children Health Immunization Act of 2011, which
requires that all children under five years old be given basic immunization
against vaccine-preventable diseases. Specifically, this bill provides for all
infants to be given the birth dose of the Hepatitis-B vaccine within 24 hours of
birth.
One strategy to strengthen Hepatitis B coverage is to integrate birth dose in the
Essential Intrapartum and Newborn Care Package (EINC). In 2011, 11 tertiary
hospitals are already EINC compliant.
The goal of Hepatitis B control is to reduce the chronic hepatitis B infection rate
as measured by HBsAg prevalence to less than 1% in five-year-olds born after
routine vaccination started 100% Hepatitis B at birth vaccination.
52
>24 hours 62% 55% 24%
Hep B 3rd dose 86% 81% 30%
*both 2010 and 2011 data are as of October 2011
One significant milestone is that the budget allocation for the immunization
program has continued to increase year by year
The Government of the Philippines allocated budget for the immunization of all
infants/children/women/older persons nationwide. For 2012, the budget for
EPI is PhP1.8 billion and another P1.5 Billion for the immunization for senior
citizen and children for the NHTS families. This is great leap towards universal
access to quality vaccines for the prevention of the most common vaccine-
preventable diseases.
53
Essential Newborn Care
Vision and Mission: None to mention as these are inclusive in the MNCHN Strategy
and NOH 2011-2016
Objectives:
Stakeholders:
1. Both public and private sector at all levels of health service delivery providing
maternal and newborn services
2. Health Professional Organizations and their member health professionals
54
Family medicine specialists of the Philippine Academy of Family Physicians
(PAFP)
Nurses, Maternal and child nurses, intensive care nurses of the Philippine
Nurses Association and its affiliate nursing societies
Midwives of the Integrated Midwives of the Philippines (IMAP), Philippine
League of Government and Private Midwives, Inc. (PLGPMI), Midwives
Foundation of the Philippines (MFP) and Well Family Midwives Clinic
4. Academe - professors and instructors from members schools and colleges of:
6. Local government units - local chief executives and LGU legislative bodies
Beneficiaries:
Program Strategies:
55
Adoption of essential newborn care protocol(including intrapartum care and
the MNCHN Strategy)
3. Curriculum Reforms
Curriculum integration of essential newborn care (including intrapartum
care and the MNCHN Strategy) in undergraduate health courses
Integration and revision of board exam questions in licensure examinations
for physicians, nurses and midwives
4. Social Marketing
Development of social marketing tools - Unang Yakap MDG 4 & 5
B.Statistics
56
Partner organizations/agencies:
Family Planning
Responsible Parenthood which means that each family has the right and duty to
determine the desired number of children they might have and when they
might have them. And beyond responsible parenthood is Responsible Parenting
which is the proper upbringing and education of children so that they grow up
to be upright, productive and civic-minded citizens.
Respect for Life. The 1987 Constitution states that the government protects the
sanctity of life. Abortion is NOT a FP method:
Birth Spacing refers to interval between pregnancies (which is ideally 3 years). It
enables women to recover their health improves women's potential to be more
productive and to realize their personal aspirations and allows more time to
care for children and spouse/husband, and;
Informed Choice that is upholding and ensuring the rights of couples to
determine the number and spacing of their children according to their life's
aspirations and reminding couples that planning size of their families have a
direct bearing on the quality of their children's and their own lives.
Intended Audience: Men and women of reproductive age (15-49) years old)
including adolescents
Area of Coverage: Nationwide
Mandate: EO 119 and EO 102
57
Vision: Empowered men and women living healthy, productive and
fulfilling lives and exercising the right to regulate their own fertility through legally
and acceptable family planning services.
Mission: The DOH in partnership with LGUs, NGOs, the private sectors and
communities ensures the availability of FP information and services to men and
women who need them.
Program Goals:
Objectives
General
To help couples, individuals achieve their desired family size within the context
of responsible parenthood and improve their reproductive health. Specifically,
by the end of 2004:
Reduce
MMR from 172 deaths 100,000 LB in 1998 to less than 100 deaths/100,000 LB
IMR from 35.3 deaths/1000 livebirths in 1998 to less than 30 deaths/1000 live
births
TFR from 3.7 children per woman in 1998 to 2.7 chidren per woman
Increase
Contraceptive Prevalence Rate from 45.6% in 1998 to 57%
Proportion of modern FP methods use from 28>2% to 50.5%
Strategies
58
Demand Generation through Community-Based Management Information
System
Mainstreaming Natural Family Planning in the public and NGO health facilities
Strengthening FP in the regions with high unmet need for FP: CAR, CHD 5, 8,
NCR, ARMM
Contraceptive Interdependence Initiative
Major Activities
IV. Mainstreaming Natural Family Planning in the public and NGO health facilities
Orientation of CHD staff and creation of Regional NFP Management Committee
Diacon with stakeholders
Information, Education and counseling activities
Advocacy and social mobilization efforts
Production of NFP IEC materials
Monitoring and evaluation activities
V. Strengthening FP in the regions with high unmet need for FP: CAR, CHD 5, 8, NCR,
ARMM
Field of itinerant teams by retained hospitals to provide VS services nearer to
the community
Installation of COmmunity Based Management Information System
Provision of augmentation funds for CBMIS activities
59
VI. Contraceptive Interdependence Initiative
Expansion of PhilHealth coverage to include health centers providing No Scalpel
Vasectomy and FP Itenerant Teams
Expansion of Philhealth benefit package to include pills, injectables and IUD
Social Marketing of contraceptives and FP services by the partner NGOs
National Funding/Subsidy
XI. Provision of logistics support such as FP commodities and VS drugs and medical
supplies
Other Partners
1. Funding Agencies
United States Agency for International Development (USAID)
United Nations Funds for Population Activities (UNFPA)
Management Sciences for Health (MSH)
Engender Health
The Futures Group
2. NGOs
Reachout foundation
DKT
Philippine Federation for Natual Family Planning (PFNFP)
John Snow Inc. - Well Family Clinic
Phlippine Legislators Committee on Population Development (PLPCD)
Remedios Foundation
Family Planning Organization of the Philippines (FPOP)
Institute of Maternal and Child Health (IMCH)
Integrated Maternal and Child Care Services and Development, Inc.
Friendly Care Foundation, Inc.
Institute of Reproductive Health
3. Other GOs
Commission on Population
DILG
DOLE
LGUs
60
Food and Waterborne Diseases Prevention and Control Program
The program covers diseases of a parasitic, fungal, viral, and bacteria in nature,
usually acquired through the ingestion of contaminated drinking water or food. The
more common of these diseases are bacterial in nature, the most common of which
are typhoid fever and cholera. These two organisms had been the cause of major
outbreaks in the Philippines in the last two years. Parasitic organisms are also an
important factor, among them capillariasis, Heterophydiasis, and paragonimiasis,
which are endemic in Luzon, Visayas, and Mindanao. Cysticercosis is also a major
problem since it has a neurologic component to the illness. The approaches to control
and prevention is centered on public health awareness regarding food safety as well
as strengthening treatment guidelines.
Beneficiaries/Target Population:
61
The Food and Waterborne Disease Control Program targets individuals, families,
and communities residing in affected areas nationwide. For parasitic infections,
endemic areas are more common.
Strategies/Management:
Partner Organizations/Agencies:
The following organizations and agencies take part in the achievement of program
objectives:
62
Food Fortification Program
Objectives:
To provide the basis for the need for a food fortification program in the
Philippines: The Micronutrient Malnutrition Problem
To discuss various types of food fortification strategies
To provide an update on the current situation of food fortification in the
Philippines
“The addition of one or more essential nutrients to food, whether or not it is normally
contained in the food, for the purpose of preventing or correcting a demonstrated
deficiency of one or more nutrients in the population or specific population groups”
Vitamin A - an essential nutrient as retinol needed by the body for normal sight,
growth, reproduction and immune competence
Iron - an essential mineral and is part of hemoglobin, the red protein in red
blood cells that carries oxygen from the lungs to the cells
63
Iron Deficiency Anemia - condition where there is lack of iron in the body
resulting to low hemoglobin concentration of the blood
Thyroid hormones - needed for the brain and nervous system to develop &
function normally
ASIN LAW
Republic Act 8172, “An Act Promoting Salt Iodization Nationwide and for other
purposes”, Signed into law on Dec. 20, 1995
64
Food Fortification Law
Republic Act 8976, “An Act Establishing the Philippine Food Fortification Program
and for other purposes” mandating fortification of flour, oil and sugar with Vitamin A
and flour and rice with iron by November 7, 2004 and promoting voluntary
fortification through the SPSP, Signed into law on November 7, 2000
There are 139 processed food products with SangkapPinoySeal with 83% with
vitamin A, 29% with iron and 14% with iodine (2008)
37% of the products are snack foods
Most of the products FDA analyzed are within the standard
Based on 2003 NNS Households’ awareness of SPS- and FF-products is 11%
and 14%, respectively, in 2008 awareness is 11.6%
Although awareness is low, usage of SPS-products is 99.2%
Recommendations:
Status:
Based on FDA monitoring all local flour millers are fortifying with vitamin A and
iron
94% and 92% of all samples tested by FDA in 2009 were fortified with vitamin A
and iron respectively while 77% and 99% were fortified with vitamin A and iron
respectively. In 2010 decrease in vitamin A due to non-fortified imported and
market samples flour.
58% of samples from local mills for vitamin A and 67% of imported flour for iron
were fortified according to standards.
Recommendations:
65
Need to show impact of flour fortification
Status and Recommendations on Mandatory Fortification of Refined Sugar with
Vitamin A
Status:
Non – fortification by industry due to the unresolved issue of who will bear the
cost of fortification brought about by the quedansystem of transferable
certificates of sugar ownership.
Lack of premix production
Fortification of refined sugar would benefit mainly those in the high income
group.
Recommendations:
Status:
Recommendation:
Status:
Based on the samples analyzed by FDA in 2009 and 2010, more than 90% are
fortified (91% in 2009 and 94% in 2010)
Samples monitored were labeled and packed
FDA is not monitoring "takal"
Recommendations:
66
To increase frequency of monitoring by FDA and other agencies such as PCA
and LGU’s, to ensure all oil refiners and repackersare monitored at least once a
year
Monitoring of “takal” oil, use of test kit
Monitoring imported oil, FDA and BOC to coordinate
Review policy of mandatory fortification of oil to possibly limit to those mostly
used by at risk population (coconut and palm oil)
Status and Recommendations on Salt Iodization
Status:
Based on the 2008 NNS, 81.1% of households were positive for iodine using
Rapid Test Kit (RTK)
In the same survey for Region III, 55.7% were positive for RTK but only 34.2%
and 24.2% have iodine content >5ppm and >15ppm respectively using WYD
Tester
For FDA monitoring in 2010, 88% were >5ppm while 44% were >15ppm
FDA started implementing localization of ASIN Law with General Santos City as
the 1stto have a MOA with FDA on localization
Recommendation:
Garantisadong Pambata
Goal
›Achievement of better health outcomes, sustained health financing and
responsive health system by ensuring that all Filipinos, esp. the disadvantaged
group (lowest 2 income quintiles) have equitable access to affordable health
care
Strategies:
Financial risk protection.
67
Improved access to quality hospitals and facilities
Attainment of health-related MDGs by:
Deploy CHTs to actively assist families in assessing and acting on their health
needs
Utilize life cycle approach in providing needed services: FP, ANC, FBD, ENC,
IPP, GP for 0-14 years old
Aggressive promotion of healthy lifestyle change
Harness strengths of inter-agency and intersectoralcooperation with DepEd,
DSWD and DILG
Objectives:
›Contribute to the reduction of infant and child morbidity and mortality towards
the attainment of MDG 1 and 4.
›Ensure that all Filipino children, especially the disadvantaged group (GIDA),
have equitable access to affordable health, nutrition and environment care.
Partner Agencies:
Department of Education
Department of Social Welfare & Development
Department of Interior and Local Government
Department of Health
USAID
UNICEF
World Health Organization
Save the Children
Fit for School
World Vision
Plan Foundation
Philippine Dental Association
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GP Services Package
Age by Year Health Nutrition Environment
Maternalnutrition
Maternal health
Iron supplementation
care Water
Vitamin A
0-1 Essential newborn Sanitation
Early &exclusive
care Hygiene promotion
breastfeeding
Immunization Oral health
Complementary feeding
Child injury
Breastfeeding prevention
Immunization Complementaryfeeding Treated bednets
1-5 Deworming Vitamin A Smoke-free homes
IMCI Iron supplementation
Iodized salt at home
Deworming
Booster Proper nutrition
6-10
immunization Iodized salt at home
(Screening)
Deworming
Booster
Proper nutrition
immunization
11-14 Iron supplementation
(Screening)
Iodized salt at home
Physical activity
(Healthy lifestyle)
Vitamin A Supplementation
›Policy remains the same for giving Vitamin A capsules:
Routine:
- every 6 months for 6-59 months preschoolers
Therapeutic:
- 1 capsule upon diagnosis regardless of when the last dose of VAC for
preschoolers with measles
- 1 capsule upon diagnosis except when child was given Vitamin A was given
less than 4 weeks for preschoolers with severe pneumonia,
persistent diarrhea, severely underweight
- 1 capsule immediately upon diagnosis, 1 capsule the next day and another capsule
after 2 weeks after for preschoolers with xerophthalmia
Recording/Reporting:
FHSIS Records and Reports
GP Forms – submitted to NCDPC thru CHDs
April – preschoolers 6-59 months given VAC from November of past year to
April of the current year October – preschoolers 6-59 months given
VAC from May to October
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Core Messages per Gateway Behavior
MAGPASUSO
(Newborn to 6 mos) Pasusuhin ng gatas ni Nanay lang
(6 mos to 2 years old) Magpasuso at bigyan ng (mga masustansiyang ibat-
ibang pagkain) ibang pagkain (pampamilyang pagkain).
Bumili/ Gumamit ng mga produktong may SANGKAP PINOY seal sa pagluluto.
MAGPABAKUNA
Siguraduhing kumpletoang bakuna ni baby bago siya magdiwang ng unang
kaarawan.
Pabakunahan ng MMR ang mga batang 1 taon hanggang 1 taon at 3 buwan.
Ito ay laban sa tigdas, beke at rubella (German Measles)
MAGBITAMINA A
Siguraduhing mabigyan (mapatakan) ng Bitamina A kada anim (6) na buwan
ang inyong mga anak na edad 6 na buwan hanggang 5 taon
MAGPURGA
Siguraduhing mapurga ang inyong mga anak na edad 1 hanggang 12 na taong
gulang kada anim na buwan.
GUMAMIT NG PALIKURAN
Gumamit ng kubeta o palikuran sa pagdumi at pagihi.
MAGSIPILYO
Wastong pagsisipilyo ng ngipin ng dalawang beses sa isang araw, lalo na bago
matulog.
MAGHUGAS NG KAMAY
Maghugas ng kamay bago kumain at matapos gumamit ng kasilyas. Ugaliin din
ang paghuhugas ng kamay matapos maglaro o humawak ng maduduming
bagay.
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Human Resource for Health Network
The Department of Health (DOH) spearheaded the creation of Human Resource
for Health Network (HRHN), which is a multi-sectoral organization composed of
government agencies and non-government organizations. The network seeks to
address and respond to human resource for health (HRH) concerns and problems.
HRHN was formally established during the launching and signing of the
Memorandum of Understanding among its member agencies and organizations held
on October 25, 2006. This network was grounded on the Human Resources for
Health Master Plan (HRHMP) developed by the DOH and the World Health
Organization (WHO). The HRHN was conceived to implement programs and activities
that require multi-sectoral coordination.
Vision: Collaborative partnerships for a better, more responsive and globally
competitive HRH.
Mission: The HRHN is a multi-sectoral organization working effectively for
coordinated and collaborative action in the accomplishment of each member
organization’s mandate and their common goals for HRH development to address the
health service needs of the Philippines, as well as in the global setting.
Values: Upholds the quality and quantity of HRH for the provision of quality health
care in the Philippines.
Objectives:
The objectives of the HRHN are as follows:
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Health Development Program for Older Persons - (Bureau or Office: National
Center for Disease Prevention and Control)
Program Briefer
Cognizant of its mandate and crucial role, the Philippine Department of Health
(DOH) formulated the Health Care Program for Older Persons (HCPOP) in 1998. The
DOH HCPOP (presently renamed Health Development Program for Older Persons)
sets the policies, standards and guidelines for local governments to implement the
program in collaboration with other government agencies, non-government
organizations and the private sector.
The program intends to promote and improve the quality of life of older persons
through the establishment and provision of basic health services for older persons,
formulation of policies and guidelines pertaining to older persons, provision of
information and health education to the public, provision of basic and essential
training of manpower dedicated to older persons and, the conduct of basic and
applied researches.
Target Population/Clients
A. Older persons (60 years and above) who are:
a. Well and free from symptoms
b. Sick and frail
c. Chronically ill and cognitively impaired
d. In need of rehabilitation services
B.Health workers and caregivers
C.LGU and partner agencies
Mandate:
International:
Vienna International Plan of Action on Ageing
General Assembly Resolutions
Local:
Philippine Constitution (Article XIII, Section XI)
Republic Act 7876 - Senior Citizens Center Act of the Philippines
Republic Act No. 7432 - An Act to Maximize the Contribution of Senior
Citizens to Nation Building, Grant Benefits and Special Privileges and for Other
Purposes
Proclamation No. 470 - Declaring the 1st week of October every year as
"Elderly Filipino Week"
Philippine Plan of action for Older Persons (1999-2004)
Vision: Healthy ageing for all Filipinos.
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Goal: A healthy and productive older population is promoted.
Health Development Program for Older Persons - R.A. 7876 (Senior Citizens Center
Act of the Philippines)
Sec. 1.Title. — This Act shall be known as the "Senior Citizens Center Act of the
Philippines."
Sec. 3.Definition of Terms. — (a) "Senior citizens," as used in this Act, shall refer to
any person who is at least sixty (60) years of age.
(b) "Center," as used in this Act, refers to the place established by this Act with
recreational, educational, health and social programs and facilities designed for the
full enjoyment and benefit of the senior citizens in the city or municipality.
Sec. 5.Functions of the Centers. — The centers are extensions of the fourteen (14)
regional offices of the Department. They shall carry out the following functions:
(a) Identify the needs, trainings, and opportunities of senior citizens in the cities and
municipalities;chan robles virtual law library
(b) Initiate, develop and implement productive activities and work schemes for senior
citizens in order to provide income or otherwise supplement their earnings in the
local community;
(c) Promote and maintain linkages with provincial government units and other
instrumentalities of government and the city and municipal councils for the elderly
and the Federation of Senior Citizens Association of the Philippines and other non-
government organizations for the delivery of health care services, facilities,
professional advice services, volunteer training and community self-help projects;
and
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(d) To exercise such other functions which are necessary to carry out the purpose for
which the centers are established.
Sec. 6.Center Workers. — The Secretary of the Department of Social Welfare and
Development (DSWD) may designate social workers from the Department as the
workers of the centers: Provided, however, That the Secretary may appoint other
personnel who possess the necessary professional qualifications to work efficiently
with the elderly of the community.
The Secretary may also call upon private volunteers who are responsible members of
the community to provide medical, educational and other services and facilities for
the senior citizens.
Sec. 8.Exemptions of the Center. — The Center shall be exempted from the
payment of customs duties, taxes and tariffs on the importation of equipment and
supplies used actually, directly and exclusively by the Center pursuant to this Act,
including those donated to the Center.
Sec. 9.Rules and Regulations. — Withinsixty (60) days from the approval of this
Act, the DSWD, in coordination with other government agencies concerned, shall
issue the rules and regulations to effectively implement the provisions of this Act.
Any violation of this section shall render the concerned official(s) liable under
Republic Act No. 6713, otherwise known as the "Code of Conduct and Ethical
Standards for Public Officials and Employees" and other existing administrative
and/or criminal laws.
Sec. 11.Appropriations. — The amount necessary to carry out the provisions of this
Act shall be included in the General Appropriations Act of the year following its
enactment into law and every year thereafter.
The sum necessary for the continuous operation of the centers shall be subsidized in
part by the DSWD and in part by the local government units concerned.
Sec. 12.Repealing or Amending Clause. — All laws, decrees, executive orders, and
rules and regulations, which are not consistent with this Act, are hereby modified,
amended or repealed accordingly.chan robles virtual law library
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Sec. 13. This Act shall take effect fifteen (15) days after its publication in two (2)
newspapers of general circulation.
Health Development Program for Older Persons (Global Movement for Active
Ageing (Global Embrace 1999))
The Global Movement for Active Ageing, which was conceived by the World
Health Organization (WHO), will need the collaboration of many different partners
from all over the world. Active ageing is the capacity of the people, as they grow older
to lead productive and healthy lives in their families, societies and economies.
The Global Movement will be a network for all those interested in moving
policies and practice towards Actives Ageing. It will provide models and ideas for
programme and projects that promote active ageing.
1. CELEBRATE –
Celebrate ageing ; getting older is good; the alternative dying prematurely is not
3. INTEGENERATIONAL SOLIDARITY
Older persons should not be marginalized: reflecting the theme of the UN
International Year of Older Persons, “towards a society for all ages”
The Global Embrace, which will mark simultaneously the launching of Global
Movement for Active Ageing 1999 International Year for Older Persons, is exactly as
the title implies, a series of walk events embracing the globe: in time zone after time
zone, ageing will be celebrated in cities around the world, through these walk events.
The walk will start in countries in the Pacific, where the date line marks the start of a
new day.
Thus, the first walk will be in New Zealand ..followed by Australia, then Japan,
Korea, China, Thailand, the Philippines, Indonesia and India.. Always at a set time, a
group of cities, within the same time zone, will be starting their celebrations.
Eventually, they will reach the Middle East, Africa, Europe, the America, until the
very last locations will close the day and embrace. The Global embrace is a round the
clock around the world party which every country is invited.
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Objectives:
2. Moreover, it will link the local project to a global community of similar concerns
and people from all over the world.
As there are still negative stereotype associated with old age in many societies, a
participatory event that promotes a positive image of ageing will assist in dissipating
these stereotypes. This is a necessary precondition both for allowing the aged to
make a contribution to the world as well as for building a harmonious global
community and an intergenerational society.
A. 2 The Message
The World Health Organization (WHO) Ageing and Health Programme has launched
initiatives that encourage healthy ageing globally. To assist in the promotion, an
annual celebration on October 2 (Saturday) as designated by the United Nation and
mandated by law shall recognize the “International Year of Older Persons (IYOP)”
These celebratory event will be held at the Quezon Memorial Circle, Quezon City, 3
p.m. till midnight
A. 4 Target Population
Since the walk event promotes healthy ageing there is NO SPECIFIC TARGET
POPULATION. Everybody (All ages) are encouraged to participate in the walk. There is
NO competitive aspect to the event that people at all levels of physical
activity are encouraged to take part. The primary aim is to promote intergenerational
exchanges.
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Health Development Program for Older Persons - R.A. 7432 (An Act to Maximize the
Contribution of Senior Citizens to Nation Building, Grant Benefits and Special
Privileges)
b) To encourage their families and communities they live with to reaffirm the
valued Filipino tradition of caring for the senior citizens.
2) Adopt measures whereby our senior citizens are assisted and appreciated
by the community as a whole;
3) Establish a program beneficial to the senior citizens, their families and the
rest of the community that they serve.
SECTION 2.Definition of Terms. – As used in this Act, the term “senior citizen”
shall mean any resident of the Philippines at least sixty (60) years old, including
those who have retired from both government offices and private enterprises, and has
an income of not more than Sixty thousand pesos (P60,000.00) per annum subject to
review by the National Economic and Development Authority (NEDA) every three (3)
years.
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The term “head of the family” shall mean any person so defined in the National
Internal Revenue Code.
In consideration of the services rendered by the qualified elderly, the Office for Senior
Citizens Affairs (OSCA) may award or grant benefits or privileges to the elderly, in
addition to the other privileges provided for under Section 4 hereof.
SECTION 4.Privileges for the Senior Citizens. – The senior citizens shall be
entitled to the following:
a) The grant of twenty percent (20%) discount from all establishments relative
to utilization of transportation services, hotels and similar lodging establishment,
restaurants and recreation centers and purchase of medicines anywhere in the
country: Provided, That private establishments may claim the cost as tax credit;
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e) Free medical and dental services in government establishment anywhere in the
country, subject to guidelines to be issued by the Department of Health, the
Government Service Insurance System and the Social Security System;
f) To the extent practicable and feasible, the continuance of the same benefits and
privileges given by the Government Service Insurance System (GSIS), Social Security
System (SSS) and PAG-IBIG, as the case may be, as are enjoyed by those in actual
service.
a) The senior citizen shall be treated as dependents provided for in the National
Internal Revenue Code and as such, individual taxpayers caring for them, be they
relatives or not shall be accorded the privileges granted by the Code insofar as having
dependents are concerned.
1) Realty tax holiday for the first five (5) years starting from the first year of
operations;
SECTION 7.The Office for Senior Citizens Affairs (OSCA). – There shall be
established in the Office of the Mayor an OSCA to be headed by a Councilor who
shall be designated by the Sangguniang Bayan and assisted by the Community
Development Officer in coordination with the Department of Social Welfare and
Development. The functions of this office are:
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d) To serve as a general information and liaison center to serve the needs of the
senior citizens.
SECTION 9.Penalties. – Violation of any provision of this Act for which no penalty is
specifically provided under any other law, shall be punished by imprisonment not
exceeding one (1) month or a fine not exceeding One thousand pesos (P1,000.00) or
both.
SECTION 13.Separability Clause. – If any part or provision of this Act shall be held
to be unconstitutional or invalid, other provisions hereof which are not affected
thereby shall continue to be in full force and effect.
SECTION 14.Effectivity. – This Act shall take effect fifteen (15 days following its
publication in one (1) national newspaper of general circulation.
Approved,
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This bill, which is a consolidation of Senate Bill Nos. 835, 1435 and House Bill No.
35335, was finally passed by the Senate and the House of Representatives on
February 7, 1992.
1. A Senior Citizen shall enlist at the Office for Senior Citizens Affairs (OSCA)
established at the Office of the Mayor in his/her city or municipality;
2. The OSCA shall determine the eligibility of the senior citizen. All eligible senior
citizens shall provide OSCA two (2) ID pictures taken within the year of enlisting at
OSCA. One ID picture shall be attached to the OSCA registration form to be kept by
the said office. The other picture shall be for the ID card;
3. The OSCA shall prepare the list of Senior Citizens to be certified by the local office
of the Bureau of Internal Revenue and the local Civil Registrar’s office;
4. Duplicate copy of the certified list of senior citizens shall be submitted by OSCA to
the DSWD filed office;
5. The Bureau of Disabled Persons Welfare, DSWD shall send to the 14 DSWD Field
Offices number of IDs needed by the Elderly of the region;
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6. The DSWD Field Office shall release the IDs to the respective local OSCAs;
7. The OSCA shall issue the ID cards duly signed by the municipal/city Mayor to the
qualified senior citizens;
8. The OSCA shall issue the nationally uniform ID card without cost to the Senior
Citizen.
In case the ID is lost, it must be reported to the local OSCA. Replacement shall be
issued upon request by OSCA with corresponding cost. The cost per ID shall be
determined by DSWD. The payment shall remain at OSCA as part of its funds. No ID
cards of senior citizens shall be issued directly by the DSWD Central Office or its field
offices.
Approving the Implementing Rules and Regulations of R.A. 7432 Maximizing the
Contribution of Senior Citizens to Nation Building, Grant Benefits and Privileges
Whereas, the Philippine Constitution recognizes the duty of the family to take care of
its elderly members with the state designing programs of social security for them,
and the need for the state to promote social justice in all phases of national
development, by making available essential social services to the priority groups such
as the sick, elderly, disabled, women and children;
Whereas, RA 7432 has been enacted to motivate and encourage senior citizens to
contribute to nation building and to mobilize their families and the communities they
live with to reaffirm the valued Filipino tradition of caring for the senior citizen;
Whereas, the Medium Term Philippine Development Plan (MTPDP) 1993-1998 aims
to pursue a better quality of life for all Filipinos particularly the disadvantaged
sectors by providing focused basic services to allow them to manage and control their
resources, as well as benefit from developmental interventions;
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(Sgd.) Honorable Nieves R. Confesor
Secretary, Department of Labor and Employment
Chairman, Social Development Committee
83
(Sgd.) Hon. Edelmiro A. Amante, Sr. Secretary Office of Executive Secretary
RULE I
Article 1. Title – These Rules shall be known and cited as the Rules and Regulations
implementing the Act to Maximize the Contribution of Senior Citizens to Nation
Building, Grant Benefits and Special Privileges and for Other Purposes.
Article 2. Purpose – These Rules are promulgated to prescribe the procedures and
guidelines for the implementation of the Act to Maximize the Contribution of Senior
Citizens to National Building, Grant Benefits and Special Privileges and for Other
Purposes in order to facilitate the compliance therewith and to achieve the objectives
thereof.
RULE II
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a) To motivate and encourage senior citizens to contribute to nation building;
b) To encourage their families and the communities they live with to reaffirm
the valued Filipino tradition of caring for the senior citizens;
b) Adopt measures whereby our senior citizens are assisted and appreciated
by the community as a whole;
c) Establish a program beneficial to the senior citizens, their families and the
rest of the community that they serve.
Article 5. Definition of Terms – As used in these rules, the following terms shall be
defined as follows:
5.1 Senior Citizen – any resident citizen of the Philippines, at least sixty (60)
years old, including those who have retired from both government offices and private
enterprises and has an income of not more than sixty thousand pesos (P60,000.00)
per annum subject to review by the National Statistics Coordination (NSCB) every
three (3) years.
Senior Citizens earning sixty thousand pesos (P60,000.00) per annum may be tapped
as resource persons to provide transfer technology and consultancy services or other
services in the community. Those without income are necessarily covered by this
definition.
5.3 Benefactor – shall mean any person whether related to the senior citizen or
not who takes care of him or her as dependent.
5.4 Head of the Family – shall mean an unmarried or legally separated man or
woman with one or both parents or with one or more brothers or sisters or with one
or more legitimate, recognized, natural or legally adopted children and/or with one or
more senior citizen living with and dependent upon him for their chief support where
brother/s or sister/s or children are not more than twenty one (21) years of age
unmarried and not gainfully employed or where such children, brother/s or sister/s,
regardless of age are incapable of self-support because of mental or physical defect.
85
5.5 National Identification Cards – are the ID cards provided for initially for free
by the Department of Social Welfare and Development and issued through the Office
for Senior Citizens Affairs (OSCA).
5.6 Office for Senior Citizens Affairs – otherwise known, as the OSCA shall be
established in the Office of the Mayor as prescribed in the Act.
5.9 Air Transportation Service – shall mean as the carriage of passenger by air.
a. Tourist Inn – a lodging establishment catering to transients which does not meet
the minimum requirement of an economy hotel.
c. Motorist Hotel – any structure with several separate units, primarily located along
the highway, with individual or common parking space, at which motorists may
obtain lodging and in some instances, meals.
The term lodging establishment shall include lodging houses, which shall mean such
establishments as are regularly engaged in the hotel business, but which,
86
nevertheless, are not registered, classified and licensed as hotels by reason of
inadequate essential facilities and services.
5.12 Restaurant – shall mean any establishment, duly licensed by the local
government units (LGUs ), offering to the public, regular and special meals or menu,
cooked food and short orders. Such eating-places may also serve coffee, beverages
and drinks.
RULE III
Article 6. Office for Senior Citizens Affairs (OSCA) – There shall be established in the
office of the Mayor and OSCA to be headed by a councilor who shall be designated by
the Sangguniang Bayan/Panglungsod in coordination with the Department of Social
Welfare and Development (DSWD) and the Municipal/City Federation of Senior
Citizens.
Article 7.The Functions of OSCA – The OSCA shall perform the following functions:
b) To mobilize the different local agencies to identify activities within their programs
which can be undertaken by the senior citizens;
c) To draw up a list of available and required services which can be provided by the
senior citizens;
The regular quarterly update of the list of senior citizens shall be made on the first
week of the first month of every quarter.
It shall the responsibility of the local Social Welfare Development Officer or any other
officer performing such functions to review and process all applications
f) To serve as a general information and liaison center to respond to the needs of the
senior citizens, the OSCA shall:
f.1 assist any complainant or aggrieved senior citizen in filing the appropriate action
with the Office of the Public Prosecutor or with the concerned Agency/Department
until same is finally terminated or resolved, and;
87
f. 2 assist the National Government in putting up the necessary appropriate notices
of the mandatory elderly discount privileges/benefits under RA 7432, which shall be
posted at a conspicuous place in all establishments.
The Municipal/City Federations of Senior Citizens shall assist OSCA in the foregoing
functions:
8.1 to provide the initial nationally uniform identification cards which shall be issued
through the OSCA.
The nationally uniform individual identification cards shall contain the following
information:
b) Name
c) Address
d) Age, as supported by a certified birth certificate from the Office of Civil Registrar;
Birth date
f) Picture
A senior citizen whose income is P60,000.00 and below annually shall be issued a
national ID card, which contains the mandatory elderly, discount privileges/benefits
under RA 7432.
This shall be duly signed by the mayor of the senior citizen’s locality, the Secretary of
the Department of Social Welfare and Development (DSWD) and the Secretary of the
Department of Interior and Local Government (DILG). This shall be non-transferrable.
RULE IV
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CONTRIBUTIONS IN THE COMMUNITY
Article 9.Contributions of Senior Citizens to the Community. Any qualified senior
citizen as determined by the OSCA may render his/her services to the community,
which shall consist of, but not limited to any of the following:
In consideration of services rendered by the qualified elderly, the OSCA may award or
grant benefits/privileges to the elderly, in addition to the other privileges provided for
under Section 4 of the Act.
Senior citizens earning above sixty thousand pesos (P60,000.00) annually can be
granted some awards or benefits by the OSCA for services rendered to his community
e.g. consultancy services, transfer of new technology, etc.
RULE V
A senior citizen shall be granted twenty per cent (20%) discount from all
establishments relative to utilization of transportation services, hotels and similar
lodging establishments, restaurants and recreation centers and purchases of
medicines, anywhere in the country.
A. Transportation Benefits
89
than twenty per cent (20%) of the fare charged or authorized, including discount of
twenty per cent (20%) on purchases of meals or food items from the restaurant either
operated by concessionaire or the carrier and medicines on board vessels.
A senior citizen, unless his/her physical appearance shows that he/she undoubtedly
60 years old or above, may prove his/her age by any of, but not limited, to the
following documents or papers:
a. Official Identification Card from the OSCA of the LGUs, SSS/GSIS ID (old or new);
A.2 Public Land Transportation – every senior citizen who is a passenger of any
public land transportation services stated below, shall be entitled to a discount in the
amount of not less than twenty per cent (20%) of the fare authorized by the Land
Transportation Franchising and Regulatory Board (LTFRB).
c. Taxi
d. Shuttle Bus
e. Tourist Bus
f. Other modes of passenger land transportation devoted for public use and for a fee
with general or limited clientele.
90
posters, handbills or pamphlets, the information about senior citizens on board their
vehicles to maximize the benefits of the senior citizens.
Every senior citizen is entitled to a grant of twenty per cent (20%) discount on the use
of Light Rail Transit (LRT) System.
Senior citizens who would wish to avail of the discount privileges on LRTC shall be
guided by the following procedures/conditions:
a) Senior citizens shall personally apply for the issuance of discount tickets (in
booklet form) at the Light Rail Transit Authority (LRTC) or METRO, Inc. with office at
the Administration Building, LRTA Compound, Aurora Boulevard, Pasay City or at
designated outlets at the LRT system by presenting their ID card issued by the OSCA.
Discount tickets will be printed with control numbers and will allow a senior citizen
to purchase LRT tokens at a twenty per cent (20%) discount.
b) A senior citizen shall personally surrender to any LRT token teller on duty at any
LRT station/terminal where he/she will board, a discount ticket for every token
he/she will purchase.
Upon surrender of the discount ticket and presentation of the national ID card by a
senior citizen, he/she shall pay for the LRT token at twenty per cent (20%) discount.
(A senior citizen is entitled to purchase only one (1) LRT token at discounted price
every time he/she avails of the LRT System.)
To avoid untoward incidents, senior citizens are discouraged from riding the LRT
during peak hours from 7:00 A.M. to 9:00 A.M. and from 5:00 P.M. to 7:00 P.M. due
to the volume of rider ship.
Twenty per cent (20%) discount for LRT tokens are available only at LRTC
stations/terminals. Discounted token are not available from off-station token
vendors.
A.3. Domestic Air Transportation – Every senior citizen who is duly certified by t he
OSCA is entitled to twenty per cent (20%) discount from the Civil Aeronautics Board
(CAB) approved and published airline rates for domestic air transportation services.
This Act shall cover individuals, partnership, or corporations and all other entities
engaged in the carriage of passengers by air.
The following are the conditions required of a senior citizen to be able to avail of the
twenty per cent (20%) discount on air transportation services:
a. The senior citizen should present his/her identification card duly issued by OSCA
in securing a passage ticket;
91
b. He/She should personally secure the passage ticket;
The DILG shall issue the necessary circulars or directives to tourism establishments
for the implementation of these guidelines and to ensure compliance herewith.
In the purchase of medicine, a senior citizen or his doctor or the latter’s duly
authorized representative should always present the national identification card duly
certified by the OSCA together with the doctor’s prescription in case of prescription
drugs. If over-the-counter, the number of drugs purchased shall be commensurate to
the elderly person’s needs.
These discount privileges shall be limited and exclusive for the benefit of the senior
citizen.
E. Income Tax Benefits/Tax Credits – For purpose of claiming tax credits, private
establishments are required to keep a separate record of sales made to senior citizens
which shall include the name, identification number, gross sales, discount and date
of transaction.
A senior citizen whose annual taxable income does not exceed the poverty level as
determined by NSCB shall be exempted from payment of individual income tax.
Provided that:
a) A senior citizen whose annual taxable income exceed the said poverty level shall be
liable to the individual income tax for the full amount of his/her taxable income net
of personal and additional exemptions;
b) Annual taxable income shall refer to the annual gross compensation, business and
other incomes as defined in Section 28 of the National Internal Revenue Code (NIRC)
other than income subject to tax under paragraphs (b), (c), (d) and (e) of Section 21 of
92
the NICR which include certain passive incomes, capital gains from sale of shares of
stock and capital gains from sale of real property;
d) NEDA shall inform the Commissioner of Internal Revenue in writing and publish in
a newspaper of general circulation the estimated poverty threshold.
F. Training Fee Benefits – A senior citizen is exempted from training fees for socio-
economic programs undertaken by or in coordination with the OSCA as part of its
work.
G.1 The DOH shall direct the government establishments in the entire country to
provide free medical and dental services to senior citizens.
a. The term “free” shall mean free of charge on medical/dental services where
capability and facility for such services are available,
b. The term “medical services” shall refer to services pertaining to the medical
care/attendance and treatment given to senior citizens. It shall include health
examinations, medical/surgical procedures within the competence and capability of
DOH establishments/hospitals/units and routine/special laboratory examinations
and ancillary procedures as required.
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f. Government establishments shall refer to and limited to DOH hospitals, which
shall include general hospitals, medical centers and regional hospitals directly under
the full control and supervision of the DOH.
g. The term “anywhere in the country” shall be construed to mean health privileges
senior citizens may avail of from any hospital in the Philippines, as defined in these
guidelines, irrespective of their place of residence/locality, subject to availability of
facilities and manpower/technical expertise of the receiving establishment.
The following are the health services that may be availed of for free in any
government establishments, subject to availability of facilities and
manpower/technical expertise of the receiving government establishment:
b. Out-Patient consultations
a. A senior citizen may obtain the benefits from any government establishment.
b. He/she shall present his/her national ID card issued by the OSCA to the medical
and social services or Medical Social Worker designated who shall determine the
validity of his/her ID card.
c. Non-presentation of the national ID card shall be sufficient reason for denial of free
hospital benefits.
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e. Should the senior citizen choose to be admitted to a private room/pay ward or be
transferred from a free room to a pay room, the amount equivalent to the rate of a
free room should be discounted from that of the pay room/ward.
a. Provide all available medical and dental services, as defined in these guidelines
that may be deemed necessary in the promotion of the health of senior citizens;
b. Establish a system by which all senior citizens in dire need of health serve shall be
given priority and utmost consideration;
d. Strengthen their competence and capability to evaluate and manage geriatic cases
through continuing education.
The responsibilities of senior citizens who are entitled to health benefits and
privileges as indicated and certified by valid national identification cards issued by
the OSCA, are as follows:
c. Secure on their own payable services that are not covered by their health benefits
and privileges stipulated herein; and
d. Safeguard the integrity of their identification card and shall not allow their misuse
and abuse.
To the extent practicable and feasible, the continuance of the same benefits and
privileges shall be given to senior citizens by the GSIS, SSS and PAG-IBIG as the case
may be as are enjoyed by those in the actual service.
G.2 Benefits extended to senior citizens who are retirees of the GSIS are as follows:
a. Life Insurance
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If a retiree opts to maintain his life insurance policy with the System, he may convert
his compulsory life insurance into an optional insurance by paying directly to the
System the monthly premiums due thereon (personal plus government share), up to
its maturity date. Amount of monthly premiums shall be determined by the System.
He will be entitled to receive benefits as enumerated below:
1. maturity benefit – retiree will receive the total face value of the policy, less any
indebtedness thereon.
2. policy loan – loanable amount will not exceed 90% of the cash value of his
insurance at the time of application.
3. death benefit – when the retiree dies while life insurance membership is in force
prior to maturity date, the designated beneficiaries double indemnity.
b. Retirement
1. Retirees under PD 1146 or RA 660 shall resume receiving their basic monthly
pension (BMP) for life after the lapse of the 5-year guaranteed period.
2. Upon death of a pensioner who retired under PD 1146 or RA 660, the primary
beneficiaries (legal spouse and minor children) shall receive a basic survivorship
pension (BSP) equivalent to 50% of the BMP plus dependent’s pension (DP)
equivalent to 10% of the BMP for every minor child, if any, but not exceeding five. The
spouse shall receive the BSP for life until she/he remarries. The minor children shall
continue receiving DP until emancipated by marriage, gainful employment or upon
reaching 21 years of age. A mentally or physically incapacitated child, however, shall
receive DP for life.
3. Funeral Benefit – payable upon death of the retirees, pensioner or gratuitant, the
latter must have retired with at least 20 years of service to be entitled to the benefit.
c. Medicare
Coverage:Employees who retired from the service before age 60 may opt to continue
their membership within 6 months from date of retirement by contributing both
personal and government shares of their Medicare premiums until their 60th
birthday.
Legal Dependents:
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2. The unmarried and unemployed children, including legitimated, acknowledged,
legally adopted and step children below 21 years of age;
3. Children 21 years old or above with disability acquired before the age of 21.
4. Surgeon’s fee
6. Anesthesiologist’s fee
2. Optometric services
3. Psychiatric services
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1. daily income benefit of not less than P10,00 nor more than P90.00 for a period not
exceeding 120 days and in severe cases up to 240 days.
2.2 ambulatory/d o miciliary care, services for hospitalization except room and board
1. monthly income benefit (MIB) for the designated number of months of not less
than P250.00 or more than P3,240.00.
1. monthly income benefit (MIB) of not less than P250.00 nor more than P3,240.00
plus 10% increment for each minor child not exceeding five starting from the
youngest without substitution payable for life and guaranteed for 5 years.
DEATH
1. MIB the same as in PPD (plus 10% thereof for each dependent child, not exceeding
five) payable to:
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1. MIB due to death (80% of the MIB after the 5-year guaranteed period) payable to:
2. Funeral benefit of P3,000.00 payable upon the death of a covered employee or PTD
pensioner to the person who can show incontrovertible proof that he shouldered
funeral expenses.
G.3 The SSS provides medical and dental services to its retirees and their dependents
through the Medicare Program without the need for additional contributions.
However, the Medicare Program does not cover the entire cost of hospitalization.
The SSS medical staff in the regional offices render free consultation to SSS
pensioners.
The SSS involvement in this Act is limited only to its retirees since the SSS funds are
held in trust for the exclusive benefits of the private workers and their beneficiaries.
Usage of such funds for other purposes is not allowed under SSS charter.
G.4 Membership in the PAG-IBIG Fund shall be open to all senior citizens who opt to
continue with their provident savings in the Fund, even after their retirement from
their employment or upon reaching the age of sixty (60) years.
a. Senior citizens who wish to enlist with the PAG-IBIG Fund for the first time may do
so upon proof of gainful employment, or of being self employed, or of membership in
trade/service cooperative (e.g. farmers cooperatives, fishermen’s cooperative, loom
weavers association, handicraft maker’s organization, and the like) and upon
payment of the monthly minimum contribution rate as may be set up by the PAG-
IBG Fund from time to time.
RULE VI
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GOVERNMENT ASSISTANCE
Article 10. Personal Tax Exemption for Benefactor – A senior citizen shall be treated
as dependent provided for in the NIRC and as such, shall be accorded the privileges
granted by the Code insofar as having dependent are concerned. In determining
personal exemptions allowable to individuals under Section 29 (k) (l) of the NIRC, a
senior citizen may be granted as a dependent. For this purpose, the definition of the
term Head of the family under the said Section shall be deemed amended to refer to
the condition under Article (5) of this implementing rules and regulations. The OSCA
shall require the senior citizen to declare his benefactor who will be granted the
exclusive right to claim him as dependent and issue a identification thereof. The said
certification shall be presented by the benefactor to the BIR for purposes of
determining personal exemptions.
Article 11.Property Tax Exemptions and Privileges for Individuals and Non-
Government Institutions. Individuals or non-government institutions establishing
homes, residential communities or retirement villages solely for the senior citizen
shall be accorded the following:
a. One per cent (1%) property tax exemption for the first five years starting first year
of operation:
b.
(1) The exemption is automatically withdrawn effective on the year after the
institution ceases its operation before the end of the fifth year of operation. The
owners of the properties shall thereafter be liable for the realty taxes applicable
thereon.
(2) The first year of operation shall be reckoned from the date the institution was
granted a mayor’s permit to operate the establishment.
(3) The exemption shall apply prospectively. Establishments which are beyond their
fifth year of operation shall not be entitled to refund of their payments or
condonation of their realty tax delinquencies during their first five years of operation.
However existing establishments which have been operating for less than five years
shall be entitled to the exemption in the remaining of the five years.
Provided that: in both cases, said exemption and priority shall apply only when said
homes residential communities or retirement villages are non-stock, no-profit as
such which shall be presented to the Assessor’s Office of the LGUs concerned.
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RULE VII
PENALTY PROVISIONS
Article 12.Penalties. Any person who willfully refuses to grant the privileges provided
for by RA 7432 or violates any provision thereof and for which no penalty is
specifically provided for by any existing law, shall be punished by imprisonment not
exceeding one (1) month or a fine not exceeding One Thousand Pesos (P1,000.00) or
both.
RULE VIII
FINAL PROVISIONS
b. The DILG, having been designated by the President to exercise general supervision
over LGUs, by virtue of the Local Code, rule XI, shall ensure the compliance of LGUs
with this Act. It shall likewise institute the necessary interventions aimed at
enhancing the capacities of the LGUs in implementing the above-mentioned
provisions.
Article 15. Separatibility Clause, If, for nay reason/s, any part or provision of this
Implementing Rules and Regulations shall be held unconstitutional or invalid, other
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parts or provisions hereof which are not affected thereby shall continue to be in full
force and effect.
Article 16.Effectivity Clause. This Implementing Rules and Regulations shall take
effect fifteen (15) days following its publication in one (1) national newspaper of
general circulation.
ADDENDUM
REVENUE REGULATIONS NO. 2-94
(August 23, 1993)
SUBJECT:
Republic Act No. 7432 otherwise known as an Act to Maximize the Contribution of
Senior Citizens to Nation Building, Grant Benefits and Special Privileges and for
Other Purposes.
Section 1. SCOPE – Pursuant to Section 245 of the National Internal Revenue Code
(NIRC) as amended, in relation to Section 10 of Republic Act No. 7432, these
regulations are hereby promulgated to (1) implement the provisions of Section 4 and
5 (a) of the said Act granting tax exemption and other privileges to senior citizens,
and (2) prescribe the guidelines for the availment thereof.
b. Senior citizen – means any resident citizen of the Philippines at least sixty (60)
years old, including those who have retired from both government offices and private
enterprises, and has an income of not more than sixty thousand pesos (P60,000.00)
per annum subject to review by the National Economic and Development Authority
(NEDA) every three (3) years.
The term “qualified senior citizen” shall refer to a resident Filipino citizen who meets
the statutory requirements of Section 2 of the Act and Section 2(b) of these
regulations.
e. Head of the Family – an unmarried or legally separated man or woman, with one or
both parents, or with one or more brothers or sisters, or with one or more legitimate,
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recognized natural or legally adopted children, living with and dependent upon
him/her for their chief support, where such brothers or sisters or children are not
more than twenty-one (21) years of age, unmarried and not gainfully employed or
where such children, brothers or sisters, regardless of age are incapable of self-
support because of mental or physical defect.
The term ‘head of family’ includes an unmarried or legally separated man or woman
who is the benefactor of a qualified senior citizen as defined in Section 2 of the Act
and these regulations.
The term “qualified senior citizen” shall refer to a resident Filipino citizen who meets
the statutory requirements of Section 2 of the Act and Section 2(b) of these
regulations.
f. Benefactor – any person whether or not related to the senior citizen who takes care
of the latter as a dependent.
1. Interest income from Philippine currency bank deposits, yield and other
monetary benefit from deposit substitutes, trust fund and similar arrangements;
royalties, prizes and winnings (Sec. 21 (c), NIRC);
2. Capital gains from sales of shares of stock (Sec. 21 (d), NIRC); and
i. Tax Credit – refers to the amount representing the 20% discount granted to a
qualified senior citizen by all establishments relative to their utilization of
transportation services, hotels and similar lodging establishments, restaurants,
drugstores, recreation centers, theaters, cinema houses, concert halls, circuses,
carnivals and other similar places of culture, leisure and amusement, which discount
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shall be deducted by the said establishments from their gross income for income tax
purposes and from their gross sales for value-added tax or other percentage tax
purposes.
Sec. 3.INCOME TAX BENEFIT AND PRIVILEGES FOR THE SENIOR CITIZENS. –
Senior citizens qualified as such by the Commissioner of Internal Revenue or his duly
authorized representative who, for purposes of these regulations, is the Regional
Director of the Revenue Region having jurisdiction of the city or municipality where
they are permanent residents shall be entitled to the following tax benefit and
privileges:
a. Exemption from the payment of individual income tax provided that their annual
taxable income does not exceed the poverty level of P60,000.00 or such amount as
may be determined bt the NEDA for a certain taxable year.
The amount of 20% discount shall be deducted from the gross income for income tax
purposes and from gross sales of the business enterprise concerned for purposes of
the VAT and other percentage taxes.
Sec. 5.AVAILMENT OF INCOME TAX EXEMPTION. – Asenior citizen who shall avail
of the exemption from income tax is required to submit the following documents to
the Revenue District Officer (RDO) of the place where he is a permanent resident,
who shall make the necessary verification and report for purposes of the income tax
exemption to be issued by the Commissioner of Internal Revenue or his duly
authorized representative:
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B. If he has a benefactor as defined in Section 2 (f) of these Regulations, Certification
as to the name, address, occupation, Office or business address (office/business) and
TIN of his benefactor;
C. If employed, a copy of his withholding tax statement (BIR Form W-2) for the
preceding taxable year;
c. 1 A senior citizen who derives taxable (fixed) compensation income from only one
employer in an amount not exceeding P60,000 per annum shall be exempt from
income tax and consequently from the withholding tax prescribed under Section 72
Chapter 10, Title II of the National Internal Code, as amended.
d.1 A senior citizen who derives taxable compensation income from two (2) or more
employers, or who receives mixed income from employment and from business shall
still file an income tax return.
For purposes of applying for the OSCA ID Card, the duly stamped income tax return
and or the BIR Certification shall be honored.
a. A senior citizen whose annual taxable income exceeds the poverty level of P60,000
or such amount as may thereafter be determined by the NEDA for a certain taxable
year shall be liable to the individual income tax in the full amount thereof on his
taxable income net of allowable deductions.
b. Regardless of the amount of taxable income, a senior citizen who derives income
from self-employment, business and practice of profession shall be subject to other
internal revenue taxes which include but are not limited to the value added tax,
caterer’s tax, documentary stamp tax, overseas communications tax, excise taxes,
and other percentage taxes. He shall therefore, file the corresponding business tax
returns in accordance with existing laws, rules and regulations.
c. He shall be subject to the 20% final withholding tax on, interest income from
Philippine Currency bank deposit, yield and other monetary benefit from deposit
substitutes, trust fund and similar arrangements; royalties, prizes (except prizes
amounting to P3,000 or less which shall be subject to income tax at the rates
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prescribed under Section 21, paragraph (a) or (f), NIRC) as the case may be, and
winnings (except Philippine Charity Sweeptakes winnings).
A qualified senior citizen living with and taken cared of by a benefactor whether
related to him or not, shall be treated as a dependent and his benefactor shall be
entitled to the basic personal exemption of P12,000 as head of the family, as defined
in Section 2 (e) of these regulations.
Caring for a dependent senior citizen shall not, however, entitle the benefactor to
claim the additional exemption allowable to a married individual or head of family
with qualified dependent children under Sec. 29 (1) (2) of the NIRC, as amended.
Sec. 8.REPEALING CLAUSE. – All existing rules, regulations and other issuances or
portions thereof inconsistent with the provisions of these regulations are hereby
modified, repealed or revoked accordingly.
Sec. 9.EFFECTIVITY. – These regulations shall take effect fifteen (15) days after
publication in the Official Gazette or newspaper of general circulation whichever
comes first and shall apply to income earned beginning January 1, 1992.
RECOMMENDED BY:
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Health and Well-being of Older Persons
Rationale
RATIONALE:
TARGET AUDIENCES:
MAG HL TAYO!
COMMUNICATION STRATEGIES
The process of behavioral changes that will lead to the adoption of a healthy
lifestyle in individuals is long and tedious. Thus, the healthy lifestyle campaign
should be continuous, sustained and integrated. Because of limited resources, the
DOH needs to start small but intense and hope that various sectors of society jump
in the bandwagon. For the first year of implementation, the following strategies were
adopted:
1. Convened the National Healthy Lifestyle Coalition composed of stakeholders
from various sectors who formulated the health promotion and communication
plan and implement them in their various capacities.
2. Developed, produced and disseminated the various IEC materials to be used
for the campaign.
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3. Highlight and schedule one Healthy Lifestyle message at certain times of the
year in connection with other more popular health campaign or traditional or
cultural celebrations of the country.
4. Mobilize politicians, legislators, media practitioners, and members of various
government and non-government agencies and organizations to push laws,
ordinances and activities to create supportive environments in communities
and places where most people are congregating.
Various activities lines up to drum up awareness are:
REGIONAL ACTIVITIES
The regions are given a free hand in implementing regional Mag HL Tayo
Campaign based on their own needs and resources. They are also enjoined to observe
the conduct of the scheduled periodic thematic Mag HL Tayo Campaign.
Reports of various activities conducted should be submitted. .
A global strategy for Infant and Young Child Feeding (IYCF) was issued jointly
by the World Health Organization (WHO) and the United Nations Children’s Fund
(UNICEF) in 2002, to reverse the disturbing trends in infant and young child feeding
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practices. This global strategy was endorsed by the 55th World Health Assembly in
May 2002 and by the UNICEF Executive Board in September 2002 respectively.
In 2004, infant and young child feeding practices were assessed using the WHO
assessment protocol and rated poor to fair. Findings showed four out of ten newborns
were initiated to breastfeeding within an hour after birth, three out of ten infants less
than six months were exclusively breastfed and the median duration of breastfeeding
was only thirteen months. The complementary feeding indicator was also rated as
poor since only 57.9 percent of 6-9 months children received complementary foods
while continuing to breastfed. The assessment also found out that complementary
foods were introduced too early, at the age of less than two months. These poor
practices needed urgent action and aggressive sustained interventions.
To address these problems on infant and young child feeding practices, the first
National IYCF Plan of Action was formulated. It aimed to improve the nutritional
status and health of children especially the under-three and consequently reduce
infant and under-five mortality. Specifically, its objectives were to improve, protect
and promote infant and young child feeding practices, increase political commitment
at all levels, provide a supportive environment and ensure its sustainability. Figure 1
shows the identified key objectives, supportive strategies and key interventions to
guide the overall implementation and evaluation of the 2005-2010 Plan of Action. The
main efforts were directed towards creating a supportive environment for appropriate
IYCF practices. The approval of the National Plan of Action in 2005 helped the
Department of Health (DOH) and its partners, in the development of the first (1st)
National Policy on Infant and Young Child Feeding. Thus on May 23, 2005,
Administrative Order (AO) 2005-0014: National Policies on IYCF was signed and
endorsed by the Secretary of Health. The policy was intended to guide health workers
and other concerned parties in ensuring the protection, promotion and support of
exclusive breastfeeding and adequate and appropriate complementary feeding with
continued breastfeeding. (1)
GUIDING PRINCIPLES
The IYCF Strategic Plan of Action upholds the following guiding principles:
1. Children have the right to adequate nutrition and access to safe and
nutritious food, and both are essential for fulfilling their right to the
highest attainable standard of health. (5)
2. Mothers and Infants form a biological and social unit and improved IYCF
begins with ensuring the health and nutritional status of women. (5)
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academe and other stakeholders acknowledges their responsibilities and
form alliances and partnerships for improving IYCF with no conflict of
interest.
GOAL:
Reduction of child mortality and morbidity through optimal feeding of infants and
young children
MAIN OBJECTIVE:
To ensure and accelerate the promotion, protection and support of good IYCF
practice
OUTCOMES:
By 2016:
90 percent of newborns are initiated to breastfeeding within one hour after
birth;
70 percent of infants are exclusively breastfeed for the first 6 months of life;
and
95 percent of infants are given timely adequate and safe complementary food
starting at 6 months of age.
TARGETS:
By 2016:
50 percent of hospitals providing maternity and child health services are
certified MBFHI;
60 percent of municipalities/cities have at least one functional IYCF support
group;
50 percent of workplaces have lactation units and/or implementing
nursing/lactation breaks;
100 percent of reported alleged Milk Code violations are acted upon and
sanctions are implemented as appropriate;
100 percent of elementary, high school and tertiary schools are using the
updated IYCF curricula including the inclusion of IYCF into the prescribed
textbooks and teaching materials; and
100 percent of IYCF related emergency/disaster response and evacuation are
compliant to the IFE guidelines.
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II. Target beneficiaries of the program are infants (0-11 months) and young
children (12 to 36 months years old or 1 to 3 years old)
1.1 Formalize partnerships with GOs and NGOs working on IYCF program
coordination and implementation
a. Strengthen the TWG to allow it to effectively coordinate the GOs and NGOs
working for the IYCF Program
The national TWG will remain but will be strengthened. It shall be constituted by:
NCDPC as Chair, FHO as secretariat and representatives from NCDPC,FHO,
NCHP, FDA, DJFMH, DSWD,CWC, NNC, ILO, WHO and UNICEF. This time, members
of theTWG will be tasked to focus participation to the intervention setting where it
ismost relevant.
The TWG shall be reporting regularly to the Service Delivery Cluster Head. At the
Regional level, the Regional Coordinators from the above offices shall collaborate
in the implementation of the IYCF Program. To ensure that GO and NGO
IYCF partners work together, the composition of the TWGs and AD Hoc committees
shall be made up of representatives from the government and non-government
sectors and the Ad Hoc Committees shall be chaired by the relevant agency where the
intervention setting belongs.
At the provincial, municipal and barangay levels the existing Coordinating
Committees which has an interagency composition shall be the coordinating arm of
the IYCF Program. This is where the participation of non-government entities will
be facilitated. Mechanisms for coordination shall be devised to build a strong
foundation for partnership between the LGU, the Coordinating Committees and local
NGOs or private entities.
A memorandum of agreement (MOA) shall be executed between DOH and other
agencies invited to become members of the TWG.
b. Organize functional Intervention Setting Committees (this is the same as the ad-
hoc committee)
The years covered by this action plan will be marked with many
developmental activities in all the intervention settings. The TWG shall create a
committee for each of the intervention setting. The committees shall be chaired by
the relevant agency/ office. Other government and non-government agencies will be
invited to the committees relevant to their mandate.
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c. Return the MBFHI responsibility from NCHFD to NCDPC
The National Policy on IYCF created in 2005 has affirmed the MBFHI responsibility to
NCHFD. Since MBFHI is now under the umbrella of the IYCF Program, it is in a
better position to consolidate efforts towards MBFHI compliance. Thus the return of
the MBFHI responsibility from NCHFD to NCDPC shall be pursued. The collaboration
of NCHFD is still needed though as it has a direct hand on health facility
development. At NCDPC the integration of IYCF in the MNCHN Action Plan shall be
worked out in all aspects of the program and at the different levels of
implementation.
d. Augment human resource complement of NCDPC- FHO, IYCF program
NCDPC-FHO as the secretariat of the TWG and supervising and supporting the
IYCF Program will not be able to effectively carry out the technical, management and
administrative roles and responsibilities without additional human resource. Funds
shall be allotted for job orders for this purpose.
e. Programmed contracting out of activities to organizations outside of DOH
To achieve the objectives and targets of the IYCF program, it shall be
implemented simultaneously in the different intervention settings and at a faster
pace. This is a gargantuan task considering the extent of the developmental work,
the management requirements, and the mobilization of the IYCF network and
the sourcing of funds for implementation.
Organizations and consultants that possess the expertise and the commitment to
the IYCF program will be contracted out for complex activities that require time
and effort beyond the capacity of the TWG and the Ad Hoc committees. These
contracts shall be arranged based on need and awarded based on merit.
STRATEGY 2: Integration of key IYCF action points in the MNCHN Plan of
Action/Strategy
2.1 Institutionalize the IYCF monitoring and tracking system for national,
regional and LGU levels
a. Institutionalize the collection of PIR Data and generate annual performance report
The established IYCF data set that are being collected during PIRs shall be further
reviewed, revised as appropriate and institutionalized through a Department Circular
and in collaboration with the other programs in the FHO.
An IYCF Program annual performance report shall be generated at the end of
every year based on the PIR data, the consolidated data from the unified monitoring
and related data coming from research and studies as appropriate. Reports on the
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performance of developmental activities shall be collected as part of the data base
and to be reported as needed to the Service Delivery Cluster Head.
b. Maximize the use of the unified monitoring tool
The CHDs through its Regional Coordinators shall be required to use and consolidate
the unified monitoring tool. A simple data management program shall be
developed to facilitate the consolidation of data extracted from monitoring. Reports
shall be required two weeks after the end of every quarter.
c. Collaborate with the National Epidemiology Center (NEC) and Information
Management Service (IMS) regarding IYCF data
The current records and reports being collected by the DOH Field Health Information
System will remain as the main source of data from health facilities. However,
collaboration with NEC and IMS to improve data quality and include data on
complementary feeding is essential.
2.2 Participation of the IYCF Focal person in MNCHN planning and monitoring
activities
a. Designate the IYCF Focal Person as a regular member of the team
working for the development and implementation of the MNCHN Strategy
The IYCF Focal Person shall ensure that the IYCF action points become an
agenda of the MNCHN Strategy and thus ultimately the IYCF services forms a part
of the integrated services for mothers and children. In the MNCHN planning and
monitoring, the IYCF Focal Person shall help ensure that in the multitude of
activities, critical IYCF action points and indicators are not overlooked.
STRATEGY 3: Harnessing the executive arm of government to implement and
enforce the IYCF related legislations and regulations (EO 51, RA 7200 and RA
10028)
3.1 Consultation mechanism with the IAC and DOJ for the enforcement of the Milk
Code and with other relevant GOs for other IYCF related legislations and regulations
a. Devise and implement a consultation mechanism to bring together the IAC,
DOJ and other relevant GOs for IYCF related legislations and regulations
The Committee for Industry Regulation shall devise and implement a consultation
mechanism to facilitate the implementation and enforcement of IYCF related laws
and regulations. This will require participation of higher levels of authority in the
GOs.
The goal of the consultation mechanisms is to develop activities that will focus on
facilitating the process of monitoring of compliance and enforcement of IYCF
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related laws and regulations not only at the national level but also at regional and
local levels and in the five IYCF intervention settings.
3.2 Support Civil Society in the implementation and enforcement of IYCF related
laws and regulations
a. Institutionalize enforcement of MBFHI compliance in the regulatory function of
the DOH
The inclusion of the MBFHI requirements in the unified licensing/accreditation
benchmarks of the BHFS and the Licensing Offices shall be pursued more
vigorously in collaboration with BHFS and the Licensing offices of the CHDs. These
offices are in a better position to enforce compliance in relation to their
regulatory function and in their power to promulgate penalties for violations.
b. Review and improve the processing of reports on violations on the Milk Code
The handling of reports on violations shall be reviewed for thoroughness and
timeliness from the time a report is submitted up to the final decision rendered on a
case. Problematic areas and bottlenecks shall be identified and threshed out.
Measures to ensure that all reports on violations are acted upon shall be devised.
To ensure speedy resolution of cases, it is necessary to set deadlines on the
processing of reports on violations.
c. Invite the Professional Regulatory Board as a resource agency of the IAC
Apart from companies who are actively marketing breastmilk substitutes, health
professionals who have direct access and influence on pregnant and postpartum
women are also among the most common violators of the law. The PRC as the legal
authority that regulates the practice of the medical and allied professions can
contribute to the development and enforcement of the IAC’s regulatory function.
d. Augment human resource of FDA as secretariat of the IAC
The current load of violations cases being processed and the fulfillment of other
responsibilities with regards to the Milk Code at FDA require a full time legal
officer who will also assist the CHDs. Furthermore, the strengthened monitoring
of compliance to the Milk Code will result in a surge on violation reports. FDA
should be prepared to process such reports. An additional full time legal officer and
an administrative/ clerical staff is required to facilitate and help speed up the
process.
e. Engage professional societies to come-up with measures for self monitoring and
regulation
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Monitoring of overt advertisements and marketing of breast milk substitutes is
a persistent challenge. Monitoring of compliance to the Milk Code among health
workers and medical and allied professional organizations is much more difficult.
Promotion of breast milk substitutes is more personal and concealed.
The medical and allied professional societies are strong and active bodies that foster
organizational development and discipline among its members. An advocating
stance over a punitive approach may be the more prudent initial approach in
this environment. There will be dialogue, negotiations and forging of agreements to
push the Milk Code and other policies on IYCF. The professional societies will be
engaged to participate in the development of the monitoring scheme within their
ranks and in health facilities. They are a good resource in the development of
schemes for MBFHI and related technical matters. Working
arrangements/contracts may be forged to seal responsibilities and partnerships.
Representatives from the professional societies will constitute the Speaker’s Bureau
which will be organized for the information dissemination/awareness campaign on
the Milk Code, the Expanded Breastfeeding Promotion Act and the Policies on IYCF.
STRATEGY 4: Intensified focused activities to create an environment
supportive to IYCF practices
4.1 Modeling the MBF system in the key intervention settings in selected
regions
a. Set up Models of MBFHI and MNCHN implementation in key strategic hospitals
and referral networks
Regional Hospitals and selected private hospitals shall be developed as models
of MBFHI and MNCHN implementation to help create an impact and to serve as
showcases for other health facilities.
If these hospitals are currently training facilities for obstetrics and pediatrics
residency program, the MBFHI environment will certainly add value to the
training.
An itinerant team will facilitate the development of the hospital models. The team
will be composed of an Obstetrician with training/background on MNCHN,
Pediatrician with training/background on Lactation Management/Essential
Newborn Care, Nurse trainer for breastfeeding counseling, Senior IYCF Program
person with administrative background who can deal with arrangements and
coordination with hospitals and local governments and who can be a trainer
and an administrative assistant who will facilitate administrative matters. The
team will facilitate the activities leading to the organization and maintenance of the
MBFHI in the hospitals. This shall include planning, setting up of operational
details and physical structures when needed, training/coaching of personnel,
keeping records and completing reports and self assessment.
117
Regional hospitals shall be developed for IYCF capacity building. Trainings at
Regional Hospitals shall be conducted in collaboration with the CHDs. This is so
that training is de-centralized and monitoring and evaluation can be done
more frequently at the provincial and municipal levels.
b. Establish protocols/standards on how to set-up and maintain MBF
workplaces and integrated in the standards for healthy workplace
The IYCF Program shall focus on the enforcement of the Expanded Breastfeeding
Promotion Act of 2009 which mandates workplaces to establish lactation stations
and/or grant breastfeeding breaks. Guidelines for the establishment and
maintenance of MBF workplace shall be developed. It will learn from lessons of
already established and successful MBF workplace. In as much as standards for the
healthy workplace are already established, the MBF guidelines shall be
integrated into those standards.
The establishment of MBF workplaces initiated in factories shall be scaled up and
efforts shall be expanded to include government and private offices in line with
Expanded Breasfeeding Act. The current collaboration partners in the workplace
setting may also need to be expanded to promote the establishment of the MBF
workplace in government and private offices. With the multitude of workplaces
scattered throughout the country, the expansion may require outsourcing of
organizations to continue the MBF workplace efforts.
c. Enhance the primary, secondary and tertiary education curricula on IYCF
The enhancement of the primary, secondary and tertiary education curricula on
IYCF shall be pursued. If necessary, a review of the curriculum will be done prior to
the enhancement. Apart from the curriculum enhancement, training materials,
books and teachers’ guide shall also be updated.
The initial collaboration for the enhancement of the primary, secondary and
tertiary education curricula shall take place at the central office of DepEd (Bureau
of Elementary Education and Bureau of Secondary Education) and TESDA. The
enhanced curriculum, training materials, books and teacher’s guide shall be field
tested province-wide in three selected provinces, evaluated and further enhanced
before a national implementation.
d. Develop policy on IYCF in emergencies (IFE) and guidelines on the
management of malnutrition, and IYCF in special medical conditions for the
community
A clear policy on IYCF is necessary to allow the program to define the guidelines
that can be easily followed by GOs, NGOs and LGUs once such situations arise.
The policy/guidelines shall address among others the issue of milk donations.
Guidelines on the Community Management of Malnutrition, IYCF in special medical
118
conditions such as errors of metabolism or HIV positive mothers shall also be
developed for implementation.
Camp managers and organized local nutrition clusters shall be oriented on the IFE
guidelines.
Disaster prone areas will be prioritized in the orientation. Training/orientation shall
be a collaborative effort between the IYCF Program, HEMS and the NDCC.
4.2 Creation of a Regional and National incentive and awarding systems for the most
outstanding IYCF champions in the different sectors of society
a. Review and update the existing awarding system
The current awarding system shall be reviewed. The search protocol shall be further
refined to allow a wider search. The organization of the search committees in the
local and national levels shall be formalized. Funds for the awards shall be ensured.
b. Establish a recognition system for health facilities complying with EO51,
RA10028 and the MBFHI National Policy
Set up an annual recognition system for facilities, establishments complying with
relevant IYCF legislations and regulations. The benefits provided for by the Milk
Code to compliant health facilities shall be reviewed and improved/established
parallel with the development of the incentive scheme for the Expanded Breastfeeding
Promotion Act. Procedures for claiming benefits shall be established and made
accessible in collaboration with PhilHealth, BIR and other relevant government
offices.
4.3 Allocate/Raise /Seek resources for IYCF Research activities that document best
practices in the Philippines
a. Carry out an inventory of best practices on IYCF Identify best IYCF practices by
allowing every province
in the country to identify exemplary or creative activities
on IYCF that boosted program services/performance. Validate the reports through
CHDs and select the best practices for documentation and publication.
b. Allocate resources and conduct IYCF related researches focusing on the
documentation and measure of impact of noble experiences and interventions
The documentation of IYCF best practices is considered a critical area that allows the
development of models/ references for appropriate IYCF protocols and guidelines
for implementation. Field personnel who are able to establish and provide
successful models of IYCF services are often deficient in resources and skills to
document the efforts. Resources to conduct IYCF related researchers, focusing on
119
the documentation and measure of impact of noble experiences and interventions,
will have to be allocated.
120
The Milk Code monitors at FDA, CHDs and local levels shall be trained on the latest
guidelines to help ensure that provisions on regulation and enforcement in the RIRR
of the Milk Code are closely adhered to. The monitors should be prepared to handle
incidents of actual violation of the code during inspection/monitoring. The local
monitors shall be equipped with user friendly monitoring tools.
The competencies of teachers and administrators to teach the new IYCF updated
curriculum and to appreciate the importance of MBF environment shall be
enhanced. A training/seminar program on IYCF for teachers/ administrators will be
developed. A core of teacher trainers in every region will be developed and organized
to conduct the training/seminars nationwide.
IV. Status of the Program
A REVIEW FROM 2005 TO 2010
Objectives and Targets set in
Status of Achievement Remarks
2005-2010
OBJECTIVE 1: TO IMPROVE,
PROTECT AND PROMOTE
APPROPRIATE INFANT AND
YOUNG CHILD FEEDING
PRACTICES CHILD FEEDING
PRACTICES
- 70% of newborns initiated to
breastfeeding within 30 53.5% (NDHS 08) 40.7%(NDHS 1998)
minutes
- 80% of 0-6 months infants
34% (NDHS 2008) 33.5%(NDHS 2003)
are exclusively breastfed
- 50% of infants are
22.2% (NDHS 2008) 16.1%(NDHS 2003)
exclusively breastfed for 6 months
- median duration of breastfeeding 13 months (NDHS
15.1months (NDHS 2008)
is 18 months 1998)
- 90% of 6- <10 months infants are
given timely, adequate and safe 58% (NDHS 2008) 57.9%(NDHS 2003)
complementary foods
- 95% of children 6 months 75.9% (NDHS 2008)
to 59 months received Vitamin 76% (NDHS 2003)
A NDHS 2008 and 2003
data refers to those
that received vitamin
A in the past 6
months from the
121
interview
37% of children age 6-59
months received iron
supplements in the seven
72.8% of 6-59
days before the survey
- 70% of low birth weight babies months received iron
(NDHS 2008)
and iron deficient 6 months to less drops /
than 5 years received complete syrup (not specified if
78.3% of children 6-59
dose of iron supplements complete dose, MCHS
months consumed foods rich
2002)
in iron in the past
24 hours from the time of the
survey
- 80% of pregnant women have
77.8% (NDHS 2008) 67.5% (MCHS 2002)
at least 4 prenatal visits
- 80% of pregnant women 82% (not specified if
received complete dose of iron 82.4% (NDHS 2008) complete dose, MCHS
supplements 2002)
44.6% (NDHS 2003)
NDHS 2003 and 2008
data represents the %
- 80% of lactating women
45.6% (NDHS 2008) of women that
received vitamin A capsule
received Vitamin A
dose during post-
partum
38%, household
41.9% (NDHS 2008) using iodized salt and
- 80% of household using iodized
81.1% household positive for 56.4% household
salt
iodine in salt (NDHS 2008) positive for iodine in
salt (NNS 2003)
OBJECTIVE 2: TO INCREASE
POLITICAL COMMITMENT
AT DIFFERENT LEVELS OF
GOVERNMENT, INTERNATIONAL
ORGANIZATIONS, NON-
GOVERNMENT ORGANIZATIONS,
PRIVATE SECTOR,
PROFESSIONAL GROUPS , CIVIL
SOCIETY, COMMUNITIES AND
FAMILIES
- Approved and widely IYCF Policy approved May 25,
disseminated National Infant and 2005 and disseminated to all
Young Child Feeding Policy Regions and LGUs.
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- Approved multi-sectoral
IYCF Plan of Action 2005-
National
2010 approved.
IYCF Plan of Action
AO 2007-0017: Guidelines on
the Acceptance and
Processing of Local and
- IYCF policy enhancement for
Foreign Donations During
emerging issues
Emergency and Disaster
Situations was signed May
28, 2007.
Active organizations
New groups were active in
include Latch, La
- Increase number of supporting activities on IFE
Leche League, Save
organizations actively involved in mostly during the post-Ondoy
the Children, Plan
IYCF interventions and in relation
International and
to breastfeeding support.
Arugaan.
Additional funds for
IYCF were secured
since April 2007, the
From 1 million pesos in 2005 start of the AHMP
to 20 million pesos in 2010. with intensive IYCF
training.
Additional funds were September 2009,
secured by the Joint program signing of the JP for
- Increase budget for IYCF
on MDG-F, wherein UN Ensuring Food
Agencies (Unicef, FAO, ILO Security and
and WHO) with NNC and Nutrition for Children
DOH, started implementing 0-24 months in the
key IYCF interventions. Philippines, funded
by the
Government of Spain
through the MDG
Achievement Fund.
OBJECTIVE 3: PROVIDE
SUPPORTIVE ENVIRONMENT
THAT WILL ENABLE PARENTS,
MOTHER, CAREGIVERS,
FAMILIES AND COMMUNITIES
TO IMPLEMENT OPTIMAL
FEEDING PRACTICES FOR
INFANTS AND YOUNG CHILD
PROGRAMME MANAGEMENT
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National TWG active and
11/12
Regions confirmed having
Data as of Dec 2009.
established a TWG.
Although the national
- Functional IYCF Program
TWG is
authority and responsibility flow
considered active, the
at the national, regional and LGU At the LGU level 7/80
collaboration between
level provinces,
agencies can be
9/120 cities and 175/1425
considered deficient.
municipalities have passed a
resolution/ordinance in
support of IYCF.
- Existing local committees
No available data
functioning as IYCF committees
INSTITUTIONAL SUPPORT
AO 2007-0026: Revitalization
of the MBFHI in Health
Facilities with Maternity Within 2 years after
Services was signed and the issuance of COC,
endorsed on July 10, 2007. 0/47 hospitals
- 1,426 currently certified applied for
MBF hospitals sustained 10 steps accreditation to
PhilHealth Circular No. 26 S- become MBF based
2005: Requirement for on the new standards
Accredited Hospitals to be and requirements.
“Mother- Baby Friendly” was
issued on October 11, 2005.
Only 47/1487 have received
- 300 additional hospitals/lying-in
a COC
certified as MBF
since 2007
- 100% of hospitals rooming–in
No available data
their newborns
RA 10028: Expanded
- All offices of government agencies RA 10028 set the
Breastfeeding Promotion Act
who are members of the IYCF IAC standards to
of 2009 was enacted on
will be MBF becoming MBF.
March 16, 2010.
6/16 Regions reported that
- At least one model workplace there are at least 88
per province/city certified as MBF breastfeeding friendly
workplaces.
- At least one model IYCF resource No resource center
center 1 province and 1 city in each established
124
region
10/16 Regions reported that
- At least 3 IYCF model
there are at least 2159
barangay/
breastfeeding support groups
municipality per province and city
at the barangay level.
RA 10028
Milk bank is functional in 3
encourages other
- Functional milk bank in all Medical
Medical
medical centers Centers: PGH, DJFMH and
Centers to set up
PCMC
their own milk bank.
IMPROVING SYSTEMS
- 100% of national, regional and
LGU health facilities have Based on monitoring visits
No available data on
integrated IEC on IYCF into regular and reports from CHDs,
private health
MCH services with clearly stated public health facilities have
facilities.
protocols on how to provide key ensured the integration.
IYCF
Only 4/13 Regions reported
some sort of Milk Code
monitoring activities.
- Functional and effective Milk
At the FDA, from 2007 to
Code
2009, there were 67 reports
Monitoring system
of violations and only 3/13
Regions reported filing a
complaint for the alleged
violations.
- Institutionalize facility IYCF Draft tool developed and used
MIS in two key instances. No
system in place by end of 2009 institutionalization yet.
28,063/34,298 staff were
-Improving skills of health NCDPC and NNC
trained on
manpower combined report
IYCF Counseling.
- Available national / regional
16/17 Regions reported
IYCF
conduct of training on IYCF.
trainers
- Active IYCF Speakers’ Bureau No available data
28,063/34,298 staff were
- Available IYCF counselors in 50% NCDPC and NNC
trained on
of health facilities combined report.
IYCF Counseling.
- At least 10 Filipino health DOH focused on capacitating With the support of
125
professionals internationally
accredited as breastfeeding
health workers on Counseling
counselors by the International NNC.
and Lactation Management.
Board of Lactation Consultants
Examiners
9/13 Regions reported having
trained a total of 1485
hospital based health
- A lactation specialist is available No denominator
workers on Lactation
in tertiary hospitals available.
Management with the
support of DJFMH,
NCDPC,CHDs and NNC.
In June 2010 a workshop on
integration/updating of good
- Improved curricula for IYCF The process of
IYCF practice into the
of medical / nursing / midwifery integration is on-
medical, nursing, midwifery
schools going.
and nutrition curricula was
conducted.
RA 10028: Expanded RA 10028 was
- Inclusion of breastfeeding in Breastfeeding Promotion Act enacted on March 16,
elementary education of 2009 mandates the 2010. The IRR is yet
integration. to be signed.
As of Dec 2009.
10/16 Regions reported that
there are at least 2,159
- Community level support RA 10028 will help
barangay level BF support
systems and services boost the number of
groups and more than 40 BF
breastfeeding friendly
friendly public places.
public places.
- 100% of target communities
with functional community level
No available data
monitoring system of IYCF
practices and changes
- At least 50% of city and 10/16 Regions reported that
poblacion municipalities with there are at least 2,159 BF
adequate number of trained IYCF support groups at the
peer counselors barangay level.
10/16 Regions reported that
- At least one functional BF / there are at least 2,159 BF
IYCF support group in poblacions support groups at the
and selected communities barangay level.
OBJECTIVE 4: ENSURE
126
SUSTAINABILITY OF
INTERVENTIONS TO IMPROVE,
PROTECT AND PROMOTE
INFANT AND YOUNG CHILD
FEEDING
- Functional self assessment
health facility tools for IYCF in Tool Drafted. Not yet
certified MBFH and main health institutionalized.
centers
- Annual progress reports of
status of implementation of Milk
1st IYCF PIR: 2007
Code, Rooming In and
Breastfeeding Act, ASIN Law, Food
2nd IYCF PIR: 2009
Fortification and ECCD Law /
IYCF Policy
Key result of
- IYCF integrated into Philippine IYCF integrated in PPAN
integration was the
Plan of Action for Nutrition and 2005-2010. PIR was
intensive training on
annual planning and health conducted last quarter of
IYCF Counseling in
monitoring systems at all levels 2010.
AHMP target areas.
Regular Presentations are
- Periodic feedback of IYCF offered by DOH on IYCF
status during annual conventions status (2005:
of health professionals/Leagues of 1st presentation during
Provinces/ Cities/Municipalities National
and Barangays Convention Liga Ng
Barangay)
V. Program Manager
127
Beauty, Brains and Breastfeeding
ARUGAAN
Action for Economic Reforms
Save Baby e-group
Philippine Pediatric Society
Philippine Obstetrics and Gynecology Society
Philippine Academy of Family Physicians Inc.
Philippine Society of Newborn Medicine
Philippine Society of Pediatric Gastroenterology
Philippine Neonatology Society
Philippine Society of Obstetric Anesthesiologist
Philippine Academy of Lactation Consultant
Perinatal Association of the Philippines
Philippine Medical Association
Integrated Midwives Association of the Philippines
Maternal and Child Nurses Association of the Philippines
Philippine Nurses Association
National League of Philippine Government Nurses Inc.
Malls: SM , NCCC
Union of Local Authorities of the Philippines
CODHEND
Government Partners:
Department of Labor and Employment
Department of Social Welfare and Development
Department of Justice
Department of Trade and Industry
Department of Local Government
Food and Drug Administration
National Nutrition Council
Council for the Welfare of Children
Department of Education
Commission on Higher Education
Nutrition Council of the Philippines
International Organizations:
World Health Organization
UNICEF
PLAN International
Helen Keller International
Save the Children-US
World Vision
128
Iligtas sa Tigdas ang Pinas
129
Inter Local Health Zone
130
Criteria for Selecting Exemplary Health Practices
3. Simple and doable so that they can be replicated within one year and a half or
less.
One million children under five years old die each year in less developed
countries. Just five diseases (pneumonia, diarrhea, malaria, measles and dengue
hemorrhagic fever) account for nearly half of these deaths and malnutrition is often
the underlying condition. Effective and affordable interventions to address these
common conditions exist but they do not yet reach the populations most in need, the
young and impoverish.
The Integrated Management of Childhood Illness strategy has been introduced
in an increasing number of countries in the region since 1995. IMCI is a major
strategy for child survival, healthy growth and development and is based on the
combined delivery of essential interventions at community, health facility and health
systems levels. IMCI includes elements of prevention as well as curative and
addresses the most common conditions that affect young children. The strategy was
131
developed by the World Health Organization (WHO) and United Nations Children’s
Fund (UNICEF).
In the Philippines, IMCI was started on a pilot basis in 1996, thereafter more
health workers and hospital staff were capacitated to implement the strategy at the
frontline level.
Objectives of IMCI
Reduce death and frequency and severity of illness and disability, and
Contribute to improved growth and development
Components of IMCI
Improving case management skills of health workers
11-day Basic Course for RHMs, PHNs and MOHs
5 - day Facilitators course
5 – day Follow-up course for IMCI Supervisors
Improving over-all health systems
Improving family and community health practices
Rationale for an integrated approach in the management of sick children
132
Counseling of caretakers on home care, correct feeding and giving of fluids, and
when to return to clinic is an essential component of IMCI
BASIS FOR CLASSIFYING THE CHILD’S ILLNESS
(please see enclosed portion of the IMCI Chartbooklet)
The child’s illness is classified based on a color-coded triage system:
PINK- indicates urgent hospital referral or admission
YELLOW- indicates initiation of specific Outpatient Treatment
GREEN – indicates supportive home care
Steps of the IMCI Case management Process
The following is the flow of the iMCI process. At the out-patient health facility,
the health worker should routinely do basic demographic data collection, vital signs
taking, and asking the mother about the child's problems. Determine whether this is
an initial or a follow-up visit. The health worker then proceeds with the IMCI process
by checking for general danger signs, assessing the main symptoms and other
processes indicated in the chart below.
Take note that for the pink box, referral facility includes district, provincial and
tertiary hospitals. Once admitted, the hospital protocol is used in the management of
the sick child.
“Knock-out Tigdas 2007” is a sequel to the 1998 and 2004 “Ligtas Tigdas” mass
measles immunization campaign. All children 9 months to 48 months old ( born
October 1, 2003 – January 1,2007) should be vaccinated against measles from
October 15 - November 15, 2007 , door-to-door. All health centers, barangay health
stations, hospitals and other temporary immunization sites such as basketball court,
town plazas and other identified public places will also offer FREE vaccination
services during the campaign period.
Other services to be given include Vitamin A Capsule and deworming tablet.
133
Knockout Tigdas for the period of the Barangay and SK Elections
Promotional materials
My child has been vaccinated against measles. Is she exempted from this
vaccination campaign?
No, she is not. A previously vaccinated child is not exempted from the vaccination
campaign because we cannot be sure if her previous vaccination was 100% effective.
Chances are a vaccinated child is already protected, but no one can really be sure.
There is 15% vaccine failure when the vaccine is given to 9 months old children. We
want to be 100% sure of their protection.
134
What strategy will be used during the campaign?
It is a door-to-door strategy. The team goes from one-household to another in all
areas nationwide.
Additional messages:
Once the child is vaccinated, the posterior upper left earlobe will be marked
with gentian violet, so do not try to remove for the purpose of validation.
Houses will also be marked, so do not erase.
“I heard that there are cases where the child who was vaccinated who became
seriously ill or died. Is this true?
135
Measles vaccine is very safe. Minor reactions may occur such as fever but in an
already immunizes child, this may not occur. The most serious and RARE adverse
event following immunization is anaphylaxis which is inherent on the child, not on
the vaccines.
136
137
Objectives:
The National
Leprosy
Control
Program
aims to:
138
Ensure the availability of adequate anti-leprosy drugs or multiple drug
therapy (MDT).
Prevent and reduce disabilities from leprosy by 35% through
Rehabilitation and Prevention of Impairments and Disabilities (RPIOD) and
SelfCare.
Improve case detection and post-elimination surveillance system using
the WHO protocol in selected LGUs.
Integration of leprosy control with other health services at the local level.
Active participation of person affected by leprosy in leprosy control and
human dignity program in collaboration with the National Program for Persons
with Disability.
Strengthen the collaboration with partners and other stakeholders in the
provision of quality leprosy services for socio-economic mobilization and
advocacy activities for leprosy.
139
Beneficiaries:
Provision of
Sustain leprosy control in Quality Leprosy Governance
all endemic countries services at all for Health
levels
Strengthen routine & Health System Service
referral service Strengthening Delivery
Ensure high quality Capability building
Policy,
diagnosis, case management, of an efficient, effective,
Standards &
recording & reporting in all accessible human and
Regulations
endemic communities facility resources
Develop policies/
Establish the guidelines/ sentinel Human
Sentinel Surveillance System sites/referral centers Resources for
to monitor Drug Resistance (Luzon,Visayas & Health
Mindanao)
Develop procedures/ tools
that are home/community-
Collaborate with
based, integrated and locally Health
NEC/RESU/ PESU /
appropriate for Self Information
MESU
Care/POD, rehabilitation
services (CBR)
Health
NLAB, NCCL
Financing
RA 7277- Rights of
PWD & Caregivers
BP 34- Accessibility
& Human Rights Law
PhilHealth Insurance
Package
140
141
LGU Scorecard
142
Licensure Examinations for Paraprofessionals Undertaken by the Department of
Health
I. Mandates
Embalmers
Administrative Order No. 2010-0033 “Revised Implementing Rules and Regulations
Governing Disposal of Dead Persons”
Committees
The Committee of Examiners for Massage Therapy (CEMT) and the Committee of
Examiners for Undertakers and Embalmers (CEUE) were created by the DOH to
regulate the practice of massage therapy and embalming to ensure that only qualified
individuals enter the profession and that the care and services to be provided are
within the standards of practice.
II. Application Procedure
Application Requirements:
a. Certified True Copy of Birth Certificate (at least 18 years old at the time of the
examination)
b. Certificate of Good Moral Character from barangay captain of the community
where the applicant resides
c. Certification or clearance from the National Bureau of Investigation (NBI) or
provincial fiscal that he/she is not convicted by the court in any case involving moral
turpitude.
d. Medical Certificate from a government physician
e. Certified True Copy of Diploma or Transcript of Record (at least high school
graduate)
f. Submit Marriage Contract for female married applicant
g. Certification from any DOH accredited training institution/ provider that he/she
has received basic instructions in five (5) subjects based on Program Curriculum
h. Certification from any DOH accredited training institution/provider that he/she
has skillfully embalmed at least 10 cadavers within one year period under his/her
supervision
143
i. Filled up application form (1 copy)
j. 1 ½ X 1 ½ size photograph taken within the last 6 months (3 copies)
When is the licensure examination?
Massage Therapist – every 1st week of June and December
Embalmers – every 1st week of March and September
III. Accredited Training Institutions
Training Institutions Office Address Contact Number
2nd Floor ABN Bldg. Mc
Massage Therapy
Arthur Highway del (045) 861-2493
Central Luzon Alternative
Rosario, City of San 09159970969
Health & Development, Inc.
Fernando, Pampanga
Unit 5 2nd Floor VMCC
Centre de Centre International Bldg. Santolan Rd. cor.
(02) 750-0442
Wellness Institute Inc. Granada St., Valencia,
Quezon City
Early Divine School Forever
59-A Escarilla Subd., 09305886037
Alternative Medicine Rehab
Mandurriao, Iloilo City (033) 500-6529
and Training Center
(02) 341-6674
1443 M. Hizon St. cor.
EMPRIZ Massage Therapy Sun- 09325337262/
Alvarez St. Sta. Cruz,
Review & Training Center 0922-8576674
Manila
Smart – 09292551959
Hand-Med Integrative Osmena Avenue, Kalibo, (036) 268-2810
Healthcare Center Aklan 09297350080
3rd Floor Crispina Bldg.
1589 Quezon Avenue,
(02) 473-7369
Brgy West Triangle
0917-5117744
HIMAS- Asian Wellness and Quezon City
Spa Academy
Door 2 Sazon Bldg.
(082) 305-1013
Ponciano Reyes St.,
Davao City
33 Bakersfield St.
(049) 544-0704
HILOT at HILOM Pilipinas Laguna Bel Air 1, Don
09175457494
Jose, Sta. Rosa, Laguna
International NKYR Academy Unit D ProVita Bldg. 26 (02) 473-5115
Columbia cor. Yale St. 09189199140
Cubao, Quezon City
(032) 238-8744
Dona Luisa Bldg. Fuente 09189199149
144
Osmena, Cebu City
Suite 708 Cattleya Bldg.
(02) 401-1242
Le Petit Paradis Academy 235 Salcedo St. Legaspi
09228576674
Village, Makati City
#2 Brgy. Court Villa 09298062688
NMA Center for Aquatic
Angela Subd., Angeles 09196133621
Therapy & Massage
City (045) 888-3458
55-B Malac St.
Potter’s Hand Review and (02) 359-3985
Masambong, Quezon
Training Center Fax #: (02) 413-3296
City
Remnant Institute of #26 Huervana St. Lapaz, 09209513589
Alternative Medicine Iloilo City (033) 329-1916
2205 Cityland Tower 2,
154 H.V. dela Costa St.
SPA @ WORK (02)840-0242/ 840-1239
cor. Valerosts Makati
City
Ventura College of Natural
Therapeutic Health and Tagum, Davao City 0927-5004167
Science
Embalmers 09175989897
1623 Quezon Avenue,
F&M Embalmers Review and (02) 400-4741
Quezon City
Training Center, Inc.
Valgosong Bldg., CM
0922-8187622
Recto cor. Bonifacio St.,
0922-8210797
Paz Review and Training Davao City
Center
0917-8240409
143 G Araneta Ave. cor.
(02) 743-6520 loc. 140
Kaliraya St. Quezon City
2139 T. Mapua St. Sta. (02) 254-0885
Ongchangco Review and Cruz, Manila (033) 775-8212
Training Center
Miag-ao, Iloilo City 0918-9395984
Nivel Hills, Lahug, Cebu
(032) 232-2282
City
Pacific Center for Advanced (032) 231-7542
Studies Cebu Branch
Abad Santos St. Camus
0918-4334695
Ext., Davao City
Philippine Embalmers & 794-2232
2070 E. Pascua St. Brgy.
Undertakers Review and 0921-5401107
Kasilawan Makati City
Training Center 0917-8312244
GSP Training and Review LT Building 815 EDSA (02) 895-4266
145
Avenue, Brgy. 144,
Center 0917-8436276
Pasay City
Malaria Control Program
146
The DOH, in coordination with its key partners and the LGUs, implements the
following interventions:
147
National Tuberculosis Control Program
Objectives:
The NTP aims to:
1. Reduce local variations in TB control program performance
2. Scale-up and sustain coverage of DOTS implementation
3. Ensure provision of quality TB services
4. Reduce out-of-pocket expenses related to TB care
Strategies:
Under PhilPACT, there are 8 strategies to be implemented, namely:
1. Localize implementation of TB control
2. Monitor health system performance
3. Engage all health care providers, public and private
4. Promote and strengthen positive behavior of communities
5. Address MDR-TB,TB-HIV and needs of vulnerable populations
6. Regulate and make quality TB diagnostic tests and drugs
7. Certify and accredit TB care providers
148
8. Secure adequate funding and improve allocation and efficiency of fund
utilization
Program Accomplishments:
Significant progress has been achieved since the Philippines adopted the DOTS
strategy in 1996 and at the end of 2002-2003, all public health centers are enabled
to deliver DOTS services. Because of the Government’s efforts to continuously
improve health care delivery, there have been progressive increases in the detection
and treatment success. While a strong groundwork has been installed, acceleration of
efforts is entailed to expand and sustain successful TB control. All stakeholders are
called upon to achieve the TB targets linked to the MDGs set to be attained by 2015.
However, with the emergence of other TB threats, more has to be done. Likewise, with
the ongoing global developments and new technologies in the pipeline, constraints
will hopefully be addressed.
The 2010-2016 PhilPACT as defined by multi-sector partners, through broad-
based collective technical inputs, underlines the key strategic approaches towards
achieving these targets at both national and local levels. The Plan aims for universal
access to DOTS including strategic responses to vulnerable groups and emerging TB
threats. Nationwide, a wide array of health facilities are installed and equipped to
provide quality TB care to the general population. This involves participation of
private facilities (clinics, hospitals), other health-related agencies or NGOs and other
Government organizations. Coverage for DOTS services, at least in the public primary
care network has reached nearly 100% in late 2002. Ever since, diagnosis through
sputum smear microscopy and treatment with a complete set of anti-TB drugs are
given free through the support of the Government. Training on TB care for different
types of health workers is being conducted through the regional and local NTP
Coordinators. The conclusions during the program implementation review (PIR) done
by the DOH of selected public health programs on January 2008 reveal the following:
Extent and quality of nationwide TB-DOTS coverage have reached levels
necessary for eventual control since 2004 up to present
NTP continues to add enhancements and improvements to TB care providers for
better delivery of services
Partner Organizations/Agencies:
The following are the organizations/agencies that take part in achieving the
objectives of the National TB Control Program:
Philippine Business for Social Progress
Philippine Coalition Against TB
Holistic Community Development Initiatives (HCDI)
National TB Ref Laboratory
Lung Center of the Philippines
Bureau of Jail Management and Penology (BJMP)
Bureau of Corrections
Department of Interior and Local Government (DILG)
Department of Education (DepEd)
Armed Forces of the Philippines-Office of the Surgeon General (AFP-OTSG)
PhilHealth
149
Research Institute of Tuberculosis/ Japan Anti-Tuberculosis
Association Philippines, Inc. (RIT/JATA)
Philippine Tuberculosis Society Inc. (PTSI)
Kabalikat sa Kalusugan
Samahang Lusog Baga
National Commission for Indigenous Peoples
Department of National Defense-Veterans Memorial Medical Center (DND-
VMMC)
Occupational Health and Safety (OSHC); Bureau of Working Conditions (BWC)
World Vision Development Foundation (WVDF)
International Committee of Red Cross
Korea Foundation for International Health Care (KOFIH)
World Health Organization (WHO)
United States Agency for International Development (USAID)
Committee of German Doctors for Developing Countries
Family Planning
150
National Filariasis Elimination Program
154
Newborn Screening
155
5. Provision of NBS services as a requirement for licensing and accreditation, the
DOH and the Philippine Health Insurance Corporation (PHIC)
6. Inclusion of cost of NBS in insurance benefits
Currently, there are four Newborn Screening Centers (NSCs) in the country: NSC-
National Institutes of Health in Manila; NSC- Visayas in Iloilo City; NSC-Mindanao in
Davao City; and NSC-Central Luzon in Angeles City. The four NSCs provide
laboratory and follow up services for more than 3000+ health facilities.
DOH, its partners and major stakeholders remain aggressive in identifying strategies
to intensify awareness in the communities and increase coverage among home
deliveries. Among the recent efforts to increase the newborn screening coverage are
appointment of full-time Regional NBS Coordinators; opening more G6PD
Confirmatory Laboratories; partnership with midwives organizations; and production
of information materials targeting different groups of health workers and
professionals.
Key Players in the Implementation
Organizational chart for the national implementation of Newborn Screening
Newborn Screening Statistics
As of December 2010, there are 2,389,959 babies that have undergone NBS and
based on these data, the incidences of the following disorders are: CH (1: 3,324); CAH
(1: 9,446); PKU (1: 149,372); Gal (1: 108,635) and G6PD deficiency (1: 52). The
program has saved the following numbers of newborns from complications and/or
death: 719 from CH, 253 from CAH, 22 from Gal, 16 from PKU and 44 273 from
G6PD deficiency.
Coverage
As of December 2010, the coverage of NBS is at 35%.
DIRECTORY OF PROGRAM IMPLEMENTERS
National Center for Disease Prevention and Control –Family Health Office
Program Manager
Dr. Juanita A. Basilio
Dr. Anthony P. Calibo
National Newborn Screening Coordinator:
Ms. Lita Orbillo
San Lazaro Compound, Sta. Cruz, Manila
Telephone: (02) 7359956
[email protected]
156
Newborn Screening Reference Center
Director: Dr. Carmencita D. Padilla
National Institutes of Health
Building H, UP Ayala Land Technohub
Complex,Commonwealth Avenue, Brgy. UP Campus
Diliman, Quezon City
Email: [email protected]
www.newbornscreening.ph
Newborn Screening Centers
For Regions I, II, III & CAR
Unit Head: Dr. Florencio Dizon
Newborn Screening Center – Central Luzon
Angeles City University Foundation Medical Center
MacArthur Highway, Barangay Salapungan, Angeles City
Telephone: (045) 6246502-03; Email: [email protected]
For Regions IV, V & NCR
Newborn Screening Center– National Institutes of Health
Unit Head: Ms. Ma. Elouisa Reyes
Building H, UP Ayala Land Technohub
Complex,Commonwealth Avenue, Brgy. UP Campus
Diliman, Quezon City
Email: [email protected]
For Visayas
Newborn Screening Center– Visayas
Unit Head: Dr. J Winston Edgar Posecion
West Visayas State University Medical Center
E. Lopez St., Jaro, Iloilo City
Telefax: (033) 329-3744; Email: [email protected]
For Mindanao
Newborn Screening Center– Mindanao
Unit Head: Dr. Conchita Abarquez
Southern Philippines Medical Center
J.P. Laurel Avenue, Davao City
Telephone: (082) 226-4595 / 224-0337
Telefax (082) 227-4152; Email:[email protected]
157
Centers for Health Development
NBS Regional
CHD Mailing Address Business Phone
Coordinator
(072) 2425315; (072) Clarita B. Lewis,
CHD 1 - Ilocos San Fernando, La Union
2424773 RN
(078) 3046585; (078) Leticia T.
CHD 2 -
Tuguegarao City 8446585; (078) Cabrera, MD,
Cagayan Valley
8446523 MPA
(045) 4552324; (045)
CHD 3 - Adelina Cabrera,
San Fernando, Pampanga 9617649; (045)
Central Luzon RN
9617654
CHD 4-A QMMC Compound, Project 4, Maria Luisa M.
(02) 4403372
Calabarzon Quezon City Malana, RN
CHD 4-B Quirino Hospital Compound, (02) 9134650; (02) Ma. Teresa
Mimaropa Quezon City 9115025 Castillo, MD
Carla A. Orozco,
First Park Subdidivion, (052) 4830840
CHD 5- Bicol MD, MPH
Daraga, Albay loc 517/516
MS III
CHD 6 -
Q. Abeto St., Mandurriao, Iloilo Renilyn P. Reyes,
Western (033)3210364
City MD
Visayas
Nayda P.
CHD 7 -
Osmeña Blvd., Cebu City (032) 4187633 Bautista,MD,
Central Visayas
MPH
CHD 8-
Lilibeth Andrade,
Eastern Candahug, Palo , Leyte (053)3235025
MD
Visayas
CHD 9 -
Upper Calarian, Zamboanga Nerissa B.
Zamboanga (062)9830314-15
City Gutierrez, RN
Peninsula
CHD 10 - Ellenietta HMV N.
J.V. Seriña St., Carmen,
Northern 088-22- 727400 Gamolo, MD,
Cagayan de Oro City
Mindanao MPH
Ma. Clarose M.
CHD 11 - (082) 3051907; (082)
J.P. Laurel Avenue, Davao City Mascardo, RN,
Davao Region 2214011
MPH
CHD 12 - ARMM Compound, Gov. (064) 4217436; (064) Lucy Decio, RN
Central Guttierez Ave, Cotabato City 4218053
158
Mindanao
Pizarro St. cor. Narra Rd. Glynna B. Andoy,
CHD CARAGA (085) 3411452
Butuan City MD, MPH
BGHMC Compound, Baguio (074) 4428096; (074) Nicolas R. Gordo,
CHD CAR
City 4445255 Jr, MD
Welfareville Compound, Brgy.
(02) 7183097; (02) Ma. Paz P.
CHD NCR Addition Hills, Mandaluyong
5354521 Corrales, MD
City
Dayan
CHD ARMM ORG Compound, Cotabato City (064) 4217703
Sangcopan, MD
Reunion of Saved Babies, October 10, 2010 at the UP Bahay ng Alumni, Quezon
City
159
Continuing Education for Health Professionals, October 4, 2011 in La Union
The Heel Prick Method
NBS Awarding Ceremony
October 3, 2011
Traders Hotel
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National HIV/STI Prevention Program
Objective:
Reduce the transmission of HIV and STI among the Most At Risk Population and
General Population and mitigate its impact at the individual, family, and community
level.
Program Activities:
With regard to the prevention and fight against stigma and discrimination, the
following are the strategies and interventions:
1. Availability of free voluntary HIV Counseling and Testing Service;
2. 100% Condom Use Program (CUP) especially for entertainment establishments;
3. Peer education and outreach;
4. Multi-sectoral coordination through Philippine National AIDS Council (PNAC);
5. Empowerment of communities;
6. Community assemblies and for a to reduce stigma;
7. Augmentation of resources of social Hygiene Clinics; and
8. Procured male condoms distributed as education materials during outreach.
Program Accomplishments:
As of the first quarter of 2011, the program has attained particular targets for
the three major final outputs: health policy and program development; capability
building of local government units (LGUs) and other stakeholders; and leveraging
services for priority health programs.
For the health policy and program development, the Manual of Procedures/
Standards/ Guidelines is already finalized and disseminated. The ARV Resistance
surveillance among People Living with HIV (PLHIV) on Treatment is being
implemented through the Research Institute for Tropical Medicine (RITM). Moreover,
both the Strategic Plan 2012-2016 for Prevention of Mother to Child Transmission
and the Strategic Plan 2012-2016 for Most at Risk Young People and HIV Prevention
and Treatment are being drafted.
With regard to capability building, the Training Curriculum for HIV Counseling
and Testing is already revised. Twenty five priority LGUs provided support in
strengthening Local AIDS councils. as of March 2011, there were already 17
Treatment Hubs nationwide.
Lastly, for the leveraging services, baseline laboratory testing is being provided
while male condoms are being distributed through social Hygiene Clinics. A total of
1,250 PLHIV were provided with treatment and 4,000 STI were treated.
Partner Organizations/Agencies:
The following organizations/agencies take part in achieving the goal of the National
HIV/STI Prevention Program:
Department of Interior and Local Government (DILG)
Philippine National AIDS Council (PNAC)
Research Institute for Tropical Medicine (RITM)
STI/AIDS Cooperative Central Laboratory (SCCL)
World Health Organization (WHO)
161
United States Agency for International Development (USAID)
Pinoy Plus Association
AIDS Society of the Philippines (ASP)
Positive Action Foundation Philippines, Inc. (PAFPI)
Action for Health Initiatives (ACHIEVES)
Affiliation Against AIDS in Mindanao (ALAGAD-Mindanao)
AIDS Watch Council (AWAC)
Family Planning Organization of the Philippines (FPOP)
Free Rehabilitation, Economic, Education, and Legal Assistance Volunteers
Association, Inc. (FREELAVA)
Philippine NGO council on Population, Health, and Welfare, Inc. (PNGOC)
Leyte Family Development Organization (LEFADO)
Remedios AIDS Foundation (RAF)
Social Development Research Institute (SDRI)
TLF share Collectives, Inc.
Trade Union Congress of the Philippines (TUCP) Katipunang Manggagawang
Pilipino
Health Action Information Network (HAIN)
Hope Volunteers Foundation, Inc.
KANLUNGAN Center Foundation, Inc. (KCFI)
Kabataang Gabay sa Positibong Pamumuhay, Inc. (KGPP)
I. Rationale:
The National Mental Health Policy shall be pursued through a Mental Health
Program strategy prioritizing the promotion of mental health, protection of the rights
and freedoms of persons with mental diseases and the reduction of the burden and
consequences of mental ill-health, mental and brain disorders and disabilities.
Stakeholders:
To ensure the sustainability and effectiveness of the National Mental Health Program,
certain committees and teams were organized.
1. National Program Management Committee (NPMC)
162
The NPMC is chaired by the Undersecretary of Health of the Policy and
Standards Development Team for Service Delivery and co-chaired by the
Director IV of the National Center for Disease Prevention and Control
(NCDPC).
Under the NPMC, PDMT shall be established corresponding to the four sub-programs
of the National Mental Health Program. A PDMT shall oversee the operations of a
sub-program of the National Mental Health Program.
Oversee the planning and operation of the National Mental Health Program at
the regional level;
163
Provide technical assistance on the issues and concerns pertaining to the
implementation of the different subprograms of the National Mental Health
Program;
Strengthen technical and managerial capability at the local level to ensure LGU
participation on the implementation of the National Mental Health Program;
Ensure establishment of LGU teams for mental health;
Ensure the conduct of monitoring and evaluation of the implementation of the
National Mental Health Program at the regional level; and
Regularly update the PDMT on the status of the regional implementation of the
National Mental Health Program.
The suggested members of the LGUMHT are the local health board members,
technical health staff, civil society groups, non-government organizations and other
stakeholders. Primarily, the LGUMHT enacts necessary legislative issuances and
promotes and advocates the implementation of Community-based Mental Health
Program among their respective localities and constituents.
Other stakeholders who may or may not belong to the above-mentioned committees
or teams may contribute to the implementation of the National Mental Health
Program by:
II. Scenario
Global Situation:
Many people with mental health conditions, as well as their families and caregiver,
experience the consequences of vulnerability on a daily basis. Stigma, abuse, and
exclusion are all-too-common. Although their vulnerability is not inevitable, but
rather brought about their social environments, over time it leads to a range of
adverse outcomes, including poverty, poor health, and premature death.
Because they are highly vulnerable and are barely noticed- expert to be stigmatized
and deprive of their rights- it is crucial that people with mental health conditions are
recognized and targeted for development interventions. The case for their inclusion is
compelling. People with mental health conditions meet vulnerability criteria: they
164
experience severe stigma and discrimination; they are more likely to be subjected to
abuse and violence than the general population; they encounter barriers to exercising
their civil and political rights, and participating fully in society; they lack access to
health and social services, and services during emergencies; they encounter
restriction to education; and they excluded from income-generating and employment
opportunities. As a cumulative result of these factors, people with mental conditions
are at heightened risk for premature death and disability. Mental health conditions
also are highly prevalent among people living in poverty, prisoners, people living with
HIV/AIDS, people in emergency settings, and other vulnerable groups.
Specific areas for action address the social and economic factors leading to
vulnerability. Mental health services should be provided in primary care settings and
integrated with general health services. To that end, mental health issues should be
mainstreamed on countries’ broader health policies, plans, and human resource
development, as well as recognized as an important issue to consider in global and
multisectoral efforts, such as the International Health Partnership, the Gloring
Health Workforce Alliance, and the Health Metrics Network. During and after
emergencies, development stakeholders should promote the (re)construction of
community-based mental health services, which can serve the population long
beyond the immediate aftermath of the emergency. Development strategies and plans
should encourage strong links between health/mental health services, housing, and
other social services. Access to education for people with mental conditions, as well
as early childhood programmes for vulnerable groups should be supported by
development stakeholders in order to achieve better development outcomes. People
with mental health conditions should be included in employment and income
generating programmes to assist with poverty alleviation, improve autonomy and
mental health. Throughout their different areas of work, development stakeholders
can and should support human rights protections for people with mental conditions
and built their capacity to participate in public affairs.
165
This report provides a number of recommendation and specifics areas of action that
need to be integrated into policy, planning, and implementation by development
stakeholders according to their role and strategic advantage. To achieve this aim
development stakeholders need to recognize people with mental health conditions as
a vulnerable group requiring support from development programmes.
(World Health Organization and Mental Health and Poverty Project, 2010)
Local Situation
In a local baseline survey in 1964-67 in Sta. Cruz, Lubao, Pampanga, Manapsal of
the DOH Division of Mental Hygiene, Bureau of Disease Control, found that the
prevalence of mental health was 36% per 1,000 adults, children and adolescents. The
1980 WHO Collaborative Studies for Extending Mental Health Care in General Health
Care Services (involving seven countries) showed that 17% for adults and 16% of
children who consulted at three health centers in Sampaloc, Manila have mental
disorders. Depressive reactions in adults and adaptation reaction in children were
most frequently found. In Sapang Palay, San Jose Del Monte, Bulacan, the
prevalence of adult schizophrenia was 12 cases per 1,000 population in 1988-1989
(Manalang et al).
In Region 6 (Iloilo, Negros Occidental and Antique), Perlas et al. im 1993-94 showed
that the prevalence of the following mental illness in the adult population were:
psychosis (4.3%), anxiety (14.3%), panic (5.6%). For the children and adolescent, the
top five most prevalent psychiatric conditions were: enuresis (9.3%), speech and
language disorder (3.9%), mental subnormality (3.7%), adaption reaction (2.4%) and
neurotic disorder (1.1%).
The current DOH bed capacity for mental disorder is 5,465. Of these, 4,200 beds are
in the NCR (at the National Center for Mental Health). The rest of the country share
the remaining 1,265 beds (CAR-40 beds, Region 2-200 beds, Region3-500 beds,
Region 11-200 beds). Regions 1,4,10,12, CARAGA and ARMM do not have inpatient
psychiatric facilities. Only 27 DOH medical centers and regional hospitals have
mental health services. Cavite is the only province with a psychiatric facility.
These situations have hampered the delivery of basic services, aborted the national
development, and reduced quality of life of the Filipino. Life has become severely
stressful to most, whether rich or poor, young or old. The resiliency of the Filipino
people to adapt to his present life situation is being stretched too far. Warning signs
of restlessness abound such as increasing reports of suicides and substance abuse.
Decline in the socio-economic condition may translate into mental-ill health and
therefore mental health disorders and mental disabilities.
However, the provision of mental health services in the country, has remained
illness-oriented, institution-based, fragmented, inadequate, inequitable, inaccessible,
prohibitive, and neglected.
166
The Department of Health (DOH), the national lead agency for health recognizes the
magnitude of the mental health problem as contained in the National Objectives for
Health (NOH) 1999-2004. Among the objectives are set the following:
However, the DOH has constraints in attaining these objectives given the limited
government resources. Within the health sector, mental health has to compare for
resources against other equally important health objectives. Concomitant reforms are
therefore being pursued in hospitals, public health, local health systems, regulation
as well as financing with the end-view of improving the health of all Filipinos as
embodied in the Health Sector Reform Agenda.
The National Mental Health Program has the following program strategies:
167
Enrichment of advocacy and multimedia information, education and community
(IEC) strategies targeting the general public, mental health patients and their
families, and service providers shall be done through the promulgation of
observances issued by the Office of the President.
2. Service Provision
Enhancement of service delivery at the national and local levels will enable the early
recognition and treatment of mental health problems. To ensure continuity of care,
mental health services for people with persistent disabilities shall be established
close to home and the workplace.
The program shall support researches and studies relevant to mental health, with
focus on the following areas: clinical behavior, epidemiology, public health treatment
options, and knowledge management. It aims to acquire evidence-based information
that will contribute to the public health information and education, policy
formulation, planning, and implementation.
5. Capability Building
The capability of national, regional and local health workers in delivering efficient,
effective and appropriate mental health services shall be strengthen. Training shall
be conducted on psychosocial care, the detection and management of specific
psychiatric morbidity, and the establishment of mental health facilities.
6. Public-Private Partnership
168
This is needed to determine the magnitude of the problem, its epidemiological
characteristics and knowledge and practices to serve as basis for shifting the
program for being institutional and treatment focused to being preventive, family
focused and community oriented.
Best practices/models for prevention of substance abuse and risk reduction for
mental illness can be replicated in different LGUs in coordination with other agencies
involved in mental health and substance abuse prevention programs.
Program Direction
Micro Point of View
Major Activities/Celebrations:
Celebration Date
Autism Consciousness Week Every 3rd Week of January
National Mental Retardation Week February 14 to 19
National Epilepsy Awareness Week Every 1st Week of September
National Mental Health Week Every 2nd Week of October
National Attention Deficit/Hyperactivity
Every 3rd Week of October
Disorder Awareness Week
Substance Abuse Prevention & Control Week Every 3rd Week of November
Partner Organizations/Agencies:
169
Philippine Psychiatric Association (PPA)
Suite 1007, 10th flr. Medical Plaza Ortigas Condominium
San Miguel Ave. Ortigas Center Pasig City
# (632) 635-98-58.
170
National Dengue Prevention and Control Program
The National Dengue Prevention and Control Program was first initiated by the
Department of Health (DOH) in 1993. Region VII and the National Capital Region
served as the pilot sites. It was not until 1998 when the program was implemented
nationwide. The target populations of the program are the general population, the
local government units, and the local health workers.
Vision: Dengue Risk-Free Philippines
Mission: To improve the quality of health of Filipinos by adopting an integrated
dengue control approach in the prevention and control of dengue infection.
Goal: Reduce morbidity and mortality from dengue infection by preventing the
transmission of the virus from the mosquito vector human.
Objectives:
The objectives of the program are categorized into three: health status objectives; risk
reduction objectives; and services & protection objectives.
Health Status Objectives:
Reduce incidence from 32 cases/100,000 population to 20 cases/100,000
population;
Reduce case fatality rate by <1%; and
Detect and contain all epidemics.
171
Philippine Health Insurance Corporation (PhilHealth)
National Prevention of Blindness Program
Mission: The DOH, Local Health Unit (LGU) partners and stakeholders commit to:
1. Strengthen partnership among and with stakeholder to eliminate avoidable
blindness in the Philippines;
2. Empower communities to take proactive roles in the promotion of eye health
and prevention of blindness;
3. Provide access to quality eye care services for all; and
4. Work towards poverty alleviation through preservation and restoration of sight
to indigent Filipinos.
Global Facts
The Philippines is a signatory in the Global Elimination of Avoidable Blindness:
Vision 2020 – The Right to Sight. The Vision 2020 was initiated by the International
Agency for Prevention of Blindness (IAPB), World Health Organization (WHO), and the
Christian Blind Mission (CBM), Vision 2020 aims to develop sustainable
comprehensive health care system to ensure the nest possible vision for all people
and thereby improve the quality of life.
According to WHO estimates:
Approximately 314 million people worldwide live with low vision and blindness
Of these, 45 million people are blind and 269 million have low vision
145 million people's low vision is due to uncorrected refractive errors (near-
sightedness, far-sightedness or astigmatism). In most cases, normal vision
could be restored with eyeglasses
Yet 80% of blindness is avoidable - i.e. readily treatable and/or preventable
90% of blind people live in low-income countries
Restorations of sight, and blindness prevention strategies are among the most
cost-effective interventions in health care
Infectious causes of blindness are decreasing as a result of public health
interventions and socio-economic development. Blinding trachoma now affects
fewer than 80 million people, compared to 360 million in 1985
Aging populations and lifestyle changes mean that chronic blinding conditions
such as diabetic retinopathy are projected to rise exponentially
Women face a significantly greater risk of vision loss than men
173
Without effective, major intervention, the number of blind people worldwide has
been projected to increase to 76 million by 2020
Burden of Blindness and Visual Impairment :
Local Facts
Number of blind people: 592,000 (based on 2011 estimated population of 102M
& 2002 blindness prevalence of 0.58%)
Number of persons with moderate or severe visual impairment: 2 million (2011
popn. & 2002 prevalence of 2.04%)
Number of blind due to cataract: 367,000 (62%)
Number of blind due to EOR: 59,000 (10%)
Number of blind from cataract below poverty line: 92,000 (25%, NSCB 2009
figures]; figure est. doubled to include first & second quintiles
RP Prevalence of Blindness (%), 2002
Caraga 0.16
National Capital Region 0.19
Cordillera Autonomous Region 0.2
Central Mindanao 0.4
Ilocos Region 0.5
Western Visayas 0.51
Eastern Visayas 0.53
Southern Luzon 0.56
National Figure 0.58
174
National Capital Region 0.81
Cordillera Autonomous Region 0.87
Central Luzon 1.21
Central Mindanao 1.53
Western Mindanao 1.59
Southern Mindanao 1.71
Central Visayas 1.76
Western Visayas 1.91
National Figure 1.98
Activities for the Vitamin A Deficiency Disorder, for practical purposes, shall be led by
the Family Health Office also of the NCDPC.
A Referral System shall form part of services delivered by the program. This is to
ensure that all patients receive quality eye health care at appropriate levels of health
care delivery system. All rural health units should be linked to an eye care referral
center.
Cataract
Cataract, the opacification of the normally clear lens of the eye, is the most common
cause of blindness worldwide. It is the cause in 62% of all blindness in the
Philippines and is found mostly in the older age groups. The only cure for cataract
blindness is surgery. This is available in almost all provinces of the country; however
there are barriers in accessing such services. Interventions will therefore consist of
increasing awareness about cataract and cataract surgery; as well as improving the
177
delivery of cataract services. The parameter used worldwide to monitor cataract
service delivery is the Cataract Surgical Rate.
Errors of Refraction
Errors of refraction is the most common cause of visual impairment in the country
(prevalence is 2.06% in the population). Errors of refraction are corrected either with
spectacle glasses, contact lenses or surgery. The services to address the problem of
EOR are provided mainly by optometrists. However, the provision of the eyeglasses or
lenses (who should provide, how is it provided, etc.) has to be addressed.
Childhood Blindness
The prevalence of blindness among children (up to age 19) is 0.06% while the
prevalence of visual impairment in the same age group is 0.43%. The problem of
childhood blindness is the highly specialized services that are needed to diagnose and
treat it. However, screening of children for any sign of visual impairment can be done
by pediatricians, school clinics and health workers.
Future Plan/Action:
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The following programs/projects are included in the Maternal and Child Care
Program of DOH:
Expanded Program for Immunization (includes vaccination for diseases
that causes blindness)
Vitamin A provision for pregnant mothers and children to prevent vitamin
A deficiency
Comprehensive newborn care includes prophylaxis for ophthalmia
neonatorum
Newborn screening includes screening for galactosemia which cause
congenital cataract
Several activities in the PBP
Consultative and Planning Workshop on PBP, October 2011
National Eye Summit, Manila Grand Opera Hotel, Manila last October
2009
Strategic Planning Workshop on the National Sight Preservation and
Blindness Program 2008
Training of Trainors of Primary Eye Care conducted 2007
Other Significant information:
Ophthalmologists
1,573 registered PAO members as of January 27, 2011
95% is in private practice
Optometrists
10,266 registered with Philippine Board of Optometry as of July 2010
Financial Resources
DOH provides funds largely for technical assistance for training, capacity
building activities, and augmentation of funds for local program
implementation.
Philippine Health Insurance Corporation covering personal eye care services
(hospital based)
Partner Organizations:
Aside from the collaborating divisions in the DOH, the following institutions partake
in the program:
Local Government Units (LGUs)
National Committee for Sight Preservation (NCSP)
Philippine Academy of Ophthalmology
Philippine Information Agency
Optometric Association of the Philippines
Rotary International
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Integrated Philippine Association of Optometrists
Foundation for Sight
Helen Keller International
Lions Club International
Tanggal Katarata Foundation
UP - Institute of Ophthalmology
Christian Blind Mission
Resources for the Blind
SentroOfthalmologico Jose Rizal
World Health Organization
Sources: Files and Links:
Administrative Order No. 179 s. 2004
World Health Organization
Vision/Mission Statement
Health for all occupations in partnership with the workers, employers, local
government authorities and other sectors in promoting self-sustaining
programs and improvement of workers' health and working environment.
Program Objectives and Targets
To promote and protect the health and well being of the working population thru
improved health, better working conditions and workers' environment.
Republic Act No. 7277, “An Act Providing for the Rehabilitation, and Self-
Reliance of Disabled Persons and Their Integration into the Mainstream of Society
and for Other Purposes,” and otherwise known as “The Magna Carta for Disabled
Persons.” was passed in July 19, 1991. This specifically required the Department of
Health (DOH) to. (1) Institute a national health program for PWDs, (2) establish
medical rehabilitation centers in provincial hospitals, and (3) adopt an integrated and
comprehensive to the Health Development of PWD which shall make essential health
services available to them at affordable cost.
Rule IV, Section 4. Paragraph B of the implementing rules and regulations
(IRRI) of this act required the Department of Health to address the health concerns of
seven (7) different categories of this ability, which includes the following: (1)
Psychosocial and behavioral disabilities, (2) Chronic illnesses with disabilities, (3)
Learning (cognitive or intellectual) disabilities, (4) Mental disabilities, (5) Visual/
seeing disabilities, (6) Orthopedic/ moving, and; (7) Communications deficits.
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In compliance thereof, the DOH piloted in 1995 a community based
rehabilitation program in 112 (7.5%) out of 1,492 towns nationwide. Between 1992
and 2004 it had upgraded DOH hospital facilities to include rehabilitation and allied
medical services for PWDs. Today there are about 21 DOH hospitals that have
rehabilitation program/units/centers representing 22% of all DOH hospitals. It had
registered 508,270 PWDs in 2004 or about 12% of the target PWD population.
(Source: DOH report 2004). The turnout was influenced by the presence, absence or
inadequacy of health services for PWDs at the local regional level and in DOH health
facilities. A Social Weather (SWS) survey commissioned by DOH last 2004 revealed
that around 7% of the households under the study have at least one family member
who is disabled. (Source SWS Survey 2004). With the frontline services of the
Department of Health developed to the local government units, the final
implementation of this Act now rests with the Local Government Units (LGUs). This
Order prescribes the guidelines in the formulation, implementation, and evaluation of
health programs for PWDs.
Vision:
Improve the total well-being of Person with Disabilities (PWD)
Mission:
The Department of Health, as the focal organization, shall ensure the development,
implementation, and monitoring of relevant and efficient health programs and
systems for PWDs that are available, affordable, and acceptable.
Global Situation
Key facts
Over a billion people, about 15% of the world’s population, have some
form of disability.
Between 110 million and 190 million people have significant difficulties in
functioning.
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Rates of disability are increasing due to population ageing and increases
in chronic health conditions, among other causes.
People with disabilities have less access to health care services and
therefore experience unmet health care needs.
1. Develop an integrated national health and human rights program and local
models to serve the special health needs;
2. Pursue the implementation and monitoring of laws and policies for PWD such
as the accessibility law, human rights, and other related laws;
3. Ensure that the health facilities and services are equitable, available,
accessible, acceptable, and affordable to PWD through the development and
implementation of essential health package that is suitable to their special needs and
enrollment of into the National Health Insurance Program;
5. Continue and fast-track the registration of PWD in order to generate data for
accurate planning and implementation of programs. The Philippine Registry for
Persons with Disability will be continued, monitored, and evaluated and developed
into an information system that will be incorporated into currently used health
service information system.
Program Strategies/Program Components:
A Health program shall be developed for each type of disability and special population
which must contain all of the following essential components:
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This component shall ensure the advocacy for the following promulgated
observances on the following specified time each year as per issuances from the
Office of the President:
Celebration Time
Autism Every 3rd week of January
National Down’s Syndrome Every February
Retarded Children’s Week February 14 to 19
Leprosy Week Last week of February
Women with disabilities Day Last Monday of March
National disability Prevention and Rehabilitation
Every 3rd week of July
Week
NDPR Week to Culminate on the Birthdate of the
July 23
Sublime Paralytic: Apolinario Mabini
White Cane Safety Day in the Philippines August 1
Brain attack awareness 3rd Week of August
Cerebral Palsy Awareness Week September 16 to 22
National Epilepsy Awareness Week 1st Week of September
National Mental Health Week 2nd Week of October
Bone and Joint (Musculo-Skeletal) Awareness Week 3rd Week of October
National Attention Deficit / Hyperactivity Disorder rd
3 week of October
(ADHD) Awareness Week
National Skin Disease Detection and Prevention nd
2 Week of November
Week
Deaf Awareness Week November 10 to 16
Drug Abuse Prevention and Control 3rd Week of November
Future related observances promulgated by the office of the President shall also
become part of this component.
2. Capability Building
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7. Research and Development
8. Service Delivery
The following areas for services to be developed for implementing facilities, localities
or organizations:
1. Community based and institution-based rehabilitation program
2. Clinical assessment of functioning, health and disability
3. Medical assistive devices
Pinoy MD Program
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Philippine Cancer Control Program
I. Rationale
Cancer is predicted to be an increasingly important cause of morbidity and
mortality in the next few decades, in all regions of the world. The challenges of
tackling cancer are enormous and – when combined with population ageing –
increases in cancer prevalence are inevitable, regardless of current or future actions
or levels of investment.
In recognition of current and emerging importance of non-communicable
diseases like cancer, E.O 119 reorganizing the Department of Health, had revised a
Non-Communicable Disease Control Service whose mandate includes planning and
management of Cancer Control activities. This order provides for guidelines on the
Philippine Cancer Control Program (PCCP) to be organized and managed by the Non-
Communicable Disease Service.
Vision :
Improve quality of life for all Filipinos
Mission :
To provide quality, effective and accessible services for the prevention and control of
cancer
Goal :
Reduce morbidity, mortality and disability due to common preventable cancers
Objectives:
1. To reduce the exposure of population to risk related factors primarily
smoking, unhealthy diet, physical inactivity, and harmful use of alcohol,
cancer related infections, chemical and ultra violet rays exposure.
2. To increase the number of patient given appropriate screening, diagnosis and
treatment on cancer
3. To increase the number of patient given appropriate pain relief and support
care services with cancer
Mandates:
A. Program Policies
AO 89-A s. 1990 Establishment of Phil. Cancer Control Program dated April 18,
1990
AO 2005-0006 Establishment of Cervical Cancer Screening Program dated
February 10, 2005
RA 7846 Compulsory Hepatitis B Immunization
AO 122 s 2003 on Smoking Cessation Program
AO 2007-2004 National Tobacco Prevention and Control Program
AO 2011-0003 National Policy on Strengthening the Prevention and Control of
Chronic Lifestyle Related Non Communicable Diseases
B. Policies on HL Promotion-Healthy Diet & Nutrition
RA7394 or Consumer Act of Phils. to enforce compulsory labeling to enable
consumer obtain accurate information as to the content of the products
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AO 88-B s. 1984 Rules & regulations on labeling of pre-Packaged Food Products
to ensure labels are not fake, misleading and deceptive
DepEd Memo 373 s. 1998 encouraging sale and consumption of healthy foods
in school.
Bureau Circular 2007-002 Guidelines in the Use of Nutrition and Health Claims
in Food
C. Policies HL Promotion-Smoking/Alcohol
RA 9334 An Act Increasing the Excise Tax Rated Imposed on Alcohol & Tobacco
Products
RA 9211 Act Regulating Use, Sale and Distribution and Advertisements of
Tobacco Products
RA 8749 Phil. Clean Air Act-prohibits smoking in public places or outdoors
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International Support, Policies and Mandates
International Policies and Mandates
WHA58.22 cancer prevention and control
WHA57.12 on the reproductive health strategy, including control of cervical
cancer screening
WHA57.16 on health promotion and healthy lifestyles;
WHA57.17 on the Global Strategy on Diet, Physical Activity and Health,
WHA56.1 on tobacco control
International Support
In 2011, the UNFPA had donated three (3) units of cryotherapy machines for use in
the treatment of pre – cancerous lesion in the cervix. This partner also provided
funds in the development of the Training Module on Cervical Cancer Prevention and
Control together with the support of Women’s Health and Safe Motherhood Project II.
II. Scenario
Global
Cancer is the major public health problem worldwide. It ranks second in the
leading cause of death in developed countries and is the third leading cause of deaths
in the developing countries. About 7.6 million deaths occurred per day worldwide, by
2030; around 27 million new cases are expected to occur if the government will not
act on it.
The forecasted changes in population demographics in the next two decades
mean that even if current global cancer rates remain unchanged, the estimated
incidence of 12.7 million new cancer cases in 2008 (5) will rise to 21.4 million by
2030, with nearly two thirds of all cancer diagnoses occurring in low- and middle-
income countries (6).
Large variations in both cancer frequency and case fatality are observed, even
in relation to the major forms of cancer, in different regions of the world.
The geographical variation in cancer distribution and patterns is mirrored on
examination of cancer morbidity and mortality data in relation to the World Bank
income groups of countries. Within upper-middle-income and high-income countries,
prostate and breast cancers are the most commonly diagnosed in males and females
respectively, with lung and colorectal cancers representing the next most common
types in both sexes. These cancers also represent the most frequent types of cancer-
related deaths in these countries although lung cancer is the most common cause of
cancer death in both sexes. Within low-income countries, the absolute burden of
cancer is much lower, and while lung and breast cancers remain among the most
common diagnoses and types of cancer-related deaths, cancers of the cervix, stomach
and liver are also among the leading types – all of which are cancers with infection-
related etiology.
Middle-income countries are intermediate with respect to their patterns of
cancer burden. Within the lower-middle-income countries, the three most common
types of cancer are lung, stomach and liver cancers in males, and breast, cervix and
lung cancer in females, i.e. a similar pattern to the low-income countries (although
liver, colorectal and esophageal cancers are also of importance). The lower middle-
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income group contains some of the most populous countries in the world, including
China and India; hence the absolute numbers of cancers and cancer-related deaths
are notably high in this group.
Future planning of service provision is an integral part of cancer control
programmes. Considering the projected growth in cancer morbidity, important
differences can be observed in relation to World Bank income groups. The estimated
percentage increase in cancer incidence by 2030 (compared with 2008) will be greater
in low- (82%) and lower-middle-income countries (70%) compared with the upper-
middle- (58%) and high-income countries (40%). Without any changes in underlying
risk factors (i.e. based only on anticipated demographic changes), between 10 and 11
million cancers will be diagnosed annually in 2030 in the low- and lower-middle-
income countries.
Local
In the Philippines, cancer ranks third in the ten leading causes of mortality.
Cancer is common in both sexes with the highest deaths in males. The common
cancer deaths in both sexes are lung, liver, breast, colon/rectum and cervix. While
the top 5 cancer cases in both sexes are lung, breast, colon/rectum, liver and cervix.
The Non Communicable Disease Service is tasked to operationalize programs
towards prevention and control of cancer that is accessible and affordable giving
priority to the disadvantaged population. This was started in 1970 when the
National Cancer Control Center was created and considered as autonomous unit. The
Rizal and Manila Cancer Registries were established during this period. In 1973 the
Community Cancer Control Program was started. Pursuant to the issuance of
Executive Order 119 in 1986, the National Cancer Control was abolished. The Office
of Public Health Services was created where Non-Communicable Disease Control was
lodge. In May 1987 the Cancer Core Group was created to assist the Secretary of
Health in developing a framework of cancer control. Orientation Training of Core of
Trainers was done in 1988. In 1990 the Philippine Cancer Control Program was
created as per Administrative Order # 89-A, s.1990. A year later the Cancer Core
Group was reconstituted as an Advisory Council.
In 1999, the Degenerative Disease Office was established as per EO 102
“Redirecting the Functions and Operations of the Department of Health”. The
intervention was focused in the control measures to promote healthy lifestyle and
avoid exposure to risk factors contributing to the development of cancer. Cancer in
particular was not given priority attention to manage patient comprehensively.
Screening for early detection and treatment intervention were not foreseen as highly
needed by population at risk of getting cancer. Funds for the operationalization of
the program were not included to address the problem.
In mid 2007, the Cervical Cancer Control Program was transferred by the Family
Health Office to the Degenerative Disease Office where the said program was
originated. The Cervical Cancer Control Program had provided Free Cervical Cancer
Screening among women 30 to 45 years of age to respond to the issuance of the
Guidelines in the Establishment of Cervical Cancer Screening Program in 2005.
The creation of the National Center for Pharmaceutical Access and Management
contributed much in the provision of intervention on cancer. These are : 1) Free
Adjuvant Chemotherapy provided to breast cancer patient newly diagnosed stage I to
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Stage IIIa piloted in Jose Reyes Memorial Medical Center, East Avenue Medical
Center, Rizal Medical Center and Philippine General Hospital, 2). Free Chemotherapy
for Acute Lymphatic Leukemia among children (ALL) in selected DOH hospital.
Due to the limited resources, the Phil Cancer Control Program is moving slowly
geared towards the improvement of health and prolonging the life of cancer patient.
Statistics/Local Data about the Disease Program
Global Data on Cancer
Top Five Cancer Deaths in 2011
Type of Cancer Cases
Lung 1.4 Million
Stomach 740,000
Liver 700,000
Colorectoral 610,000
Breast 460,000
Philippine Data on Cancer, 2010 Cancer Facts and Estimates
Number of Cases, Both Sexes 2010
Cancer Number of Cases
Breast 12,262
Lung 11,458
Liver 7,331
Colon/Rectum 5,787
Cervix 4,812
Leukemia 3,153
Stomach 3,129
Prostate 2,712
Brain/Nervous System 2,236
Ovary 2,165
Number of Deaths, Both Sexes, 2010
Cancer Number of Deaths
Lung 9,184
Liver 6,819
Breast 4,371
Colon/Rectum 3,060
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Leukemia 2,609
Stomach 2,274
Cervix 1,984
Brain/Nervous System 1,855
Prostate 1,410
Ovary 1,016
Number of New Cases, 2010, Males
Cancer Cases
Lung 8,772
Liver 5,522
Colon/Rectum 3,208
Prostate 2,712
Stomach 1,920
Leukemia 1,669
Brain/Nervous System 1,236
Other Pharynx 1,145
Non-Non-Hodgkin Lymphoma 982
Kidney 848
Number of Deaths, 2010, Males
Cancer Cases
Lung 6,987
Liver 5,102
Colon/Rectum 1,690
Prostate 1,410
Stomach 1,340
Leukemia 1,381
Brain/Nervous System 1,069
Other Pharynx 804
Non-Hodgkin Leukemia 598
Kidney 389
10 Most Common Cancer Cases in 2010, Females
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Type of Cancer Cases
Breast 12,262
Cervix Uteri 4,812
Lung 2,686
Colon/Rectum 2,579
Ovary 2,165
Liver 1,809
Corpus Uteri 1,760
Leukemia 1,484
Thyroid 1,474
Stomach 1,209
10 Most Common Cancer Deaths in 2010, Females
Type of Cancer Cases
Breast 4,371
Cervix Uteri 1,984
Lung 2,197
Colon/Rectum 1,370
Ovary 1,016
Liver 1,717
Corpus Uteri 796
Leukemia 1,228
Thyroid 450
Stomach 934
III. Interventions/Strategies employed or implemented by DOH
Packages of Services
Free Cervical Cancer Screeningprovided every year in 58 DOH Hospitals done
during the month of May to screen women ages 30-45 years of age
Free Adjuvant Chemotherapy for women diagnosed stage 1 to IIIa breast cancer
in 4 pilot hospitals (Jose Reyes Memorial Medical Hospital, East Avenue
Medical Center, Rizal medical Center, UP-PGH) funded by NCPAM
Free Chemotherapy for Acute Lymphatic Leukemia (ALL) among children with
cancer funded by NCPAM
Strategies
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Promotion of Healthy Lifestyle
Increase avoidance of the risk factors done in coordination with the National
Center for Health Promotion
Vaccinate against human papilloma virus (HPV) and hepatitis B virus (HBV)
not in nationwide scope but done by professional societies among children
who can afford HPV vaccination
Control occupational hazards done in coordination with the Environmental
and Occupational Health Office
Reduce exposure to sunlight
Improve Screening/Diagnosis and Treatment
Improve Rehabilitation and Palliative Care
Improve Cancer Registry
IV. Status of implementation/Accomplishment
The status of the implementation on the different types of cancer varies due to the
limited resources in the operationalization of the program.
A. Cervical Cancer
Conducted Free Cervical Cancer Screening in DOH Hospitals from 2009 to 2011
Conducted Cervical Cancer Awareness Month during the month of May from
2009 to 2011
Drafted Training Module on Cervical Cancer Prevention and Control in 2010
Provided 3 units of cryotherapy machine in Bicol Regional & Teaching Hospital,
Jose Reyes Memorial Medical Center, Cotabato Regional Hospital from UNFPA
in 2011
Provided supplies (acetic acid, cotton swab ) for cervical cancer screening in 58
DOH Hospitals in 2011
Conducted the 1st National Symposium on Cervical Cancer Prevention and
Control in 2010
Conducted Catching Cancer : A Forum on Cervical Cancer Prevention and
Control in 2011
Conducted Press Conference on Cervical Cancer in 2009 to 2011
Created Technical Working Group on Cervical Cancer in 2010
B. Cancer Registry
Provided funds for the Population-Based Cancer Registry in Rizal and Manila
Develop Cancer Registry Forms for the Establishment of an Integrated Chronic-
Non-Communicable Disease Registry System in 2010
Conducted Training on Integrated Chronic NCD Registry in pilot hospital in
2010
Conducted 1st Batch of Integrated NCD Registry Training last April 4-5, 2011
Conducted 2nd Batch of Integrated NCD Registry dated Sept 22-30, 2011
C. Breast Cancer
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Reviewed Guidelines on Patient Navigator Program for the Provision of Free
Chemotherapy on Breast Cancer with Stage I-IIIa initiated by NCPAM
A five year medium term plan prepared by F1 convergence provinces using the
Fourmula One for Health framework to improve the highly decentralized system;
financing, regulation, good governance and service delivery
The five year province-wide investment plan for health is an important evidence-
based platform for local health system management and a milestone in DoH
engagement at the local level.
PIPH was adopted on a pilot basis by 16 provinces in 2007, followed by 21 more
in 2008, including six provinces from the Autonomous Region of Muslim Mindanao
(ARMM). In 2009, 44 provinces and eqight cities have completed their own five year
plans.
Vision:
"The global leader in providing quality health care for all through universal health
care"
Mission:
To ensure that the Philippines is globally competitive through implementation of
quality standards in both public and private sector.
Goal:
1. The local Global Health Care industry will contribute a noticeable and quantifiable
amount to the Philippine economy and improvement in the quality of life.
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2. Increase the number of institutions offering advanced medical services suitable for
Global HealthCare, the generation of jobs in the Medical Services industry and other
related industries, thereby increasing the productivity of the workforce and enabling
it to expand and upgrade.
3. Attract increased numbers of visitors from other countries availing of medical
services and at the same time ensure that quality of those currently offering services
suitable for Global Health Care is on the same level as with globally-recognized
standards, and making these services equitably available for both Medical Travellers
and local patients.
Objectives:
1. To increase competitiveness by compliance to recognized bodies that implement
national and international healthcare organization accreditation
2. Institutionalize policies and enact legislation for high level quality healthcare and
patient safety standards in all health facilities
3. Continue collaboration with national government agencies, LGUs, private sector
organizations and academe involved in quality healthcare and patient safety,
international medical travel and wellness services, retirement, trade and tourism
4. Continue advocacy in all regions of the country on quality healthcare and patient
safety, international medical travel and wellness services, retirement, trade and
tourism through quad media approach, capacity building activities and collaborative
participation in international forum and conferences
Stakeholders/Beneficiaries:
Private clinics/centers, Public and Private Hospitals, National Government Agencies,
Private Specialty Clinics/Centers providing Dermatology, plastic surgery,
ophthalmology and dental medicine, Geriatric and Treatment and Rehabilitation
Centers for substance abuse
Partner Organizations/Agencies:
Department of Tourism (DOT)
Department of Foreign Affairs (DFA)
Department of Trade and Industry (DTI)
Department of Public Works and Highways (DPWH)
Department of Interior Local Governments (DILG)
Department of Justice (DOJ)
Department of Finance (DFA)
Department of Science and Technology (DOST)
Department of Labor and Employment (DOLE)
DTI - Board of Investments (BOI)
DTI - Philippine Export Zone Authority (PEZA)
DOT - Tourism Infrastructure Enterpise Zone Authority (TIEZA)
DOJ - Bureau of Immigration (BI)
DOF - Bureau of Customs (BoC)
Subic Bay Metropolitan Authority (SBMA)
Clark Development Corporation (CDC)
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Philippine Health Insurance Corporation (PhilHealth)
Philippine Retirement Authority (PRA)
Cebu Health and Wellness Council (CHWC)
Development Academy of the Philippines (DAP)
National Economic Development Authority (NEDA)
Technical Education and Skills Development Authority (TESDA)
Commission on Higher Education Development (CHED)
Philippine Information Agency (PIA)
Public Private Partnership Center (PPPC)
Joint Foreign Chambers of Commerce in the Philippines
European Chamber of Commerce in the Philippines (ECCP)
American Chamber of Commerce in the Philippines (ACCP)
Canadian Chamber of Commerce (CCC)
Australian New Zealand Chamber of Commerce in the Philippines (ANZCHAM)
Japanese Chamber of Commerce in the Philippines (JCCP)
Korean Chamber of Commerce in the Philippines (KCCP)
Philippine Association of Multinational Companies Regional Headquarters, Inc.
(PAMURI)
Professional Regulations Commission (PRC)
Philippine Medical Association (PMA)
Philippine Nurses Association (PNA)
Philippine Hospital Association (PHA)
Philippine Council for the Accreditation of Health Care Organizations (PCAHO)
International Society for Quality in Healthcare (ISQUA)
Joint Commission International (JCI)
National Accrediting Body for Hospitals (NABH - India)
TUV Rheinland
Private Sector
Health and Wellness Alliance of the Philippines (HEAL Philippines)
Health Core and HIM Communications
Retirement and Healthcare Coalition (RHC)
Spas and Wellness Association of the Philippines (SAPI)
Philippine Dental Association (PDA)
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2005-2010, particularly because these diseases have common risk factors which are
to a large extent related to unhealthy lifestyle.
The risk factors involved are tobacco use, unhealthy diet, physical inactivity and
alcohol use.A study conducted by Food and Nutrition Research Institute (FNRI) in
2003 revealed that 90% of Filipinos have one or more of the following risk factors:
physical inactivity, smoking, obesity, hypertension, diabetes and abnormal
cholesterol. Among adults, 20% are overweight and 5% are obese, 22.5% are
hypertensive, 60.5% are physically inactive, and a significant number have high
levels of blood cholesterol and sugar. More than half (56%) of adult males and 12% of
adult females are current smokers. Alcohol use has also risen steadily since the
1960s.
Children and adolescents are also exposed to the above-mentioned risks. The
prevalence of overweight among adolescents 9-11 years old had increased two folds
from 2.4% in 1993 to 4.8% in 2005. Similarly, the prevalence rate of overweight for
children 6-10 years old doubled from 0.8% in 2001 to 1.6% in 2005. (Source:
Philippine Nutrition Facts and Figures 2005)
Twenty two (22) per cent of teenagers currently smoke cigarettes. (Source:
Philippines Global Youth Tobacco Survey, 2007). About 30% of teenage students are
physically inactive, spending three or more hours per day sitting and watching
television, playing computer games, talking with friends, or doing other sitting
activities. (Source: Philippines Global School-based Student Health Survey, 2007)
The cost of care of lifestyle-related diseases may cause people to fall into poverty
and create a downward spiral of worsening poverty and illness. They also undermine
the country's economic development. In response to the increasing prevalence of
lifestyle related diseases in the country, vertical programs on the prevention and
control of cardiovascular diseases, cancers, and diabetes were put in place in the
mid 1990’s. The individual programs however, were focused on treatment and
management of those who were already sick and thus were competing with each
other for resources and for attention upon field implementation.
Recent evidence shows that the most cost-effective way of controlling these non-
communicable lifestyle related diseases is by the prevention of the emergence of the
risk factors in an integrated manner, employing health promotion strategies across
the life course and intervening at the level of family and community. This is essential
because the causal risk factors causing these illnesses are deeply entrenched in the
social and cultural framework of the society. Thus, an integrated comprehensive
program for the prevention and control of these non-communicable lifestyle related
diseases has to be put in place.
Goals:
To reduce morbidity, mortality and disability rates due to chronic lifestyle related
NCDs through an integrated and comprehensive program on the prevention and
control of lifestyle related
diseases.
198
Objectives:
1. To develop and promote an integrated and comprehensive program on the
prevention and control of lifestyle related diseases in the country.
2. To engage all province-wide or city-wide health systems to adopt an integrated
and comprehensive program on the prevention and control of lifestyle related
diseases.
3. To achieve improvement in the following Key Performance Indicators from 2011
to 2016:
Disease
a. Reduction in mortality from non-communicable diseases at 2% per year
through the MDG max initiative.
The Action Framework for the National Program on the Prevention and
Control of Chronic Lifestyle Related Non-Communicable Diseases is based on the
Causation Pathway Model for Major Chronic Diseases as contained in the WHO
Western Pacific Regional Action Plan for Addressing Non-Communicable Diseases,
where the underlying determinants, common risk and intermediate risk factors that
would lead to lifestyle-related diseases are identified (Figure 1).
199
The action framework (Figure 2) has seven action areas as follows: (1)
Environmental interventions; (2) Lifestyle interventions; (3) Clinical interventions; (4)
Advocacy; (5) Research, surveillance, monitoring, and evaluation; (6) Networking and
coalition building; and (7) Health system strengthening. It draws primarily from the
WHO Western Pacific Regional Framework for Addressing Non-communicable
Diseases and emphasizes the requirement for integrated comprehensive approaches
that encompass and address the various levels of determinants and risks for non-
communicable lifestyle related diseases (Figure 2).
Figure 2: Action Framework for the Prevention and Control of Chronic Lifestyle-
Related Non-communicable Diseases
201
3. The acute attacks and exacerbations from failed prevention, financial barriers in
access to acute care and financial risk that must be addressed by adequate
financing.
4. The co-morbidities requiring coordination by various providers and teams that
must be managed by proper governance infrastructure.
V. ROLES OF STAKEHOLDERS
The National Center for Disease Prevention and Control (NCDPC) shall:
1. Oversee the implementation of the national policy and program on the
Prevention and Control of Lifestyle-Related Diseases.
2. Establish standards and package of services on lifestyle-related diseases and
ensure their quality, access, and availability at all levels of the health system.
3. Provide technical assistance to the LGUs and other partners on clinical
interventions for lifestyle-related diseases.
4. Support the design of health financing of personal care related to lifestyle
related diseases in collaboration with PhilHealth and other partners.
5. Conduct regular monitoring and evaluation of the burden of disease related to
lifestyle related diseases.
6. Ensure participation of other DOH offices and bureaus and coordinate with
partners within and outside the health sector for the effective implementation
of the national program.
The National Center for Health Promotion (NCHP:
1. Lead in the development and implementation of the National Healthy Lifestyle
Program as a major strategy for the prevention and control of lifestyle-related
diseases.
2. Advocate with other government agencies, non-government organizations,
private sector, development partners, and other relevant stakeholders for
support in policy development and resource generation towards the creation of
supportive environments for lifestyle modification.
3. Provide technical assistance to ensure environmental interventions at the 3
health promotion settings: community, school and workplace.
4. Facilitate organization and development of a multi-sectoral coalition for the
prevention and control of lifestyle related diseases.
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3. Support conduct of population-based surveys on risk factors and lifestyle-
related diseases.
The Philippine Health Insurance Corporation (PHIC) shall develop and implement
health insurance package for clients at risk and afflicted with lifestyle-related
diseases to reduce financial burden and impoverishment of individuals and families
resulting from said diseases.
The Centers for Health Development (CHDs) shall provide technical assistance and
lead the regions to ensure local implementation of the National Program on
Prevention and Control of Lifestyle-Related
Diseases.
DOH hospitals shall ensure provision of quality promotive, preventive, curative,
rehabilitative, and palliative care for patients with lifestyle related diseases;
203
The Local Government Units (LGUs) shall adopt and implement the National
Program on Prevention and Control of Lifestyle-Related Diseases and provide services
and products in primary health care facilities and hospitals in their localities.
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Provision of Potable Water Program (SALINTUBIG Program - Sagana at Ligtas na
Tubig Para sa Lahat)
Provision of safe water supply is one of the basic social services that improve
health and well-being by preventing transmission of waterborne diseases. However,
about 455 municipalities nationwide have been identified by NAPC as waterless areas
that are having households with access to safe water of less 50% only. As a result,
diarrhea and other waterborne diseases still rank among the leading causes of
morbidity and mortality in the Philippines. The incidence rate for these diseases is
high as 1,997 per 100,000 population while mortality rate is 6.7 per 100,000
populations. The Sagana at Ligtas na Tubig sa Lahat Program (SALINTUBIG) is one of
the government’s main actions in addressing the plight of Filipino households in
such areas.
The program aims to contribute to the attainment of the goal of providing
potable water to the entire country and the targets defined in the Philippine
Development Plan 2011-2016 Millennium Development Goals (MDG), and the
Philippine Water Supply Sector Roadmap and the Philippine Sustainable Sanitation
Roadmap. To attain this objective, One Billion and Five Hundred Million Pesos
(Php 1,500,000,000) is appropriated to the DOH through Item B.I.a of the 2011
General Appropriations Act (GAA). The appropriation is a grant facility for LGU to
develop infrastructure for the provision of potable water supply.
A. OBJECTIVES
1. To increase water service for the waterless population
2. To reduce incidence of water-borne and sanitation related diseases
3. To improved access of the poor to sanitation services
B. TARGETS
1. Increased water service for the waterless population by 50%
2. Reduced incidence of water-borne and sanitation related diseases by 20%
3. Improved access of the poor to sanitation services by at least 10%
4. Sustainable operation of all water supply and sanitation projects constructed,
organized and supported by the Program by 80%.
II. ABOUT THE STAKEHOLDERS/ BENEFICIARIES
Administrative Issuances
Department Order # 2011-0090
Department Order # 2011-0091
Department Order # 2011-0091-A
Department Order # 2011-0091-B
Memorandum of Agreement of the National Poverty Commission, Department of
Health and Department of Interior and Local Government
Implementing Guidelines of the Salintubig Program
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V. PROGRAM MANAGER(S)
Rationale:
The Philippines’ maternal and infant morbidity and mortality rates have been
marked despite its efforts to assist local government units for the past decade. An
important factor identified was the lack of trained healthcare providers particularly,
in the far flung areas of the country. This hinders the recognition of basic obstetric
needs and delivery of quality health service to the community.
The RHMPP aims to provide competent midwives to areas that have not
performed well in terms of facility-based deliveries, fully immunized child and
contraceptive prevalence rates, hence, improve facility-based health services. By
augmenting health staff to selected government units, the DOH may improve
maternal and child health and attain the Millennium Development Goals (MDGs).
Program Description:
The World Health Organization (WHO) affirms that approximately 15% of all
pregnant women develop a potentially life-threatening complication that calls for
either skilled care or major obstetrical interventions to survive. Readily accessible
Emergency Obstetric Care may thus reduce maternal and perinatal morbidity and
mortality.
The DOH is restating its commitment towards a health nation through more
aggressive safe motherhood initiatives, hence, the upgrading of obstetric deliveries to
strategic facility-based Basic Emergency Obstetric Care (BEmONC), where these
facilities are manned by a team composed of a licensed physician, public health
nurse, and a rural health midwife at the primary level.
Since the rural health midwives are considered as the frontline health workers
in the rural areas and have progressed to become multi-task personnel in the
delivery of healthcare services, amidst migration of other healthcare professionals,
the DOH created the Rural Health Midwife Placement Program (RHMPP) to address
the inequitable distribution of midwives and equip them for facility-based BEmONC
practice. In support to the RHMPP, thus, ensure constant supply of competent
midwives, the DOH created the Midwifery Scholarship Program of the Philippines
(MSPP).
Expected Output:
208
The MSPP aims to produce and ensure constant supply of competent midwives
who are ready to serve the DOH identified priority areas of the country.
The RHMPP addresses the inequitable distribution of midwives and equip them
for facility-based BEmONC practice. Likewise, it provides competent midwives to
areas that have not performed well in terms of facility-based deliveries, fully
immunized child and contraceptive prevalence rates, hence, improve facility-based
health services. The DOH ultimately aims in the attainment of the Millennium
Development Goals (MDGs).
Program Status:
For the MSPP, a hundred scholars are currently pursuing the Midwifery Course.
On April of this year, 11 scholars graduated and passed the Board Examination by
the Professional Regulation Commission (PRC). These scholars were deployed to DOH
identified priority areas starting July 2011. This coming November, 37 other scholars
will take the Board Examination.
For the RHMPP, 23 Registered Midwives were already deployed for the first
batch (2008-2010). In addition to that, 175 Registered Midwives (batch 2, 2010-2012)
and 11 scholars (batch 3, 2011-2013) are currently being deployed in the DOH
(BEmONC/CCT) identified priority areas.
Partner Schools:
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Batch 2: 29 scholars
(June 2010-May
2012)
Batch 1: 14 scholars
Tecarro College Foundation,
Mindanao (June 2011-May
Inc., Davao City
2013)
The RHMPP has deployed midwives in the different DOH identified priority areas of
the country:
Batch/ Year Total Number of Midwives
Batch 1
23 RHMs
2008-2010
175 RHMs
Batch 2
(to include the 16 scholars from MSPP for Return
2010-2012
Service)
Batch 3 11 RHMs
2011-2013 Return service of scholars
The MSPP aims to produce and ensure constant supply of competent midwives
who are ready to serve the DOH identified priority areas of the country.
The RHMPP addresses the inequitable distribution of midwives and equip them
for facility-based BEmONC practice. Likewise, it provides competent midwives to
areas that haver not performed well in terms of facility based deliveries, fully
immunized child and contraceptive prevalence rates, improve facility-based health
services. The DOH ultimately aims in the attainment of the Millenium Development
Goals (MDGs).
V. Program Status:
A. MSPP
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11 scholars graduated on April 2011 and passed the Board Examination by the
Professional Regulation Commission will be deployed starting July 2011 to
DOH identified priority areas.
37 scholars will take the November 2011 Board Examination by the Professional
Regulation Commission
100 scholars pursuing the Midwifery Course
B. RHMPP
Goal:
To reduce the disease prevalence by 50% with a vision of eliminating the disease
eventually in all endemic areas
Objectives:
The Schistosomiasis control Program has the following objectives:
1. Reduce the Prevalence Rate by 50% in endemic provinces; and
2. Increase the coverage of mass treatment of population in endemic provinces.
Program Strategies:
The Schistosomiasis Control Program employs the following key interventions:
1. Morbidity control: Mass Treatment
2. Infection control: Active Surveillance
3. Surveillance of School Children
4. Transmission Control
5. Advocacy and Promotion
Its enabling activities include; linkaging and networking; policy guidelines and
CPGs; institutional capacity building; competency enhancement of frontline service
provider; and monitoring and supervision.
211
212
Soil Transmitted Helminth Control Program
Profile/Rationale of the Health Program
Given the relatively high prevalence rate of STH infections in the country and
the existing issues confronting the implementation of the STHCP nationwide, there is
a need to integrate all related efforts and strengthen coordination of those involved to
ensure better complementation of resource, obtain higher coverage and generate
better health outcomes. Within the Department of Health (DOH), several programs
exist which are viable mechanisms to operationalize an integrated approach in
preventing and controlling STH infections more effectively and efficiently. This needs
to expand to the other national and local agencies and organizations engaged in the
same endeavor.
The IHCP envisions healthy and productive Filipinos. It aims to reduce the
deaths and diseases due to STH infections by reducing the prevalence of the infection
among population groups found most at risk. Helminth infections adversely affect the
health of the children and women. Program interventions and related measures have
to be focused on them. Children are classified into preschoolers and school children
while women include adolescent females and pregnant women. In addition, there are
also special groups, which by the nature of their work and situation, are gravely
exposed to helminthes infection. These include the soldiers, farmers, food handlers
and operators as well as indigenous people. They also require the necessary
attention.
The IHCP interventions consist primarily of chemotherapy, WASH and several
behavior changing approaches. Chemotherapy remains as the core package in
helminth infection control. The IHCP identifies the corresponding approach of
deworming that must be applied for each identified population group. Water,
sanitation and hygiene (WASH) serves as the cornerstone in reducing the prevalence
of worm infection. The expansion of these measures reduces more effectively the
transmission of worm infection. The promotion of desired behaviors ensures that
these efforts on chemotheraphy and WASH are translated into actual healthy
practices and better utilization of these facilities.
These interventions only become viable and effective if they are carried out in a
supportive environment. Enabling mechanisms must therefore be established to
support their implementation. An enabling environment entails good governance of
the IHCP at all levels of operations. The political will and support of national and
local leaders are essential to propel the cause of the IHCP. Quality of deworming
services and expansion of service outlet to increase access must be given due to
consideration. Financing reforms must likewise introduce. The LGUs must begin to
allocate budget for their own deworming program. A more equitable or rationalized
allocation of deworming assistance from the DOH must be established. Local
financing mechanisms to sustain the delivery of STHCP services need to be explored
and established. Strict monitoring of LGUs compliance to national laws and policies
must be undertaken while several program support systems (e.g., procurement and
logistics management, information management system, surveillance and research)
have to be installed.
213
Central to the achievement of the IHCP vision is the commitment and
participation of all sectors concerned considering that helminth infection is a multi-
faceted problem. While the LGUs are expected to be primarily responsible for the
controlling helminth infection, the support of DOH, DepEd and other national
government agencies including the private sector, civil society and the community is
very critical to the success of IHCP.
Vision: Healthy and Productive Filipinos in the 21st Century
Mission: To reduce the morbidity and mortality due to STH infections.
Goals/Objectives
The program aims to reduce the prevalence of STH infection to below 50.0% among
the 1-12 years old children by 2010 and lower STH infection among adolescent
females, pregnant women and other special population group.
Stakeholders/Beneficiaries:
The DOH is the lead agency in the deworming of children while the Department of
Education (DepEd) is in charge of deworming all children aged 6-12 years old
enrolled in public schools (Grade 1-VI). Deworming is done by teachers under the
supervision of school nurses or any health personnel.
Program Strategies:
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4. Strengthen regulations
5. Installation of management support systems
a. Drug procurement
b. Research
c. Surveillance
Targets and Doses
Albendazole - 200 mg, single dose every 6 months. Since the preparation is
400mg, the tablet is halve and can be chewed by the child or taken with a glass of
water or
Mebendazole - 500 mg, single dose every 6 months
For children 24 months old and above
Albendazole - 400 mg, single dose every 6 months
Or
Mebendazole - 500 mg, single dose every 6 months
Note: If Vitamin A and deworming drug are given simultaneously during the GP
activity, either drug can be given first.
215
4. Special groups, e.g., food handlers and operators, soldiers, farmers and
indigenous people
Partner Organizations/Agencies:
World Health Organization (WHO)
University of the Philippines-National Institutes of Health (UP-NIH)
United Nations Children’s Fund (UNICEF)
World Vision
Feed the Children International
Helen Keller International (HKI)
Council for the Welfare of Children
Department of Science and Technology-Food and Nutrition Institute
(DOST -FNRI)
Department of Education (DepEd)
Plan International
Save the Children
216
Smoking Cessation Program
Rationale:
1. Training
The NSCP training committee shall define, review, and regularly recommend training
programs that are consistent with the good clinical practices approved by specialty
associations and the in line with the rules and regulations of the DOH.
All DOH health personnel, local government units (LGUs), selected schools, industrial
and other government health practitioners must be trained on the policies and
guidelines on smoking cessation.
2. Advocacy
A smoke-free environment (SFE) shall be maintained in DOH and participating non-
DOH facilities, offices, attached agencies, and retained hospitals. DOH officials, staff,
and employees, together with the officials of participating non-DOH offices, shall
participate in the observance and celebration of the World No Tobacco Day (WNTD)
every 31st of May and the World No Tobacco Month every June.
3. Health Education
Through health education, smokers shall be assisted to quit their habit and their
immediate family members shall be empowered to assist and facilitate the smoking
cessation process.
218
(Note:
Use Risk
Assessme
nt Form)
Assess for
Tobacco
Use
If smoker,
do Brief
Intervens
ion
Contract
Health Advice (5
Referral
Station A's) See
Form
Attached
Protocol
If non-
smoker,
Congratu
late and
advice
continue
Healthy
Lifestyle
activity
PRIMARY Above Plus Above Plus Use of Patient
LEVEL Nurses Doc Quit Nicoti Assessment
II. RHU tors and Clinic ne Tool:
other (Use DOH Repla Stages of
SECONDA health Protocol or ceme change
RY personnel other suggested nt WHO
LEVEL protocols e.g. thera Mental
Motivational py Health
Interview, SDA partic Checklist
TERTIAR Protocol, etc. as ularly Motivatio
Y LEVEL available) Nicoti n and
DOH ne Confiden
Protocol patch ce to quit
provides: and Smoking
Assessme Nicoti History
nt of ne and
client's Gum Current
Smoking is Smoking
History, advoc Status
Current ated Self-test
Smoking for
Status reason
219
and for
Readiness smoking
to stop (Horn's
smoking Smoker's
Planning Selt-test)
for clients Fagerstro
Readiness m
to stop Nicotine
smoking Depende
Quit day: ncetest
Pharmaco Self-test
logic, on
Psycholog Readines
ical and s to stop
Behaviora smoking
l Previous
Interventi attempts
ons to stop
5. Research and Development
Research and development activities are to be conducted to better understand the
nature of nicotine dependence among Filipinos and to undertake new
pharmacological approaches.
Partner Organizations:
The following institutions take part in achieving the goals of the program:
220
LUNG CENTER OF THE PHILIPPINES
Contact Number: 924-9204
221
PSYCHOLOGICAL ASSOCIATION OF THE PHILIPPINES
Contact Number: 453-8257
(As contained in Administrative Order No. 2011-0008 dated July 12, 2011)
I. RATIONALE
222
In developing countries, the rapid rate of urbanization has outpaced the ability
of governments to build essential infrastructure for health and social services. Among
many features of urbanization in developing countries include greater population
densities and more congestion, concentrated poverty and slum formation, and greater
exposure to risks, hazards and vulnerabilities to health (eg. violence, traffic injuries,
obesity, and settlement in unsafe areas). The concentration of risks is seen in the
poorest neighborhoods resulting to health inequities.
From the above, it will require more than the provision and use of health
services to improve the health of urban populations. UHSD must help cities address
the challenges of rapid urbanization brought about by the interplay of different social
determinants of health.
A. Goals
C. Specific objectives:
III. Components
The following are the developmental components of the UHSD Program:
223
improve the policy, design and practice of an urban transport system and lead
to improvement of health and safety of urban population.
3. Capability Building
Short Course on Urban Health Equity (SCUHE) is a 6-month course offered to
cities and urban stakeholders that aims to improve the knowledge, practice
and skills of health practitioners, policy and decision-makers at the national,
regional and city levels to identify and address urban health inequities and
challenges, particularly in relation to social determinants of health.
224
as building knowledge and purchasing power, and mechanisms to increase client
accountability.
The DOH approach in the reform of urban health systems is the management of
social determinants of health in urban settings, with focused application on poor
populations, particularly those living in slum communities/settlements to address
equity concerns.
Briefer on the Urban Health Equity Assessment and Response Tool (Urban
HEART)
I. Rationale:
To address the above concerns, the Urban HEART or the Urban Health Equity
Assessment and Response Tool was developed by the WHO Centre for Health
Development in Kobe, Japan to assist Ministries of Health of countries in
systematically generating evidence to assess and respond to unfair health conditions
and inequity in the urban setting. It was initially launched in Tehran, Iran on April
2008, and the Philippines along with Iran, Zambia, and Brazil were the pilot sites to
test the Urban HEART in each country.
Seven cities initiated the use of the Urban HEART in the Philippines in 2008-
2009, namely: Paranaque City, Taguig City, Olongapo City, Naga City, Tacloban City,
Zamboanga City, and Davao City. The cities helped develop the tool for applicability
in varied urban settings in the country.
Many initiatives, globally and locally, help save lives of pregnant women and
children. Essential Newborn Care (ENC) is one.
225
ENC is a simple cost-effective newborn care intervention that can improve
neonatal as well as maternal care. IT is an evidence-based intervention that
226
Engineering provides and effective way of reducing the impact of injury causes
through application of energy transmission designs.
The program and action plan that are to be developed for each classification of
injuries shall consider the following principles:
227
all available resources. Sharing of responsibilities and allocation of resources to
address the problem to achieve maximum results shall be explored.
5. Monitoring and Evaluation
DOH, in consultation with various stakeholders, shall identify indicators and targets
for program monitoring and evaluation purposes.
6. Equitable Health Financing Package
DOH in collaboration with various stakeholders, shall advocate to health financing
institutions and financial intermediaries, insurance companies, the development and
implementation of policies that would be beneficial to victims of violence and injury.
7. Research and Development
DOH shall promote the conduct of multi-disciplinary and multi-sectoral solutions
and researches for purposes of developing national and local competence in injury
prevention, health care services and for other purposes that may be necessary.
8. Service Delivery
In collaboration with stakeholders, DOH shall institutionalize systems and
procedures for the integration and provisions of services at the community level.
Information shall be utilized for continued public health information and education,
planning and implementation, and policy revision. Appropriate primary prevention,
care and rehabilitation of injured people shall also be crucially provided.
9. Community Participation
DOH shall aim for a successful community based violence and injury prevention to
anchor upon a community-wide sense of ownership and empowerment to accomplish
tasks. This is to ensure that all patients receive quality services at the appropriate
levels of health care delivery system. Successful community-based programs also
revolve around the formation of new partnerships between a diverse group of
constituents who have vested interest in violence and injury control, including
representatives of public safety, law enforcement, fire, local governments, schools,
business, community groups, and health care provider. All rural health units should
be linked to a referral center specific and appropriate to the type of injury sustained.
10. Policy Advocacy
DOH shall advocate for the necessary policy instruments, such as laws, executive
orders, administrative orders, and ordinances to the Congress, other national
agencies and LGUs, respectively. This approach shall ensure sectoral and
community-based interventions to propel action on violence ad injury.
Major Activities and its Guidelines:
In line with the effort to reduce the incidence of firecracker - related injuries
during the Holiday Season and in consonance with its present strategy, the
Department of Health embarks on the project, Kontra Paputok which promotes
228
information and awareness on the dangers of firecrackers and the prevention of
firecrackers and fireworks- related injuries. In this regard, all Center for Health
Development Directors and Chiefs of DOH Hospitals are hereby directed to mobilize
their respective offices and hospitals to undertake the following activities:
1. Public Information Campaign
All Centers for Health Development should take the lead and shall implement a
public information campaign in their respective Region or catchments area for Kontra
Paputok Activities. They should coordinate with their local radio and TV Network and
assign a pool of speakers to promote the prevention of firecracker injuries, especially
informing the public on the dangers of using prohibited firecrackers and watusi. As
per Memorandum of the Firearms and Explosives Division-Philippine National Police
(FED-PNP) dated 17 January 2002, WATUSI IS ALREADY BANNED FROM THE
MARKET and no longer authorized the sale of the said firecracker. Streamers and
posters should be posted in strategic and public places. The slogan for this year's
campaign is "Walang Batang Magpapaputok" See the Prototypes of the streamer and
poster at the DOH website.
All DOH Hospitals are hereby declared on CODE WHITE ALERT on December
24, 25, 31, 2010 and January 1, 2011 to prepare their emergency units and ensure
the provision of prompt emergency services to injured patients during the Holiday.
3. Nationwide Registry Injuries
All DOH Sentinel Hospitals shall report to the Online National Electronic
Surveillance System Registry (ONEISS) of the Department of Health. The surveillance
period for fireworks related injuries, stray bullets and watusi ingestion victims shall
commence at 6:00 am of December 21, 2010 and will end at 5:59 am of January 5,
2011. Reporting should be done daily and strict observance of time is required.
4. Tetanus Surveillance
The strategy for this year's campaign is advocating the use of safe and
alternative ways of celebrating the New Year with a Healthy Bang such as street
parties, concerts, amateur contests, Ati-Atihan, designation of identified area for
229
fireworks display and other ways of noise-making like using pots and pans and
torotot. And in the light of the devolution, provision of technical assistance and close
coordination with the Local Government Units (LGUs) should be enhanced wherein
the Local Government Executives (LGEs) should enforce strictly the Republic Act
7183 (Firecracker Law) and spread the safe and alternative celebration of the New
Year in their respective areas.
Coordination among the Regional Offices of various Agencies – Philippine
National Police, Armed Forces of the Philippines, Department of Education,
Department of Trade and Industry, Department of Interior and Local Government,
Department of Labor and Employment, Philippine Information Agency, Bureau of Fire
Protection, National Police Commission, Department of Environment and Natural
Resources, Department of Science and Technology, different Leagues of the
Philippines (Provincial, Cities, Municipalities, and Barangay) and non-government
agencies – strengthen public information campaign and other advocacy activities
especially against the use of Watusi and illegal Firecrackers, which is prohibited
under Republic Act 7183 or the Firecracker Law.
6. Firecracker Ban on all DOH Facilities
All offices, hospitals of the DOH and its attached agencies are hereby declared a
FIRECRACKER FREE ZONE. Moreover, SELLING OF FIRECRACKERS IS STRICTLY
PROHIBITED within the premises of the Department of Health Facilities. All Heads of
Agencies are hereby instructed to disseminate these guidelines to their respective
personnel.
Status of the Program:
230
3. Implement the most reliable and effective technology solution to interconnect
with the different agencies and/or beneficiaries/stakeholders of the injury
related data; and
ONEISS shall be the standard reporting system for the collection, storage,
analysis and reporting of data pertaining to injury. ONEISS is the information system
being implemented by the DOH in support of the Injury Program.
The PNIDMS
232
Women's Health and Safe Motherhood Project
I. RATIONALE
The Project contributes to the national goal of improving women’s health by:
2. Establishing the core knowledge base and support systems that can facilitate
countrywide replication of project experience as part of mainstream approaches to
reproductive health care within the Kalusugan Pangkalahatan framework.
Project Components
233
a. Women’s Health Teams
b. BEmONC Teams
c. CEmONC Teams
d. Itinerant Teams
2. Establishment of Reliable Sustainable Support Systems for WHSM Service
Delivery:
a. Drug and Contraceptive Security
b. Safe Blood Supply
c. Behavior Change Interventions
d. Sustainable financing of local WHSM services and commodities
Component B: National Capacity
The Department of Health through the Women’s Health and Safe Motherhood
Project 2 introduces new strategies to address critical reproductive health concerns
while confronting both demand and supply side obstacles to access for disadvantaged
women of reproductive age. Among the changes that the Project introduced and has
systematically mainstreamed into the current National Safe Motherhood Program are
the following:
Strategic Change in the Design of Women’s Health and Safe Motherhood
Services
WHSMP2 brought about strategic changes in the way services are delivered to
clients particularly the disadvantaged and underserved. These changes involve (1) a
shift in emphasis from the risk approach that identifies high-risk pregnancies during
the prenatal period to an approach that prepares all pregnant for the complications
at childbirth – this change brought about the establishment of the BEmONC –
CEmONC network, which is now part of the MNCHN service delivery
network; (2) improved quality of FP counseling and expanded service availability,
including the organization of more Itinerant Teams providing permanent methods
and IUD insertion on an outreach basis and (3) the integration of STI screening into
the maternal care and family planning protocols.
An Integrated Package to Women’s Health Services
The above changes in service delivery will likewise involve a shift from centrally
controlled national programs (MC, FP, STI and AH) operating separately and
governed independently at various levels of the health system to an LGU governed
system that delivers an integrated women’s health and safe motherhood service
234
package. This service delivery strategy is focused on maximizing synergies among key
services and on ensuring a continuum of care across levels of the referral system. At
the ground level, this implies that a woman, whatever her age and specially if she is
disadvantaged, who seeks care from a public health provider for reproductive health
concerns, could expect to be given a comprehensive array of services that addresses
her most critical reproductive health needs.
Reliable Sustainable Support Systems
Support Systems for WHSM service delivery include systems for (1) drug and
contraceptive security, through a strategy of contraceptive self reliance; (2) safe blood
supply; (3) stakeholder behavior change, through a combination of performance –
based grants and advocacy and communication; (4) sustainable financing, through a
diversification of funding sources, principally given by the development of client
classification scheme so that the poor gets public subsidies and the non-poor are
charged user fees.
Stronger Stewardship and Guidance from the DOH
Phase 1 (2006-2012): Sorsogon in the Bicol region and Surigao del Sur in the
Caraga Region
Phase 2 (2009-2012): Albay, Catanduanes and Masbate
III. STATUS OF IMPLEMENTATION AND ACCOMPLISHMENTS
As of December 2011, the project accomplishments via-a-vis its life of project work
plan is 71%. Among the operations issues that delays accomplishments of critical
inputs relates to procurement and other external factors such as LGU organizational
structures.
The following summarizes the over-all accomplishment of the project.
Results Matrix:
2011
Baseline (2010) 2011
Outcome Indicators Target
Accomplishments Accomplishments
Values
80% Facility-based Births 67% 80% 77%
80% of the Women who gave
99% 80% 100%
birth have birth plans
235
75% of facility deliveries are
17% 55% 27%
financed by PHIC
Increase CPR by 10 5% points 3% points increase
36%
percentage points increase 39%
100% of LGUs have passed
an ordinance on the 47% 100% 70%
Contraceptive Self Reliance
100% of BEmONC have MCP
45% 50% 52%
accreditation
Universal Social Health
72% 75% 100%
Insurance Coverage
Relative to the physical targets, the Project has accomplished the following in the
Project sites:
236
Sorsogon: 73%
Albay: 103%
Women's Health Teams Catanduanes: 55%
Masbate: 73%
Surigao del Sur: 63%
2008-2010 BEmONC Teams
2008-2010 Midwives on BEmONC Skills Module currently being finalized
2011-2012 CEmONC Doctors (non-specialists) Module currently being finalized
2010 Provincial Review Teams Done
Behavior Change Interventions
Performance-based Grants:
Facility based Deliveries
2009-2013 Universal Social Health
Insurance Coverage
Essential Drugs and
Contraceptive Security
Advocacy for Positive Behavior 4 Infomercials produced and aired
2010-2013 Change in 2011; another 4 being
TV Infomercials produced for airing in 2012.
52%
Albay: 31% (5/16)
BEmONC Facility MCP Catanduanes: 17% (1/6)
2009-2013
Accreditation Masbate: 62% (13.21)
Sorsogon: 82% (14/17)
Surigao del Sur: 16% (3/19)
237
The project also supported the BEmONC Skills Training Program of the National
Safe Motherhood Program and was instrumental in the –
2. Publication of the Project Experience (in Sorsogon) in the November 2011 issue of
the WHO Bulletin.
Program Manager:
The Aquino Health Agenda (AHA): Achieving Universal Health Care for All
Filipinos embodied in Administrative Order No. 2010-0036, dated December 16, 2010
states that poor Filipino families “have yet to experience equity and access to critical
health services.” A.0. 2010-0036 further recognizes that the public hospitals and
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health facilities have suffered neglect due to the inadequacy of health budgets in
terms of support for upgrading to expand capacity and improve quality of services.
AHA also states “the poorest of the population are the main users of government
health facilities. This means that the deterioration and poor quality of many
government health facilities is particularly disadvantageous to the poor who needs
the services the most.”
In 1997, Administrative Order 1-B or the “Establishment of a Women and
Children Protection Unit in All Department of Health (DOH) Hospitals” was
promulgated in response to the increasing number of women and children who
consult due to violence, rape, incest, and other related cases.
Since A.O. 1-B was issued, the partnership among the Department of Health
(DOH), University of the Philippines Manila, the Child Protection Network
Foundation, several local government units, development partners and other
agencies resulted in the establishment of women and child protection units (WCPUs)
in DOH-retained and Local Government Unit (LGU) -supported hospitals. As of 2011,
there are 38 working WCPUs in 25 provinces of the country. For the past years, there
have been attempts to increase the number of WCPUs especially in DOH-retained
hospitals but they have been unsuccessful for many reasons.
The experience of these 38 women and children protection units reflect that:
1. Over the last 7 years from 2004 to 2010, all these WCPUs handled an average of
6,224 new cases with a mean increase of 156 percent. The 2010 statistics
presented a record high of 12,787 new cases and an average of 79.86 percent
increase from 2009. More than 59 percent were cases of sexual abuse; more
than 37 percent were physical abuse and the rest on neglect, combined sexual
and physical abuse and minor perpetrators. More than 50 percent of these new
cases were obtained from WCPUs based in highly urbanized areas across the
country. Figures show there is a need to continue to raise awareness on
domestic violence to have more accurate recording and reporting;
2. The National Demographic and Health Survey of 2008 reveals that one in five
women aged 15-49 are physically abused and one out of 10 of the same age
group are sexually abused. This figure runs into millions of abused women
nationwide who do not seek any help or assistance;
6. Doctors and social workers are reluctant to take on the task due to heavy
workload of women and child protection work, lack of training and feeling of
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inadequacy, and the nature of work, which among others requires responding
to subpoenas and appearing in court;
7. All the WCPUs are being managed by part-time personnel who are given add-on
responsibilities and their appointments are not classified as regular plantilla
positions;
8. Women and child protection work is a new field and a pool of professionals
must be recruited and trained to sustain the work; and
9. Women and children protection work has gone beyond being a health advocacy
to becoming an essential health service addressing the needs of victims of
violence against women and children.
The strategies espoused by the AHA, specifically the service delivery network
(SDN) and public-private partnership (PPP), will be utilized in the institutionalization
of the women and children protection program nationwide. A health SDN is
composed of a network of health service providers at different levels of care from
levels 1: health centers or women and children’s desks offering primary services, 2:
district health facilities offering secondary care and 3: regional and national hospitals
with tertiary care. An SDN can be as small as an Inter-Local Health Zone or as large
as a regional SDN with a regional hospital serving as the end-referral hospital. The
most efficient system for women and child protection facilities follows the SDN model
where a complete and integrated women and child protection unit is located in a
strategic hospital.
The primary goal is to identify where the women and children protection units
will be located across the country and to ensure that there will be at least one in each
province. Hospitals, whether public or private, which do not have a women and child
protection unit may be trained to refer the victims to women and children protection
coordinators (WCPCs) and WCPUs in other hospitals where the staff is trained in
recognizing, recording, reporting and referring abuse cases. This will ensure that all
women and children victims of violence who seek medical care have access to health
services provided by trained, competent, and caring health personnel.
GOAL: To institutionalize and standardize the quality of service and training of all
women and children protection units.
GENERAL OBJECTIVES:
1. Establish at least one women and children protection unit in every province;
2. Ensure that all health facilities have competent and trained gender-responsive
professionals who will coordinate the services needed by women and children victims
of violence;
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3. Standardize and maintain the quality of health care services rendered by all
women and children protection units;
4. Ensure the sustainability of women and children’s protection unit programs
through appropriate organizational and budgetary support;
5. Create and maintain a centralized and harmonized database for all reports
submitted by the different women and children protection units.
This issuance shall apply to the entire health sector, including the DOH
hospitals, LGU-supported health facilities, private hospitals, and other attached
agencies involved in the implementation of the AHA.
Health professionals from private hospitals seeing patients who they suspect are
victims of abuse are duty-bound to refer the said individuals to concerned
government agencies for appropriate response in accord with either Republic Act Nos.
7610[1] or 9262[2].
This issuance supports the Government Health Reform Agenda, the Convention
on the Rights of the Child, the Convention on the Elimination of All Forms of
Discrimination Against Women, the Beijing Platform for Action, the Child Protection
Law,[3] the Anti-Violence Against Women and Their Children’s Act of 2004,[4] Anti-
Rape Act of 1998,[5] the Rape Victim Assistance and Protection Act of 1998[6], and
the Magna Carta of Women (2009).[7]
The DOH shall there by contribute to the realization of the country’s goal of
eliminating all forms of gender-based violence and promoting social justice.[8]
V. GUIDING PRINCIPLES
2. Best interest of the child. – All actions concerning victims of abuse, neglect, and
maltreatment shall take full account of the children’s best interests. All decisions
regarding children shall be based upon the needs of individual children, taking into
account their development and evolving capacities so that their welfare is of
paramount importance. This necessitates careful consideration of the children’s
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physical, emotional/psychological, developmental and spiritual needs. Adequate care
shall be provided by multidisciplinary child protection teams when the parents
and/or guardians fail to do so. In cases whether there is doubt or conflict, the
principle of the best interest of the child shall prevail.
3. Holistic service delivery. – Care focused on the whole person addressing the bio-
medical, psycho-social, and legal concerns.
4. Respect for diversity and non-discrimination. – Holistic and appropriate health
care delivered shall be coupled with respect for cultural, religious, developmental
(including special needs), gender and sexual orientation, and socio-economic
diversity. All women and children victims of violence shall have a right to receive
medical treatment, care, and psycho-social interventions.
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Emergency Medicine, the Philippine College of Surgeons, and the Philippine
Academy of Family Physicians, Inc.
The Chairperson shall appoint a Vice-Chair from among the Committee
members who shall preside over the meeting in the former’s absence.
The Committee shall designate from among its members a program manager
who will be given appointment by the Undersecretary of Health through a
Department Personnel Order.
The Committee may create a technical working group, as the need arises, to
help it in the performance of its functions.
3. Term. – The Committee shall hold office for three (3) years and may be
reappointed or until their successors shall have been appointed.
5. Reportorial Functions. – The Committee shall submit to the Office of the
Secretary of Health its annual report on policies, plans, programs and activities on or
before the last working day of February.
6. Meetings. – The Committee shall meet regularly at least once every quarter. The
venue shall be agreed upon by the members. Special meetings may be requested by
the Chairperson or any Committee member, as the need arises.
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VIII. ROLES AND RESPONSIBILITIES OF PARTNER AGENCIES
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Maintain an accurate and complete database on WCPU clients.
MANUAL OF OPERATIONS
The Committee on Women and Children Protection Program shall regulate the
establishment and operations of all WCPUs in the Philippines.
A. Training. – The Committee shall require that all hospital personnel undergo
training on the recognition, reporting, recording and referral (4R’s) of cases of
violence against women and children.
B. Women and Children Protection Coordinator. – Hospitals without a women and
children protection unit shall have a women and children protection coordinator
(WCPC) responsible for coordinating the management and referral of all violence
against women and children cases in the hospital.
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II. The minimum standard criteria shall be maintained by all WCPUs.
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e. Syringes, needles and sterile swabs
f. Examination gloves
g. Pregnancy testing kits
h. Microscope slides
i. Measuring devices like rulers and calipers
j. Urine specimen containers
k. Refrigerator for storage of specimens
l. Analgesics, medicines for STI prophylaxis, and emergency
contraceptives
m. Labels
n. Medical forms including consent forms and anatomical diagrams
o. Colposcope (Optional)
p. Video camera for recording the forensic interview (optional)
q. Tape recorder (optional)
1. Personnel
A trained physician, and
A trained and registered social worker.
4. Research
Proper documentation of experiences which will serve as inputs for policy
research, formulation and program improvement
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b. Level II WCPU
1. Personnel
A trained physician;
A trained and registered social worker, also with full-time coverage of
duties at the WCPU; and
A trained police officer or a trained mental health professional.
2. Services
Medical services similar to a Level I WCPU including rape kits and surgical
intervention.
In the preparation of the medico-legal certificate and report, the WCPU
shall utilize the terminology and the form attached as Annexes “A” and
“B,” respectively, to this Manual of Operations
Full coverage, 24/7
Social work intervention similar to that of a Level I WCPU plus case
management and case conferences
Additional services in the form of police investigation or mental health care
Proper documentation and record-keeping using the Child Protection
Management Information System (CPMIS)
Expert testimony in court
Peer review of cases
Availability of specialty consultations (ENT, ophthalmology, surgery, OB-
Gyne, pathology)
Networks with other disciplines and agencies.
3. Training Capability
Training on 4Rs
Residency training
4. Research
Proper documentation of experiences which will serve as inputs for policy
research, formulation and program improvement
1. Personnel
At least two (2) trained physicians;
At least two (2) trained and registered social workers;
A registered nurse;
A trained police officer; and
A mental health professional
2. Services
Medical services of a Level 2 WCPU
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In the preparation of the medico-legal certificate and report, the WCPU
shall utilize the terminology and the form attached as Annexes “A” and
“B,” respectively, to this Manual of Operations
Full coverage, 24/7
Social work intervention of a Level 2 WCPU capacity plus long-term case
management
Mental health care
Police investigation
Nursing services
Peer review of cases
Death review
Proper documentation and record-keeping using the CPMIS
Expert testimony in court
Availability of specialty consultations (i.e., ENT, ophthalmology, surgery,
OB-gyne, pathology)
Other support services (i.e., livelihood, educational)
Networks with other discipline and agencies
Availability of subspecialty consultations (e.g., child development, forensic
psychiatry, forensic pathology)
3. Training Capability
Training on 4Rs
Competence and facility to run residency training and specialty trainings
4. Research
Proper documentation of experiences which will serve as inputs for policy
research, formulation and program improvement;
Conduct of empirical investigations on women and children protection
work;
Publication of such research studies in reputable journals and/or
presentation in scientific conferences or meetings.
IV. TRAINING AND EDUCATION IN WOMEN AND CHILDREN PROTECTION
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2. For the trainees to develop/strengthen their skills in early detection, screening,
interviewing, physical examination, use of appropriate diagnostic procedures,
management, counseling and referral.
1. Physician
Six (6)-week Child Protection Specialist Training for Physicians of the Child
Protection Network Foundation or its equivalent
joyshe
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