Republic of the Philippines

Department of Health
OFFICE OF THE SECRETARY

17th Meeting of the National Implementation Team (NIT)

for Responsible Parenthood Reproductive Health (RPRH) Law
09 October 2015, 1:00pm – 5:00pm, OSEC Conference Room
DOH Compound, Sta. Cruz, Manila

Attendees:
Dr. Esperanza Cabral NIT Chair Ms. Joy Salgado LIKHAAN
Dir. Juan Antonio Perez III POPCOM Ms. Yna Masilungan PCPD
Hon. Krisel Lagman-Luistro DOH-OSEC Dr. Nicolas Catindig PSRP
Dr. Miriam Sales DOH-OSEC Ms. Patricia Gomez IMAP
Dr. Diego Danila DOH-DPCB Ms. Adelaida Legurpa IMAP
Ms. Edna Nito DOH-HPCS Ms. Suzanne Ceresko MSF
Ms. Karen Villanueva DOH-HPCS Ms. Patricia Malay PHAP
Ms. Mary Grace Paua DOH-HPCS Dr. Eleazar Lim, Jr. FriendlyCare
Dr.Dax Edward Nofuente DOH-BLHSD Mr. Arnel Rostom Deiparine PSPI
Engr. Dave Masiado DOH-LMD Ms. Elizabeth Angsioco DSWP
Ms. Jesusa Lugtu POPCOM Ms. Claire Padilla EnGendeRights
Mr. Randy Calseña NCDA Atty. Jihan Jacob CRR
Ms. Silayan Kintanar PCW Ms. Racine Denise Mariejo FPOP
Mr. Francis Ubalde NAPC Mr. Jose Mateo Dela Cruz FPOP
Mr. Tom Javate NEDA Mr. Alvin Cloyd Dakis ZFF
Dr. Florence Tienzo WHO Ms. Tina Langit HPDP
Ms. Consuelo Añonuevo USAID Ms. Nikki Mecayer HPDP
Dr. Angelito Umali UNFPA Mr. Ken Raymund Borling DPCB
Dr. Bernabe Marinduque JPHEIGO Mr. Ramon San Pascual RPRH

Preliminaries: The Meeting was called to order at 1:20 PM by former Secretary of Health, Dr.
Esperanza I. Cabral, as the presiding officer. The provisional agenda of which was approved.

Highlights: The following discussions and agreements were made during the meeting:

Meeting/Agenda Agreement Person/Agency

Item & Discussion Responsible
Review of the Highlights of the previous NIT meeting (Sept 24, 2015) was
Minutes of the discussed by Dir. Juan Antonio Perez:
previous NIT  POPCOM
1. Family Development Session
meeting was
presented to the - Dr. Cabral agreed that the NIT should direct some of
body whereby its attention to non-4Ps clients for demand generation
matters arising and also reminded to keep track of the 2Million
were discussed and couples that were already counseled on family
issues resolved. planning and to make sure that they are linked to
service provision.
- Dr. Perez has met with the regional directors and
 discussed the catch up plan. Some of the regions will
be going back to their records of FDS for the past 2
years.
- Dr. Cabral requested for a complete report on the
results so far of the pool of 2 million couples who were
already counseled on FP.

2. Update on Sorsogon’s “Pro-Life” Case

- Mayor Krisel Lagman-Luistro

o Dr. Listanco reported last Oct 8, 2015 that the
ordinance was not put on hold according to
Committee on Health Chairperson. There are
even revisions filed as a response to the
comments during the public hearing. Suggest
to validate report and get supporting data, ex.
Revised ordinance, schedule of committee
hearings, etc.
o Meeting with Mayor Sally Lee last 4
September 2015 attended by Dr. Perez of
PopCom, Dra. Rita Ang of DOH RO V, and
other DOH officials. Dra Ang will provide the
transcript of the meeting. Main
pronouncements by Mayor Sally Lee during
the meeting were:
1) Ordinance will be put on hold. She will
“not continue with the ordinance”.
2) The city government will conduct an
information-dissemination campaign on
Natural Family Planning. “Pagktapos naming
silang –brain-wash at gusto pa rin nila ng FP
commodities ibabalik ko ang services”, she
added.
3) After the campaign, the city government
will conduct a survey.
The Mayor expressed her opposition to
vaccination because “they cause autism in
children”.
o On Family Planning supplies and commodities
returned to PHO, Dra. Listanco corrected the
report that the commodities that were returned
to the PHO were not accepted. The
commodities from DOH National were not
accepted by PHO because it did not come from
them. However, the commodities from PHO
were accepted even if the City stated that the
contraceptives were “near expiry date”
because the PHO wanted to redistribute them
to other LGUs. A copy of the letter
accompanying the return of commodities was
requested for submission.
o On Interventions from DOH ROV, PHO
Sorsogon have initiated partnerships with
private providers, private clinics and hospitals,
and CSOs (FPOP). Copy of the MOA will be
emailed by Dra. Listanco. Training of nurses
under the Nurse Deployment Program on
RPRH. They will be farmed out to barangays
 to provide RH information and distribute
commodities. No mention of services. The
training is scheduled on 9-13 November 2015
for 30 participants, 16 of them will be from
Sorsogon City plus 4 volunteers. The rest are
from other Bicol provinces. Lakbay Buhay
Kalusugan Health Caravan is scheduled on
Nov-Dec 2015. Interfaith Forum to be
participated in by CHR and faith based groups,
including Iglesia ni Kristo is scheduled this
last quarter (Oct-Dec). Adolescent Congress,
originally slated for next year, will be
scheduled to coincide with the Health Caravan
this year. Usapan sessions in barangays are
held to counter misinformation. DOH Rep
Nory is effective in reaching-out to the
communities. DOH ROV will fund the
Usapan sessions. RIT requested position letters
from CHR, NYC, and DILG. Responses were
positive from CHR and NYC. Copies will be
emailed. DILG has no comment to date. Dra.
Rita Ang committed to submit the RPRH
activities for the last quarter via email.
o On Family Development Sessions on Family
Planning, Dra Listanco said that there were
reports that the Family Development Sessions
on Family Planning were limited to Natural
Family Planning as ordered by the Mayor.
This has to be validated with PopCom
Regional Director Leni Abellera.
o On RPRH campaign, Former Mayor Leovic
Dioneda is willing to help with the RPRH
campaign as well as in the RH service
provision through Rotarian doctors from
Sorsogon. He is requesting for 1) an action
plan from DOH ROV so that he can comment
on the partnership, Commodities for 2)
Distribution and training for doctors and
service providers and 3) Legal assistance to
the women who will come forward to file
complaints against the mayor and the city
government
o Adolescent Congress will be held in
November 2015
o The RIT has requested position papers from 4
agencies, among are CHR, NYC and DILG.
DILG had no comments.
- Dr. Cabral had a teleconference with Regional Director
Monicimpo, Dr. Rita Ang and other staff of RO V.
Plan is for RO V
o For Service Delivery, the PSRP will be going
to Sorsogon to conduct trainings on FP
(October 15 and 16, 2015) particularly on
Implant Insertion as well as a mission for
implant. Region 5 will mobilize the women
who would like to avail of the subdermal
implants as well as the doctors who will be
trained by PSRP
 o Training of Nurses from the NDP will be
continued for November (Lakbay Buhay
Caravan) excluding the implant until such time
that the TRO has been lifted.
o RO 5 agreed to engage Mayor Dioneda in
public information campaign to counter all of
the false information that the mayor is
peddling not only in family planning but also
on vaccines and iodized salt. RO 5 were also
given instructions to request for a regular air
time where they can discuss this issues, also in
the other radio stations in the other parts of RO
5. They will also engage Mayor Dioneda in
service provision.
o RO 5 will provide a report every two weeks
regarding what is happening and developments
on the actions points
o The women’s group will file a case against the
mayor and will be assisted by Likhaan
o On FDS, the regional POPCOM will be
instructed to provide counselling on all FP
methods.
o Likhaan will be gathering testimonies and
continued investigation
o RO 5 will be meeting with RO 5 DSWD Mr.
Arnel Garcia regarding FDS.

3. TWG on Good Governance (Dr. Nofuente)

- Issue raised on how the DOH can permanently address

the monitoring of FP logistics at the LGU level
NOSIRRS vs CDLMIS
- Dr. Cabral suggested to focus first on the FP Hotline
until such time that the DOH has already established
the NOSIRRS

Agenda of the
October 9, 2015 1. Update on the FP Communications Planning Report
Meeting (Ms. Edna Nito- HPCS); Update on the RPRH Website  DOH-HPCS
and Facebook (Mary Grace Paya)

- Proposed Information Services Communication

Campaign for RPRH was presented. The Target
Population are the Urban and Rural Households D and
E Classes.
- Campaign Phasing involves 2 phases. The objective of
the first phase is to increase by 10% the percentage of
Filipinos that are aware of the existence of the RPRH
Law and to increase the understanding among the
campaign audiences of the benefits and services that
the RPRH Law provides. The campaign theme is
“RPRH LAW, MAY MAPAPALA KA BA?” The
strategy is to launch an intense public relations
campaign amplified through social media, and aided in
part by targeted mass media advertising.
 o Phase 1 Campaign Timeline: Digital & PR
Campaign Oct 2015 – Feb 2016; Information
Materials Development Oct 5 – Nov 13, 2015
(Development and production of information
materials about RPRH Law to be used at the
launch event and beyond); Launch Event
(Pop&Dev Week) Nov 22-26, 2015 (One
whole day of activities related to
POPULATION AND DEVELOPMENT
WEEK. To be synchronized with the DOH
regional offices’ own celebration of POP &
DEV’T WEEK.); Advertisement Production
Oct-Dec 2015; Advertisement Airing Jan-Feb
2016
o Phase 2 Campaign- will talk about the services
and their availability
- Dr. Perez- the POPCOM will be celebrating the Salas
Population Development Awards on November 26,
2015 which is a half day event and will be attended
mainly by local governments; there will also be an
indie film festival on teenage pregnancies the same
week as the Salas Award.
- Dr. Cabral commented to make the fonts clearer and
asked what the target increase in the awareness
campaign is.
- Ms. Karen Villanueva said that the 10% percentage
point increase goal was based on the available
resources, budget and time. Basline survey that will be
used will be the SWS survey of 2014
- Mr. Alvin Cloyd Dakis (ZFF)- inquired about the
measuring tool to be used for the campaign and the
ads. Suggested to engage Rappler because of its wide
coverage and technical know-how. They also have a
measuring tool to see the reach of their post.
- Ms. Beth Angsioco suggested to change the word
“magamit” in slide 4 of the powerpoint presentation. It
was also sighted that the target population often has
little access to the internet, therefore limited access to
social media. It was suggested to get a copy/list of the
materials on FP.
- RPRH Website- all information are being
consolidated. Writers assigned are already preparing
for the content which includes what RPRH is all about,
its services and its benefits.
- RPRH Website- all information are being
consolidated. Writers assigned are already preparing
for the content which includes what RPRH is all about,
its services and its benefits.
- Volunteers as responders for social media: Ms. Beth  DOH-LMD
Angsioco, Mr. Alvin Cloyd Dakis, Ms. Karen
Villanueva and Mr. Ramon San Pascual.
 - Dr. Cabral followed up on the list/inventory of
materials on FP as well as a copy of each, date when
they were made and where they are.

2. Updates on the FP Hotline and Logistics

A. Logistics:
- For the first Semester of 2015, 98% of the FP logistics
were already delivered except for region 11 and 8.
- XDE has started deliveries to recipients in NCR. The
latest allocation contains COC, DMPA and Exluton
(POP) sufficient for 6 months. Two recipients refused
to accept their shipment due to sufficient stocks for all
items (Quezon and Pasay). Manila and Navotas City
return Microgynon (COC) due to overstocking. Areas
with stock outs based on the FP Logistics Hotline
report will be prioritized.
B. Hotline:
- The Hotline asked for comments on the current FP
Logistics. The answer of 176 facilities were analyzed
and it was found that:
o 46 facilities requested for an increase in their
allocation as it is not enough for their needs vs
15 who requested for fewer stocks
o 11 facilities complained about the painful
administration of DMPA reported by clients
(see Annex B for list and copy of complaint
submitted by Guinobatan, Albay to PHO)
o 7 facilities mentioned they do not have trained
IUD providers (see Annex C for list of
facilities)
o 8 facilities mentioned they have commodities
that expired already (Marvelon) (See Annex D
for list of facilities)
- Next Steps:
o Need to define process flows and timelines
with FHO (i.e., approval of allocation, etc.)
o LMD to provide updates to Hotline on the
status of preparation of shipment for facilities
with stock outs
o Hotline to call back facilities for update
- FP Commodities Stock Available As of October 9,
2015:
o Depo Provera DMPA w/ Syringe-
1,221,625 vials
o Etonoregestrel (Implanon NXT) 68mg TDR-
250,000 pieces
o Oral Pills (Microgynon) - 4,658,036 cycles
o Oral Pills (Femme)- 8,000,000 cycles
o Progestin Only Pill (Excluton)- 1,099,852
 cycles
- At Pipelines(For Delivery):
o Oral Pills (Femme)- 12,000,000 cycles
o Progestin Only Pill (Excluton)- 1,181,000
cycles
* NIT Agreement: Fully launch the FP Hotline nationwide and
disseminate the telephone number of the Hotline to all RHU.

Dr. Cabral on IUD stock outs at some RHUs- PHIC is already

reimbursing IUD insertion that is why the poor no longer need
to rely on the government for this because all of them are
enrolled to PHIC.

3. Prevention and Management of Abortion

Complications (PMAC) Report (Atty. Claire
Padilla/Atty. Jihan Jacob)

A. Post-Abortion Care in the Philippines

- RH Law: Abortion remains illegal; Post abortion care is legal
- RA 9710: Abortion remains illegal; Post abortion care is
legal; Access to services for prevention of abortion and
management of pregnancy-related complications [Sec. 17(7)]
- RA 8344: An act penalizing the refusal of hospitals and
medical clinics to administer appropriate initial medical
treatment and support in emergency or serious cases; no
specific mention of duty to render post-abortion care services;
duty to render treatment in emergency or serious cases to
prevent death or permanent disability is expressed
- PMAC POLICY: Prevention and Management of Abortion
and its Complications; “…quality and humane post-abortion
care services by competent, compassionate, objective and non-
judgmental service providers in a well-equipped institution,
complemented by a supportive environment.”; Elements (1)
prevention and treatment of abortion and its complications, (2)
counseling, and (3) linkages to other reproductive health
services
- CEDAW COMMITTEE: recommends that the State
party…provide [women] with access to quality services for the
management of complications arising from unsafe
abortions….(para. 28, 2006 Concluding Observations);
Provide access to quality post-abortion care in all public health
facilities by— 1) reintroducing misoprostol to help prevent
maternal mortality and morbidity; 2) ensuring that women
experiencing abortion-related complications are neither
reported to law enforcement nor subjected to abuse, threats,
discrimination, stigma, or delays in or denial of care; 3)
establishing policies and mechanisms that protect patients’
privacy and allow them to, without fear of retaliation, file
complaints concerning abuse and discrimination; and
4) researching the incidence of unsafe abortions in the country
- RPRH REPORT: The DOH is set to review existing
guidelines on the management of post-abortion complications
per Administrative Order 45-B s. 2000 or the “Prevention and
Management of Abortion and its Complications (PMAC)
Policy”; Post-abortion care is being delivered in most hospitals
in the country, but is currently not being reported as a program
indicator; Total PhilHealth claims: 25,617 (Php258,690,120);
The RPRH NIT plays a key role in respecting, protecting and
fulfilling women’s right to quality, humane, compassionate
and nonjudgmental post abortion care.
B. Challenges and Gaps
- Lack of access to safe and legal abortion
Dr. Romualdez: abortion is a medical issue, not a moral issue
- Conservative religious beliefs; stigma
- As long as unintended pregnancy is high (low CPR), there are
no express grounds making abortion legal and rape exists,
many women will induce abortion, many of these would be
unsafe
- High incidence and prevalence of: 1) Intimate partner
violence; 2) Rape
- Legal gap:
 no clear exceptions in our penal law:
 danger to the life and health of the woman (e.g.,
young woman died after childbirth; she had
dwarfism condition)
 rape or incest
 fatal fetal impairment or serious fetal
malformation incompatible with life outside the
uterus (e.g., anencephalic/case)
 up to 14 weeks of pregnancy
- Draft DOJ Criminal Code increasing penalties on abortion
- Efforts:
 PMAC
 CEDAW 2006 Concluding Comments (access to
the full range contraceptive methods (including
emergency contraception), access to safe and legal
abortion)
 RH Law 2012
 CEDAW Inquiry 2008-2012, 2012, 2015;
CEDAW Committee (Recommendations on the
Manila Inquiry on Reproductive Rights Violations:
provide access to quality post abortion care to
women including by reintroducing misoprostol to
reduce maternal mortality and morbidity rates,
ensure that women experiencing abortion-related
complications are not reported to law enforcement
authorities and are not threatened with arrest;
amend articles 256 to 259 of the Revised Penal
Code to “legalize abortion in cases of rape, incest,
threats to the life and/or health of the mother, or
 serious malformation of the fetus and
decriminalize all other cases where women
undergo abortion)
- Recommendations for PMAC Policy:
 Prevention (PMAC, MCW, RH): reduce levels of
unintended pregnancy and unsafe abortion
 Management and Services:
1. expanding services under the PMAC program:
o counseling (supportive & FP)
o provision of FP and other health services
o infection prevention practices
o clinical management of post-abortion
complications (including the use of
MVA))
o non-prosecution – determine abortifacients
taken only for clinical management for
medical abortion, not for MVA; determine
physical abuse on stomach/abdomen of
pregnant woman to determine if surgery is
needed
o Philhealth coverage
2. protocol (RA 8344)
3. hotline #; FAQs
4. registration, procurement, distribution and use
of MVA for PAC; source MVA? registered
MVAs?
5. Awareness-raising, dissemination:
a. eliminate stigma; training modules
b. complete and accurate information on
reproductive health and contraception,
the risks of unsafe abortion, and
importance of PAC
c. Dissemination –
collaboration/partnership with women,
POs, NGOs, lawyers, health care
providers, social workers, among
others; PINSAN network can help
with raising awareness on
PMAC/Trainings/ IEC;
6. Training & Sustainability
7. training hospitals: a) list of MVA trainers and
trainees paying for their MVA; training-of-
trainers courses; b) transfer of PMAC-related
skills to new staff, with senior residents
teaching junior residents and interns; c)
development of a preservice PMAC
curriculum for nursing and midwifery schools
8. creation of PAC units
9. Complaints mechanism: a) RA 8344,
MCW/CHR, hospital director, DOH/DOH
 Integrity Dev’t Committee, CSC #165/allow
anonymous complaints
(complaint/institution/date/time/name of resp),
PMA, PRC; b) file cases for violations
10. Monitoring and incidence: a) Whether the
hospitals have a policy/RHO; b) Incidence:
Number of unsafe abortions; Unsafe abortion
rate (per 1000 women aged 15–44 years);
Number of maternal deaths due to unsafe
abortion; Unsafe abortion mortality ratio (per
100 000 live births); % of maternal deaths due
to unsafe abortion; Unsafe abortion case–
fatality (deaths per 100 000 unsafe abortions)
- Issuance of other relevant policies
 Misoprostol:
o Register misoprostol for management of
abortion complications and
prevention/treatment of PPH including in
non-tertiary hospitals
o DOH circular withdrawing the 2002
BFAD Advisory 02-02 on Misoprostol
(Cytotec) as an unregistered drug product;
manufacture, importation, sale or
distribution is a violation of RA
3720/Food, Drugs, Devices and Cosmetics
Act
o provision of EC
o Provision PEP (PGH Sagip Unit); repeat
HIV test 3rd & 6th month;
o PAP smear within a year and thereafter;
HPV vaccine
o Diagnosis & treatment of RTI/STI (e.g.,
gonorrhea, chlamydia, syphilis,
hepatitis B & C, HIV, UTI, HPV 16 & 18,
etc)  NIT
- Action points:
 make it an election issue; make it a buzzword
 FACE the challenges and DREAM to change
hearts and minds to scale up post-abortion care and
provide access to legal abortion

* NIT Agreement: form a technical working group who will

review the AO and make necessary updates/improvements, to
include FHO, PCW, EnGendeRights, chaired by Dr. Bernabe
Marinduque

Other Matters 1. TRO- Another extension was requested last October 8,

2015 up to November 9, 2015
2. International Leadership Awards on FP at the International
 Conference on Family Planning. Categories are country
level, organization level and individual or team level. Sec
Garin and Cong. Lagman were nominated and won.
3. Invitation to submit an article for the Health Beat regarding
RPRH- deadline end of October 2015
4. Request for standard presentation on RPRH to be used for
giving lectures on RPRH

Adjournment The meeting was adjourned at 4:50PM

Schedule of Next October 29, 2015, 1:00PM to be held at OSEC conference

Meeting room, DOH Compound

Prepared by: Noted by:

DR. MIRIAM CECILIA B. SALES DR. JUAN ANTONIO A. PEREZ, III

EXECUTIVE ASSISTANT IV NIT for RPRH, VICE CHAIR

Approved by:

DR. ESPERANZA I. CABRAL

CHAIRPERSON