SAFE MOTHERHOOD PROGRAM

Contact Person:
Zenaida Dy Recidoro, RN, MPH
Telephone Nos.:
651-7800 loc. 1727-1730
The Philippines has committed to the Unites States millennium declaration that translated into a roadmap
a set of goals that targets reduction of poverty, hunger, and ill health. In the light of this government
commitment, the Department of Health is faced with a challenge: to champion the cause of women and
children towards achieving MDGs 4 (reduce child mortality), 5 (improve maternal health) and 6 (combat
HIV/AIDS, malaria and other diseases). Pregnancy and childbirth are among the leading causes for death,
disease and disability in women of reproductive age in developing countries. The Philippine government
commitment to the MDGs is among others, a commitment to work towards the reduction of maternal
mortality ratios by three-quarters and under five mortality by two-thirds by 2015 at all cost.
Confronted with the challenge of MDG 5 and the multi-faceted challenges of high maternal mortality ratio,
increasing neonatal deaths particularly on the first week after birth, unmet need for reproductive health
services and weak maternal care delivery system, in addition to identifying the technical interventions to
address these problems, the DOH Safe Motherhood Program decided to focus on making pregnancy and
childbirth safer and sought to change fundamental societal dynamics that influence decision making on
matters related to pregnancy and childbirth while it tries to bring quality emergency obstetrics and
newborn care facilities nearest to homes. This move ensures that those most in need of quality health care
by competent doctors, nurses and midwives have easy access to such care.
Program Objectives
The program contributes to the national goal of improving womens health by:
1. Collaborating with Local Government Units in establishing sustainable, cost-effective approach of
delivering health services that ensure access of disadvantaged women to acceptable and high quality
maternal and newborn health services and enable them to safely give birth in health facilities.
2. Establishing core knowledge base and support systems that facilitate the delivery of quality maternal
and newborn health services with special focus in the upgrade of facilities designated to provide
emergency obstetrics and newborn care within the Kalusugan Pangkalahatan framework.
Program Components
Component A: Local Delivery of the Maternal- Newborn Service Package
This Component supports LGUs in mobilizing networks of public and private providers to deliver the
integrated maternal-newborn service package. In each province and city, the following are currently being
undertaken.
1.
Establishment of critical capacities to provide quality maternal-newborn services through the
organization and operation of a network of Service of Delivery Teams consisting of:
a.
Womens/ Community Health Teams
b.
BEmONC Teams
c.
CEmONC Teams
2.
Establishment of Reliable Sustainable Support Systems for Maternal-Newborn Service Delivery
through such initiatives as:
a.
Essential BemONC Drugs and Supplies and Contraceptive Security
b.
Establishment of Safe Blood Supply Network in collaboration with the National Voluntary Blood
Program
c.
Behaviour Change Interventions
d.
Sustainable financing of local maternal-newborn services and commodities through locally initiated
revenue generation and retention activities.
Component B: National Capacity to sustain Maternal-Newborn services
1.
Operational and Regulatory Guidelines
a.
Manual of operation
b.
Referral manual
c.
Essential care practice guide for pregnancy, childbirth, postpartum and newborn care (BEmONC
Protocol)
d.
CEmONC curriculum and protocol for service delivery
e.
Maternal death reporting and review protocol
f.
Issuance of relevant policies

2.
Network of Training Providers
a.
Currently, 29 training centers that provide BEmONC skills training are operating in the country.
3.
Monitoring, Evaluation, Research and Dissemination
II. INTERVENTIONS AND STRATEGIES EMPLOYED
The Department of Health through the National Safe Motherhood Program introduces strategies to address
critical reproductive health concerns ( maternal and newborn health, adolescent health, family planning
and STI prevention) while confronting both demand and supply side obstacle to access for disadvantaged
women of reproductive age. Among the changes, the following have been systematically mainstreamed
into the safe motherhood service delivery network:

Strategic Change in the Design of Safe Motherhood Services

These changes involve (1) 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 childbirththis change brought about the establishment of the BEmONC-CEmONC network, which is now part of the
MNCHN service delivery network and the inter-local health zones or the Local Health Area Development
Zones; (2) improved quality of FP counselling 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 antenatal care and Family planning protocols.

An Integrated Package of Womens Health and Safe Motherhood Services

The above changes in the delivery also involved a shift from centrally controlled national programs (MC,
FP, STI and AH) operating separately and governed system that delivers an integrated womens health and
safe motherhood service package. This service delivery strategy is focused on maximizing synergies
among key services that influence maternal and newborn health and on ensuring a continuum of care
across levels of the referral system.

Reliable Sustainable Support Systems

Support systems for Maternal-Newborn service delivery include systems for (1) drug and contraceptive
security, through a strategy of contraceptive self reliance (2) safe blood supply; (3) stakeholder behaviour
change, through a combination of advocacy and communication; (4) sustainable financing, through a
diversification of funding sources, principally driven 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 Program Managers

DOH provides stewardship and guidance through (1) evidence-based guidelines and protocols on maternalnewborn services (2) a system for accrediting providers of emergency obstetrics and newborn care
(BEmONC and CEmONC) training program and (3) monitoring, evaluation and research on the maternal;newborn strategies.
III. STATUS OF IMPLEMENTATION AND ACCOMPLISHMENTS
As of December 2012, the program accomplishment is 65%. This accomplishment is based on the
accomplishments vis-a-vis the targets of the programs of 3 indicators. These are: antenatal care, facilitybased delivery and post-natal care. The 2012 target for all indictors is 70%. The below target
accomplishments is brought about by the low post-natal coverage of 52%. Among the operations issues
that delays accomplishments of critical inputs relates to procurement and other external factors such as
LGU organizational structures and priorities.
IV. PLANS FOR 2013
For the current year, the program hopes to pursue the completion of sustainable support systems to
ensure the delivery of quality maternal-newborn health service package by the local health system. The
following have been planned for implementation:
1.
Development of Guidelines on EmONC training and amendment the policy on BEmONC training fees.
2.
Development of the BemONC Module for Midwives and pursue the submission of its final version.
3.
Development of a mechanism for EmONC Post Training Evaluation and supportive supervision of
BEmONC Teams.
4.
Collaborate with Training Centers on the conduct of BEmONC and CEmONC Skills Training.
5.
Collaborate with Development Partners in the implementation of maternal-newborn initiative in
selected sites.
6.
Monitor and evaluate program targets accomplishments and compliance to program protocols
a.
Maternal Death Reporting and Review
b.
Training on Emergency Obstetrics and Newborn Care
c.
BemONC provision BEmONC provision assessment
OTHER SIGNIFICANT INFORMATION

The program participated in the multi-country survey on Maternal and Newborn Near-Miss Cases organized by the Reproductive Health Research Unit of WHO HQ and with the Program
Manager as country coordinator. The study was published in the Lancet in its May 18, 2013 issue: Moving beyond essential interventions for reduction of maternal mortality (the WHO
Multicountry Survey on Maternal and Newborn Health): a cross-sectional study.

SCHISTOSOMIASIS CONTROL PROGRAM

Goal:
To reduce the disease prevalence by 50% with a vision of
eliminating the disease eventually in all endemic areas
Schistosomiasis is an infection caused by blood fluke,
specifically Schistosoma japonicum. An individual may acquire the infection from fresh
water contaminated with larval cercariae, which develop in snails. Infected yet untreated
individuals could transmit the disease through discharging schistosome eggs in feces
into bodies of water.
Long term infections can result to severe development of lesions, which can
lead to blockage of blood flow. The infection can also cause portal hypertension, which
can make collateral circulation, hence, redirecting the eggs to other parts of the body.
Schistosomiasis is still endemic in 12 regions with 28 provinces, 190
municipalities, and 2,230 barangays. Approximately 12 million people are affected and
about 2.5 million are directly exposed

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.

Program Manager:
Ms. Ruth M. Martinez
Department of Health-National Center for Disease Prevention and Control (DOHNCDPC)
Contact Number: 651-78-00 local 2353

SMOKING CESSATION PROGRAM

Rationale:
The use of tobacco continues to be a major cause of health problems worldwide. There is
currently an estimated 1.3 billion smokers in the world, with 4.9 million people dying
because of tobacco use in a year. If this trend continues, the number of deaths will
increase to 10 million by the year 2020, 70% of which will be coming from countries like
the Philippines. (The Role of Health Professionals in Tobacco Control, WHO, 2005)
The World Health Organization released a document in 2003 entitled Policy
Recommendations for Smoking Cessation and Treatment of Tobacco Dependence. This
document very clearly stated that as current statistics indicate, it will not be possible to
reduce tobacco related deaths over the next 30-50 years unless adult smokers are
encouraged to quit. Also, because of the addictiveness of tobacco products, many
tobacco users will need support in quitting. Population survey reports showed that
approximately one third of smokers attempt to quit each year and that majority of these
attempts are undertaken without help. However, only a small percentage of cigarette
smokers (1-3%) achieve lasting abstinence, which is at least 12 months of abstinence
from smoking, using will power alone (Fiore et al 2000) as cited by the above policy
paper.
The policy paper also stated that support for smoking cessation or treatment of tobacco
dependence refers to a range of techniques including motivation, advise and guidance,
counseling, telephone and internet support, and appropriate pharmaceutical aids all of
which aim to encourage and help tobacco users to stop using tobacco and to avoid
subsequent relapse. Evidence has shown that cessation is the only intervention with the
potential to reduce tobacco-related mortality in the short and medium term and
therefore should be part of an overall comprehensive tobacco-control policy of any
country.

The Philippine Global Adult Tobacco Survey conducted in 2009 (DOH, Philippines GATS
Country Report, March 16, 2010) revealed that 28.3% (17.3 million) of the population
aged 15 years old and over currently smoke tobacco, 47.7% (14.6 million) of whom are
men, while 9.0% (2.8 million) are women. Eighty percent of these current smokers are
daily smokers with men and women smoking an average of 11.3 and 7 sticks of
cigarettes per day respectively.
The survey also revealed that among ever daily smokers, 21.5% have quit smoking.
Among those who smoked in the last 12 months, 47.8% made a quit attempt, 12.3%
stated they used counseling and or advise as their cessation method, but only 4.5%
successfully quit. Among current cigarette smokers, 60.6% stated they are interested in
quitting, translating to around 10 million Filipinos needing help to quit smoking as of the
moment. The above scenario dictates the great need to build the capacity of health
workers to help smokers quit smoking, thus the need for the Department of Health to set
up a national infrastructure to help smokers quit smoking.
The national smoking infrastructure is mandated by the Tobacco Regulations Act which
orders the Department of Health to set up withdrawal clinics. As such DOH
Administrative Order No. 122 s. 2003 titled The Smoking Cessation Program to support
the National Tobacco Control and Healthy Lifestyle Program allowed the setting up of the
National Smoking Cessation Program.
Vision:
health risks.
Mission:

Reduced prevalence of smoking and minimizing smoking-related

To establish a national smoking cessation program (NSCP).

Objectives:
The program aims to:
1.
Promote and advocate smoking cessation in the Philippines; and
2.
Provide smoking cessation services to current smokers interested in quitting the
habit.
Program Components:
The NSCP shall have the following components:
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 31 of May
and the World No Tobacco Month every June.
3.
Health Education
st

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.
4.
Smoking Cessation Services
Below is the National Smoking Cessation Framework detailing Smoking Cessation
services at different levels of care:
LEVEL OF CARE

STAFFING

Intervention Package

PRIMARY LEVEL
I. Barangay Health
Station

BHW
RM

DRUGS/MEDS

Risk
assessm
ent/ Risk
screenin
g (Note:
Use Risk
Assessm
ent
Form)
Assess
for
Tobacco
Use
If
smoker,
do Brief
Interven
sion
Advice
(5 A's)
See
Attache
d
Protocol
If nonsmoker,
Congrat
ulate
and
advice
continue
Healthy
Lifestyle
activity

None

PRIMARY LEVEL

Above Plus Above Plus

Nurses Doct
Quit
ors and
Clinic
other health
personnel (Use DOH Protocol
or other suggested
SECONDARY LEVEL
protocols e.g.
Motivational
Interview, SDA
Protocol, etc. as
available)
II. RHU

EQUIPMENTS

Use
of
Nico
tine
Repl
ace
men
t
ther
apy
parti
cular
ly
Nico

Risk
Assessment
Tool
Quit
Contract

Referral
Form

Patient Assessment
Tool:

Stages of
change
WHO
Mental
Health
Checklist
Motivation
and
Confidence
to quit


TERTIARY LEVEL

DOH
Protocol
provides
:
Assessm
ent of
client's
Smoking
History,
Current
Smoking
Status
and
Readine
ss to
stop
smoking
Planning
for
clients
Readine
ss to

tine
patc
h
and
Nico
tine
Gum
is
advo
cate
d

Smoking
History and
Current
Smoking
Status

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:

LUNG CENTER OF THE PHILIPPINES

Contact Number: 924-9204

PHILIPPINE COLLEGE OF CHEST PHYSICIAN

Contact Number:924-6101 to 20

PHILIPPINE GENERAL HOSPITAL

Contact Number: 554-8400

WORLD HEALTH ORGANIZATION

Contact Number: 338-7478/ 338-7479

PHILIPPINE ACADEMY OF FAMILY PHYSICIANS

Contact Number: 844-2135 / 889-8053

PHILIPPINE MEDICAL ASSOCIATION

Contact Number: 929-6366

FRAMEWORK CONVENTION ON TOBACCO CONTROL

Contact Number: 468- 7222

PSYCHOLOGICAL ASSOCIATION OF THE PHILIPPINES

Contact Number: 453-8257

SEVENTH DAY ADVENTIST

Contact Number: 526-9870/ 526-9871/ 536-1080

PHILIPPINE AMBULATORY PEDIATRIC ASSOCIATION

Contact Number:525-1797

PHILIPPINE PSYCHIATRIC ASSOCIATION

Contact Number: 635-9858

METROPOLITAN MANILA DEVELOPMENT AUTHORITY

Contact Number: 882-4151

Department of Health-National Center for Disease Prevention and Control

(DOH-NCDPC)
DEGENERATIVE DISEASE OFFICE
Contact Number: 651-78-00 local 1750-1751 and 732-2493
Program Coordinator:
Ms. Frances Prescilla Cuevas
e-mail address:prescyncd@gmail.com, prescyncd@yahoo.com
Smoking Cessation Councilors:
Dr. Franklin Diza
Ms. Frances Prescilla Cuevas
Ms. Remedios Guerrero
e-mail address: jing_s_guerrero@yahoo.com

TUBERCULOSIS CONTROL PROGRAM

Tuberculosis is a disease caused by a bacterium called Mycobeacterium tuberculosis
that is mainly acquired by inhalation of infectious droplets containing viable tubercle
bacilli. Infectious droplets can be produced by coughing, sneezing, talking and singing.
Coughing is generally considered as the most efficient way of producing infectious
droplets.
In 2007, there are 9.27 million incident cases of TB worldwide and Asia accounts for
55% of the cases. Through the National TB Program (NTP), the Philippines achieved the
global targets of 70% case detection for new smear positive TB cases and 89% of these
became successfully treated. The various initiatives undertaken by the Program, in
partnership with critical stakeholders, enabled the NTP to sustain these targets.
Nonetheless, emerging concerns like drug resistance and co-morbidities need to be
addressed to prevent rapid transmission and future generation of such threats. Coverage
should also be broadened to capture the marginalized populations and the vulnerable
groups namely, urban and rural poor, captive populations (inmates/prisoners), elderly
and indigenous groups.
Last 2009, the National Center for Disease Prevention and Control of the Department
of Health led the process of formulating the 2010-2016 Philippine Plan of Action to
Control TB (PhilPACT) that serves as the guiding direction for the attainment of the
Millenium Development Goals (MDGs). Learning from the Directly-Observed Treatment
Shortcourse (DOTS) strategy, the eight (8) strategies of PhilPACT are anchored on this TB

control framework. Moreover, these strategies are also attuned with the Governments
health reform agenda known as Kalusugang Pangkalahatan (KP) to ensure sustainability
and risk protection.
Vision: TB-free Philippines
Goal: To reduce by half TB prevalence and mortality compared to 1990 figures by 2015
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
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 Governments 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. Eversince, 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 revealed 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

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 (DNDVMMC)

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

Program Manager:
Dr. Rosalind G. Vianzon
Department of Health-National Center for Disease Prevention and Control (DOH-NCDPC)
Contact Number: 651-78-00 local 2353

URBAN HEALTH SYSTEM DEVELOPMENT (UHSD)

PROGRAM
(As contained in Administrative Order No. 2011-0008 dated July 12, 2011)
I. RATIONALE
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.
II. UHSD GOALS AND OBJECTIVES
A. Goals
1. To improve Health System Outcomes Urban Health Systems shall be directed
towards achieving the following goals: (i) Better Health Outcomes; (ii) More equitable
healthcare financing; and (iii) Improved responsiveness and client satisfaction.
2. To influence social determinants of health The DOH must help influence social
determinants of health in urban settings, with focused application on urban poor
populations particularly those living in slums.
3. To reduce health inequities Urban Health Systems Development seeks to narrow
the disparity of health outcome indicators between the rich and the poor.
B.

General objective: To address the Urban Health challenge

C.
1.
2.
3.

Specific objectives:
To establish awareness on the challenges of Urban Health;
To initiate inter-sectoral approach to Urban Health Systems Development; and
To guide LGUs to develop sustainable responses to the Urban Health challenge

III. Components
The following are the developmental components of the UHSD Program:
1. Programs and Strategies
- Healthy Cities Initiative (HCI): the approach of continuously improving health and
social determinants of health, and continually creating and improving physical and social
environments shall be continued and further strengthened.
- Reaching Every Depressed Barangay (RED)/Reaching the Urban Poor (RUP): a strategy
of going to every depressed barangay to reach the urban poor, vulnerable groups and
hidden slums to increase access to health services.
- Environmentally Sustainable and Healthy Urban Transport (ESHUT) initiatives which

include the development or enhancement of existing projects that improve the policy,
design and practice of an urban transport system and lead to improvement of health and
safety of urban population.
2. Planning Tools and Framework
- Urban Health Equity Assessment and Response Tool (Urban HEART): a tool to facilitate
identification of and response to health equity concerns. It is used as a situational
assessment, monitoring and planning tool particularly for Highly Urbanized Cities, in
tandem with the Local Government Unit (LGU) Scorecard.
- City-wide Investment Planning for Health (CIPH): a framework for the development of
public investment plans in health covering the utilization, mobilization and
rationalization of the citys relatively abundant resources, more extensive capabilities
and stronger institutions to attain health system goals.
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.
IV. General Principles
1. Healthy urbanization. Urban Health Systems (UHS) must promote healthy
urbanization so that cities develop in ways that achieve better health and avoid risks to
ill health under conditions of rapid urbanization.
2. Inter-sectoral action. UHS must be designed through inter-sectoral collaboration with
people and institutions from outside the health sector to influence a broad range of
health determinants and generate responses producing sustainable health outcomes.
3. Inter-city coordination. Inter-city coordination between contiguous cities is important
because a city, particularly if it is not a Highly Urbanized City may not have all the
resources, institutions and capacities to be able to respond to the entire health needs of
its constituents, and may thus benefit from resources, institutions and capacities of other
cities through inter-city or inter-LGU coordination.
4. Social cohesion. Social cohesion is action through core groups.
5. Community participation. Community participation must be integrated in all aspects
of the intervention process, including planning, designing, implementing, and sustaining
any project/program.
6. Empowerment. Empowerment is enabling individuals and communities to have
ultimate control over key decisions involving their wellbeing through strategies such 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:

Rapid unplanned urbanization gives rise to urban poverty, health problems, and health
inequities in the cities. Disparities in health system outcomes between the affluent and
the poor are becoming more prominent in highly urbanized areas as government sectors
find it hard to cope with the increasing demands of the fast growing population of urban
poor.
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.
Urban Health Systems need to establish evidence on the status of the disadvantaged
population in the highly urbanized areas in order to develop objective interventions to
address inequities. Department Memorandum No. 2010-0207 dated August 20, 2010 on
the Use of the Urban Health Equity Assessment and Response Tool in Highly Urbanized
Cities is intended to help Highly Urbanized Cities (HUCs) generate systematic data on
health inequities to guide effective interventions.

UNIVERSAL HEALTH CARE IMPLEMENTERS

PROJECT (UHCIP)
I. Background/Description
In order to bridge the gaps in the Philippine health system and to reduce barriers in accessing health care
services especially among marginalized communities, the Aquino administration launched its Health Agenda
called Universal Health Care (UHC), also referred to as Kalusugan Pangkalahatan (KP), in 2010. Universal
Health Care is defined as the provision to every Filipino of the highest possible quality of health care that is
accessible, efficient, equitably distributed, adequately funded, fairly financed, and appropriately used by an
informed and empowered public. Moreover, while the Philippines is on target for most of its Millennium
Development Goals (MDG), it is lagging behind in reducing maternal and infant mortality. Therefore,
strengthening of public health efforts towards the attainment of UHC and MDGs must be done.
In line with this, the Department of Health (DOH) launched High-Impact Five (Hi-5) last June 2015 which aims
to produce major improvements in health outcomes and the highest impact among the vulnerable population.
The Hi-5 strategies focuses on five (5) critical UHC interventions, namely: reduction of infant mortality rate;
lowering under-five mortality rate; reducing maternal mortality rate; halting Human Immunodeficiency
Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS); and increasing the service delivery networks in
poor communities. National implementation of the Hi-5 activities involves intensifying and synchronizing
regional operations through a convergence approach in priority poverty program areas. Thus, the Universal
Health Care Implementers Project (UHCIP) was conceptualized to accelerate the attainment of UHC and Hi-5

strategies. Currently, the project deploys physicians who focus on localization of UHC policies and sustainable
health financing in order to protect marginalized communities from health financial risks.
II. Objectives
The Universal Health Care Implementers (UHCI) Project aims to:
a. Improve local health systems that will support the countrys attainment of UHC or Kalusugan
Pangkalahatan;
b. Provide quality service delivery to marginalized population of the country to accelerate the attainment of
Universal Health Care (UHC); and
c. Foster independence in the communitys health care delivery system.
III. Functions of UHC Implementers
a. Develops local health systems / programs / projects in the locality based on the UHC-HI5 Strategy;
b. Manages the mobilization of resources and projects related to UHC-HI-5 program implementation in the
RHU;
c. Develops / conducts capability building interventions / initiatives / packages for health workers and other
stakeholders in the local government unit relative to UHC-HI5;
d. Develops and implements advocacy projects and strategies for UHC-HI5 programs;
e. Conducts regular medical consultations relative to achieving health objectives of the UHC-HI5 strategy;
f. Manages UHC-HI5 data such as reporting, recording and analysis of data; and
g. Conducts epidemiology investigation whenever necessary.
IV. Minimum Qualification Standards
Education: Doctor of Medicine
V. Target Population/Client
a. (274) 5th and (39) 6th class municipalities
b. National Government Priority Areas
- 44 Focus Geographical Areas (FGA) with 1,045 Municipalities
- Accelerated and Sustainable Anti-Poverty (ASAP) municipalities
- Whole Nation Initiative (WNI) municipalities
- Areas with Bottom-Up Budgeting (BuB) programs
- Geographic location and socio-economic classification of the area (GIDA, ICC/IP areas, national priority areas
for poverty reduction)
c. LGU Hospitals (Level 1 or 2)
VI
. Salaries and Benefits
VII. Policies and Laws

Salary- 56,000.00/month
GSIS- 500.00/year
PHIC- 300.00/month

Department Memorandum No. 2015-0383

VIII. Program Accomplishments/Status
As of May 2016, a total of 75 UHC implementers
were deployed nationwide.

IX. Updates
Starting FY 2017, the minimum qualification standard for UHC Implementers assistants will be licensed in any
Health Related Profession preferably graduate of Doctor of Medicine. Moreover, salary grade of UHC
implementers will be adjusted from SG 24 to SG 15.
X. Program Coordinator Contact Information
Ms. Janette S. Cruz
HRMO III, HHRDB-DOH
Tel No. 02-743-1776, or 02-651-7800 local 4227

UNANG YAKAP (ESSENTIAL NEWBORN CARE:

PROTOCOL FOR NEW LIFE)
Unang Yakap: Essential Newborn Care (ENC)
Many initiatives, globally and locally, help save lives of pregnant women and children.
Essential Newborn Care (ENC) is one.
ENC is a simple cost-effective newborn care intervention that can improve neonatal as
well as maternal care. IT is an evidence-based intervintion that

emphasizes a core sequence of actions, performed methodically (step -bystep);

is organized so that essential time bound interventions are not interrupted;
and
fills a gap for a package of bundled interventions in a guideline format.

VIOLENCE AND INJURY PREVENTION PROGRAM

Background
The first global study on premature deaths in 2009 (WHO Report) revealed that road
crashes, suicide and violence were among the main causes of death worldwide for
people aged 10 to 24 years. In 2011 (WHO Report), injuries were reported to be
responsible for 9% of all deaths with road traffic injuries claiming nearly 3,500 lives each
day, making it among the 10 leading causes of mortality globally. In response to the
foregoing, WHO called upon Member States to develop measures to prevent road traffic
injuries and violence. WHO recommended that such policies, strategies and plans of
action be concrete and contain objectives, priorities, timetables and mechanisms for
evaluation.
In the Western Pacific, WHO called on its Member States to take firmer action to reduce
the region's more than 600 suicides per day. At the September 2011 Fifth Milestones in a
Global Campaign for Violence Prevention (GCVP) Meeting in South Africa, the Violence

Prevention Alliance (VPA) developed the plan of action geared towards increasing the
priority of evidence-informed violence prevention, building the foundations for violence
prevention, and implementing violence prevention strategies. Likewise, the United
Nations General Assembly adopted Resolution 64/255 proclaiming 20112020 to be a
Decade of Action for Road Safety to stabilize and reduce global road traffic fatalities by
2020.
The Global Burden of Diseases, Injuries, and Risk Factors Study conducted in 2010
showed that interpersonal violence, road injury, drowning, and self-harm (suicide) ranked
sixth, 11th, 17th, and 27th, respectively, on the leading causes of premature deaths in
the Philippines. Accidents are the fifth leading cause of mortality for the period of 20052010 as reported in the Philippine Health Statistics of the National Epidemiology Center.
The Online National Electronic Injury Surveillance System (ONEISS) Fact Sheet for 20102012 revealed that transport or vehicular crash was the leading cause of unintentional
injuries and interpersonal violence (mauling/assault, contact with sharp objects, and
gunshot) was the leading cause of intentional injuries.
The Department of Health (DOH) shall serve as the focal agency with respect to violence
and injury prevention. As such, it shall design, coordinate and integrate plans, projects
and activities of various stakeholders into a more effective and efficient system geared
towards violence and injury prevention. The Violence and Injury Prevention Program has
been institutionalized as one of the programs of the Disease Prevention and Control
Bureau (DPCB) formerly, National Center for Disease Prevention and Control (NCDPC).
The program was the offshoot of Administrative Order No. 2007-0010 National Policy on
Violence and Injury Prevention which was issued in 2007. After seven years in January
2014, said AO was further enhanced thru the issuance of AO 2014-0002 Revised National
Policy on Violence and Injury Prevention which serves as the overarching Administrative
Order of different policies concerning violence and injuries and shall include the service
delivery mechanism and the well-defined roles and responsibilities of the Department of
Health and other major players. The program aims to reduce mortality, morbidity and
disability due to the following intentional and unintentional injuries:
1)
road traffic injuries
2)
interpersonal violence including bullying, torture and violence against women
and children
3)
falls
4)
occupational and work-related injuries
5)
burns and fireworks-related injuries
6)
drowning
7)
poisoning and drug toxicity
8)
animal bites and stings
9)
self-harm / suicide
10)
sports and recreational injuries
For a comprehensive approach, the program shall coordinate with other programs like
the Child Injury Prevention Program, Violence Against Women and Children Program and
other DOH Offices such as the Health Facility Development Bureau, Health Emergency
and Management Bureau, among others, solicit active representation from public and
private stakeholders that are involved in violence and injury prevention.
VIP Program Objectives

1.
To reduce the number of deaths from violence and injuries
2.
To reduce disability caused by violence and injury
3.
To enhance capacity of CHDs and other stakeholders in the prevention of
violence and injury
4.
To develop & implement evidence-based policies, standards and guidelines
in the prevention of violence and injury
5.
To strengthen collaboration with stakeholders in the prevention violence
and injury
6.
To ensure reliable, timely, and complete data and researches on violence
and injury
7.
To advocate for alternative health financing schemes for trauma care
VIPP Program Strategies
A.
Evidence-Based Research and Electronic Surveillance System Multidisciplinary and multi-sectoral interventions shall be developed based on evidence-based
research. DOH shall establish and institutionalize a system of data reporting, recording,
collection, management and analysis at the national, regional, and local levels. An
information system, that is, Online National Electronic Injury Surveillance System
(ONEISS) and Philippine Network for Injury Data Management System (PNIDMS), shall be
fully operationalized for this purpose.
B.
Networking and Alliance Building DOH shall promote partnerships with
and among stakeholders to build alliance and networks and to generate resources for
activities related to VIPP.
C.
Capacity Building and Community Participation - DOH shall develop and
enhance the violence and injury prevention capabilities of a wide range of sectors and
stakeholders at the national, regional and local levels.
D.
Advocacy DOH shall advocate to LGUs for ordinance development and lobby
to Congress for enactment of laws.
E.
Equitable Health Financing Package DOH, in collaboration with various
stakeholders, shall advocate to health financing institutions and financial intermediaries,
i.e. the Philippine Health Insurance Corporation (PHIC) and insurance companies, the
development and implementation of policies that would be beneficial for the victims of
all forms of violence and injury.
F.
Service Delivery In collaboration with stakeholders, DOH shall
institutionalize systems and procedures for the integration and provision of services at
the community level. In collaboration with various stakeholders, DOH shall undertake
advocacy, information and education, political support, and multi-sectoral action on
violence and injury prevention. Appropriate interventions at all levels of prevention shall
be crucially provided.
G.
Six (6) Es. Strategies shall utilize the concept of the six Es (Education,
Enactment / Enforcement, Empowerment, Engineering, Emergency Medical Service, and
Engagement in surveillance and research) in the prevention of violence and injuries.
1.
Education entails wide dissemination of information and
communication related to violence and injury prevention;

2.
Enactment / Enforcement of laws and policies related to violence and
injury
prevention;
3.
Empowerment of all stakeholders in the implementation of VIPP. This
also covers the provision of psychosocial support to the victims of violence and injury to
help them recover from the psychological trauma;
4.
Engineering control provides the most effective way of reducing the
cause and impact of violence and injuries. This involves the improvement of facilities and
infrastructures to promote safe environments;
5.
Emergency Medical Services prior to hospital care. This is vital in
providing pre-hospital trauma life support to the injured on site at the soonest possible
time so as to prevent needless mortality or long-term morbidity or permanent disability;
and
6.
Engagement in surveillance and research to promote evidence-based,
substantial, scientific, and systematic approach to VIPP.
H. Monitoring and Evaluation DOH, together with various stakeholders, shall identify
indicators, targets and milestones for program monitoring and evaluation purposes.
There shall be a regular audit and feedback mechanism of all VIPP-related strategies and
activities.
ONEISS
As a nationwide undertaking, the DOH requires all health facilities to adhere to all
national policies and guidelines on injury reporting. The DPCB is the central coordinating
body for the evaluation, processing, monitoring, and dissemination of data or
information. Each health facility is required to report on a daily basis all injury related
cases through the Online National Electronic Injury Surveillance System. While the DPCB
has no regulatory power over the health facilities, it does have indirect power thru the
Health Facilities and Services Regulatory Bureau (HFSRB). The DPCB as the highest policy
making body can make recommendations to the HFSRB for appropriate actions on erring
health facilities.
The general objective of Online National Electronic Injury Surveillance System (ONEISS)
is to make efficient and effective the current systems and procedures of reporting injuryrelated data. Specifically, ONEISS aims to:
1.
Promote efficiency to maximize time and effort in data collection, processing,
validation, analysis and dissemination of injury-related data;
2.
Improve accuracy, reliability, integrity and timeliness of injury-related data;
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
4.
Enforce standards on inputs, processes and outputs on injury-related data
collection, analysis, report generation and feedback.
ONEISS shall be the standard reporting system for the collection, storage, analysis and
reporting of data pertaining to violence and injury. ONEISS is the information system
being implemented by the DOH in support of the Injury Program.
PNIDMS
The Philippine Network for Injury Data Management System (PNIDMS) is a multi-sectoral
organization which aims to establish and maintain a coordinated data management
system that can link, integrate, or combine injury data from various sources or systems
to provide an overall picture for policy makers and decision makers at the national,

regional and local levels. Presently, its members include more than twenty inter-agencies
and multi-sectoral organizations.
Program Management Committee (PMC)
The PMC shall provide direction and technical support on policies and plans pertaining to
the prevention of violence and injury. It shall also provide the forum for coordinating all
aspects of the implementation of the program. It shall be chaired by the Director IV of
the Disease Prevention and Control Bureau (DPCB) with the following members:
a)
Chief of the Essential Non-Communicable Disease Division
b)
National Focal Person (Program Manager) of VIPP
c)
Representatives from CHED, DepEd, DOTC, DPWH, DOLE, DSWD, DILG, MMDA,
and
Philippine National Police.
d)
Representatives from specialty societies and other agencies / organizations
which can
greatly contribute to the various aspects of violence and injury prevention.
PMC members shall be nominated by the agency / organization that they represent.
Their membership to the PMC shall be on annual basis. Renewal or replacement of
membership shall be the exclusive prerogative of the represented agency / organization.
PMC shall be subdivided into Sub-Committees to undertake more specific policy
interventions and activities in relation to each area of concern. Each Sub-Committee
shall have an inter-disciplinary composition.
The composition of PMC shall be provided in pertinent Department issuances in addition
to written agreements such as Memorandum of Agreement (MOA) or Memorandum of
Understanding (MOU) with the involved agencies and stakeholders.
PMC shall have the following functions:
a)
Recommend to the Secretary of Health VIPP-related plans, programs,
strategies and
activities
b)
Ensure the implementation of integrated, comprehensive, sustainable and
genderresponsive community-based VIPP
c)
Ensure the collection and analysis of violence- and injury-related data
d)
Empower and engage all the stakeholders to participate in the VIPP
thru Violence and
Injury Prevention Alliance (VIPA)
e)
Monitor and evaluate the VIPP regularly through program implementation
review
f)
Initiate and undertake inter-agency collaboration through formal and informal
modes
g)
Endorse support of researches in the clinical, epidemiological, public health
and
knowledge management areas as well as evaluate them
h)
Others that may be identified and approved by the Secretary of Health
National Focal Person / Program Manager Dr. Clarito U. Cairo, Jr.
Department of Health - Disease Prevention and Control Bureau (DOH-DPCB)

WOMEN'S HEALTH AND SAFE MOTHERHOOD

PROJECT
I. RATIONALE
The Philippines has committed to the United Nation millennium declaration that
translated into a roadmap a set of goals that targets reduction of poverty, hunger and ill
health. In the light of this government commitment, the Department of Health is faced
with a challenge: to champion the cause of women and children towards achieving MDGs
4 (reduce child mortality), 5 (improve maternal health) and 6(combat HIV/AIDS, malaria
and other diseases). Pregnancy and child birth are among the leading causes of death,
disease and disability in women of reproductive age in developing countries. The
Philippine government commitment to the MDGs is, among others, a commitment to
work towards the reduction of maternal mortality ratios by three-quarters and under-five
mortality by two-thirds by 2015 at all cost.
Confronted with the challenge of MDG 5 and the multi-faceted challenges of high
maternal mortality ratio, increasing neonatal deaths particularly on the first week after
birth, unmet need for reproductive health services and weak maternal care delivery
system, in addition to identifying the technical interventions to address these problems,
the DOH with support from the World Bank decided to focus on making pregnancy and
childbirth safer and sought to change fundamental societal dynamics that influence
decision making on matters related to pregnancy and childbirth while it tries to bring
quality emergency obstetrics and newborn care to facilities nearest to homes. This
moves ensures that those most in need of quality health care by competent doctors,
nurses and midwives have easy access to such care.
Project Development Objectives and Indicators
The Project contributes to the national goal of improving womens health by:
1. Demonstrating in selected sites a sustainable, cost-effective model of delivering
health services access of disadvantaged women to acceptable and high quality
reproductive health services and enables them to safely attain their desired number of
children.
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
Component A: Local Delivery of the WHSM Service Package
This component supports LGUs in mobilizing networks of public and private providers to
deliver the integrated WHSM-SP. In such project site, the following are currently being
undertaken:
1. Establishment of Critical Capabilities to Provide Quality WHSM Services through the
organization and operation of a network of Service Delivery Teams consisting of:
a. Womens 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
1. Operational and Regulatory Guidelines (Manual of Operations)
2. Network of Training Providers
3. Monitoring, Evaluation, Research and Dissemination
II. INTERVENTIONS AND STRATEGIES EMPLOYED
The Department of Health through the Womens 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 Womens 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 Womens 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 womens health and safe motherhood service 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
DOH provides stewardship and guidance through (1) evidence-based guidelines and
protocols on WHSM services, (2) a system for accrediting providers of integrated WHSM
service package training program; and (3) monitoring, evaluation and research on the
new WHSM strategies.
The Project is implemented in LGUs in 2 phases:
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:

Outcome Indicators

Baseline (2010)
Accomplishments

2011 Target
2011
Values
Accomplishments

80% Facility-based Births

67%

80%

77%

80% of the Women who gave birth have

birth plans

99%

80%

100%

75% of facility deliveries are financed

by PHIC

17%

55%

27%

Increase CPR by 10 percentage points

36%

5% points
increase

3% points increase
39%

100% of LGUs have passed an

ordinance on the Contraceptive Self
Reliance

47%

100%

70%

100% of BEmONC have MCP

accreditation

45%

50%

52%

Universal Social Health Insurance

Coverage

72%

75%

100%

Relative to the physical targets, the Project has accomplished the following in the Project
sites:
Year

Project Milestones

Status

Social Preparation of Batch 2 Sites

Done
Organization of Service Delivery
2009 Teams

Done

Regional Blood Centers equipment

upgrade

Done

73%
Ongoing:
Albay: 90%
20092011

Facility upgrade: Infrastructure and Equipment Masbate: 80%

Catanduanes: 60%
Surigao del Sur: 53%
Sorsogon: 84%

Currently undergoing procurement

20092010

Training Centers Insfrastructure and equipment

13 Training Centers already provided
enhancement
with equipment and other training
logistics

Ensuring environmental Safeguards

20092010

20082012

Organization of EMU in
CEmONCs
Designation of Waste
Management Focal
Persons in BEmONCs

Capability Enhancement: Women's Health

Teams

Done

BEmONC Skills: 60%

Sorsogon: 73%
Albay: 103%
Catanduanes: 55%
Masbate: 73%
Surigao del Sur: 63%
20082010

BEmONC Teams

20082010

Midwives on BEmONC Skills

Module currently being finalized

20112012

CEmONC Doctors (non-specialists)

Module currently being finalized

2010

Provincial Review Teams

Done

Behavior Change Interventions

Performance-based Grants:
20092013

20102013

Facility based Deliveries

Universal Social Health
Insurance Coverage
Essential Drugs and
Contraceptive Security

Advocacy for Positive Behavior Change 4 Infomercials produced and aired in 2011;
another 4 being produced for airing in 2012.
TV Infomercials
52%
Albay: 31% (5/16)

20092013

Catanduanes: 17% (1/6)

BEmONC Facility MCP Accreditation
Masbate: 62% (13.21)
Sorsogon: 82% (14/17)
Surigao del Sur: 16% (3/19)

IV. PLANS FOR 2012

The Project intends to propose for an extension of another year to enable it to
accomplish important activities as provided for by the design and loan agreement with
the World Bank. These are:

1. Pilot test of an Adolescent Health Program model for the Philippines. This
requires 2 years.
2. Study on the Impact of the WHSMP2 Performance Based Grant on Facility Based
Deliveries is a one-year study.
3. Assessment of BEmONC Functionality is nationwide in scope and requires 1 year.
If the extension is not granted, the Project implementation ends by December 2012. The
activities therefore will be focused on accomplishing the remaining tasks with no new
activities, except the conduct of the end of Project survey to determine its impact at the
Project LGUs and its contribution to the attainment of national goals. Writing of end of
project reports will be done in January to June of 2013.
The project also supported the BEmONC Skills Training Program of the National Safe
Motherhood Program and was instrumental in the
1. Establishment of 30 Training Centers in the country for the BEmONC Skills Training
Course. Three of these training centers have efficiently partnered with academic
institutions.
2. Development of training guidelines.
3. Passage of the Department Order allowing for the collection of training fees for the
operation of the Training Centers.
4. Engagement of Technical Assistance (UP-Manila College of Public Health) for the
development of the CEmONC Training Curriculum and Module.
5. Development of the Harmonized Module for BEmONC for Midwives in cooperation with
UNICEF and UNFPA.
6. Training of BEmONC Teams nationwide; the current accomplishment is 48%.
7. Development and maintenance of a database on BEmONC Training.
V. Other Significant Information Worth Mentioning
1. The Project provided assistance in the development of the Maternal Health Reporting
and Review Protocol in cooperation with the National Safe Motherhood Program and
WHO.
2. Publication of the Project Experience (in Sorsogon) in the November 2011 issue of the
WHO Bulletin.
Program Manager:
Ms. Zenaida D. Recidoro
National Center for Disease Prevention and Control - Family Health Office

WOMEN AND CHILDREN PROTECTION PROGRAM

I. BACKGROUND AND RATIONALE

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 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;
3. A consistent and adequate budget is necessary to sustain a women and children
protection unit once it is established;
4. The source of budget cited in A.O. 1-B is subjected to multiple interpretations and is
dependent on the priorities of the local chief executive and/or the healthcare facility
management;
5. There is no standard quality of service;
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 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 childrens 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.
II. GOALS AND OBJECTIVES
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;
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 childrens 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.
III. SCOPE AND COVERAGE
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].
IV. DECLARATION OF POLICY
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 AntiViolence Against Women and Their Childrens 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 thereby contribute to the realization of the countrys goal of eliminating all
forms of gender-based violence and promoting social justice.[8]
V. GUIDING PRINCIPLES
This issuance is governed by the following principles:
1. Rights-based approach. Identification and treatment of violence against women and
children is anchored on respect for and recognition of the rights of women and children
as mandated by the Philippine Constitution, the Convention on the Elimination of All
Forms of Discrimination Against Women, the Convention on the Rights of the Child, and
the Beijing Platform for Action.
2. Best interest of the child. All actions concerning victims of abuse, neglect, and
maltreatment shall take full account of the childrens 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 childrens 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 biomedical, 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.
5. Evidence-based interventions and approaches. Policies and guidelines shall be
developed in accordance with recent data gathered through prevalence surveys, efficacy
studies, and other research done locally and internationally. Recommendations from
international organizations may also be utilized when appropriate.
6. Multidisciplinary approach. Recognition, reporting, and care management of cases
involving violence against women and children are be best achieved through medical,
psycho-social, and legal teamwork including the mental health intervention and local
government
unit
response
and
cooperation,
whenever
necessary.

VI. IMPLEMENTING RULES AND GUIDELINES

1. Committee on Women and Children Protection Program. The Committee on Women
and Children Protection Program, hereinafter referred to as the Committee, shall be
primarily responsible for policymaking, coordinating, monitoring, and overseeing the
implementation of this revised issuance.
2. Composition. - The Committee shall be composed of the following:
a. Undersecretary of Health Service Delivery as ex officio Chairperson;
b. Undersecretary for the Local Affairs of the Department of the Interior and Local
Government or his/her authorized representative;
c. Undersecretary for Policy of the Department of Social Welfare and Development or
his/her authorized representative;
d. A regional director of the Department of Health;
e. A hospital director of a DOH-retained hospital;
f.

Executive Director of the Philippine Commission for Women;

g. Executive Director of the Council for the Welfare of Children;

h. Executive Director of the Child Protection Network Foundation;

i.
One representative each from the Philippine Pediatrics Society, the Philippine
Obstetrics and Gynecological Society, Inc., the Philippine Psychiatric Association, the
Philippine Psychological Association, the Philippine College of 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 formers 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.
4. Functions. The Committee shall have the following functions:
1. Identify and recommend strategically-located DOH-retained and LGU-supported hospitals
for WCPU establishment using geographical and population ratio criteria;
2. Formulate standard protocols and procedures and the manual of operations for
multidisciplinary care for women and children victims of abuse and violence;
3. Set the policy for criteria and procedure for accreditation of women and children protection
units to be forwarded to the Bureau of Standards and Regulation for appropriate action by
the Department of Health (DOH);
4. Lay down the policy for minimum requirements for training programs that are gender
responsive, such as the Certificates for Women and Child Protection Specialty Program and
other relevant residency programs;
5. Monitor and evaluate the efficacy, effectiveness and sustainability of creation, operations,
and maintenance of WCPUs;
6. Recommend policy reforms and new guidelines anchored on evidence-based interventions
and approaches;
7. Harmonize existing databases and create a central databank for women and children
protection cases; and
8. Perform other functions as may be necessary for the implementation of the revised
issuance.

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.
The Committee members and program manager shall be entitled to an honorarium
for every meeting.

VII. ROLES AND RESPONSIBILITIES OF PARTNER AGENCIES

A. Department of Health at the National Level
1. The Committee shall be under the direct supervision of the Office of the Undersecretary
for Health Services Delivery.
2. The specific office/s to be designated by the Undersecretary for Health Services Delivery
shall be primarily responsible for:

a. The overall execution of the revised policy and manual of operations on Women and
Children Protection Program;
b. Accreditation of WCPUs;
c. Generation mobilization of resources for the operations of WCPUs.
B. Philippine Health Insurance Office (PhilHealth)
The PhilHealth shall develop a service package for all WCPU patients that will facilitate
the provision of inpatient and outpatient services.
C. Centers for Health Development
1. Disseminate the policy for adoption and implementation by LGU health systems in the
different localities within their respective regions;
2. Provide technical assistance to LGUs in organizing WCPU activities and developing
relevant technical references and information, education and communication (IEC)
materials;
3. Generate resources to strengthen the implementation of the policy and manual of
operations for WCPUs;
4. Formulate and implement advocacy plans to generate stakeholders support, particularly
the local officials;
5. Monitor the implementation of the policy and guidelines in both public and private
hospitals, and in different localities in their respective regions;
6. Undertake regular review with LGUs on the progress of the WCPU policy and guidelines.

D. Local Government Units

1. Provincial / City Health Office
a. Train private and public health workers on the women and children protection
program;
b. Advocate with municipalities/cities and other concerned agencies and stakeholders
to adopt and implement the revised policy on the women and children protection
program;
c. Generate and allocate resources in support of WCPU provision (e.g., counterpart
funds for training, procurement of additional WCPUs, etc);

d. Require all hospitals to implement the revised policy and its manual of operation as
an integral part of their treatment and care protocols.
2. Regional and provincial hospitals
a. Require all hospitals to implement the revised policy and its manual of operation as
an integral part of their treatment and care protocols;
a.

Allocate budget sufficient for the operations of WCPUs;

b.

Conduct training and orientation on 4Rs;

c.

Maintain an accurate and complete database on WCPU clients.

D. Child Protection Network Foundation, Inc.

1. Provide expertise and technical support for the establishment of WCPUs and the central
database on childrens cases;
2. Extend guidance to the trained physicians and social workers in WCPUs;
3. Coordinate with the Philippine Commission for Women, Council for the Welfare of Children
and non-government organizations (NGOs) regarding matters related to womens and
childrens health and gender concerns;
4. Participate in the implementation of the WCPU policy including its manual of operations.

E. Philippine Commission on Women

1. Provide expertise and technical assistance on gender-responsive delivery of services by
the WCPU service providers and the central database on womens cases;
2. Assist the DOH in monitoring the implementation of the WCPU using the Performance
Standards and Assessment Tools for Services Addressing VAW in the Philippines;
3. Require all hospitals to allocate from their gender and development (GAD) budget the
funds required to create, operate, and maintain WCPUs and to report the use of their GAD
funds to PCW.

VIII. REQUIREMENTS FOR THE ESTABLISHMENT OF WOMEN AND CHILDREN

PROTECTION UNITS
The Committee shall ensure that all present and future WCPUs comply with the
criteria mandated in this revised policy and its Manual of Operations.
All WCPUS, depending on the number of their personnel, range of services rendered, and
annual budget shall be classified as Levels I, II and III facilities. Minimum criteria for each
of these units are enumerated in the Manual of Operations of this
policy.
XI. MANUAL OF OPERATIONS
The Committee on Women and Children Protection Program shall regulate the
establishment and operations of all WCPUs in the Philippines.
I.

MINIMUM REQUIREMENTS FOR ALL HOSPITALS

A. Training. The Committee shall require that all hospital personnel undergo training on
the recognition, reporting, recording and referral (4Rs) 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.
II. The minimum standard criteria shall be maintained by all WCPUs.
A. Organizational Structure - The WCPU shall:
1. Be an integral part of the hospital;
2. Be under the Office of the Chief of Clinics;
3. Be supervised by a WCPU head who shall have the following responsibilities:
a. Integrate and operationalize the multidisciplinary functions of the WCPU
b. Prepare the annual work and financial plan, including budget preparation,

4. Submit quarterly reports to the Office of the Undersecretary for Health Services
Delivery.
5. Have the following minimum staff, preferably with regular plantilla positions, who
shall be primarily responsible to the WCPU:
a. a trained physician and
b. a trained social worker.
B. Facilities - The WCPU shall:
1. Be permanently situated in a designated area, preferably near the emergency room of the
hospital;
2. Be spacious enough to accommodate all the services provided by the facility, such as:

a. A separate room for interviews and crisis counselling

b. A separate room for medical examination;
c. A reception area to accommodate those waiting to be served, including their
companions. The reception area must have culture- and gender-sensitive information
materials on violence against women and children (VAWC)
d. Filing cabinets and other furniture/equipment that will ensure the security
and confidentiality of files and records;
3. Have its own toilet or comfort room;
4. Have the following fixtures:
a. Examination table
b. Desk and chairs
c. Washing facilities with clean running water
d. Light source, and
e. Telephone line
f. Computer and printer
g. Office supplies
5. Have readily available supplies and equipment for medical examination, including:

a.
b.
c.
d.
e.
f.
g.
h.
i.
j.
k.
l.
m.
n.
o.
p.
q.
III.

Digital camera
Rape kit
Speculum of different sizes
Blood tubes
Syringes, needles and sterile swabs
Examination gloves
Pregnancy testing kits
Microscope slides
Measuring devices like rulers and calipers
Urine specimen containers
Refrigerator for storage of specimens
Analgesics, medicines for STI prophylaxis, and emergency contraceptives
Labels
Medical forms including consent forms and anatomical diagrams
Colposcope (Optional)
Video camera for recording the forensic interview (optional)
Tape recorder (optional)

LEVELS OF CARE DELIVERED BY WCPUs

A.

Level I WCPU

1. Personnel

A trained physician, and

A trained and registered social worker.

2. Services. A level I WCPU provides

3.

Training Capability

4.

Minimum medical services in the form of medico-legal examination, acute medical

treatment, minor surgical treatment, monitoring & follow-up
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
A full coverage, 24/7
Minimum social work intervention such as safety (and risk) assessment, coordination
with other disciplines (i.e., Department of Social Welfare and Development (DSWD) or
the local social welfare and development office (SWDO), police, legal, NGOs)
Peer review of cases
Proper documentation and record-keeping
Expert testimony in court
Networks with other disciplines and agencies

Training on 4Rs

Research

B.

Proper documentation of experiences which will serve as inputs for policy research,
formulation and program improvement

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

3.

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.

Training Capability

4.

Training on 4Rs
Residency training

Research

Proper documentation of experiences which will serve as inputs for policy research,
formulation and program improvement

C. Level III WCPU

1.

Personnel

2.

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

Services

Medical services of a Level 2 WCPU

3.

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)

Training Capability

4.

Training on 4Rs
Competence and facility to run residency training and specialty trainings

Research

IV.

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.

TRAINING AND EDUCATION IN WOMEN AND CHILDREN PROTECTION

A multi-disciplinary training program will address human resource needs of

women and child protection units and womens and childrens desk as well as create and
sustain a woman- and child-sensitive hospital environment. The women and children
protection program in the central office will set directions and define a career path for
medical and paramedical graduates who might be interested in professionally pursuing
this line of work. This will be made available not only to hospital personnel but to
community and interested organizations that would like to avail of the training. Training
areas may focus on the following:
1.

For trainees to acquire/enhance attitudes necessary in the management of acute and

chronic causes of crisis such as sensitivity, compassion, confidentiality and empathy.
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.
3. For the trainees to have additional knowledge on understanding of conditions leading to
crisis, recognition of early sign of crisis identification, analysis of aggravating/contributory
factors including family factors/stresses, understanding of the impact of crisis on the

individual the family and the community management of patients and their families
networking, linkage development and referral.

V. MINIMUM REQUIREMENTS OF A TRAINED WOMEN AND CHILDREN

PROTECTION SPECIALIST
1. Physician

Six (6)-week Child Protection Specialist Training for Physicians of the Child Protection
Network Foundation or its equivalent

2. Social Worker

Four (4) -week Child Protection Specialist Training for Social Workers of the Child
Protection Network Foundation or its equivalent

3. Police Officer

Four (4)-week Child Protection Specialist Training for Police Officers of the Child
Protection Network Foundation or its equivalent

[1] Republic Act 7610: Anti-Child Abuse Law

[2] Republic Act 9262: Anti-Violence Against Women and their Children Act
[3] Republic Act No. 7610
[4] Republic Act No. 9262
[5] Republic Act No. 8353
[6] Republic Act No. 8505
[7] Republic Act 9710
[8] DOH Performance Standards and Assessment Tools for Services Addressing Violence
against Women in the Philippines, 2008 (ed), at p.9.
Program Manager:
Ms. Norma Escobido
National Center for Disease Prevention and Control - Family Health Office