5/6/2013

INTRODUCTION TO ESSENTIAL INTRAPARTUM AND NEWBORN CARE (EINC)

Anthony Calibo, MD, DPPS
Medical Specialist IV Family Health Office, NCDPC Department of Health
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Maternal, Newborn, Child Health and Nutrition Strategy

Essential Intrapartum and Newborn Care

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Policy Objective
Administrative Order 2008-0029

Maternal, Newborn, Child Health and Nutrition Strategy (MNCHN)

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Implementing Health Reforms for Rapid Reduction of Maternal and Newborn Mortality (MNCHN Strategy)

Administrative Order 2009-0025

Adopting Policies and Guidelines on Essential Newborn Care (ENC) To reduce maternal and neonatal mortality rates faster from 2007 to 2015 to meet MDG targets
However, we need to understand features and characteristics of maternal and newborn deaths to focus our interventions.
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MNCHN Strategy
Every pregnancy is wanted, planned and supported Every pregnancy is adequately managed

Integrated MNCHN Service Package

Pre-Pregnancy Services
Financing

Antenatal care

Intermediate Goals

Health Facilities and Service Packages Human Resource, Health information** Health Products and Pharmaceuticals Other Support Systems

Every delivery is facility-based and managed by skilled health professional

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Every mother and newborn pair secures proper postpartum and postnatal care with smooth transitions to the womens health care package for the mother and child survival package for the newborn.
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Postpartum and Postnatal Care

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Care during Delivery

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Prepared by Team EINC for APDCN Faculty

Prepared by Team EINC for APDCN Faculty May 6, 2013

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MNCHN Service Delivery Network

A. Third Tier: CEmONC Capable Health Facilities
B. Second Tier: BEmONC Capable Health Facilities C. First Tier: Community Level Service Providers with Community Health Teams

Community Health Teams (CHTs)

Under the universal health care, P-Noys (Aquino) Health Agenda (DOH Administrative Order 2010-0036) Cabinet collaboration
DOH, PhilHealth, DSWD, DepEd, DILG, etc.

CCT areas Door-to-door campaign

Health messages, identification of health facilities, PhilHealth membership and enrollment

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Prepared by Team EINC for APDCN Faculty

Community Health Teams (CHTs)

With the support of barangay leaders, CHTs known before as womens health teams Led by the public health midwife (CHT Team Leader) Members:

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RN HEALS Barangay nutrition scholars Barangay health workers Barangay service point officers Womens groups TBAs as trackers in some CHTs
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Life Events
Pre-union Premarital counseling Conception Pregnancy Birth and Delivery
MBFHI BEmONC with POGS MDG

Things to Consider in Curriculum Integration for MNCHN-related programs

Under 5 years Pre-union Premarital counseling Conception Pregnancy Birth and Delivery
MBFHI

Under 5 years

EINC
NBS, EPI, IMCI, IYCF NBS, EPI, IMCI, IYCF

EINC
Family Planning, Adolescent Health Healthy Lifestyle Micronutrient Supplementation
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Essential intrapartum and newborn care Rooming-in and breastfeeding Breastfeeding and infant and young child feeding (IYCF) Breastfeeding during emergencies and disasters Newborn screening and newborn hearing screening Postpartum care and postnatal care Birth spacing, family planning Health lifestyle Oral health 5/6/2013 Prepared by Team EINC for APDCN Faculty

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Prepared by Team EINC for APDCN Faculty May 6, 2013

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Guideline Development

Essential Intrapartum and Newborn Care

Dissemination

Implementation & Monitoring

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Develop Guidelines Convened Technical Committee

Disseminate

Implement & Monitor

The EINC Campaign

Hospital Reform Agenda Network of Centers of Excellence

Identified problems incl. observational studies

Appraised evidence GRADE methodology Evidence-based draft developed

Essential Newborn Care Protocol Launch & Signing of DOH Administrative Order December 7, 2009 Hotel Sofitel Manila
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Review by individual and en banc panel stakeholder and experts

Scale-Up Project
Curriculum Changes
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Social Marketing Campaign

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Finalize PROTOCOL
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Prepared by Team EINC for APDCN Faculty

Hospital Reform Agenda

Network of Centers of Excellence

The EINC Campaign

Hospital Reform Agenda

Network of Centers of Excellence

The EINC Campaign

Curriculum Changes

Social Marketing Campaign

Curriculum Changes

Social Marketing Campaign

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Prepared by Team EINC for APDCN Faculty May 6, 2013

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Hospital Reform Agenda

Network of Centers of Excellence

The EINC Campaign

Hospital Reform Agenda

Network of Centers of Excellence

The EINC Campaign

Curriculum Changes

Social Marketing Campaign

BEFORE
NSD 6,800

NOW
NSD 8,000* CS 19,000
*Use partograph 25

Curriculum Changes

Social Marketing Campaign

NSD Package Cesarean Section

CS

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Hospital Reform Agenda

Network of Centers of Excellence

The EINC Campaign Before Php 1,000

Php 250
(eye prophylaxis, umbilical cord care, vit. K, thermal care, BCG vaccine, resuscitation of the NB)

Hospital Reform Agenda

Network of Centers of Excellence

Curriculum Changes

Social Marketing Campaign

Curriculum Changes

Social Marketing Campaign

The EINC Campaign Now Php 1,750

UNBUNDLED
Php 1000
PhP 500 for caregiver plus: PE of NB, breastfeeding support, 4 EINC core steps, eye prophylaxis, vit. K,BCG vaccine, Hep B vaccine

Newborn Care Package

Newborn Care Package

Php 250
(Hep B vaccine)

PhP 200
(Hearing Screen)

Php 500
(NB screening)
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PhP 550
(Newborn Screening)
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Hospital Reform Agenda

Network of Centers of Excellence

The EINC Campaign

LUZONQuirino (8): Memorial QMMC , PGH, Fabella, Jose Reyes,Medical East Ave, Center Tondo Medical, San Lorenzo Ruiz, Jose Rodriguez St. Lukes VISAYAS (1): Medical EVRMC Center (Tacloban)

Curriculum Changes

Social Marketing Campaign

Local Government Units (LGU) General Santos City Cotabato City Quezon City Paraaque City Pagsanjan

Private Institutions: Spontaneous Scale-Up NCR The Medical City St. Lukes - Global City Perpetual Help Las Pinas VRP Medical Center Cardinal Santos Med Center Medical Center Muntinlupa Jesus Delgado Memorial World Citi Medical Center UST Hospital Chinese General Hospital Asian Hospital & Medical Center Paraaque Doctors Hospital Manila Doctors Hospital Las Pias City Medical Center Our Lady of Lourdes Hospital Medical Center Paraaque Makati Medical Center Provincial Sites: Tagaytay Medical Center New Sinai MDI Hospital Our Lady of the Pillar Med Center Lorma Medical Center Castro Maternity & Gen Hospital De La Salle University Med31 Ctr

Project Sites
MINDANAO (2): GSCH (General Santos) CRMC (Cotabato City)
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Provincial Health Offices (PHO) Bulacan Rizal Aurora Sorsogon Capiz Cavite Centers for Health Development (CHD) Region IV-A (CALABARZON) Region XI (Davao) Region VIII (Eastern Visayas) Region II (Cagayan Valley) Region III (Central Luzon) Government Hospitals Bataan General Hospital Pasay City General Hospital Zamboanga City Medical Center 5/6/2013 Ospital ng Muntinlupa

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Hospital Reform Agenda

Network of Centers of Excellence

The EINC Campaign

Medicine Nursing Midwifery

Hospital Reform Agenda

Network of Centers of Excellence

The EINC Campaign

Curriculum Changes

Social Marketing Campaign

Curriculum Changes

Social Marketing Campaign

Association of Phil. Medical Colleges Foundation Philippines Nurses Association Association of Deans of Phil. Colleges of Nursing Association of Philippine Schools of Midwifery
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Hospital Reform Agenda

Network of Centers of Excellence

The EINC Campaign

1st MNCHN EINC Advocacy Partners Forum

Hospital Reform Agenda

Network of Centers of Excellence

The EINC Campaign

Curriculum Changes

Social Marketing Campaign

Curriculum Changes

Social Marketing Campaign

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July 13 15, 2011, Century Park Hotel, Manila Prepared by Team EINC for APDCN Faculty

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eincbulletin.blogspot.com
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www.facebook.com/UnangYakap

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Prepared by Team EINC for APDCN Faculty May 6, 2013