Health Development Program for Older Persons - R.A.

7432 (An Act to Maximize the Contribution of Senior Citizens to Nation

Building, Grant Benefits and Special Privileges)

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AN ACT TO MAXIMIZE THE CONTRIBUTION OF SENIOR CITIZENS TO NATION BUILDING, GRANT BENEFITS AND SPECIAL
PRIVILEGES AND FOR OTHER PURPOSES.

Be it enacted by the Senate and House of Representative of the Philippines in Congress assembled:

SECTION 1. Declaration of Policies and Objectives – Pursuant to Article XV, Section 4 of the Constitution, it is the duty of the family to
take care of its elderly members while the State may design programs of social security for them. In addition to this, Section 10 in the
Declaration of Principles and State Policies provides: “The State shall provide social justice in all phases of national development”. Further,
Article XIII, Section II provides: “The State shall adopt an integrated and comprehensive approach to health development which shall endeavor
to make essential goods, health and other social services available to all the people at affordable cost. There shall be priority for the needs of
the underprivileged, sick, elderly, disabled, women and children.” Consonant with these constitutional principles the following are the declared
policies of this Act:

a) To motivate and encourage the senior citizens to contribute to nation building;

b) To encourage their families and communities they live with to reaffirm the valued Filipino tradition of caring for the senior citizens.

In accordance with these policies, this act aims to:

1) Establish mechanism whereby the contribution of the senior citizens are maximized;

2) Adopt measures whereby our senior citizens are assisted and appreciated by the community as a whole;

3) Establish a program beneficial to the senior citizens, their families and the rest of the community that they serve.

SECTION 2. Definition of Terms. – As used in this Act, the term “senior citizen” shall mean any resident of the Philippines at least sixty (60)
years old, including those who have retired from both government offices and private enterprises, and has an income of not more than Sixty
thousand pesos (P60,000.00) per annum subject to review by the National Economic and Development Authority (NEDA) every three (3) years.

fThe term “head of the family” shall mean any person so defined in the National Internal Revenue Code.

SECTION 3. Contribution to the Community. – Any qualified senior citizens as determined by the Office for Senior Citizen Affairs (OSCA)
may render his/her services to the community which shall consist of but not limited to any of the following:

a) Tutorial and/or consultancy services;

b) Actual teaching and demonstration of hobbies and income generating skills;

c) Lectures on specialized fields like agriculture, health, environmental protection and the like;

d) The transfer of new skills acquired by virtue of their training mentioned in Section 4, paragraph (d)

e) Undertaking other appropriate services as determined by the Office for Senior Citizens Affairs (OSCA) such as school traffic guide,
tourist aid, pre-school assistant, etc.

In consideration of the services rendered by the qualified elderly, the Office for Senior Citizens Affairs (OSCA) may award or grant benefits or
privileges to the elderly, in addition to the other privileges provided for under Section 4 hereof.

SECTION 4. Privileges for the Senior Citizens. – The senior citizens shall be entitled to the following:

a) The grant of twenty percent (20%) discount from all establishments relative to utilization of transportation services, hotels and similar
lodging establishment, restaurants and recreation centers and purchase of medicines anywhere in the country: Provided, That private
establishments may claim the cost as tax credit;

b) A minimum of twenty percent (20%) discount on admission fees charged by theaters, cinema houses and concert halls, circuses,
carnivals and other similar places of culture, leisure, and amusements;

c) Exemption from the payment of individual income taxes: Provided, That their annual taxable income does not exceed the poverty
level as determined by the National Economic and Development Authority (NEDA) for that year;

d) Exemption from training fees for socioeconomic programs undertaken by the OSCA as part of its work;

e) Free medical and dental services in government establishment anywhere in the country, subject to guidelines to be issued by the Department
of Health, the Government Service Insurance System and the Social Security System;

f) To the extent practicable and feasible, the continuance of the same benefits and privileges given by the Government Service Insurance
System (GSIS), Social Security System (SSS) and PAG-IBIG, as the case may be, as are enjoyed by those in actual service.

SECTION 5. Government Assistance. – The Government shall provide the following assistance to those caring for and living with the senior
citizen:

a) The senior citizen shall be treated as dependents provided for in the National Internal Revenue Code and as such, individual taxpayers
caring for them, be they relatives or not shall be accorded the privileges granted by the Code insofar as having dependents are concerned.

b) Individuals or non-governmental institutions establishing homes, residential communities or retirement villages solely for the senior
citizens shall be accorded the following:

1) Realty tax holiday for the first five (5) years starting from the first year of operations;

2) Priority in the building and/or maintenance of provincial or municipal roads leading to the aforesaid home, residential community or
retirement village.

SECTION 6. Retirement Benefits. – To the extent practicable and feasible retirement benefits from both the Government and the private
sectors shall be upgraded to be at par with the current scale enjoyed by those in actual service.

SECTION 7. The Office for Senior Citizens Affairs (OSCA). – There shall be established in the Office of the Mayor an OSCA to be headed
by a Councilor who shall be designated by the Sangguniang Bayan and assisted by the Community Development Officer in coordination with the
Department of Social Welfare and Development. The functions of this office are:

a) To plan, implement and monitor yearly work programs in pursuance of the objectives of this Act;

b) To draw up a list of available and required services which can be provided by the senior citizens;

c) To maintain and regularly update on a quarterly basis the list of senior citizens and to issue nationally uniform individual identification
cards which shall be valid anywhere in the country;

d) To serve as a general information and liaison center to serve the needs of the senior citizens.

SECTION 8. Municipal Responsibility. – It shall be the responsibility of the municipality through the Mayor to ensure that the provisions of
this Act are implemented to its fullest.

SECTION 9. Penalties. – Violation of any provision of this Act for which no penalty is specifically provided under any other law, shall be
punished by imprisonment not exceeding one (1) month or a fine not exceeding One thousand pesos (P1,000.00) or both.

SECTION 10. Implementing Rules and Regulations. – The Secretary of Social Welfare and Development jointly with the Department of
Finance, the Department of Tourism, the Department of Health, the Department of Transportation and Communications and the Department of
Interior and Local Government shall issue the necessary rules and regulations to carry out the objectives of this Act.

SECTION 11. Appropriation. – The necessary appropriation for the operation and maintenance of the OSCA shall be appropriated and
approved by the local government units concerned. The National Government shall appropriate such amount as may be necessary to carry out
the objectives of this Act.

SECTION 12. Repealing Clause. – All provisions of laws, orders, and decrees, including rules and regulations inconsistent herewith are
hereby repealed and/or modified accordingly.

SECTION 13. Separability Clause. – If any part or provision of this Act shall be held to be unconstitutional or invalid, other provisions hereof
which are not affected thereby shall continue to be in full force and effect.

SECTION 14. Effectivity. – This Act shall take effect fifteen (15 days following its publication in one (1) national newspaper of general
circulation.

Approved,

(SGD.) RAMON V. MITRA

Speaker of the House of Representatives

(SGD.) NEPTHALI A. GONZALES

President of the Senate

This bill, which is a consolidation of Senate Bill Nos. 835, 1435 and House Bill No. 35335, was finally passed by the Senate and the House of
Representatives on February 7, 1992.

(SGD.) CAMILO L. SABIO

Secretary General

House of Representatives

(SGD.) ANACLETO D. BADOY, JR.

Secretary of the Senate

Approved: April 23, 1992

(SGD.) CORAZON C. AQUINO

President of the Philippines

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GUIDELINES ON THE ISSUANCE OF THE NATIONALLY UNIFORM IDs OF SENIOR CITIZENS AS PER R.A. 7432
The national I.D. of Senior Citizens as per provision of RA 7432 is to be provided by the Department of Social Welfare and Development
(DSWD) for free. A senior citizen who has an income of P60,000.00 and below per annum shall be granted the benefits per Section 4 of RA
7432. The process of securing the ID is as follows:

1. A Senior Citizen shall enlist at the Office for Senior Citizens Affairs (OSCA) established at the Office of the Mayor in his/her city or
municipality;

2. The OSCA shall determine the eligibility of the senior citizen. All eligible senior citizens shall provide OSCA two (2) ID pictures taken within the
year of enlisting at OSCA. One ID picture shall be attached to the OSCA registration form to be kept by the said office. The other picture shall
be for the ID card;
3. The OSCA shall prepare the list of Senior Citizens to be certified by the local office of the Bureau of Internal Revenue and the local Civil
Registrar’s office;

4. Duplicate copy of the certified list of senior citizens shall be submitted by OSCA to the DSWD filed office;

5. The Bureau of Disabled Persons Welfare, DSWD shall send to the 14 DSWD Field Offices number of IDs needed by the Elderly of the region;

6. The DSWD Field Office shall release the IDs to the respective local OSCAs;

7. The OSCA shall issue the ID cards duly signed by the municipal/city Mayor to the qualified senior citizens;

8. The OSCA shall issue the nationally uniform ID card without cost to the Senior Citizen.

In case the ID is lost, it must be reported to the local OSCA. Replacement shall be issued upon request by OSCA with corresponding cost. The
cost per ID shall be determined by DSWD. The payment shall remain at OSCA as part of its funds. No ID cards of senior citizens shall be issued
directly by the DSWD Central Office or its field offices.

SOCIAL DEVELOPMENT COMMITTEE Resolution No. 1 (Series 1993)

Approving the Implementing Rules and Regulations of R.A. 7432 Maximizing the Contribution of Senior Citizens to Nation Building, Grant
Benefits and Privileges

Whereas, the Philippine Constitution recognizes the duty of the family to take care of its elderly members with the state designing programs of
social security for them, and the need for the state to promote social justice in all phases of national development, by making available essential
social services to the priority groups such as the sick, elderly, disabled, women and children;

Whereas, RA 7432 has been enacted to motivate and encourage senior citizens to contribute to nation building and to mobilize their families
and the communities they live with to reaffirm the valued Filipino tradition of caring for the senior citizen;

Whereas, the Medium Term Philippine Development Plan (MTPDP) 1993-1998 aims to pursue a better quality of life for all Filipinos particularly
the disadvantaged sectors by providing focused basic services to allow them to manage and control their resources, as well as benefit from
developmental interventions;

Whereas, the draft IR on R.A. 7432 was formulated by an Inter-agency Committee headed by the Department of Social Welfare and
Development (DSWD), and participated in by the Department of Interior and Local Government (DILG), Tourism (DOT), Transportation and
Communications (DOTC), Health (DOH) and Finance (DOF), including the National Federation of Senior Citizens Association of the Philippines
(NFSCAP).

NOW, THEREFORE, BE IT RESOLVED, AS IT IS HEREBY RESOLVED, by the Chairman and the members (of the NEDA, Board’s Social
Development Committee (SPC) Cabinet level, to approve the Implementing Rules and Regulations of R.A. 7432.

(Sgd.) Honorable Nieves R. Confesor

Secretary, Department of Labor and Employment

Chairman, Social Development Committee

(Sgd.) Honorable Cielito F. Habito, Jr.

Secretary for Socioeconomic Planning

Co-Chairman, Social Development Committee

(Sgd.) Hon. Corazon Alma G. De Leon

Acting Secretary

Department of Social Welfare and Development

(Sgd.) Hon. Roberto S. Sebastian

Secretary

Department of Agriculture

(Sgd.) Hon. Ernesto D. Garilao

Secretary

Department of Agrarian Reform

(Sgd.) Hon. Juan M. Flavier

Secretary

Department of Health

(Sgd.) Hon. Rafael M. Alunan, III

Secretary

Department of Interior and Local Government

(Sgd.) Hon. Armand V. Fabella

Secretary

Department of Education, Culture and Sports

(Sgd.) Hon. Edelmiro A. Amante, Sr. Secretary Office of Executive Secretary

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RULES AND REGULATIONS IN THE IMPLEMENTATION OF RA 7432, THE ACT TO MAXIMIZE THE CONTRIBUTION OF SENIOR
CITIZENS TO NATION BUILDING, GRANT BENEFITS AND SPECIAL PRIVILEGES AND FOR OTHER PURPOSES

RULE I

TITLE, PURPOSE AND CONSTRUCTION

Article 1. Title – These Rules shall be known and cited as the Rules and Regulations implementing the Act to Maximize the Contribution of
Senior Citizens to Nation Building, Grant Benefits and Special Privileges and for Other Purposes.

Article 2. Purpose – These Rules are promulgated to prescribe the procedures and guidelines for the implementation of the Act to Maximize
the Contribution of Senior Citizens to National Building, Grant Benefits and Special Privileges and for Other Purposes in order to facilitate the
compliance therewith and to achieve the objectives thereof.

Article 3. Construction – These Rules shall be construed and applied in accordance with and in furtherance of the policy and objectives of the
law. In case of conflict and/or ambiguity, which may arise in the implementation of these rules, the concerned agencies shall issue the
necessary clarification. In case of doubt, the same shall be construed liberally and in favor of the beneficiaries.

RULE II

DECLARATION OF POLICIES AND OBJECTIVES, SCOPE AND APPLICATION

Article 4. Declaration of Policies and Objectives – Pursuant to Article XV, Section 4 of the Constitution it is the duty of the family to take
care to its elderly members while the State may design programs of social security for them. In addition to this, Section 10 in the Declaration of
Principles and State Policies provides: “The State shall provide social justice in all phases of national development.” Further, Article XIII, Section
II provides: “The State shall adopt an integrated and comprehensive approach to health development which shall endeavor to make essential
goods, health, and other social services available to all the people at affordable cost. There shall be priority for the needs of the underprivileged,
sick, elderly, disabled, women and children.” Consonant to these constitutional principles, the following are the declared policies of this Act:

a) To motivate and encourage senior citizens to contribute to nation building;

b) To encourage their families and the communities they live with to reaffirm the valued Filipino tradition of caring for the senior
citizens;

In accordance with these policies, the Act aims to:

a) Establish mechanisms whereby the contribution of the senior citizens are maximized;

b) Adopt measures whereby our senior citizens are assisted and appreciated by the community as a whole;

c) Establish a program beneficial to the senior citizens, their families and the rest of the community that they serve.

Article 5. Definition of Terms – As used in these rules, the following terms shall be defined as follows:

5.1 Senior Citizen – any resident citizen of the Philippines, at least sixty (60) years old, including those who have retired from both
government offices and private enterprises and has an income of not more than sixty thousand pesos (P60,000.00) per annum subject to
review by the National Statistics Coordination (NSCB) every three (3) years.

Senior Citizens earning sixty thousand pesos (P60,000.00) per annum may be tapped as resource persons to provide transfer technology and
consultancy services or other services in the community. Those without income are necessarily covered by this definition.

5.2 Resident Citizen – refers to Filipino Citizen who establishes to the satisfaction of the Office of the Senior Citizens Affairs (OSCA)
the fact of his physical presence in the Philippines for at least 183 days with a definite intention to reside therein.

5.3 Benefactor – shall mean any person whether related to the senior citizen or not who takes care of him or her as dependent.

5.4 Head of the Family – shall mean an unmarried or legally separated man or woman with one or both parents or with one or more
brothers or sisters or with one or more legitimate, recognized, natural or legally adopted children and/or with one or more senior citizen living
with and dependent upon him for their chief support where brother/s or sister/s or children are not more than twenty one (21) years of age
unmarried and not gainfully employed or where such children, brother/s or sister/s, regardless of age are incapable of self-support because of
mental or physical defect.

5.5 National Identification Cards – are the ID cards provided for initially for free by the Department of Social Welfare and
Development and issued through the Office for Senior Citizens Affairs (OSCA).

5.6 Office for Senior Citizens Affairs – otherwise known, as the OSCA shall be established in the Office of the Mayor as prescribed in
the Act.
 5.7 Department of Social Welfare and Development – otherwise known as DSWD in this rule, shall mean the national office located
at Batasan Complex, Quezon City and its field offices in the fourteen regions of the country.

5.8 Municipal/City Federation of Senior Citizens – an organization of senior citizens in the locality which is affiliated with the
National Federation of Senior Citizens’ Associations of the Philippines (NFSCAP). In the absence of such organization, any organization of senior
citizens in the locality duly accredited by the Sangguniang Bayan/Panglungsod.

5.9 Air Transportation Service – shall mean as the carriage of passenger by air.

5.10 Hotel – shall mean the building, edifice or premises or a completely independent part thereof, which is used for the regular
reception, accommodation, or lodging of travelers and tourists and the provision of services incidental thereto for a fee.

5.11 Lodging Establishment – shall mean any of the following:

a. Tourist Inn – a lodging establishment catering to transients which does not meet the minimum requirement of an economy hotel.

b. Apartel – any building or edifice containing several independent and furnished or semi-furnished apartments, regularly leased to
tourists and travelers for dwelling on a more or less long-term basis and offering basic services to its tenants, similar to hotels.

c. Motorist Hotel – any structure with several separate units, primarily located along the highway, with individual or common parking space, at
which motorists may obtain lodging and in some instances, meals.

d. Pension House – a private, or family-operated tourist boarding house, tourist guest house or tourist lodging house, employing non-
professional domestic helpers, regularly catering to tourist, and/or travelers, containing several independent lettable rooms, providing common
facilities such as toilets, bathrooms/showers, living and dining rooms and/or kitchen and where a combination of board and lodging may be
provided.

The term lodging establishment shall include lodging houses, which shall mean such establishments as are regularly engaged in the hotel
business, but which, nevertheless, are not registered, classified and licensed as hotels by reason of inadequate essential facilities and services.

5.12 Restaurant – shall mean any establishment, duly licensed by the local government units (LGUs ), offering to the public, regular and special
meals or menu, cooked food and short orders. Such eating-places may also serve coffee, beverages and drinks.

RULE III

CREATION OF THE OFFICE FOR SENIOR CITIZENS AFFAIRS

Article 6. Office for Senior Citizens Affairs (OSCA) – There shall be established in the office of the Mayor and OSCA to be headed by a councilor
who shall be designated by the Sangguniang Bayan/Panglungsod in coordination with the Department of Social Welfare and Development
(DSWD) and the Municipal/City Federation of Senior Citizens.

Article 7. The Functions of OSCA – The OSCA shall perform the following functions:

a) To plan, implement and monitor yearly work programs in pursuance of the objectives of this Act;

b) To mobilize the different local agencies to identify activities within their programs which can be undertaken by the senior citizens;

c) To draw up a list of available and required services which can be provided by the senior citizens;

d) To maintain a regular update on a quarterly basis a list of senior citizens;

The regular quarterly update of the list of senior citizens shall be made on the first week of the first month of every quarter.

e) To issue nationally uniform individual identification cards which shall be valid anywhere in the country;

It shall the responsibility of the local Social Welfare Development Officer or any other officer performing such functions to review and process all
applications

f) To serve as a general information and liaison center to respond to the needs of the senior citizens, the OSCA shall:

f.1 assist any complainant or aggrieved senior citizen in filing the appropriate action with the Office of the Public Prosecutor or with the
concerned Agency/Department until same is finally terminated or resolved, and;

f. 2 assist the National Government in putting up the necessary appropriate notices of the mandatory elderly discount privileges/benefits under
RA 7432, which shall be posted at a conspicuous place in all establishments.

This shall be made as a requirement in the renewal of business licenses annually.

The Municipal/City Federations of Senior Citizens shall assist OSCA in the foregoing functions:

8.1 to provide the initial nationally uniform identification cards which shall be issued through the OSCA.

The nationally uniform individual identification cards shall contain the following information:

a) Control Number, Date of Issue

b) Name

c) Address

d) Age, as supported by a certified birth certificate from the Office of Civil Registrar; Birth date

e) Annual income, as supported by a certificate of exemption from payment of income tax issued by the local office of the Bureau of internal
Revenue (BIR)

f) Picture

g) Signature of senior citizen

A senior citizen whose income is P60,000.00 and below annually shall be issued a national ID card, which contains the mandatory elderly,
discount privileges/benefits under RA 7432.
This shall be duly signed by the mayor of the senior citizen’s locality, the Secretary of the Department of Social Welfare and Development
(DSWD) and the Secretary of the Department of Interior and Local Government (DILG). This shall be non-transferrable.

8.2. to assist in developing the standards of programs and services of OSCA.

8.3. to provide technical assistance and monitor services and projects to be undertaken by the OSCA.

RULE IV

CONTRIBUTIONS IN THE COMMUNITY

Article 9. Contributions of Senior Citizens to the Community. Any qualified senior citizen as determined by the OSCA may render his/her services
to the community, which shall consist of, but not limited to any of the following:

a. tutorial and/or consultancy services;

b. actual teaching and demonstration of hobbies and income generating skills;

c. lectures on specialized field like agriculture, health, environmental protection;

d. transfer of new skill acquired by virtue of their training mentioned in Section 4 of paragraph (d) of the Act;

e. undertake other appropriate services as determined by the OSCA such as school traffic guide, tourist aide, pre-school assistance, etc.

In consideration of services rendered by the qualified elderly, the OSCA may award or grant benefits/privileges to the elderly, in addition to the
other privileges provided for under Section 4 of the Act.

In the absence of resources, OSCA shall mobilize resources of the community to provide awards or incentives.

Financially able institutions desiring to acquire services of the elderly shall be mobilized to provide a reasonable compensation e.g. transport,
food, etc. for the duration of the senior citizen’s services.

Senior citizens earning above sixty thousand pesos (P60,000.00) annually can be granted some awards or benefits by the OSCA for services
rendered to his community e.g. consultancy services, transfer of new technology, etc.

RULE V

PRIVILEGES AND BENEFITS OF SENIOR CITIZENS

A senior citizen shall be granted twenty per cent (20%) discount from all establishments relative to utilization of transportation services, hotels
and similar lodging establishments, restaurants and recreation centers and purchases of medicines, anywhere in the country.

A. Transportation Benefits

A. 1 Public Water Transportation – Every senior citizen who is a passenger of any public water transportation service as this term is understood
under the Public Service Act, as amended, shall be entitled to a discount in the amount of not less than twenty per cent (20%) of the fare
charged or authorized, including discount of twenty per cent (20%) on purchases of meals or food items from the restaurant either operated by
concessionaire or the carrier and medicines on board vessels.

The Maritime Industry Authority (MARINA) is hereby directed to issue corresponding circulars or directives to the shipping industry for the
implementation of these guidelines to ensure compliance herewith, as well as requirements to ship operators/ship owners to disseminate, by
posters, handbills or pamphlets, the information about senior citizen on board vessels to maximize the benefits of the senior citizens.

A senior citizen, unless his/her physical appearance shows that he/she undoubtedly 60 years old or above, may prove his/her age by any of, but
not limited, to the following documents or papers:

a. Official Identification Card from the OSCA of the LGUs, SSS/GSIS ID (old or new);

b. Driver’s License or Birth Certificate;

c. Voter’s ID or Voter’s Affidavit;

d. Residence Certificate (old or new);

e. And other public/official record or document, from relevant government agencies.

A.2 Public Land Transportation – every senior citizen who is a passenger of any public land transportation services stated below, shall be
entitled to a discount in the amount of not less than twenty per cent (20%) of the fare authorized by the Land Transportation Franchising and
Regulatory Board (LTFRB).

The public land transportation referred to are the following:

a. Bus (pub) b. Jeepney (puj)

c. Taxi

d. Shuttle Bus

e. Tourist Bus

f. Other modes of passenger land transportation devoted for public use and for a fee with general or limited clientele.

The LTFRB is hereby directed to issue corresponding circular or directives to the public land transport sector for the implementation of these
guidelines to ensure compliance herewith, as well as requirements to these operators to disseminate, by posters, handbills or pamphlets, the
information about senior citizens on board their vehicles to maximize the benefits of the senior citizens.

Every senior citizen is entitled to a grant of twenty per cent (20%) discount on the use of Light Rail Transit (LRT) System.

Senior citizens who would wish to avail of the discount privileges on LRTC shall be guided by the following procedures/conditions:

a) Senior citizens shall personally apply for the issuance of discount tickets (in booklet form) at the Light Rail Transit Authority (LRTC) or
METRO, Inc. with office at the Administration Building, LRTA Compound, Aurora Boulevard, Pasay City or at designated outlets at the LRT
system by presenting their ID card issued by the OSCA.

Discount tickets will be printed with control numbers and will allow a senior citizen to purchase LRT tokens at a twenty per cent (20%) discount.

b) A senior citizen shall personally surrender to any LRT token teller on duty at any LRT station/terminal where he/she will board, a discount
ticket for every token he/she will purchase.

Upon surrender of the discount ticket and presentation of the national ID card by a senior citizen, he/she shall pay for the LRT token at twenty
per cent (20%) discount. (A senior citizen is entitled to purchase only one (1) LRT token at discounted price every time he/she avails of the LRT
System.)

To avoid untoward incidents, senior citizens are discouraged from riding the LRT during peak hours from 7:00 A.M. to 9:00 A.M. and from 5:00
P.M. to 7:00 P.M. due to the volume of rider ship.

Twenty per cent (20%) discount for LRT tokens are available only at LRTC stations/terminals. Discounted token are not available from off-
station token vendors.

A.3. Domestic Air Transportation – Every senior citizen who is duly certified by t he OSCA is entitled to twenty per cent (20%) discount from the
Civil Aeronautics Board (CAB) approved and published airline rates for domestic air transportation services.

This Act shall cover individuals, partnership, or corporations and all other entities engaged in the carriage of passengers by air.

The following are the conditions required of a senior citizen to be able to avail of the twenty per cent (20%) discount on air transportation
services:

a. The senior citizen should present his/her identification card duly issued by OSCA in securing a passage ticket;

b. He/She should personally secure the passage ticket;

c. The passage ticket shall be non-transferable.

B. Hotels/Lodging Establishments Benefits – the twenty per cent (20%) discount privileges of the senior citizen from hotels/establishments shall
be limited to room accommodation only.

The DILG shall issue the necessary circulars or directives to tourism establishments for the implementation of these guidelines and to ensure
compliance herewith.

Likewise the Department of Tourism (DOT) shall issue the corresponding Administrative Order to DOT accredited establishments. v C.
Recreation Center Benefits – A senior citizen is entitled to a minimum of twenty per cent (20%) discount on all admission fees charged by the
theatres, cinema houses and concert halls, circuses, carnivals and other similar places of culture, leisure and amusement.

D. Purchases of Medicine Benefits – A senior citizen is entitled to a minimum of twenty per cent (20%) discount in the purchase of medicine for
his personal use and according to his personal needs.

In the purchase of medicine, a senior citizen or his doctor or the latter’s duly authorized representative should always present the national
identification card duly certified by the OSCA together with the doctor’s prescription in case of prescription drugs. If over-the-counter, the
number of drugs purchased shall be commensurate to the elderly person’s needs.

These discount privileges shall be limited and exclusive for the benefit of the senior citizen.

E. Income Tax Benefits/Tax Credits – For purpose of claiming tax credits, private establishments are required to keep a separate record of sales
made to senior citizens which shall include the name, identification number, gross sales, discount and date of transaction.

A senior citizen whose annual taxable income does not exceed the poverty level as determined by NSCB shall be exempted from payment of
individual income tax. Provided that:

a) A senior citizen whose annual taxable income exceed the said poverty level shall be liable to the individual income tax for the full amount of
his/her taxable income net of personal and additional exemptions;

b) Annual taxable income shall refer to the annual gross compensation, business and other incomes as defined in Section 28 of the National
Internal Revenue Code (NIRC) other than income subject to tax under paragraphs (b), (c), (d) and (e) of Section 21 of the NICR which include
certain passive incomes, capital gains from sale of shares of stock and capital gains from sale of real property;

c) The senior citizen is a resident citizen;

d) NEDA shall inform the Commissioner of Internal Revenue in writing and publish in a newspaper of general circulation the estimated poverty
threshold.

F. Training Fee Benefits – A senior citizen is exempted from training fees for socio-economic programs undertaken by or in coordination with the
OSCA as part of its work.

G. Medical/Dental Benefits – A senior citizen is entitled to free medical and dental services in government establishments anywhere in the
country subject to guidelines to be issued by the Department of Health (DOH), the Government Service Insurance System (GSIS) and the Social
Security System (SSS).

G.1 The DOH shall direct the government establishments in the entire country to provide free medical and dental services to senior citizens.

a. The term “free” shall mean free of charge on medical/dental services where capability and facility for such services are available,

b. The term “medical services” shall refer to services pertaining to the medical care/attendance and treatment given to senior citizens. It shall
include health examinations, medical/surgical procedures within the competence and capability of DOH establishments/hospitals/units and
routine/special laboratory examinations and ancillary procedures as required.

c. The term “dental services” shall refer to services pertaining to dental care/attendance and remedy given to senior citizens. It shall include oral
examination, curative services like permanent and temporary fillings, extractions and gum treatment.

d. Professional services – shall refer to services rendered or extended by medical, dental and nursing professionals, which shall also include
services rendered by surgeons, EENT practitioners, gynecologists, urologists, neurologists, psychiatrists, psychologists and other allied
specialists.

e. Counseling services – shall refer to advices given by health professional, e.g. psychologists, psychiatrists, nutritionists, nurses and other allied
health professionals in support to specific treatment of illnesses.
Provision of all of the above-mentioned services shall be subject to availability of appropriate facilities and trained manpower expertise of the
receiving establishment.

f. Government establishments shall refer to and limited to DOH hospitals, which shall include general hospitals, medical centers and regional
hospitals directly under the full control and supervision of the DOH.

g. The term “anywhere in the country” shall be construed to mean health privileges senior citizens may avail of from any hospital in the
Philippines, as defined in these guidelines, irrespective of their place of residence/locality, subject to availability of facilities and
manpower/technical expertise of the receiving establishment.

The following are the health services that may be availed of for free in any government establishments, subject to availability of facilities and
manpower/technical expertise of the receiving government establishment:

a. Medical and dental services

b. Out-Patient consultations

c. Available medicines in all public health programs

d. Available diagnostic and therapeutic procedures

e. Use of operating rooms, special units and central supply items

f. Accommodations in the charity ward

g. Professional and counseling services

To be able to avail of the aforementioned services, the following mechanics are stipulated:

a. A senior citizen may obtain the benefits from any government establishment.

b. He/she shall present his/her national ID card issued by the OSCA to the medical and social services or Medical Social Worker designated who
shall determine the validity of his/her ID card.

c. Non-presentation of the national ID card shall be sufficient reason for denial of free hospital benefits.

d. In case of emergency, the medical benefits shall be accordingly provided by the receiving hospital even if the ID is not available. However,
the national ID card should be presented within a reasonable time. Non-presentation of the national ID card shall be sufficient ground for
charging the service already given and denial of further availment of the benefits.

e. Should the senior citizen choose to be admitted to a private room/pay ward or be transferred from a free room to a pay room, the amount
equivalent to the rate of a free room should be discounted from that of the pay room/ward.

f. As regard referral or transfer of senior citizen-patient to another government establishment, the receiving hospital shall provide the full
benefits under this rule. In case of transfer/referral between the DOH hospitals, procedures shall be based on the DOH Network Guidelines.

The responsibilities of the government establishment are as follows:

a. Provide all available medical and dental services, as defined in these guidelines that may be deemed necessary in the promotion of the health
of senior citizens;

b. Establish a system by which all senior citizens in dire need of health serve shall be given priority and utmost consideration;

c. Establish and maintain a recording/reporting system which data may be used as inputs for program/project planning and evaluation; and

d. Strengthen their competence and capability to evaluate and manage geriatic cases through continuing education.

The responsibilities of senior citizens who are entitled to health benefits and privileges as indicated and certified by valid national identification
cards issued by the OSCA, are as follows:

a. Adhere to rules and regulations relative to the implementation of this program;

b. Recognize that the government establishments have limitations and constraints in providing health services and not demand for services that
are not available and beyond the level of their competence;

c. Secure on their own payable services that are not covered by their health benefits and privileges stipulated herein; and

d. Safeguard the integrity of their identification card and shall not allow their misuse and abuse.

To the extent practicable and feasible, the continuance of the same benefits and privileges shall be given to senior citizens by the GSIS, SSS
and PAG-IBIG as the case may be as are enjoyed by those in the actual service.

G.2 Benefits extended to senior citizens who are retirees of the GSIS are as follows:

a. Life Insurance

If a retiree opts to maintain his life insurance policy with the System, he may convert his compulsory life insurance into an optional insurance by
paying directly to the System the monthly premiums due thereon (personal plus government share), up to its maturity date. Amount of monthly
premiums shall be determined by the System. He will be entitled to receive benefits as enumerated below:

1. maturity benefit – retiree will receive the total face value of the policy, less any indebtedness thereon.

2. policy loan – loanable amount will not exceed 90% of the cash value of his insurance at the time of application.

3. death benefit – when the retiree dies while life insurance membership is in force prior to maturity date, the designated beneficiaries double
indemnity.

b. Retirement

1. Retirees under PD 1146 or RA 660 shall resume receiving their basic monthly pension (BMP) for life after the lapse of the 5-year guaranteed
period.
2. Upon death of a pensioner who retired under PD 1146 or RA 660, the primary beneficiaries (legal spouse and minor children) shall receive a
basic survivorship pension (BSP) equivalent to 50% of the BMP plus dependent’s pension (DP) equivalent to 10% of the BMP for every minor
child, if any, but not exceeding five. The spouse shall receive the BSP for life until she/he remarries. The minor children shall continue receiving
DP until emancipated by marriage, gainful employment or upon reaching 21 years of age. A mentally or physically incapacitated child, however,
shall receive DP for life.

3. Funeral Benefit – payable upon death of the retirees, pensioner or gratuitant, the latter must have retired with at least 20 years of service to
be entitled to the benefit.

c. Medicare

Coverage:Employees who retired from the service before age 60 may opt to continue their membership within 6 months from date of retirement
by contributing both personal and government shares of their Medicare premiums until their 60th birthday.

However, a government employee who retires under RA 1616, PD 1146 or PD 1184 at age 60 or above or under RA 660 (regardless of age) are
covered without paying contributions pursuant to PD No. 408. Effective January 1, 1992, their legal dependents are also extended Medicare
benefits.

Legal Dependents:

1. The legal spouse who is not a Medicare member.

2. The unmarried and unemployed children, including legitimated, acknowledged, legally adopted and step children below 21 years of age;

3. Children 21 years old or above with disability acquired before the age of 21.

Benefits under the Medicare Act consist of:

1. Allowance for room and board

2. Allowance for drugs and medicines

3. Allowance for x-ray/laboratory examinations/others (“others” means items such as syringes, gloves, vaco sets, butterfly, contrast media and
other agents used in establishing correct diagnosis).

4. Surgeon’s fee

5. Medical Practitioner’s fee

6. Anesthesiologist’s fee

7. Operating room fee

8. Allowance for sterilization procedures

Types of Non-Compensable Treatments

1. Cosmetic surgery or treatment

2. Optometric services

3. Psychiatric services

4. Services which are purely diagnostic

d. Employees Compensation (PD 626)

Only employment-connected injury or sickness resulting in disability or death is compensable. It therefore presupposes the existence of an
employee-employer relationship at the time the contingency occurs. The legal and/or medical evaluation to determine compensability is lodged
solely with the System.

Type of Disability Benefits

Temporary Total Disability (TTD)

1. daily income benefit of not less than P10,00 nor more than P90.00 for a period not exceeding 120 days and in severe cases up to 240 days.

2. medical and/or related services (for work-connected injury or sickness) consisting of:

2.1 hospitalization room and board supplies, x-ray, medicines, laboratory, professional fee.

2.2 ambulatory/d o miciliary care, services for hospitalization except room and board

2.3 reimbursement of medicines (in case of non-confinement)

Permanent Partial Disability (PPD)

1. monthly income benefit (MIB) for the designated number of months of not less than P250.00 or more than P3,240.00.

2. medical and/or related services (for work-connected injury or sickness) (refer to 2.1 2.2 and 2.3)

Permanent Total Disability (PTD)

1. monthly income benefit (MIB) of not less than P250.00 nor more than P3,240.00 plus 10% increment for each minor child not exceeding five
starting from the youngest without substitution payable for life and guaranteed for 5 years.
2. medical and/or related services (refer to 2.1, 2.2 and 2.3)

3. rehabilitation services – consist of medical/surgical management, necessary appliances and supplies such as artificial leg and arm, wheelchair,
crutches, etc. and vocational training and assistance for placement.

DEATH

A. Death of the Employee

1. MIB the same as in PPD (plus 10% thereof for each dependent child, not exceeding five) payable to:

a. primary beneficiary/ies for life and/or as long as qualified

b. secondary beneficiary/ies (in the absence of primary beneficiary/ies) for a period not ot exceed 60 months

B. Death of a PTD Pensioner

1. MIB due to death (80% of the MIB after the 5-year guaranteed period) payable to:

a. primary beneficiary/ies for life and/or as long as qualified

b. secondary beneficiary/ies (in the absence of primary beneficiary/ies)

MIB excluding dependent’s pension of the remaining balance of the 5-year guaranteed period.

2. Funeral benefit of P3,000.00 payable upon the death of a covered employee or PTD pensioner to the person who can show incontrovertible
proof that he shouldered funeral expenses.

G.3 The SSS provides medical and dental services to its retirees and their dependents through the Medicare Program without the need for
additional contributions. However, the Medicare Program does not cover the entire cost of hospitalization.

The SSS medical staff in the regional offices render free consultation to SSS pensioners.

The SSS regularly evaluates the level of pension of the retirees.

The SSS involvement in this Act is limited only to its retirees since the SSS funds are held in trust for the exclusive benefits of the private
workers and their beneficiaries. Usage of such funds for other purposes is not allowed under SSS charter.

G.4 Membership in the PAG-IBIG Fund shall be open to all senior citizens who opt to continue with their provident savings in the Fund, even
after their retirement from their employment or upon reaching the age of sixty (60) years.

a. Senior citizens who wish to enlist with the PAG-IBIG Fund for the first time may do so upon proof of gainful employment, or of being self
employed, or of membership in trade/service cooperative (e.g. farmers cooperatives, fishermen’s cooperative, loom weavers association,
handicraft maker’s organization, and the like) and upon payment of the monthly minimum contribution rate as may be set up by the PAG-IBG
Fund from time to time.

b. PAG-IBIG members of good standing shall be entitled to avail themselves of PAG-IBIG loan privileges subject to the customary guidelines on
loan availments. For PAG-IBIG housing loans, the loan availments. For PAG-IBIG housing loans, the loan period shall not be more than twenty
five (25) years but in no case shall it exceed the difference between the present age reckoned from the borrower’s nearest birthday and his
seventieth (70th) year; in the case of a joint and several loan, the loan period shall be based on the age of the youngest of the co-borrowers.

RULE VI

GOVERNMENT ASSISTANCE

Article 10. Personal Tax Exemption for Benefactor – A senior citizen shall be treated as dependent provided for in the NIRC and as such, shall be
accorded the privileges granted by the Code insofar as having dependent are concerned. In determining personal exemptions allowable to
individuals under Section 29 (k) (l) of the NIRC, a senior citizen may be granted as a dependent. For this purpose, the definition of the term
Head of the family under the said Section shall be deemed amended to refer to the condition under Article (5) of this implementing rules and
regulations. The OSCA shall require the senior citizen to declare his benefactor who will be granted the exclusive right to claim him as
dependent and issue a identification thereof. The said certification shall be presented by the benefactor to the BIR for purposes of determining
personal exemptions.

The personal tax exemption shall take effect January 1992.

Article 11. Property Tax Exemptions and Privileges for Individuals and Non-Government Institutions. Individuals or non-government institutions
establishing homes, residential communities or retirement villages solely for the senior citizen shall be accorded the following:

a. One per cent (1%) property tax exemption for the first five years starting first year of operation:

b.

(1) The exemption is automatically withdrawn effective on the year after the institution ceases its operation before the end of the fifth year of
operation. The owners of the properties shall thereafter be liable for the realty taxes applicable thereon.

(2) The first year of operation shall be reckoned from the date the institution was granted a mayor’s permit to operate the establishment.

(3) The exemption shall apply prospectively. Establishments which are beyond their fifth year of operation shall not be entitled to refund of their
payments or condonation of their realty tax delinquencies during their first five years of operation. However existing establishments which have
been operating for less than five years shall be entitled to the exemption in the remaining of the five years.

c. Priority in the building and/or maintenance of provincial or municipal roads leading to the aforesaid home residential community or retirement
village.

Provided that: in both cases, said exemption and priority shall apply only when said homes residential communities or retirement villages are
non-stock, no-profit as such which shall be presented to the Assessor’s Office of the LGUs concerned.

RULE VII

PENALTY PROVISIONS

Article 12. Penalties. Any person who willfully refuses to grant the privileges provided for by RA 7432 or violates any provision thereof and for
which no penalty is specifically provided for by any existing law, shall be punished by imprisonment not exceeding one (1) month or a fine not
exceeding One Thousand Pesos (P1,000.00) or both.

Any organization, private government establishment and government department/bureau/agency/institution who willfully refuses to grant the
privileges given to senior citizens or violates any provision of RA 7432 shall be administratively dealt with by any of the agency/department
concerned including, but not limited to the cancellation of permit/s or franchise/s to operate to a business establishment or institution or public
service.

RULE VIII

FINAL PROVISIONS

Article 13. Implementation, Supervision, Monitoring and Technical Assistance.

a. Municipal Responsibility. It shall be the responsibility of every municipality, through its chief executive, to ensure that the provisions of RA
7432 are operationalized and implemented to the fullest within its jurisdiction.

b. The DILG, having been designated by the President to exercise general supervision over LGUs, by virtue of the Local Code, rule XI, shall
ensure the compliance of LGUs with this Act. It shall likewise institute the necessary interventions aimed at enhancing the capacities of the LGUs
in implementing the above-mentioned provisions.

c. On a national scale, the DSWD, by virtue of its monitoring and technical assistance function shall ensure the viability and standard of the
programs and services that are implemented, while the DILG shall ensure compliance of LGUs.

Article 14. Appropriation. The municipality, through its Sangguniang Bayan shall appropriate funds on a yearly basis for the maintenance and
other operating expenses of the OSCA to incorporate in the annual budget.

The concerned provincial/municipal government agency shall likewise mobilize other sources of funds particularly those that are made available
for local development activities by the national government, the legislature and the private sector.

Article 15. Separatibility Clause, If, for nay reason/s, any part or provision of this Implementing Rules and Regulations shall be held
unconstitutional or invalid, other parts or provisions hereof which are not affected thereby shall continue to be in full force and effect.

Article 16. Effectivity Clause. This Implementing Rules and Regulations shall take effect fifteen (15) days following its publication in one (1)
national newspaper of general circulation.

ADDENDUM

REVENUE REGULATIONS NO. 2-94

(August 23, 1993)

SUBJECT:

Republic Act No. 7432 otherwise known as an Act to Maximize the Contribution of Senior Citizens to Nation Building, Grant Benefits and Special
Privileges and for Other Purposes.

To: All Internal Revenue Officers and Others Concerned.

Section 1. SCOPE – Pursuant to Section 245 of the National Internal Revenue Code (NIRC) as amended, in relation to Section 10 of Republic
Act No. 7432, these regulations are hereby promulgated to (1) implement the provisions of Section 4 and 5 (a) of the said Act granting tax
exemption and other privileges to senior citizens, and (2) prescribe the guidelines for the availment thereof.

SECTION 2. DEFINITIONS. – For purposes of these regulations:

a. Act – refers to Republic Act No. 7432.

b. Senior citizen – means any resident citizen of the Philippines at least sixty (60) years old, including those who have retired from both
government offices and private enterprises, and has an income of not more than sixty thousand pesos (P60,000.00) per annum subject to
review by the National Economic and Development Authority (NEDA) every three (3) years.

The term “qualified senior citizen” shall refer to a resident Filipino citizen who meets the statutory requirements of Section 2 of the Act and
Section 2(b) of these regulations.

c. Resident citizen – refers to a Filipino citizen with permanent/legal residence in the Philippines, and shall include those, who, having
migrated to a foreign country, have returned to the Philippines with a definite intention to side therein, and whose immigrant visa has been
surrendered to the foreign government.

d. Dependent – a qualified senior citizen whether or not related to a benefactor with whom he lives and who takes care of him/her.

e. Head of the Family – an unmarried or legally separated man or woman, with one or both parents, or with one or more brothers or sisters,
or with one or more legitimate, recognized natural or legally adopted children, living with and dependent upon him/her for their chief support,
where such brothers or sisters or children are not more than twenty-one (21) years of age, unmarried and not gainfully employed or where
such children, brothers or sisters, regardless of age are incapable of self-support because of mental or physical defect.

The term ‘head of family’ includes an unmarried or legally separated man or woman who is the benefactor of a qualified senior citizen as
defined in Section 2 of the Act and these regulations.

The term “qualified senior citizen” shall refer to a resident Filipino citizen who meets the statutory requirements of Section 2 of the Act and
Section 2(b) of these regulations.

f. Benefactor – any person whether or not related to the senior citizen who takes care of the latter as a dependent.

g. OSCA – refers to the Office for Senior Citizens Affairs.

h. Income/Annual Taxable Income of a resident Senior Citizen shall refer to the annual gross compensation, business and other income received
during each taxable year from all sources as defined in Section 28 of the NIRC, which shall not exceed the poverty level of P60, 000 or such
amount as may thereafter be determined by the NEDA.

However, income derived by a qualified senior citizen from the following sources:
 1. Interest income from Philippine currency bank deposits, yield and other monetary benefit from deposit substitutes, trust fund and
similar arrangements; royalties, prizes and winnings (Sec. 21 (c), NIRC);

2. Capital gains from sales of shares of stock (Sec. 21 (d), NIRC); and

3. Capital gains from sales of real property (Sec.21(e), NIRC).

shall not be included in the determination of his income/annual taxable income’ which should not exceed the poverty level of P60,000 or such
amount as may thereafter be determined by the NEDA for a certain taxable year inasmuch as income from such sources shall be subject to the
corresponding income tax rates prescribed under Section 21 (c), (d) and (e) of the NIRC as amended.

i. Tax Credit – refers to the amount representing the 20% discount granted to a qualified senior citizen by all establishments relative to their
utilization of transportation services, hotels and similar lodging establishments, restaurants, drugstores, recreation centers, theaters, cinema
houses, concert halls, circuses, carnivals and other similar places of culture, leisure and amusement, which discount shall be deducted by the
said establishments from their gross income for income tax purposes and from their gross sales for value-added tax or other percentage tax
purposes.

Sec. 3. INCOME TAX BENEFIT AND PRIVILEGES FOR THE SENIOR CITIZENS. – Senior citizens qualified as such by the Commissioner
of Internal Revenue or his duly authorized representative who, for purposes of these regulations, is the Regional Director of the Revenue Region
having jurisdiction of the city or municipality where they are permanent residents shall be entitled to the following tax benefit and privileges:

a. Exemption from the payment of individual income tax provided that their annual taxable income does not exceed the poverty level of
P60,000.00 or such amount as may be determined bt the NEDA for a certain taxable year.

b. A 20% discount from all establishements relative to utilization of transportation services, hotels and similar lodging establishments,
restaurants and recreation center, and on purchases of medicine anywhere in the country.

c. A minimum of twenty perecent (20%) discount on admission fees charged by theaters, cinema houses and concert halls, circuses, carnivals
and other similar places of culture, leisure, and amusement.

Sec. 4. RECORDING/BOOKKEEPING REQUIREMENTS FOR PRIVATE ESTABLISHMENTS. – Private establishments, i.e., transport
services, hotels and similar lodging establishments, restaurants, recreation centers, drugstores, theaters, cinema houses, concert halls, circuses,
carnivals and other similar places of culture leisure and amusement, giving 20% discounts to qualified senior citizens are required to keep
separate and accurate record of sales made to senior citizens, which shall include the name, identification number, gross sales/receipts,
discounts, dates of transactions and invoice number for every transaction.

The amount of 20% discount shall be deducted from the gross income for income tax purposes and from gross sales of the business enterprise
concerned for purposes of the VAT and other percentage taxes.

Sec. 5. AVAILMENT OF INCOME TAX EXEMPTION. – Asenior citizen who shall avail of the exemption from income tax is required to submit
the following documents to the Revenue District Officer (RDO) of the place where he is a permanent resident, who shall make the necessary
verification and report for purposes of the income tax exemption to be issued by the Commissioner of Internal Revenue or his duly authorized
representative:

A. Certified true copy of his Birth Certificate/Baptismal Certificate or in the absence thereof, a certification from the National Statistics and
Census Bureau or an affidavit by two (2) disinterested credible persons who know personally the senior citizen.

B. If he has a benefactor as defined in Section 2 (f) of these Regulations, Certification as to the name, address, occupation, Office or business
address (office/business) and TIN of his benefactor;

C. If employed, a copy of his withholding tax statement (BIR Form W-2) for the preceding taxable year;

c. 1 A senior citizen who derives taxable (fixed) compensation income from only one employer in an amount not exceeding P60,000 per annum
shall be exempt from income tax and consequently from the withholding tax prescribed under Section 72 Chapter 10, Title II of the National
Internal Code, as amended.

D. If self-employed, (i.e., practice of profession, or in business as single proprietorship) a copy of his income tax return (ITR) for the preceding
taxable year together with the annual license or permit issued by the city or municipality where he has his principal place of business, supported
by a copy of his declaration of sales or income.

d.1 A senior citizen who derives taxable compensation income from two (2) or more employers, or who receives mixed income from
employment and from business shall still file an income tax return.

The RDO concerned shall transmit his verification report/recommendation to the said Regional Director, as duly authorized representative of the
Commissioner, for issuance of the certificate of income tax exemption to the senior citizen.

For purposes of applying for the OSCA ID Card, the duly stamped income tax return and or the BIR Certification shall be honored.

Sec. 6. TAXABILITY OF SENIOR CITIZENS TO OTHER INTERNAL REVENUE TAXES.

a. A senior citizen whose annual taxable income exceeds the poverty level of P60,000 or such amount as may thereafter be determined by the
NEDA for a certain taxable year shall be liable to the individual income tax in the full amount thereof on his taxable income net of allowable
deductions.

b. Regardless of the amount of taxable income, a senior citizen who derives income from self-employment, business and practice of profession
shall be subject to other internal revenue taxes which include but are not limited to the value added tax, caterer’s tax, documentary stamp tax,
overseas communications tax, excise taxes, and other percentage taxes. He shall therefore, file the corresponding business tax returns in
accordance with existing laws, rules and regulations.

c. He shall be subject to the 20% final withholding tax on, interest income from Philippine Currency bank deposit, yield and other monetary
benefit from deposit substitutes, trust fund and similar arrangements; royalties, prizes (except prizes amounting to P3,000 or less which shall be
subject to income tax at the rates prescribed under Section 21, paragraph (a) or (f), NIRC) as the case may be, and winnings (except Philippine
Charity Sweeptakes winnings).

d. Capital gains from sales of shares of stock (Sec. 21 (d), NIRC).

e. Capital gains from sales of real property (Sec. 21 (e), NIRC).

Sec. 7. BASIC PERSONAL EXEMPTION ONLY FOR BENEFACTOR -.

A qualified senior citizen living with and taken cared of by a benefactor whether related to him or not, shall be treated as a dependent and his
benefactor shall be entitled to the basic personal exemption of P12,000 as head of the family, as defined in Section 2 (e) of these regulations.
For purposes of claiming personal exemptions as head of family with dependent senior citizen, the identification card number issued by the
OSCA shall be indicated in the ITR to be filed by the benefactor. The senior citizen shall indicate in a certification to be submitted to the RDO
and the OSCA his benefactor who will be granted the exclusive right to claim him as dependent for income tax purposes.

Caring for a dependent senior citizen shall not, however, entitle the benefactor to claim the additional exemption allowable to a married
individual or head of family with qualified dependent children under Sec. 29 (1) (2) of the NIRC, as amended.

Sec. 8. REPEALING CLAUSE. – All existing rules, regulations and other issuances or portions thereof inconsistent with the provisions of these
regulations are hereby modified, repealed or revoked accordingly.

Sec. 9. EFFECTIVITY. – These regulations shall take effect fifteen (15) days after publication in the Official Gazette or newspaper of general
circulation whichever comes first and shall apply to income earned beginning January 1, 1992.

(Sgd.) ERNESTO LEUNG

Acting Secretary of Finance

RECOMMENDED BY:

(Sgd.) LIWAYWAY VINZONS-CHATO

Commissioner of Internal Revenue

Health and Well-being of Older Persons

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Rationale

The proportion of older persons is expected to rise worldwide. In the 1998 World Health Report, there were 390 million older people and this
figure is expected to increase further (WHO). This growth will certainly pose a challenge to country governments, particularly to the developing
countries, in caring for their aging population. In the Philippines, the population of 60 years or older was 3.7 million in 1995 or 5.4% of total
population. In the CY 2000 census, this has increased to about 4.8 million or almost 6% (NSCB). At present there are 7M senior citizens (6.9%
of the total population), 1.3M of which are indigents.

With the rise of the aging population is the increase in the demand for health services by the elderly. A study done by Racelis et al (2003) on
the share of health expenditure of Filipino elderly on the National Health Account, the elderly are “relatively heavy consumers of personal health
care (22%) and relatively light consumers of public health care (5%).” From out-of-pocket costs, the aged are heavy users of care provided by
medical centers, hospitals, non-hospital health facilities and traditional care facilities.

Cognizant of the growing concerns of the older population, laws and policies were developed which would provide them with enabling
mechanisms for them to have quality life. RA 9257 or the Expanded Senior Citizens Act of 2003 (predecessor of RA 9994) provided for the
expansion of coverage of benefits and privileges that the elderly may acquire, including medically necessary services. Parallel to this objective is
the Department’s desire to provide affordable and quality health services to the marginalized population, especially the elderly, without
impeding currently pursued objectives and alongside health systems reform.

One of the provisions of RA 9994 or the Expanded Senior Citizens act of 2010 is for the DOH to administer free vaccination against the influenza
virus and pneumococcal diseases for indigent senior citizens. The DOH in coordination with local government units (LGUs), NGOs and POs for
senior citizens shall institute a national health program and shall provide an integrated health service for senior citizens. It shall train community
– based health workers among senior citizens health personnel to specialize in the geriatric care and health problems of senior citizens.

Interventions/Strategies Implemented by DOH

1. Creation of a National Technical Working Group on the Health and Well-being of Older Persons (DPO. No. 2011- 3578 dated June 29,
2011 Chaired by NCDPC- Director III.

2. Planning Meeting for the Senior Citizens Immunization Program

3. Consultative Planning and Finalization of Immunization Guidelines for Indigent Senior Citizens

4. Provision of Pneumococcal and Flu Vaccines to Indigent Senior Citizens aged 60 years old and above using the NHTS of the DSWD
including GO – NGO shelter homes in 2011

5. Conduct annual “ Summer Camp ni Lolo at Lola “

6. Support the annual “Walk for Life” for the elderly every October

Status of Implementation / Accomplishment

1. The total pneumococcal and influenza vaccines delivered to all CHD’s for the CY 2011 were 197,000 and 173,000 respectively
including the sub-allotment per region for HWOP activities.

2. Training and Orientation of Pneumo and Flu Vaccines for HWOP Coordinators

3. Signed Guidelines to Implement the Provisions Relevant to Health of RA 9994 or the Expanded Senior Citizens Act of 2010.

4. Summer Camp ni Lolo at Lola 2012 held at Davao, City.

5. Support World Health Day April 12, 2012 with the theme “ Ageing and Health “ in coordination with NCHP and WHO

Future Plan / Action

 1. Pneumococcal and Influenza Vaccines for CY 2012 still with COBAC

2. Support to Walk for Life Activity on October 2012.

3. Summer Camp nina Lolo at Lola 2013

Program Manager:

Ms. Remedios Guerrero

Department of Health-Non Communicable Disease Office (DOH NCDPC-DDO)

Contact Number: 651-78-00 local 1750-1752

Infant and Young Child Feeding (IYCF)

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I. Profile/Rationale of the Health Program

A global strategy for Infant and Young Child Feeding (IYCF) was issued jointly by the World Health Organization (WHO) and the United Nations
Children’s Fund (UNICEF) in 2002, to reverse the disturbing trends in infant and young child feeding practices. This global strategy was
endorsed by the 55th World Health Assembly in May 2002 and by the UNICEF Executive Board in September 2002 respectively.

In 2004, infant and young child feeding practices were assessed using the WHO assessment protocol and rated poor to fair. Findings showed
four out of ten newborns were initiated to breastfeeding within an hour after birth, three out of ten infants less than six months were exclusively
breastfed and the median duration of breastfeeding was only thirteen months. The complementary feeding indicator was also rated as poor
since only 57.9 percent of 6-9 months children received complementary foods while continuing to breastfed. The assessment also found out
that complementary foods were introduced too early, at the age of less than two months. These poor practices needed urgent action and
aggressive sustained interventions.

To address these problems on infant and young child feeding practices, the first National IYCF Plan of Action was formulated. It aimed to
improve the nutritional status and health of children especially the under-three and consequently reduce infant and under-five mortality.
Specifically, its objectives were to improve, protect and promote infant and young child feeding practices, increase political commitment at all
levels, provide a supportive environment and ensure its sustainability. Figure 1 shows the identified key objectives, supportive strategies and
key interventions to guide the overall implementation and evaluation of the 2005-2010 Plan of Action. The main efforts were directed towards
creating a supportive environment for appropriate IYCF practices. The approval of the National Plan of Action in 2005 helped the Department of
Health (DOH) and its partners, in the development of the first (1st) National Policy on Infant and Young Child Feeding. Thus on May 23, 2005,
Administrative Order (AO) 2005-0014: National Policies on IYCF was signed and endorsed by the Secretary of Health. The policy was intended
to guide health workers and other concerned parties in ensuring the protection, promotion and support of exclusive breastfeeding and adequate
and appropriate complementary feeding with continued breastfeeding. (1)

GUIDING PRINCIPLES

The IYCF Strategic Plan of Action upholds the following guiding principles:

1. Children have the right to adequate nutrition and access to safe and nutritious food, and both are essential for fulfilling their right to the
highest attainable standard of health. (5)

2. Mothers and Infants form a biological and social unit and improved IYCF begins with ensuring the health and nutritional status of women. (5)

3. Almost every woman can breastfeed provided they have accurate information and support from their families, communities and responsible
health and non-health related institutions during critical settings and various circumstances including special and emergency situations.(5)

4. The national and local government, development partners, non-government organizations, business sectors, professional groups, academe
and other stakeholders acknowledges their responsibilities and form alliances and partnerships for improving IYCF with no conflict of interest.

5. Strengthened communication approaches focusing on behavioral and social change is essential for demand generation and community
empowerment.

GOAL, MAIN OBJECTIVE, OUTCOMES AND TARGETS

GOAL:

Reduction of child mortality and morbidity through optimal feeding of infants and young children

MAIN OBJECTIVE:

To ensure and accelerate the promotion, protection and support of good IYCF practice

OUTCOMES:

By 2016:

• 90 percent of newborns are initiated to breastfeeding within one hour after birth;
• 70 percent of infants are exclusively breastfeed for the first 6 months of life; and
• 95 percent of infants are given timely adequate and safe complementary food starting at 6 months of age.
TARGETS:

By 2016:

• 50 percent of hospitals providing maternity and child health services are certified MBFHI;
• 60 percent of municipalities/cities have at least one functional IYCF support group;
• 50 percent of workplaces have lactation units and/or implementing nursing/lactation breaks;
• 100 percent of reported alleged Milk Code violations are acted upon and sanctions are implemented as appropriate;
• 100 percent of elementary, high school and tertiary schools are using the updated IYCF curricula including the inclusion of IYCF into the
prescribed textbooks and teaching materials; and
• 100 percent of IYCF related emergency/disaster response and evacuation are compliant to the IFE guidelines.

II. Target beneficiaries of the program are infants (0-11 months) and young children (12 to 36 months years old or 1 to 3
years old)

III. Action/Work Plan

KEY INTERVENTION SETTINGS AND SERVICES

STRATEGIES, PILLARS AND ACTION POINTS

STRATEGY1: Partnerships with NGOsand GOs in the coordination and implementation of the IYCF Program

1.1 Formalize partnerships with GOs and NGOs working on IYCF program coordination and implementation

a. Strengthen the TWG to allow it to effectively coordinate the GOs and NGOs working for the IYCF Program

The national TWG will remain but will be strengthened. It shall be constituted by: NCDPC as Chair, FHO as secretariat
and representatives from NCDPC,FHO, NCHP, FDA, DJFMH, DSWD,CWC, NNC, ILO, WHO and UNICEF. This time, members of theTWG will
be tasked to focus participation to the intervention setting where it ismost relevant.

The TWG shall be reporting regularly to the Service Delivery Cluster Head. At the Regional level, the Regional Coordinators from the above
offices shall collaborate in the implementation of the IYCF Program. To ensure that GO and NGO IYCF partners work together, the
composition of the TWGs and AD Hoc committees shall be made up of representatives from the government and non-government sectors and
the Ad Hoc Committees shall be chaired by the relevant agency where the intervention setting belongs.

At the provincial, municipal and barangay levels the existing Coordinating Committees which has an interagency composition shall be
the coordinating arm of the IYCF Program. This is where the participation of non-government entities will be facilitated. Mechanisms for
coordination shall be devised to build a strong foundation for partnership between the LGU, the Coordinating Committees and local NGOs or
private entities.

A memorandum of agreement (MOA) shall be executed between DOH and other agencies invited to become members of the TWG.

b. Organize functional Intervention Setting Committees (this is the same as the ad-hoc committee)

The years covered by this action plan will be marked with many developmental activities in all the intervention settings. The
TWG shall create a committee for each of the intervention setting. The committees shall be chaired by the relevant agency/ office. Other
government and non-government agencies will be invited to the committees relevant to their mandate.

c. Return the MBFHI responsibility from NCHFD to NCDPC

The National Policy on IYCF created in 2005 has affirmed the MBFHI responsibility to NCHFD. Since MBFHI is now under the umbrella of the
IYCF Program, it is in a better position to consolidate efforts towards MBFHI compliance. Thus the return of the MBFHI responsibility from
NCHFD to NCDPC shall be pursued. The collaboration of NCHFD is still needed though as it has a direct hand on health facility development. At
NCDPC the integration of IYCF in the MNCHN Action Plan shall be worked out in all aspects of the program and at the different levels of
implementation.

d. Augment human resource complement of NCDPC- FHO, IYCF program

NCDPC-FHO as the secretariat of the TWG and supervising and supporting the IYCF Program will not be able to effectively carry out the
technical, management and administrative roles and responsibilities without additional human resource. Funds shall be allotted for job orders for
this purpose.

e. Programmed contracting out of activities to organizations outside of DOH

To achieve the objectives and targets of the IYCF program, it shall be implemented simultaneously in the different intervention
settings and at a faster pace. This is a gargantuan task considering the extent of the developmental work, the management requirements,
and the mobilization of the IYCF network and the sourcing of funds for implementation.

Organizations and consultants that possess the expertise and the commitment to the IYCF program
will be contracted out for complex activities that require time and effort beyond the capacity of the TWG and the Ad Hoc committees.
These contracts shall be arranged based on need and awarded based on merit.

STRATEGY 2: Integration of key IYCF action points in the MNCHN Plan of Action/Strategy

2.1 Institutionalize the IYCF monitoring and tracking system for national, regional and LGU levels

a. Institutionalize the collection of PIR Data and generate annual performance report

The established IYCF data set that are being collected during PIRs shall be further reviewed, revised as appropriate and institutionalized through
a Department Circular and in collaboration with the other programs in the FHO.

An IYCF Program annual performance report shall be generated at the end of every year based on the PIR data, the consolidated data
from the unified monitoring and related data coming from research and studies as appropriate. Reports on the performance of
developmental activities shall be collected as part of the data base and to be reported as needed to the Service Delivery Cluster Head.

b. Maximize the use of the unified monitoring tool

The CHDs through its Regional Coordinators shall be required to use and consolidate the unified monitoring tool. A
simple data management program shall be developed to facilitate the consolidation of data extracted from monitoring. Reports shall be
required two weeks after the end of every quarter.

c. Collaborate with the National Epidemiology Center (NEC) and Information Management Service (IMS) regarding IYCF data

The current records and reports being collected by the DOH Field Health Information System will remain as the main source of data from
health facilities. However, collaboration with NEC and IMS to improve data quality and include data on complementary feeding is
essential.

2.2 Participation of the IYCF Focal person in MNCHN planning and monitoring activities

a. Designate the IYCF Focal Person as a regular member of the team working for the development and implementation of the MNCHN
Strategy

The IYCF Focal Person shall ensure that the IYCF action points become an agenda of the MNCHN Strategy and thus ultimately the
IYCF services forms a part of the integrated services for mothers and children. In the MNCHN planning and monitoring, the IYCF Focal
Person shall help ensure that in the multitude of activities, critical IYCF action points and indicators are not overlooked.

STRATEGY 3: Harnessing the executive arm of government to implement and enforce the IYCF related legislations and
regulations (EO 51, RA 7200 and RA 10028)

3.1 Consultation mechanism with the IAC and DOJ for the enforcement of the Milk Code and with other relevant GOs for other IYCF related
legislations and regulations

a. Devise and implement a consultation mechanism to bring together the IAC, DOJ and other relevant GOs for IYCF related legislations and
regulations

The Committee for Industry Regulation shall devise and implement a consultation mechanism to facilitate the implementation and
enforcement of IYCF related laws and regulations. This will require participation of higher levels of authority in the GOs.

The goal of the consultation mechanisms is to develop activities that will focus on facilitating the process of monitoring of
compliance and enforcement of IYCF related laws and regulations not only at the national level but also at regional and local levels and in
the five IYCF intervention settings.

3.2 Support Civil Society in the implementation and enforcement of IYCF related laws and regulations

a. Institutionalize enforcement of MBFHI compliance in the regulatory function of the DOH

The inclusion of the MBFHI requirements in the unified licensing/accreditation benchmarks of the BHFS and the Licensing Offices shall be
pursued more vigorously in collaboration with BHFS and the Licensing offices of the CHDs. These offices are in a better position to enforce
compliance in relation to their regulatory function and in their power to promulgate penalties for violations.

b. Review and improve the processing of reports on violations on the Milk Code

The handling of reports on violations shall be reviewed for thoroughness and timeliness from the time a report is submitted up to the final
decision rendered on a case. Problematic areas and bottlenecks shall be identified and threshed out. Measures to ensure that all reports on
violations are acted upon shall be devised.

To ensure speedy resolution of cases, it is necessary to set deadlines on the processing of reports on violations.

c. Invite the Professional Regulatory Board as a resource agency of the IAC

Apart from companies who are actively marketing breastmilk substitutes, health professionals who have direct access and influence on
pregnant and postpartum women are also among the most common violators of the law. The PRC as the legal authority that regulates the
practice of the medical and allied professions can contribute to the development and enforcement of the IAC’s regulatory function.

d. Augment human resource of FDA as secretariat of the IAC

The current load of violations cases being processed and the fulfillment of other responsibilities with regards to the Milk Code at FDA
require a full time legal officer who will also assist the CHDs. Furthermore, the strengthened monitoring of compliance to the Milk Code
will result in a surge on violation reports. FDA should be prepared to process such reports. An additional full time legal officer and an
administrative/ clerical staff is required to facilitate and help speed up the process.

e. Engage professional societies to come-up with measures for self monitoring and regulation

Monitoring of overt advertisements and marketing of breast milk substitutes is a persistent challenge. Monitoring of
compliance to the Milk Code among health workers and medical and allied professional organizations is much more difficult. Promotion of
breast milk substitutes is more personal and concealed.

The medical and allied professional societies are strong and active bodies that foster organizational development
and discipline among its members. An advocating stance over a punitive approach may be the more prudent initial approach in this
environment. There will be dialogue, negotiations and forging of agreements to push the Milk Code and other policies on IYCF. The
professional societies will be engaged to participate in the development of the monitoring scheme within their ranks and in health
facilities. They are a good resource in the development of schemes for MBFHI and related technical matters. Working arrangements/contracts
may be forged to seal responsibilities and partnerships.

Representatives from the professional societies will constitute the Speaker’s Bureau which will be organized for the information
dissemination/awareness campaign on the Milk Code, the Expanded Breastfeeding Promotion Act and the Policies on IYCF.

STRATEGY 4: Intensified focused activities to create an environment supportive to IYCF practices

4.1 Modeling the MBF system in the key intervention settings in selected regions

a. Set up Models of MBFHI and MNCHN implementation in key strategic hospitals and referral networks

Regional Hospitals and selected private hospitals shall be developed as models of MBFHI and MNCHN implementation to help create an
impact and to serve as showcases for other health facilities.

If these hospitals are currently training facilities for obstetrics and pediatrics residency program, the MBFHI environment will
certainly add value to the training.

An itinerant team will facilitate the development of the hospital models. The team will be composed of an Obstetrician with
training/background on MNCHN, Pediatrician with training/background on Lactation Management/Essential Newborn Care, Nurse trainer
for breastfeeding counseling, Senior IYCF Program person with administrative background who can deal
with arrangements and coordination with hospitals and local governments and who can be a trainer and an
administrative assistant who will facilitate administrative matters. The team will facilitate the activities leading to the organization and
maintenance of the MBFHI in the hospitals. This shall include planning, setting up of operational details and physical structures when
needed, training/coaching of personnel, keeping records and completing reports and self assessment.

Regional hospitals shall be developed for IYCF capacity building. Trainings at Regional Hospitals shall be conducted in
collaboration with the CHDs. This is so that training is de-centralized and monitoring and evaluation can be done
more frequently at the provincial and municipal levels.

b. Establish protocols/standards on how to set-up and maintain MBF workplaces and integrated in the standards for healthy workplace

The IYCF Program shall focus on the enforcement of the Expanded Breastfeeding Promotion Act of 2009 which mandates workplaces to
establish lactation stations and/or grant breastfeeding breaks. Guidelines for the establishment and maintenance of MBF workplace shall
be developed. It will learn from lessons of already established and successful MBF workplace. In as much as standards for the healthy
workplace are already established, the MBF guidelines shall be integrated into those standards.

The establishment of MBF workplaces initiated in factories shall be scaled up and efforts shall be expanded to include government and private
offices in line with Expanded Breasfeeding Act. The current collaboration partners in the workplace setting may also need to be
expanded to promote the establishment of the MBF workplace in government and private offices. With the multitude of workplaces
scattered throughout the country, the expansion may require outsourcing of organizations to continue the MBF workplace efforts.

c. Enhance the primary, secondary and tertiary education curricula on IYCF

The enhancement of the primary, secondary and tertiary education curricula on IYCF shall be pursued. If necessary, a review of the
curriculum will be done prior to the enhancement. Apart from the curriculum enhancement, training materials, books and teachers’ guide shall
also be updated.

The initial collaboration for the enhancement of the primary, secondary and tertiary education curricula shall take place at the central
office of DepEd (Bureau of Elementary Education and Bureau of Secondary Education) and TESDA. The enhanced curriculum, training
materials, books and teacher’s guide shall be field tested province-wide in three selected provinces, evaluated and further enhanced before a
national implementation.

d. Develop policy on IYCF in emergencies (IFE) and guidelines on the management of malnutrition, and IYCF in special medical
conditions for the community
A clear policy on IYCF is necessary to allow the program to define the guidelines that can be easily followed by GOs, NGOs and LGUs once
such situations arise. The policy/guidelines shall address among others the issue of milk donations. Guidelines on the Community
Management of Malnutrition, IYCF in special medical conditions such as errors of metabolism or HIV positive mothers shall also be developed
for implementation.

Camp managers and organized local nutrition clusters shall be oriented on the IFE guidelines.

Disaster prone areas will be prioritized in the orientation. Training/orientation shall be a collaborative effort between the IYCF Program, HEMS
and the NDCC.

4.2 Creation of a Regional and National incentive and awarding systems for the most outstanding IYCF champions in the different sectors of
society

a. Review and update the existing awarding system

The current awarding system shall be reviewed. The search protocol shall be further refined to allow a wider search. The organization of
the search committees in the local and national levels shall be formalized. Funds for the awards shall be ensured.

b. Establish a recognition system for health facilities complying with EO51, RA10028 and the MBFHI National Policy

Set up an annual recognition system for facilities, establishments complying with relevant IYCF legislations and regulations. The benefits
provided for by the Milk Code to compliant health facilities shall be reviewed and improved/established parallel with the development of the
incentive scheme for the Expanded Breastfeeding Promotion Act. Procedures for claiming benefits shall be
established and made accessible in collaboration with PhilHealth, BIR and other relevant government offices.

4.3 Allocate/Raise /Seek resources for IYCF Research activities that document best practices in the Philippines

a. Carry out an inventory of best practices on IYCF Identify best IYCF practices by allowing every province
in the country to identify exemplary or creative activities
on IYCF that boosted program services/performance. Validate the reports through CHDs and select the best practices for documentation and
publication.

b. Allocate resources and conduct IYCF related researches focusing on the documentation and measure of impact of noble experiences and
interventions

The documentation of IYCF best practices is considered a critical area that allows the development of models/ references for appropriate IYCF
protocols and guidelines for implementation. Field personnel who are able to establish and provide successful models of IYCF services are
often deficient in resources and skills to document the efforts. Resources to conduct IYCF
related researchers, focusing on the documentation and measure of impact of noble experiences and interventions, will have to be
allocated.

STRATEGY 5: Engaging the Private Sector and International Organizations to raise funds for the scaling up and support of
the IYCF program

5.2 Setting up of a fund raising mechanism for IYCF with the participation of International Organizations and the Private Sector

a. Set-up the fund raising mechanism

The development and sustainability of IYCF activities partly depends on the availability of resources. At the national level,
where many developmental activities will take place, the regular sources of funds are not sufficient. At the local levels, the poorer more
problematic areas have the least resources to promote, protect and support good IYCF practices. It is critical
for the IYCF Program to determine and actively source budgetary and other resource requirements.
The availability of resources will guide the scale and prioritization of IYCF activities in the annual operational planning.

To augment the funds for the IYCF program, a funding mechanism/body that will serve as a fund raising arm for the elimination of child
malnutrition shall be established.

The effort should be able to explore and proceed with the development of a funding mechanism that can encourage public-private
partnership and ensure resources to initiate and sustain critical interventions nationwide. The arena of fund raising is not within the expertise
of DOH, and it will be important to discuss with the international and national partners on the most suitable mechanism that can help
attain such important goal.

PILLAR 1: Capacity Building

Capacity building shall take different forms and intensity in accordance to the requirement of the intervention settings.

In health facilities, training on Lactation Management and Counseling shall continue. A system for regular in- service or refresher training to
address the fast turnover of health staff in hospitals and to provide necessary program updates shall be put in place. Staggered training and
self- enforcing programs may also be devised to improve access to training when warranted. Periodic evaluation shall be
incorporated into the system to ensure effectiveness and efficiency of the trainings.

The Milk Code monitors at FDA, CHDs and local levels shall be trained on the latest guidelines to help ensure that provisions on regulation and
enforcement in the RIRR of the Milk Code are closely adhered to. The monitors should be prepared to handle incidents of actual violation of
the code during inspection/monitoring. The local monitors shall be equipped with user friendly monitoring tools.

The competencies of teachers and administrators to teach the new IYCF updated curriculum and to appreciate the importance of
MBF environment shall be enhanced. A training/seminar program on IYCF for teachers/ administrators will be developed. A core of teacher
trainers in every region will be developed and organized to conduct the training/seminars nationwide.

IV. Status of the Program

A REVIEW FROM 2005 TO 2010

Objectives and Targets set in 2005-2010 Status of Achievement Remarks

OBJECTIVE 1: TO IMPROVE, PROTECT AND
PROMOTE APPROPRIATE INFANT AND YOUNG
CHILD FEEDING PRACTICES CHILD FEEDING
PRACTICES
- 70% of newborns initiated to
53.5% (NDHS 08) 40.7%(NDHS 1998)
breastfeeding within 30 minutes
- 80% of 0-6 months infants are exclusively
34% (NDHS 2008) 33.5%(NDHS 2003)
breastfed
- 50% of infants are exclusively breastfed for 6
22.2% (NDHS 2008) 16.1%(NDHS 2003)
months
- median duration of breastfeeding is 18 months 15.1months (NDHS 2008) 13 months (NDHS 1998)
- 90% of 6- <10 months infants are given timely,
58% (NDHS 2008) 57.9%(NDHS 2003)
adequate and safe complementary foods

76% (NDHS 2003)

- 95% of children 6 months to
75.9% (NDHS 2008) NDHS 2008 and 2003 data refers
59 months received Vitamin A
to those that received vitamin A
in the past 6 months from the
interview
37% of children age 6-59 months
received iron supplements in the
seven days before the survey
72.8% of 6-59 months received
- 70% of low birth weight babies and iron deficient 6 (NDHS 2008)
iron drops /
months to less than 5 years received complete dose of
syrup (not specified if complete
iron supplements 78.3% of children 6-59 months
dose, MCHS 2002)
consumed foods rich in iron in the
past
24 hours from the time of the survey
- 80% of pregnant women have at least 4
77.8% (NDHS 2008) 67.5% (MCHS 2002)
prenatal visits
- 80% of pregnant women received complete dose 82% (not specified if complete
82.4% (NDHS 2008)
of iron supplements dose, MCHS 2002)
44.6% (NDHS 2003) NDHS 2003
- 80% of lactating women received vitamin A and 2008 data represents the %
45.6% (NDHS 2008)
capsule of women that received Vitamin
A dose during post-partum
41.9% (NDHS 2008)
38%, household using iodized
salt and
- 80% of household using iodized salt 81.1% household positive for iodine
56.4% household positive for
in salt (NDHS 2008)
iodine in salt (NNS 2003)
OBJECTIVE 2: TO INCREASE POLITICAL
COMMITMENT
AT DIFFERENT LEVELS OF GOVERNMENT,
INTERNATIONAL ORGANIZATIONS, NON-
GOVERNMENT ORGANIZATIONS, PRIVATE
SECTOR, PROFESSIONAL GROUPS , CIVIL
SOCIETY, COMMUNITIES AND FAMILIES
IYCF Policy approved May 25, 2005
- Approved and widely disseminated National Infant
and disseminated to all Regions and
and Young Child Feeding Policy
LGUs.
- Approved multi-sectoral National IYCF Plan of Action 2005-2010
IYCF Plan of Action approved.
AO 2007-0017: Guidelines on the
Acceptance and Processing of Local
- IYCF policy enhancement for emerging issues and Foreign Donations During
Emergency and Disaster Situations
was signed May 28, 2007.
New groups were active in
Active organizations include
supporting activities on IFE mostly
- Increase number of organizations actively involved Latch, La Leche League, Save
during the post-Ondoy interventions
in IYCF the Children, Plan
and in relation to breastfeeding
International and Arugaan.
support.
Additional funds for IYCF were
From 1 million pesos in 2005 to 20
secured since April 2007, the
million pesos in 2010.
start of the AHMP with intensive
IYCF training.
Additional funds were secured by the
September 2009, signing of the
- Increase budget for IYCF Joint program on MDG-F, wherein
JP for Ensuring Food Security
UN Agencies (Unicef, FAO, ILO
and Nutrition for Children 0-24
and WHO) with NNC and DOH,
months in the Philippines,
started implementing key IYCF
funded by the
interventions.
Government of Spain through
the MDG Achievement Fund.
OBJECTIVE 3: PROVIDE SUPPORTIVE
ENVIRONMENT THAT WILL ENABLE PARENTS,
MOTHER, CAREGIVERS, FAMILIES AND
COMMUNITIES TO IMPLEMENT OPTIMAL
FEEDING PRACTICES FOR INFANTS AND YOUNG
CHILD
PROGRAMME MANAGEMENT
National TWG active and 11/12
Regions confirmed having
established a TWG.
Data as of Dec 2009. Although
the national TWG is
- Functional IYCF Program authority and responsibility
considered active, the
flow at the national, regional and LGU level At the LGU level 7/80 provinces,
collaboration between agencies
9/120 cities and 175/1425
can be considered deficient.
municipalities have passed a
resolution/ordinance in support of
IYCF.
- Existing local committees functioning as IYCF
No available data
committees
INSTITUTIONAL SUPPORT
AO 2007-0026: Revitalization of the
MBFHI in Health Facilities with
Maternity Services was signed and
Within 2 years after the issuance
endorsed on July 10, 2007.
of COC, 0/47 hospitals applied
- 1,426 currently certified MBF hospitals sustained 10
for accreditation to become MBF
steps
based on the new
PhilHealth Circular No. 26 S-2005:
standards and requirements.
Requirement for Accredited Hospitals
to be “Mother- Baby Friendly” was
issued on October 11, 2005.
Only 47/1487 have received a COC
- 300 additional hospitals/lying-in certified as MBF
since 2007
- 100% of hospitals rooming–in their newborns No available data
RA 10028: Expanded Breastfeeding
- All offices of government agencies who are members RA 10028 set the standards to
Promotion Act of 2009 was enacted
of the IYCF IAC will be MBF becoming MBF.
on March 16, 2010.
6/16 Regions reported that there are
- At least one model workplace per province/city
at least 88 breastfeeding friendly
certified as MBF
workplaces.
- At least one model IYCF resource center 1 province
No resource center established
and 1 city in each region
10/16 Regions reported that there
- At least 3 IYCF model barangay/ are at least 2159 breastfeeding
municipality per province and city support groups at the barangay
level.
RA 10028 encourages other
Milk bank is functional in 3 Medical Medical
- Functional milk bank in all medical centers
Centers: PGH, DJFMH and PCMC Centers to set up their own milk
bank.
IMPROVING SYSTEMS
- 100% of national, regional and LGU health facilities Based on monitoring visits and
have integrated IEC on IYCF into regular MCH services reports from CHDs, public health No available data on private
with clearly stated protocols on how to provide key facilities have ensured the health facilities.
IYCF integration.
Only 4/13 Regions reported some
sort of Milk Code monitoring
activities.
- Functional and effective Milk Code
At the FDA, from 2007 to 2009,
Monitoring system
there were 67 reports of violations
and only 3/13 Regions reported filing
a complaint for the alleged
violations.
Draft tool developed and used in
- Institutionalize facility IYCF MIS
two key instances. No
system in place by end of 2009
institutionalization yet.
28,063/34,298 staff were trained on NCDPC and NNC combined
-Improving skills of health manpower
IYCF Counseling. report
- Available national / regional IYCF 16/17 Regions reported conduct of
trainers training on IYCF.
- Active IYCF Speakers’ Bureau No available data
- Available IYCF counselors in 50% 28,063/34,298 staff were trained on NCDPC and NNC combined
of health facilities IYCF Counseling. report.
- At least 10 Filipino health professionals internationally DOH focused on capacitating health
accredited as breastfeeding counselors by the workers on Counseling and Lactation With the support of NNC.
International Board of Lactation Consultants Examiners Management.
9/13 Regions reported having trained
a total of 1485 hospital based health
- A lactation specialist is available in tertiary hospitals workers on Lactation Management No denominator available.
with the support of DJFMH,
NCDPC,CHDs and NNC.
In June 2010 a workshop on
integration/updating of good IYCF
- Improved curricula for IYCF of medical / nursing The process of integration is on-
practice into the medical, nursing,
/ midwifery schools going.
midwifery and nutrition curricula was
conducted.
RA 10028 was enacted on
RA 10028: Expanded Breastfeeding
March 16,
- Inclusion of breastfeeding in elementary education Promotion Act of 2009 mandates the
2010. The IRR is yet to be
integration.
signed.
As of Dec 2009.
10/16 Regions reported that there
are at least 2,159 barangay level BF
- Community level support systems and services RA 10028 will help boost the
support groups and more than 40 BF
number of breastfeeding friendly
friendly public places.
public places.
- 100% of target communities with functional
community level monitoring system of IYCF practices No available data
and changes
10/16 Regions reported that there
- At least 50% of city and poblacion municipalities
are at least 2,159 BF support groups
with adequate number of trained IYCF peer counselors
at the barangay level.
10/16 Regions reported that there
- At least one functional BF / IYCF support group in are at least 2,159 BF support groups
poblacions and selected communities at the barangay level.

OBJECTIVE 4: ENSURE SUSTAINABILITY OF

INTERVENTIONS TO IMPROVE, PROTECT AND
PROMOTE INFANT AND YOUNG CHILD FEEDING
- Functional self assessment health Tool Drafted. Not yet
facility tools for IYCF in certified MBFH and main institutionalized.
health centers
- Annual progress reports of status of
1st IYCF PIR: 2007
implementation of Milk Code, Rooming In and
Breastfeeding Act, ASIN Law, Food Fortification and
2nd IYCF PIR: 2009
ECCD Law / IYCF Policy
Key result of integration was the
- IYCF integrated into Philippine Plan of Action for IYCF integrated in PPAN 2005-
intensive training on IYCF
Nutrition and annual planning and health monitoring 2010. PIR was conducted last
Counseling in AHMP target
systems at all levels quarter of 2010.
areas.
Regular Presentations are offered by
- Periodic feedback of IYCF status during annual
DOH on IYCF status (2005:
conventions of health professionals/Leagues of
1st presentation during National
Provinces/ Cities/Municipalities and Barangays
Convention Liga Ng Barangay)

V. Program Manager
VICENTA E. BORJA, RN, MPH

Supervising Health Program Officer

Family Health Office

National Center for Disease Prevention and Control

Department of Health

Telephone no. 7329956

E-mail Add: vicentaborja@hotmail.com

Partner Organizations/agencies

NGO Partners:

Local:

• Employers Confederation of the Philippines

• Trade Union Congress of the Philippines
• Beauty, Brains and Breastfeeding
• ARUGAAN
• Action for Economic Reforms
• Save Baby e-group
• Philippine Pediatric Society
• Philippine Obstetric and Gynecology Society
• Philippine Academy of Family Physicians Inc.
• Philippine Society of Newborn Medicine
• Philippine Society of Pediatric Gastroenterology
• Philippine Neonatology Society
• Philippine Society of Obstetric Anesthesiologist
• Philippine Academy of Lactation Consultant
• Perinatal Association of the Philippines
• Philippine Medical Association
• Integrated Midwives Association of the Philippines
• Maternal and Child Nurses Association of the Philippines
• Philippine Nurses Association
• National League of Philippine Government Nurses Inc.
• Malls: SM , NCCC
• Union of Local Authorities of the Philippines
• CODHEND

Government Partners:

• Department of Labor and Employment

• Department of Social Welfare and Development
• Department of Justice
• Department of Trade and Industry
• Department of Local Government
• Food and Drug Administration
• National Nutrition Council
• Council for the Welfare of Children
• Department of Education
• Commission on Higher Education
• Nutrition Council of the Philippines
International Organizations:

• World Health Organization

• UNICEF
• PLAN International
• Helen Keller International
• Save the Children-US
World Vision

Iligtas sa Tigdas ang Pinas

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A Door-to-Door Measles-Rubella (MR) Immunization Campaign Vaccinating All Children, 9 months to below 8 years old From April 4 to May 4,
2011

The Philippines has committed to eliminate measles in 2012, the target year agreed upon with the other countries in the Western Pacific
Region. Three (3) mass measles immunization campaigns were conducted in 1998, 2004 and 2007, achieving 95% coverage in each round. In
contrast, the annual coverage for routine measles vaccination given to infants’ ages 9-11 months never reached the target of at least 95%. The
highest coverage ever attained is 92% and the lowest coverage was 67% (1987 DOH EPI Report).

The lower the coverage, the faster is the accumulation of unimmunized susceptible infants, resulting in measles outbreaks in different areas of
the Philippines. Laboratory confirmed measles cases continued to be reported all over the country, which indicates uninterrupted circulation of
measles virus transmission resulting to illness and deaths among children.

Mass measles immunization campaigns provide a “second opportunity” to “catch missed children”, but these are done every 2-3 years interval
and therefore not enough to prevent seasonal outbreaks from occurring in areas with low immunization coverage. The administration of a 2nd
dose of measles containing vaccines on a routine schedule will provide this “second opportunity” at an earlier time and ensure the protection
against measles of infants/children who failed to be protected during the first dose.

As a response to interrupt the transmission of the measles virus and prevent a potential large measles outbreak to occur, there is an urgent
need to conduct a measles supplemental immunization activity this April 2011. All children ages 9-95 months old nationwide should be given a
dose of measles-rubella vaccine through a door-to-door vaccination campaign. Unlike previous campaign, a measles-free certification will be
issued to city/province meeting all the criteria of (1) all barangays passed the RCA with no missed child and 95% and above house marking
accuracy; (2) there are no measles cases for the next 3 months after the campaign and (3) measles surveillance indicators have met the
national standards.

Inter Local Health Zone

An ILHZ is defined to be any form or organized arrangement for coordinating the operations of an array and hierarchy of health providers and
facilities, which typically includes primary health providers, core referral hospital and end-referral hospital, jointly serving a common population
within a local geographic area under the jurisdictions of more than one local government.

ILHZ, as a form of inter-LGU cooperation is established in order to better protect the public or collective health of their community, assure the
constituents access to a range of services necessary to meet health care needs of individuals, and to manage their limited resources for health
more efficiently and equitably.

For these to happen, existing ILHZs in the country must strengthen their operations and sustain their functionality. Regardless of the
organizational nature of each ILHZ, whether these are formally organized, informally organized or DOH-initiated, the overall aim is to make each
ILHZ functional in order to perform its abovementioned purposes and tasks.

It must be recognized that a good inter-LGU coordination in health is one that secures health benefits for the people living in LGUs that are
coordinating with one another. A functional ILHZ therefore is to be viewed as one that provides health benefits to its individual residents and
to the zone population as a whole. The ILHZ functionality is defined mainly by observable zone-wide health sector performance results in terms
of:

(i) improved health status and coverage of public health intervention of the zone population;

(ii) access by everyone in the zone to quality care; and


(iii) efficiency in the operations of the inter-local health services.

Replication of Exemplary

Replication: Sharing Good Practices and Practical Solutions to Common Problems

By virtue of Administrative Order No. 2008-0006, dated January 22, 2008, the DOH has adopted the integration of replication strategies in
its operation.

Replication is learning from and sharing with others exemplary practices that are proven and effective solutions to common and similar
problems encountered by local government units, with the least possible costs and effort. The underlying principle of replication is to avoid
reinventing the wheel and benefiting from already tested solutions.

LGUs can share lessons learned from practices that work, as well as share experiences systematically. A structured organized process of
replicating, including proper dissemination of validated exemplary practices and making Lakbay Arals more meaningful and useful, help ensure
the chances of achieving best results. Replication makes learning more interesting and exciting as one gets to see the model and its benefits
firsthand.

Criteria for Selecting Exemplary Health Practices

3. Simple and doable so that they can be replicated
less.
1. LGU-initiated solutions initiated to address one or more health issues or problems encountered.
2. High level of sustainability 4. Cost effective and cost efficient

• Consistent with existing health policies
• LGU support
• Had been in place for more than three ears
• Widely participated and supported by the communities
• Adopted as a permanent structure or program with regular budgetary support
• Adopted as a permanent structure or program with regular budgetary support
• Community representation in decision making bodies and committees
• Mobilization and utilization of indigenous resources
• Minimal support from external sources
5. Positive results on the beneficiaries and communitie
Other important factors to consider:
• Consistency with the thrusts or priorities of the Depar
• Willingness of the Host LGU to share its practice to o
• Demand for the practice from other LGUs

Integrated Management of Childhood Illness (IMCI)

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One million children under five years old die each year in less developed countries. Just five diseases (pneumonia, diarrhea, malaria,
measles and dengue hemorrhagic fever) account for nearly half of these deaths and malnutrition is often the underlying condition. Effective and
affordable interventions to address these common conditions exist but they do not yet reach the populations most in need, the young and
impoverish.

The Integrated Management of Childhood Illness strategy has been introduced in an increasing number of countries in the region
since 1995. IMCI is a major strategy for child survival, healthy growth and development and is based on the combined delivery of essential
interventions at community, health facility and health systems levels. IMCI includes elements of prevention as well as curative and addresses
the most common conditions that affect young children. The strategy was developed by the World Health Organization (WHO) and United
Nations Children’s Fund (UNICEF).

In the Philippines, IMCI was started on a pilot basis in 1996, thereafter more health workers and hospital staff were capacitated to
implement the strategy at the frontline level.

Objectives of IMCI

• Reduce death and frequency and severity of illness and disability, and
• Contribute to improved growth and development
Components of IMCI

• Improving case management skills of health workers

11-day Basic Course for RHMs, PHNs and MOHs

5 - day Facilitators course

5 – day Follow-up course for IMCI Supervisors

• Improving over-all health systems

• Improving family and community health practices

Rationale for an integrated approach in the management of sick children

Majority of these deaths are caused by 5 preventable and treatable conditions namely: pneumonia, diarrhea, malaria, measles
and malnutrition. Three (3) out of four (4) episodes of childhood illness are caused by these five conditions

Most children have more than one illness at one time. This overlap means that a single diagnosis may not be possible or appropriate.

Who are the children covered by the IMCI protocol?

Sick children birth up to 2 months (Sick Young Infant)

Sick children 2 months up to 5 years old (Sick child)

Strategies/Principles of IMCI

• All sick children aged 2 months up to 5 years are examined for GENERAL DANGER signs and all Sick Young Infants Birth up to 2
months are examined for VERY SEVERE DISEASE AND LOCAL BACTERIAL INFECTION. These signs indicate immediate referral
or admission to hospital
• The children and infants are then assessed for main symptoms. For sick children, the main symptoms include: cough or difficulty
breathing, diarrhea, fever and ear infection. For sick young infants, local bacterial infection, diarrhea and jaundice. All sick
children are routinely assessed for nutritional, immunization and deworming status and for other problems
• Only a limited number of clinical signs are used
• A combination of individual signs leads to a child’s classification within one or more symptom groups rather than a diagnosis.
• IMCI management procedures use limited number of essential drugs and encourage active participation of caretakers in the treatment of
children
• Counseling of caretakers on home care, correct feeding and giving of fluids, and when to return to clinic is an essential component of IMCI

BASIS FOR CLASSIFYING THE CHILD’S ILLNESS (please see enclosed portion of the IMCI Chartbooklet) The child’s illness is classified
based on a color-coded triage system:

PINK- indicates urgent hospital referral or admission

YELLOW- indicates initiation of specific Outpatient Treatment

GREEN – indicates supportive home care

Steps of the IMCI Case management Process

The following is the flow of the iMCI process. At the out-patient health facility, the health worker should routinely do basic demographic
data collection, vital signs taking, and asking the mother about the child's problems. Determine whether this is an initial or a follow-up visit. The
health worker then proceeds with the IMCI process by checking for general danger signs, assessing the main symptoms and other processes
indicated in the chart below.

Take note that for the pink box, referral facility includes district, provincial and tertiary hospitals. Once admitted, the hospital protocol
is used in the management of the sick child.

THE INTEGRATED CASE MANAGEMENT PROCESS

Contact:

Department of Health

National Center for Disease Prevention and Control -Family Health Office

Contact Number: 651-7800 local 1726-1730

Knock Out Tigdas 2007

Knock-out Tigdas Logo

“Knock-out Tigdas 2007” is a sequel to the 1998 and 2004 “Ligtas Tigdas” mass measles immunization campaign. All children 9 months to 48
months old ( born October 1, 2003 – January 1,2007) should be vaccinated against measles from October 15 - November 15, 2007 , door-to-
door. All health centers, barangay health stations, hospitals and other temporary immunization sites such as basketball court, town plazas and
other identified public places will also offer FREE vaccination services during the campaign period.

Other services to be given include Vitamin A Capsule and deworming tablet.

Knockout Tigdas for the period of the Barangay and SK Elections
 Executive Order No. 663
 Promotional materials

What is “Knock-out Tigdas (KOT) 2007?

“Knock-out Tigdas 2007” is a sequel to the 1998 and 2004 “Ligtas Tigdas” mass measles immunization campaigns. This is the second follow-up
measles campaign to eliminate measles infection as a public health problem.

What is the over-all objective of the Knock-out Tigdas?

The Knock-out Tigdas is a strategy to reduce the number or pool of children at risk of getting measles or being susceptible to measles and
achieve 95% measles immunization coverage. Ultimately, the objective of KOT is to eliminate measles circulation in all communities by 2008.

What does measles elimination mean?

Measles elimination means:

1. Less than one (1) measles case is confirmed measles per one million population.

2. Detects and extracts blood for laboratory confirmation from at least 2 suspect measles cases per 100,000 populations.

3. No secondary transmission of measles. This means that when a measles case occurs, measles is not transmitted to others.

Who should be vaccinated?

All children between 9 months to 48 months old ( born October 1, 2003 – January 1,2007) should be vaccinated against measles.

When will it be done?

Immunization among these children will be done on October 15-November 15, 2007.

How will it be done?

Vaccination teams go from door-to-door of every house or every building in search of the targeted children who needs to be vaccinated with a
dose of measles vaccines, Vitamin A capsule and deworming drug.

All health centers, barangay health stations, hospitals and other temporary immunization sites such as basketball court, town plazas and other
identified public places will also offer FREE vaccination services during the campaign period.

My child has been vaccinated against measles. Is she exempted from this vaccination campaign?

No, she is not. A previously vaccinated child is not exempted from the vaccination campaign because we cannot be sure if her previous
vaccination was 100% effective.

Chances are a vaccinated child is already protected, but no one can really be sure. There is 15% vaccine failure when the vaccine is given to 9
months old children. We want to be 100% sure of their protection.

What strategy will be used during the campaign?

It is a door-to-door strategy. The team goes from one-household to another in all areas nationwide.

My child had measles previously, is he exempted in this campaign?

There are many measles-like diseases. We cannot be sure exactly what the child had, especially if the illness occurred years ago. Anyway, the
vaccination will not harm a child who already had measles. The effect will also be like a booster vaccination. The previously received measles
immunization has formed antibodies, with the booster shot it will strengthened the said antibodies.

Is there any overdose, if my child receives this booster immunization?

Antibodies in the blood which provide protection against disease decrease as the child grows older. Booster vaccinations are needed to raise
protection again. Measles vaccination during the said campaign will be a booster vaccination for a previously vaccinated child. The child’s
waning internal protection will increase. The child will not harm because there is no vaccine overdose for the measles vaccine. The measles
vaccine is even known to enhance overall immunity against other diseases.

What will happen to my child after receiving the measles immunization?

Normally, the child will have slight fever. The fever is a sign that the child’s vaccine is working and is helping the body develop antibodies
against measles.

The best thing to do when the child has fever is to give him paracetamol every four (4) hours. Give him plenty of fluids and breastfeed the
child. Ensure that the child has enough rest and sleep.

What will happen after the “Knock-out Tigdas 2007”?

To interrupt measles circulation by 2008, ALL children ages 9 months will continue to routinely receive one dose of the measles vaccine together
with the vaccines the other disease of the childhood like polio, diphtheria, pertussis, etc. All children with fever and rashes have to be listed and
tested to verify the cause of the infection.

ALL 18 months old children will be given a second dose of measles immunization to really ensure that these children are protected against
measles infection.

What other services will be given?

Vitamin A capsule will be given to all children 6 months to 71 month old and deworming tablet to 12 months to 71 months old nationwide.

Additional messages:

• Once the child is vaccinated, the posterior upper left earlobe will be marked with gentian violet, so do not try to remove for the purpose of
validation.

• Houses will also be marked, so do not erase.

“I heard that there are cases where the child who was vaccinated who became seriously ill or died. Is this true?

Measles vaccine is very safe. Minor reactions may occur such as fever but in an already immunizes child, this may not occur. The most serious
and RARE adverse event following immunization is anaphylaxis which is inherent on the child, not on the vaccines.

Leprosy Control Program

Vision: Empowered primary stakeholders in leprosy and eliminated leprosy as a public health problem by 2020

Mission: To ensure the provision of a comprehensive, integrated quality leprosy services at all levels of health care

Goal: To maintain and sustain the elimination status

Objectives:

The National Leprosy Control Program aims to:

• Ensure the availability of adequate anti-leprosy drugs or multiple drug therapy (MDT).
• Prevent and reduce disabilities from leprosy by 35% through Rehabilitation and Prevention of Impairments and Disabilities (RPIOD)
and SelfCare.
• Improve case detection and post-elimination surveillance system using the WHO protocol in selected LGUs.
• Integration of leprosy control with other health services at the local level.
• Active participation of person affected by leprosy in leprosy control and human dignity program in collaboration with the National
Program for Persons with Disability.
• Strengthen the collaboration with partners and other stakeholders in the provision of quality leprosy services for socio-economic
mobilization and advocacy activities for leprosy.

Beneficiaries:

The NLCP targets individuals, families, and communities living in hyperendemic areas and those with history of previous cases.
 NLCP Strategy
Global Strategy Universal Health Care
(2011-2016)
(2006-2010) (Kalusugang Pangkalahatan)
MDG& NOH

• Provision of Quality Leprosy services

• Sustain leprosy control in all endemic countries • Governance for Health
at all levels
• Strengthen routine & referral service • Health System Strengthening • Service Delivery
• Capability building of an efficient,
• Ensure high quality diagnosis, case management, recording
effective, accessible human • Policy, Standards & Regulations
& reporting in all endemic communities
and facility resources
• Develop policies/ guidelines/ sentinel
• Establish the Sentinel Surveillance System to monitor Drug
sites/referral centers • Human Resources for Health
Resistance
(Luzon,Visayas & Mindanao)
• Develop procedures/ tools that are home/community- based,
• Collaborate with NEC/RESU/ PESU /
integrated and locally appropriate for Self Care/POD, • Health Information
MESU
rehabilitation services (CBR)
• NLAB, NCCL • Health Financing
• RA 7277- Rights of PWD &
Caregivers
• BP 34- Accessibility & Human Rights
Law
• PhilHealth Insurance Package

Program Manager:

Dr. Francesca C. Gajete

Department of Health-National Center for Disease Prevention and Control (DOH-NCDPC)

Contact Number: 651-78-00 local 2353

Email: francesca_gajete@yahoo.com

LGU Scorecard

The performance indicators in the LGU Scorecard are a subset of the Performance Indicator Framework (PIF) of the ME3. The performance
indicators measure basic intermediate outcomes and major outputs of health reform programs, projects and activities (PPAs).

There are 46 performance indicators in the LGU Scorecard categorized in two sets (Set I and Set II). The two sets of performance indicators are
the following:

Set I is composed of 27 outcome indicators mostly representing intermediate outcomes that can be assessed every year (See Annex 1: Data
Definitions for Set I Indicators in LGU Scorecard). Set II is composed of 27 output indicators representing major thrusts and key interventions
for the four reform components of service delivery, regulation, financing, and governance. They are mostly composed of health system reform
outputs. These indicators are assessed only every 3-5 years, since these require more time and more resources to set up. The equity
dimensions of these indicators are not measured (See Annex 2: Data Definitions for Set II Indicators in LGU Scorecard).

Set I performance indicators of the LGU Scorecard are standardized as to numerators, denominators, multipliers and data sources. The
definition of performance indicators is consistent with the Department of Health FHSIS data dictionary. The other references used in defining
performance indicators in the LGU Scorecard are PhilHealth data definitions and WHO definitions of indicators. The standardization of
performance indicators guarantees consistency of data across various LGUs and across years of implementation. It also facilitates the
automation of the LGU Scorecard collection and publication of results.

The sources of data utilized for the LGU Scorecard are the institutional data sources in the Department of Health. The availability of data on an
annual basis was an important consideration for inclusion of Set I performance indicators in the LGU Scorecard.

National 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 Government’s 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:

• Reduce local variations in TB control program performance

• Scale-up and sustain coverage of DOTS implementation

• Ensure provision of quality TB services

• Reduce out-of-pocket expenses related to TB care

Strategies:

Under PhilPACT, there are 8 strategies to be implemented, namely:

• Localize implementation of TB control

• Monitor health system performance

• Engage all health care providers, public and private

• Promote and strengthen positive behavior of communities

• Address MDR-TB,TB-HIV and needs of vulnerable populations

• Regulate and make quality TB diagnostic tests and drugs

• Certify and accredit TB care providers

• Secure adequate funding and improve allocation and efficiency of fund utilization

Program Accomplishments:

Significant progress has been achieved since the Philippines adopted the DOTS strategy in 1996 and at the end of 2002-2003, all public
health centers are enabled to deliver DOTS services. Because of the Government’s efforts to continuously improve health care delivery, there
have been progressive increases in the detection and treatment success. While a strong groundwork has been installed, acceleration of efforts is
entailed to expand and sustain successful TB control. All stakeholders are called upon to achieve the TB targets linked to the MDGs set to be
attained by 2015. However, with the emergence of other TB threats, more has to be done. Likewise, with the ongoing global developments and
new technologies in the pipeline, constraints will hopefully be addressed.

The 2010-2016 PhilPACT as defined by multi-sector partners, through broad-based collective technical inputs, underlines the key strategic
approaches towards achieving these targets at both national and local levels. The Plan aims for universal access to DOTS including strategic
responses to vulnerable groups and emerging TB threats. Nationwide, a wide array of health facilities are installed and equipped to provide
quality TB care to the general population. This involves participation of private facilities (clinics, hospitals), other health-related agencies or
NGOs and other Government organizations. Coverage for DOTS services, at least in the public primary care network has reached nearly 100% in
late 2002. 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 (DND-VMMC)

• Occupational Health and Safety (OSHC); Bureau of Working Conditions (BWC)

• World Vision Development Foundation (WVDF)

• International Committee of Red Cross

• Korea Foundation for International Health Care (KOFIH)

• World Health Organization (WHO)

• United States Agency for International Development (USAID)

• Committee of German Doctors for Developing Countries

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

Email: rgvianzon10@yahoo.com

Natural Family Planning

Population/Family Planning Issue

Senate Bill No. 1546: "Reproductive Health Act of 2004"

House Bill No. 16: "Reproductive Health Act of 2004"

The Truth About the P50M CFC Contract with DOH

CFC-DOH Partnership

Letter to the Editor: Philippine Daily Inquirer

Family Planning
Brief Description of Program

A national mandated priority public health program to attain the country's national health development: a health intervention program and an
important tool for the improvement of the health and welfare of mothers, children and other members of the family. It also provides information
and services for the couples of reproductive age to plan their family according to their beliefs and circumstances through legally and medically
acceptable family planning methods.

The program is anchored on the following basic principles.

 Responsible Parenthood which means that each family has the right and duty to determine the desired number of children they might
have and when they might have them. And beyond responsible parenthood is Responsible Parenting which is the proper ubringing
and education of chidren so that they grow up to be upright, productive and civic-minded citizens.

National Filariasis Elimination Program

Filariasis is a major parasitic infection, which continues to be a public health problem in the Philippines. It was first discovered in the Philippines
in 1907 by foreign workers. Consolidated field reports showed a prevalence rate of 9.7% per 1000 population in 1998. It is the second leading
cause of permanent and long-term disability. The disease affects mostly the poorest municipalities in the country about 71% of the case live in
the 4th-6th class type of municipalities.

The World Health Assembly in 1997 declared “Filariasis Elimination as a priority” and followed by WHO’s call for global elimination. A sign of the
DOH’s commitment to eliminate the disease, the program’s official shift from control to elimination strategies was evident in an Administrative
Order #25-A,s 1998 disseminated to endemic regions. A major strategy of the Elimination Plan was the Mass Annual Treatment using the
combination drug, Diethylcarbamazine Citrate and Albendazole for a minimum of 2 years & above living in established endemic areas after the
issuance from WHO of the safety data on the use of the drugs. The Philippine Plan was approved by WHO which gave the government free
supply of the Albendazole (donated b y GSK thru WHO) for filariasis elimination. In support to the program, an Administrative Order declaring
“November as Filariasis Mass Treatment Month was signed by the Secretary of Health last July 2004 and was disseminated to all endemic
regions.

Vision: Healthy and productive individuals and families for Filariasis-free Philippines

Mission: Elimination of Filariasis as a public health problem thru a comprehensive approach and universal access to quality health services

Goal: To eliminate Lymphatic Filariasis as a public health problem in the Philippines by year 2017

General Objectives: To decrease Prevalence Rate of filariasis in endemic municipalities to <1/1000 population.

Specific Objectives:

The National Filariasis Elimination Program specifically aims to:

1. Reduce the Prevalence Rate to elimination level of <1%;

2. Perform Mass treatment in all established endemic areas;

3. Develop a Filariasis disability prevention program in established endemic areas; and

4. Continue surveillance of established endemic areas 5 years after mass treatment.

Baseline Data:

Prevalence Rate (1997): 9.7% per 1,000 pop.

Endemic in 43 provinces in 11 regions with a total population at risk of 30,000,000

Target Population/Clients/Beneficiaries:

The program targets individuals, families and communities living in endemic municipalities in 44 provinces in 12 regions (30 million targeted for
mass treatment or 1/3 of the total population of the country). However, 9 provinces have reached elimination level namely: Southern Leyte;
Sorsogon; Biliran; Bukidnon; Romblon; Agusan Sur; Dinagat Islands; Cotabato Province; and COMVAL.

Program Strategies:

STRATEGY 1. Endemic Mapping

STRATEGY 2. Capability Building

STRATEGY 3. Mass Treatment (integrated with other existing parasitic programs)

STRATEGY 4. Support Control

STRATEGY 5. Monitoring and Supervision

STRATEGY 6. Evaluation

STRATEGY 7. National Certification

STRATEGY 8. International Certification

Management Being Used:

1. Selective Treatment – treating individuals found to be positive for microfilariae in nocturnal blood examination.

Drug: Diethylcarbamazine Citrate

Dosage: 6 mg/kg body weight in 3 divided doses for 12 consecutive days (usually given after meals)

2. Mass Treatment – giving the drugs to all population from aged 2 years and above in all established endemic areas.

Drug: Diethlcarbamazine Citrate (single dose based on 6 mg/kg body wt) plus Albendazole 400mg given single dose
given once annually to people 2 yrs & above living in established endemic areas

3. Disability Prevention thru home-based or community-based care for lymphedema & elephantiasis cases. Surgical
management for hydrocele patients.

Status of the Program:

PROVINCES THAT REACHED ELIMINATION STAGE: Southern Leyte, Sorsogon, Biliran, Bukidnon, Romblon, Agusan Sur, Dinagat island,
Cotabato Province and COMVAL

Partner Organizations/Agencies:

The following are the organizations/agencies that take part in achieving the objectives of the National Filariasis Elimination Program:

• Coalition for the Elimination of Lymphatic Filariasis

• Culion Foundation, Inc.
• Peace and Equity Foundation, Inc. (PEF)
• Iloilo Caucus of Development NGOs, Inc. Iloilo (ICODE)
• Marinducare Foundation, Inc.
• Lingap Para sa Kalusugan ng Sambayanan, Inc. (LIKAS)
• Del Monte Foundation, Inc.
• Ang-Hortaleza Foundation (Splash Foundation)
• Belo Medical Group
• GlaxoSmitheKline Foundation
• Center for Social Concern and Action (COSCA) with Theology Religious Education Department (TREDTWO) – De La Salle University-Manila
• UP Open University-Manila
• UP Manila – National Institutes of Health (UP Manila-NIH)
• UP-College of Public Health

Program Manager:

Dr. Leda M. Hernandez

Division Chief, Infectious Disease Office

Department of Health-National Center for Disease Prevention and Control (DOH-NCDPC)

Contact Number: 651-78-00 local 2353

Email: dr_ledamher@yahoo.com

Files and Links:

• Administrative Order No. 25-A s. 1998
Administrative Order No. 2010-0009

National Rabies Prevention and Control Program

Rabies is a human infection that occurs after a transdermal bite or scratch by an infected animal, like dogs and cats. It can be transmitted when
infectious material, usually saliva, comes into direct contact with a victim’s fresh skin lesions. Rabies may also occur, though in very rare cases,
through inhalation of virus-containing spray or through organ transplants.

Rabies is considered to be a neglected disease, which is 100% fatal though 100% preventable. It is not among the leading causes of mortality
and morbidity in the country but it is regarded as a significant public health problem because (1) it is one of the most acutely fatal infection and
(2) it is responsible for the death of 200-300 Filipinos annually.

Vision: To Declare Philippines Rabies-Free by year 2020

Goal: To eliminate human rabies by the year 2020

Program Strategies:

To attain its goal, the program employs the following strategies:

1. Provision of Post Exposure Prophylaxis (PEP) to all Animal Bite Treatment Centers (ABTCs)

2. Provision of Pre-Exposure Prophylaxis (PrEP) to high risk individuals and school children in high incidence zones

3. Health Education

Public awareness will be strengthened through the Information, Education, and Communication (IEC)
campaign. The rabies program shall be integrated into the elementary curriculum and the Responsible Pet Ownership
(RPO) shall be promoted. In coordination with the Department of Agriculture, the DOH shall intensify the promotion of
dog vaccination, dog population control, as well as the control of stray animals.

In accordance with RA 9482 or “The Rabies Act of 2007”, rabies control ordinances shall be strictly
implemented. In the same manner, the public shall be informed on the proper management of animal bites and/or rabies
exposures.

4. Advocacy

The rabies awareness and advocacy campaign is a year-round activity highlighted on two occasions – March as
the Rabies Awareness Month and September 28 as the World Rabies Day.

5. Training/Capability Building

Medical doctors and Registered Nurses are to be trained on the guidelines on managing a victim.

6. Establishment of ABTCs by Inter-Local Health Zone

7. DOH-DA joint evaluation and declaration of Rabies-free islands

Program Achievements:

The DOH, together with the partner organizations/agencies, has already developed the guidelines for managing rabies exposures. With the
implementation of the program strategies, five islands were already declared to be rabies-free.

In 2010, 257 rabies cases and 266,200 animal bites or rabies exposures were reported. A total of 365 ABTCs were established and strategically
located all over the country. Post Exposure Prophylaxis against rabies was provided in all the 365 ABTCs.

Partner Organizations/Agencies:

The following organizations/agencies take part in attaining the goal of the National Rabies Prevention and Control Program:

• Department of Agriculture (DA)

• Department of Education (DepEd)
• Department of Interior and Local Government (DILG)
• World Health Organization (WHO)
• Animal Welfare Coalition (AWC)
• BMGF Foundation
• WHO/BMGF Rabies Elimination Project
Bill and Melinda Gates Foundation
World Society for the Protection of Animals (WSPA)
Medical Research Council (MRC)

Program Manager:

Dr. Raffy A. Deray

Department of Health-National Center for Disease Prevention and Control (DOH-NCDPC)

Contact Number: 751-78-00 or 651-78-00 local 2352

Email: raffysj84@yahoo.com
Newborn Screening

Republic Act 9288

Newborn screening (NBS) is a public health program aimed at the early identification of infants who are affected by certain
genetic/metabolic/infectious conditions. Early identification and timely intervention can lead to significant reduction of morbidity, mortality, and
associated disabilities in affected infants. NBS in the Philippines started in June 1996 and was integrated into the public health delivery system
with the enactment of the Newborn Screening Act of 2004 (Republic Act 9288). From 1996 to December 2010, the program has saved 45 283
patients. Five conditions are currently screened: Congenital Hypothyroidism, Congenital Adrenal Hyperplasia, Phenylketonuria, Galactosemia,
and Glucose-6-Phosphate Dehydrogenase Deficiency.

Current Status of NBS Implementation in the Philippines

Newborn Screening Legislation

NBS was integrated into the public health delivery system with the enactment of Republic Act 9288 or Newborn Screening Act of 2004 as it
institutionalized the ‘National NBS System’, which shall ensure the following: [a] that every baby born in the Philippines is offered NBS; [b] the
establishment and integration of a sustainable NBS System within the public health delivery system; [c] that all health practitioners are aware
of the benefits of NBS and of their responsibilities in offering it; and [d] that all parents are aware of NBS and their responsibility in protecting
their child from any of the disorders. The highlights of the law and its implementing rules and regulations are:

• DOH is the lead agency tasked with implementing this law;

• Any health practitioner who delivers or assists in the delivery of a newborn in the Philippines shall prior to delivery, inform parents or legal
guardians of the newborns the availability, nature and benefits of NBS;
• Health facilities shall integrate NBS in its delivery of health services;
• Creation of the Newborn Screening Reference Center at the National Institutes of Health and establishment and accreditation of NSCs
equipped with a NBS laboratory and recall/follow up program;
• Provision of NBS services as a requirement for licensing and accreditation, the DOH and the Philippine Health Insurance Corporation (PHIC)
• Inclusion of cost of NBS in insurance benefits

Currently, there are four Newborn Screening Centers (NSCs) in the country: NSC-National Institutes of Health in Manila; NSC- Visayas in Iloilo
City; NSC-Mindanao in Davao City; and NSC-Central Luzon in Angeles City. The four NSCs provide laboratory and follow up services for more
than 3000+ health facilities.

DOH, its partners and major stakeholders remain aggressive in identifying strategies to intensify awareness in the communities and increase
coverage among home deliveries. Among the recent efforts to increase the newborn screening coverage are appointment of full-time Regional
NBS Coordinators; opening more G6PD Confirmatory Laboratories; partnership with midwives organizations; and production of information
materials targeting different groups of health workers and professionals.

Key Players in the Implementation

Organizational chart for the national implementation of Newborn Screening

Newborn Screening Statistics

As of December 2010, there are 2,389,959 babies that have undergone NBS and based on these data, the incidences of the following disorders
are: CH (1: 3,324); CAH (1: 9,446); PKU (1: 149,372); Gal (1: 108,635) and G6PD deficiency (1: 52). The program has saved the following
numbers of newborns from complications and/or death: 719 from CH, 253 from CAH, 22 from Gal, 16 from PKU and 44 273 from G6PD
deficiency.
Coverage
As of December 2010, the coverage of NBS is at 35%.

DIRECTORY OF PROGRAM IMPLEMENTERS

National Center for Disease Prevention and Control –Family Health Office
Program Manager
Dr. Juanita A. Basilio
Dr. Anthony P. Calibo

National Newborn Screening Coordinator:

Ms. Lita Orbillo
San Lazaro Compound, Sta. Cruz, Manila
Telephone: (02) 7359956
litaorbillo_rn@yahoo.com

Newborn Screening Reference Center

Director: Dr. Carmencita D. Padilla
National Institutes of Health
Building H, UP Ayala Land Technohub
Complex,Commonwealth Avenue, Brgy. UP Campus
Diliman, Quezon City
Email: info@newbornscreening.ph
www.newbornscreening.ph

Newborn Screening Centers

For Regions I, II, III & CAR

Unit Head: Dr. Florencio Dizon
Newborn Screening Center – Central Luzon
Angeles City University Foundation Medical Center
MacArthur Highway, Barangay Salapungan, Angeles City
Telephone: (045) 6246502-03; Email: nsc@aufmc.org

For Regions IV, V & NCR

Newborn Screening Center– National Institutes of Health
Unit Head: Ms. Ma. Elouisa Reyes
Building H, UP Ayala Land Technohub
Complex,Commonwealth Avenue, Brgy. UP Campus
Diliman, Quezon City
Email: nbsadmin.ihg@gmail.com

For Visayas
Newborn Screening Center– Visayas
Unit Head: Dr. J Winston Edgar Posecion
West Visayas State University Medical Center
E. Lopez St., Jaro, Iloilo City
Telefax: (033) 329-3744; Email: wvsumc_nsc@info.com.ph

For Mindanao
Newborn Screening Center– Mindanao
Unit Head: Dr. Conchita Abarquez
Southern Philippines Medical Center
J.P. Laurel Avenue, Davao City
Telephone: (082) 226-4595 / 224-0337
Telefax (082) 227-4152; Email:nscmindanao@gmail.com

Centers for Health Development

NBS Regional
CHD Mailing Address Business Phone
Coordinator
CHD 1 - Ilocos San Fernando, La Union (072) 2425315; (072) 2424773 Clarita B. Lewis, RN
CHD 2 - Cagayan (078) 3046585; (078) 8446585; Leticia T. Cabrera, MD,
Tuguegarao City
Valley (078) 8446523 MPA
CHD 3 - Central (045) 4552324; (045) 9617649;
San Fernando, Pampanga Adelina Cabrera, RN
Luzon (045) 9617654
CHD 4-A Maria Luisa M. Malana,
QMMC Compound, Project 4, Quezon City (02) 4403372
Calabarzon RN
Ma. Teresa Castillo,
CHD 4-B Mimaropa Quirino Hospital Compound, Quezon City (02) 9134650; (02) 9115025
MD
Carla A. Orozco, MD,
(052) 4830840
CHD 5- Bicol First Park Subdidivion, Daraga, Albay MPH
loc 517/516
MS III
CHD 6 - Western
Q. Abeto St., Mandurriao, Iloilo City (033)3210364 Renilyn P. Reyes, MD
Visayas
CHD 7 - Central Nayda P. Bautista,MD,
Osmeña Blvd., Cebu City (032) 4187633
Visayas MPH
CHD 8- Eastern
Candahug, Palo , Leyte (053)3235025 Lilibeth Andrade, MD
Visayas
CHD 9 -
Nerissa B. Gutierrez,
Zamboanga Upper Calarian, Zamboanga City (062)9830314-15
RN
Peninsula
CHD 10 - Northern J.V. Seriña St., Carmen, Cagayan de Oro Ellenietta HMV N.
088-22- 727400
Mindanao City Gamolo, MD, MPH
CHD 11 - Davao Ma. Clarose M.
J.P. Laurel Avenue, Davao City (082) 3051907; (082) 2214011
Region Mascardo, RN, MPH
CHD 12 - Central ARMM Compound, Gov. Guttierez Ave,
(064) 4217436; (064) 4218053 Lucy Decio, RN
Mindanao Cotabato City
CHD CARAGA Pizarro St. cor. Narra Rd. Butuan City (085) 3411452 Glynna B. Andoy, MD,
 MPH
Nicolas R. Gordo, Jr,
CHD CAR BGHMC Compound, Baguio City (074) 4428096; (074) 4445255
MD
Welfareville Compound, Brgy. Addition Hills, Ma. Paz P. Corrales,
CHD NCR (02) 7183097; (02) 5354521
Mandaluyong City MD
CHD ARMM ORG Compound, Cotabato City (064) 4217703 Dayan Sangcopan, MD

Reunion of Saved Babies, October 10, 2010 at the UP Bahay ng Alumni, Quezon City

Newborn Screening Poster

Continuing Education for Health Professionals, October 4, 2011 in La Union

The Heel Prick Method

NBS Awarding Ceremony

October 3, 2011

Traders Hotel

National HIV/STI Prevention Program

Objective:

Reduce the transmission of HIV and STI among the Most At Risk Population and General Population and mitigate its impact at the individual,
family, and community level.

Program Activities:

With regard to the prevention and fight against stigma and discrimination, the following are the strategies and interventions:

1. Availability of free voluntary HIV Counseling and Testing Service;

2. 100% Condom Use Program (CUP) especially for entertainment establishments;

3. Peer education and outreach;

4. Multi-sectoral coordination through Philippine National AIDS Council (PNAC);

5. Empowerment of communities;

6. Community assemblies and for a to reduce stigma;

7. Augmentation of resources of social Hygiene Clinics; and

8. Procured male condoms distributed as education materials during outreach.

Program Accomplishments:

As of the first quarter of 2011, the program has attained particular targets for the three major final outputs: health policy and program
development; capability building of local government units (LGUs) and other stakeholders; and leveraging services for priority health programs.

For the health policy and program development, the Manual of Procedures/ Standards/ Guidelines is already finalized and disseminated. The
ARV Resistance surveillance among People Living with HIV (PLHIV) on Treatment is being implemented through the Research Institute for
Tropical Medicine (RITM). Moreover, both the Strategic Plan 2012-2016 for Prevention of Mother to Child Transmission and the Strategic Plan
2012-2016 for Most at Risk Young People and HIV Prevention and Treatment are being drafted.

With regard to capability building, the Training Curriculum for HIV Counseling and Testing is already revised. Twenty five priority LGUs provided
support in strengthening Local AIDS councils. as of March 2011, there were already 17 Treatment Hubs nationwide.

Lastly, for the leveraging services, baseline laboratory testing is being provided while male condoms are being distributed through social
Hygiene Clinics. A total of 1,250 PLHIV were provided with treatment and 4,000 STI were treated.
Partner Organizations/Agencies:

The following organizations/agencies take part in achieving the goal of the National HIV/STI Prevention Program:

• Department of Interior and Local Government (DILG)

• Philippine National AIDS Council (PNAC)
• Research Institute for Tropical Medicine (RITM)
• STI/AIDS Cooperative Central Laboratory (SCCL)
• World Health Organization (WHO)
• United States Agency for International Development (USAID)
• Pinoy Plus Association
• AIDS Society of the Philippines (ASP)
• Positive Action Foundation Philippines, Inc. (PAFPI)
• Action for Health Initiatives (ACHIEVES)
• Affiliation Against AIDS in Mindanao (ALAGAD-Mindanao)
• AIDS Watch Council (AWAC)
• Family Planning Organization of the Philippines (FPOP)
• Free Rehabilitation, Economic, Education, and Legal Assistance Volunteers Association, Inc. (FREELAVA)
• Philippine NGO council on Population, Health, and Welfare, Inc. (PNGOC)
• Leyte Family Development Organization (LEFADO)
• Remedios AIDS Foundation (RAF)
• Social Development Research Institute (SDRI)
• TLF share Collectives, Inc.
• Trade Union Congress of the Philippines (TUCP) Katipunang Manggagawang Pilipino
• Health Action Information Network (HAIN)
• Hope Volunteers Foundation, Inc.
• KANLUNGAN Center Foundation, Inc. (KCFI)
• Kabataang Gabay sa Positibong Pamumuhay, Inc. (KGPP)

Program Manager:

Dr. Jose Gerard B. Belimac

Department of Health-National Center for Disease Prevention and Control (DOH-NCDPC)

Contact Number: 651-78-00 local 2353

Email: naspcp@yahoo.com

National Dengue Prevention and Control Program

The National Dengue Prevention and Control Program was first initiated by the Department of Health (DOH) in 1993. Region VII and the
National Capital Region served as the pilot sites. It was not until 1998 when the program was implemented nationwide. The target populations
of the program are the general population, the local government units, and the local health workers.

Vision: Dengue Risk-Free Philippines

Mission: To improve the quality of health of Filipinos by adopting an integrated dengue control approach in the prevention and control
of dengue infection.

Goal: Reduce morbidity and mortality from dengue infection by preventing the transmission of the virus from the mosquito vector
human.

Objectives:

The objectives of the program are categorized into three: health status objectives; risk reduction objectives; and services & protection
objectives.

Health Status Objectives:

• Reduce incidence from 32 cases/100,000 population to 20 cases/100,000 population;

•
• Reduce case fatality rate by <1%; and
• 


• Detect and contain all epidemics.

•
Risk Reduction Objectives:

• Reduce the risk of human exposure to aedes bite by House index of <5 and Breteau index of 20;
•
• Increase % of HH practicing removal of mosquito breeding places to 80%; and
• 


• Increase awareness on DF/DHF to 100%.

•

Services & Protection Objectives:

• Establish a Dengue Reference Laboratory capable of performing IgM capture ELISA for Dengue Surveillance;
• Increase the % of 1° and 2° government hospitals with laboratory capable of platelet count and hematocrit; and
• Ensure surveillance and investigation of all epidemics.
Partner Organizations/Agencies:

The following organizations/agencies take part in the achievement of the program’s objectives:

• World Health Organization (WHO)

• United Nations children’s Fund (UNICEF)
• Department of Interior and Local Government (DILG)
• Department of Education (DepEd)
• United States Agency for International Development (USAID)
• Asian Development Bank (ADB)
• Philippine Health Insurance Corporation (PhilHealth)

Program Manager:

Dr. Lyndon L. Lee Suy

Department of Health-National Center for Disease Prevention and Control (DOH-NCDPC)

Contact Number: 651-78-00 local 2353

Email: donleesuymd@yahoo.com

National Prevention of Blindness Program

Government Mandates and Policies :

• Administrative Order No. 179 s.2004: Guidelines for the Implementation of the National Prevention of Blindness Program
•
• Department Personnel Order No. 2005-0547: Creation of Program Management Committee for the National Prevention of Blindness Program
•
Subcommittees: Refractive Error/Low Vision, Childhood Blindness, Cataract

• Proclamation No. 40 declaring the month of August every year as “Sight Saving Month”
Vision: All Filipinos enjoy the right to sight by year 2020

Mission: The DOH, Local Health Unit (LGU) partners and stakeholders commit to:

• Strengthen partnership among and with stakeholder to eliminate avoidable blindness in the Philippines;
•
• Empower communities to take proactive roles in the promotion of eye health and prevention of blindness;
• 


• Provide access to quality eye care services for all; and

• 


• Work towards poverty alleviation through preservation and restoration of sight to indigent Filipinos.
•
Goal: Reduce the prevalence of avoidable blindness in the Philippines through the provision of quality eye care.

The program has the following objectives:

General Objective No. 1: Increase Cataract Surgical Rate from 730 to 2,500 by the year 2010

Specific:

• Conduct 74,000 good outcome cataract surgeries by 2010;

•
• Ensure that all health centers are actively linked to a cataract referral center by 2008;
• 


• Advocate for the full coverage of cataract surgeries by Philhealth;

• 


• Establish provincial sight preservation committees in at least 80% of provinces by 2010;

• 


• Mobilize and train at least one primary eye care worker per barangay by 2010;
• 


• Mobilize and train at least one mid-level eye care health personnel per municipality by 2010;
• 


• Improve capabilities of at least 500 ophthalmologists in appropriate techniques and technology for cataract surgery;
• 


• Develop quality assurance system for all ophthalmology service facilities by 2008; and
• 


• Ensure that 76 provincial,16 regional and 56 DOH retained hospitals are equipped for appropriate technology for cataract surgery.
•

General objective no 2: Reduce visual impairment due to refractive errors by 10% by the year 2010

1. Institutionalize visual acuity screening for all sectors by 2010;

2. Ensure that all health centers are actively linked to a referral center by 2008;

3. Distribute 125,000 eye glasses by 2010;

 4. Ensure that the hospitals and of health centers have professional eye health care providers by 2010;

5. Ensure establishment of equipped refraction centers in municipalities by 2008; and

6. Establish and maintain an eyeglass bank by 2007.

General objective no 3: Reduce the prevalence of visual disability in children from 0.3% to 0.20% by the 2010

1. Identify children with visual disability in the community for timely intervention;

2. Improve capability of 90% of health worker to identify and treat visual disability in children by 2010; and

3. Establish a completely equipped primary eye care facility in municipalities by 2008.

Burden of Blindness and Visual Impairment : Global Facts

The Philippines is a signatory in the Global Elimination of Avoidable Blindness: Vision 2020 – The Right to Sight. The Vision 2020 was
initiated by the International Agency for Prevention of Blindness (IAPB), World Health Organization (WHO), and the Christian Blind Mission
(CBM), Vision 2020 aims to develop sustainable comprehensive health care system to ensure the nest possible vision for all people and thereby
improve the quality of life.

According to WHO estimates :

• Approximately 314 million people worldwide live with low vision and blindness
•
• Of these, 45 million people are blind and 269 million have low vision
• 


• 145 million people's low vision is due to uncorrected refractive errors (near-sightedness, far-sightedness or astigmatism). In most cases,
normal vision could be restored with eyeglasses
• 


• Yet 80% of blindness is avoidable - i.e. readily treatable and/or preventable

• 


• 90% of blind people live in low-income countries

• 


• Restorations of sight, and blindness prevention strategies are among the most cost-effective interventions in health care
• 


• Infectious causes of blindness are decreasing as a result of public health interventions and socio-economic development. Blinding trachoma
now affects fewer than 80 million people, compared to 360 million in 1985
• 


• Aging populations and lifestyle changes mean that chronic blinding conditions such as diabetic retinopathy are projected to rise exponentially
• 


• Women face a significantly greater risk of vision loss than men

• 


• Without effective, major intervention, the number of blind people worldwide has been projected to increase to 76 million by 2020
•

Burden of Blindness and Visual Impairment : Local Facts

• Number of blind people: 592,000 (based on 2011 estimated population of 102M & 2002 blindness prevalence of 0.58%)
•
• Number of persons with moderate or severe visual impairment: 2 million (2011 popn. & 2002 prevalence of 2.04%)
• 


• Number of blind due to cataract: 367,000 (62%)

• 


• Number of blind due to EOR: 59,000 (10%)

• 


• Number of blind from cataract below poverty line: 92,000 (25%, NSCB 2009 figures]; figure est. doubled to include first & second quintiles
•

RP Prevalence of Blindness (%), 2002

Caraga 0.16
National Capital Region 0.19
Cordillera Autonomous Region 0.2
Central Mindanao 0.4
Ilocos Region 0.5
Western Visayas 0.51
Eastern Visayas 0.53
Southern Luzon 0.56
National Figure 0.58

Northern Mindanao 0.61

Central Visayas 0.62
Bicol Region 0.71
Western Mindanao 0.74
Central Luzon 0.79
Autonomous Region of Mislim Mindanao 0.8
Cagayan Valley 0.87
Southern Mindanao 1.08

RP Prevalence of Low Vision (%), 2002

Caraga 0.6
National Capital Region 0.81
Cordillera Autonomous Region 0.87
Central Luzon 1.21
Central Mindanao 1.53
Western Mindanao 1.59
Southern Mindanao 1.71
Central Visayas 1.76
Western Visayas 1.91
National Figure 1.98

Northern Mindanao 2.17

Ilocos Region 2.43
Autonomous Region of Muslim Mindanao 2.43
Bicol Region 2.52
Eastern Visayas 2.56
Southern Luzon 3.71
Cagayan Valley 4.07

RP Prevalence of Visual Impairment (%) , 2002

Caraga 0.76
National Capital Region 1
Cordillera Autonomous Region 1.07
Central Mindanao 1.93
Central Luzon 2
Western Mindanao 2.33
Central Visayas 2.38
Western Visayas 2.42
National Figure 2.56

Northern Mindanao 2.78

Southern Mindanao (blindness) 2.79
Ilocos Region (Low Vision) 2.93
Eastern Visayas (Low Vision) 3.18
Autonomous Region of Muslim Mindanao 3.23
Bicol Region 3.23
Southern Luzon (Low Vision) 4.27
Cagayan Valley 4.94

Interventions/Strategies employed or Implementation by the DOH

1. Advocacy and Health Education

This includes patient information and education, public information and education and intersectoral collaboration on eye health
promotion and the nature and extent of visual impairments particularly its risk factors and complications and the need/urgency of
early diagnosis and management.

2. Capability Building

This component shall focus on ensuring the capability of national and local government health facilities in delivering the
appropriate eye health care services especially to the indigent sector of the population. Program shall provide training for
coordinators at regional and provincial levels; will ensure the availability of and access to training programs by program
implementers. It shall include strengthening treatment/management capabilities of existing personnel and operating capabilities of
facilities conducting cataract operations etc., taking into outmost consideration basic quality assurance and standardization of
procedures and techniques appropriate to each facility/locality.

3. Information Management

The program shall develop an information management system for purposes of reporting and recording. As far as practicable,
this system shall consider and will build on any existing mechanism. The system shall be national in scope, although the
mechanism shall consider the regional and local needs and capabilities.

4. Networking, Partnership Building and Resource Mobilization

An important component of the program is networking and partnership building to ensure that services are available at the
local level. This shall include public-private and public-public partnership aimed at building coalition and networks for the delivery
of appropriate eye health care services at affordable cost especially to the indigent sector. This component shall also focus on
ensuring that the highest appropriate quality services are made available and accessible to the people.

5. Supervision, Monitoring and Evaluation

The Program shall be coordinated by a national program coordinator from the Degenerative Disease Office of the National
Center for Disease Prevention and Control, Department of Health. The national program coordinator shall oversee the
implementation of program plans and activities with the assistance of the regional coordinators from the Centers for Health
 Development.

A system of monitoring program plans and activities shall be developed and implemented taking into consideration the provision
of the local government code as well as the organic act of Muslim Mindanao, and any similar issuances/laws that will be passed in
the future.

A program review shall be conducted as needed. Result of program evaluation shall be used in formulating policies, program
objectives and action plans.

6. Research and Development

The program shall encourage the conduct of researches for purposes of developing local competence in eye health care and
for other purposes that may be necessary. The development and dissemination of clinical practice guidelines for eye health shall
form part of the research agenda of the program.

The program shall support researches/studies in the clinical behavior (KAP) and epidemiological (trends) areas. It also aims to
acquire information that is utilized for continuing public health information and education, policy formulation, planning and
implementation.

7. Service Delivery

Service delivery for the prevention of Blindness Program shall be covered by the principle of best practice. In collaboration
with the local government units and stakeholders, the program shall develop systems and procedures for the integration and
provision of services at the community level. This means primary eye prevention concentrating on health education, advocacy and
primary eye interventions; Secondary prevention; screening/early detection/basic management/ counseling, referral and/or
definitive care and tertiary prevention: management of complications, continuing care and follow up including rehabilitation. The
following areas will be the priority areas for services to be provided by the National Prevention of Blindness Program:

a. Cataract Surgeries

b. Errors of Refraction

c. Childhood Blindness

Activities for the Vitamin A Deficiency Disorder, for practical purposes, shall be led by the Family Health Office also of the NCDPC.

A Referral System shall form part of services delivered by the program. This is to ensure that all patients receive quality eye health
care at appropriate levels of health care delivery system. All rural health units should be linked to an eye care referral center.

Cataract

Cataract, the opacification of the normally clear lens of the eye, is the most common cause of blindness worldwide. It is the cause
in 62% of all blindness in the Philippines and is found mostly in the older age groups. The only cure for cataract blindness is
surgery. This is available in almost all provinces of the country; however there are barriers in accessing such services.
Interventions will therefore consist of increasing awareness about cataract and cataract surgery; as well as improving the delivery
of cataract services. The parameter used worldwide to monitor cataract service delivery is the Cataract Surgical Rate.

Errors of Refraction

Errors of refraction is the most common cause of visual impairment in the country (prevalence is 2.06% in the population). Errors
of refraction are corrected either with spectacle glasses, contact lenses or surgery. The services to address the problem of EOR are
provided mainly by optometrists. However, the provision of the eyeglasses or lenses (who should provide, how is it provided, etc.)
has to be addressed.

Childhood Blindness

The prevalence of blindness among children (up to age 19) is 0.06% while the prevalence of visual impairment in the same age
group is 0.43%. The problem of childhood blindness is the highly specialized services that are needed to diagnose and treat it.
However, screening of children for any sign of visual impairment can be done by pediatricians, school clinics and health workers.

Future Plan/Action:

• Development of Service Package for Prevention Blindness Program

•
• Development of Clinical Practice Guidelines for Prevention Blindness Program
• 


• Development of Strategic Framework and a Five Year Strategic Plan for Prevention Blindness Program (2012-2016)
• 


• Continue conduct of promotion and advocacy activities and partnership with National Committee for Sight Preservation, Specialty
Societies and other stakeholders on PBP
• 


• Creation of PBP Registry System

• 


• Ensure the implementation of the National Prevention of Blindness Program

•

Status of Implementation/Accomplishment:

• Department of Health supports prevention of blindness and vision impairment o Signatory of all World Health Assembly
resolution on Vision 2020 and blindness prevention.
 o National Prevention on Blindness Program under Non-Communicable
Disease Cluster.
 o Funded 3 national surveys of blindness 1987, 1955 and 2002.
 o Planning workshop 2004 crafted 5
year development plan for eye care 2005-2010 assisted by IAPB / ICEH.
 o AO 179 issued on Nov. 2004 by Sec. Dayrit
creating “Guidelines for Implementation of the National Prevention Blindness Program (NPBP)” which set-up the Program
Management Committee (PMC)
 o Blindness prevention and rehabilitation of persons with irreversible blindness are
incorporated in the health program for persons with disability of DOH
• The following programs/projects are included in the Maternal and Child Care Program
of DOH: 
 o Expanded Program for Immunization (includes vaccination for diseases that causes
blindness)
 o Vitamin A provision for pregnant mothers and children to prevent vitamin A deficiency
 o Comprehensive
newborn care includes prophylaxis for ophthalmia neonatorum
 o Newborn screening includes screening for galactosemia which
cause congenital cataract

• Several activities in the PBP
 o Consultative and Planning Workshop on PBP, October 2011
 o National Eye Summit, Manila
Grand Opera Hotel, Manila last October 2009
 o Strategic Planning Workshop on the National Sight Preservation and Blindness
Program 2008
 o Training of Trainors of Primary Eye Care conducted 2007

Other Significant information:

• Available Human Resources:

Ophthalmologists - 1,573 registered PAO members as of January 27, 2011

- 95% is in private practice

Optometrists - 10,266 registered with Philippine Board of Optometry as of July

2010

• Financial Resources
o DOH provides funds largely for technical assistance for training, capacity building activities, and augmentation of
funds for local program implementation.

o Philippine Health Insurance Corporation covering personal eye care services (hospital based)

• Partner Organizations:
Aside from the collaborating divisions in the DOH, the following institutions partake in the program:

• Local Government Units (LGUs)

• National Committee for Sight Preservation (NCSP)
• Philippine Academy of Ophthalmology
• Philippine Information Agency
• Optometric Association of the Philippines
• Rotary International
• Integrated Philippine Association of Optometrists
• Foundation for Sight
• Helen Keller International
• Lions Club International
• Tanggal Katarata Foundation
• UP - Institute of Ophthalmology
• Christian Blind Mission
• Resources for the Blind
• SentroOfthalmologico Jose Rizal
• World Health Organization
Sources: Files and Links:

Administrative Order No. 179 s. 2004

World Health Organization

Program Manager:

Ma. Cristina Raymundo

Department of Health-National Center for Disease Prevention and Control (DOH-NCDPC)

Contact Number: 651-78-00 locals 1750-1752

National 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 women’s 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. Women’s/ 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 childbirth- this 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 Women’s 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 women’s 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 maternal-newborn 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, facility-based 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.

Oral Health Program

Contact Person:
Dr. Manuel F. Calonge
Email Address:
mfcalonge@yahoo.com
Telephone Nos.:
651-7800 loc. 1727-1730
Oral Health Program cuts across all life-cycle programs (child, maternal, adolescent, older, person, etc) of the Family Health Office, National
Center for Disease Prevention and Control.

1. Problem

• The main oral health problems are dental caries (tooth decay) and peridontal disease (gum disease). These two oral diseases are so
widespread that 87% of our people are suffering from tooth decay and 48% have gum disease. (2011 NMEDS Survey)
• The combined ill effects of these two major diseases (except oral cancer) weaken bodily defense and serve as portal of entry to other more
serious, potentially dangerous and opportunistic infections overlapping other diseases present. Such will incapacitate a young victim
as in crippling heart conditions arising from oral infection that may end in death.
• The individual so affected with such handicap also has disturbed speech, becomes withdrawn and avoids socializing with people and so
lessen his opportunities for advancement. More critical however is the effect of poor or defective teeth to overall nutrition to maintain
good general health, that begins with the first bite and chewing the food efficiently.
2. Program Objectives/ Indicators/ Parameters

General:

Reduction on the prevalence rate of dental caries and periodontal diseases from 92% in 1998 to 85% and from 78% in
1998 to 60%, respectively, by end of 2016 among general population.

Specific:

a) To increase the proportion of Orally Fit Children (OFC) under 6 years old to 12% by 20% by 2020

b) To control oral health risks among the young people

c) To improve the oral health conditions of pregnant women by 20% and older persons by 10% every year till 2016.

3. Target Priorities

Pre-school children, Adolescents, Mothers, Elderly

4. Strategies and future Plans/ Actions

1. Formulate policy and regulations to ensure the full implentation of OHP

a. Establishment of effctive networking system (DepEd, DSWD, LGU, PDA, Fit for School, Academe and others)

b. Development of policies, standards, guidelines and clinical protocols

- Fluoride Use
 - Toothbrushing

- other preventive measures

c. Upgrading of Dental Services Unit all levels

2. Ensure financial access to essential public and personal oral health services

a. Develop an outpatient benefit package for oral health under NHIP of the government.

b. Develop financing schemes for oral health applicable to other levels of care (fee for service,
cooperatives, network with HMOS)

c. Restoration of oral health budget line item in the GAA of DOH CO.

3. Provide relevant, timely and accurate information management system for oral health

a. Improve existing information system/ data collection (reporting and recording dental services and accomplishments)

- Setting essential indicators

- Development of IT system on recording and reporting oral health services accomplishments and indices- Integrate oral
health in every family health information tools, recording books/manuals

b. Conduct regular epidemiological dental surveys- every 5 years

4. Ensure access and delivery of quality oral health care services

a. Upgrading of facilities, equipment, instruments, supplies

b. Develop packages of essential care/services for different groups (children, mothers and marginalized groups)

- Revival of the sealant program for school children

- Tooth brushing program for pre-school children

- Outreach programs for marginalized groups

c. Design and implement grant assistance mechanism for high performing LGUs

- Awards and incentives

- Funding grants for priority programs/activities

d. Regular conduct of consultation meetings, technical updates and program implementation reviews with stakeholders

5. Build up highly motivated health professionals and trained auxiliaries to manage and provide quality oral health care

a. Provision of adequate dental personnel

b. Capacity enhancement programs for dental personnel and non-dental personnel

5. Status of Implementation / Accomplishments

· Outpatient Dental Health Care Finance Package – Being advocated for inclusion under PhilHealth outpatient packages. The best scheme
is through Capitation wherein a certain amount will be provided for these dental services for indigent patients to certain health facilities
including RHUs.

· Capacity Enhancement Program (CEP) for Public Health Dentists- This training program was designed with the public health dentists
(PHDs) as the main recipients of the Basic Course on the Management of Oral Health Program. The training is expected to provide an in-depth
understanding of the different roles and functions of the PHDs in the management and delivery of Public Health Services. For the last two years
(2010-2011) 10.2 Million pesos were sub-allotted to all CHDs for this purpose. To date almost 87% of all PHDs are trained. NCDPC is proposing
to develop Skills Training (Oral and Maxillo-facial surgery) for Hospital dentist as continuation to the CEP.

· Oral Health Survey – The Department of Health (DOH) has been conducting nationwide surveys every five years (1977, 1982, 1987,
1992 and 1998) to determine the prevalence of oral diseases in the Philippines. In 2011, the NCDPC with a 5 Million pesos budget conducted
the National Monitoring and Evaluation Dental Survey (NMEDS) through the UP-National Institute of Health (UP-NIH).

· Orally Fit Child (OFC) Campaign- In 2009 the DOH launched the OFC campaign for 2-6 years old children (pre-school children) in day
care centers. Orally Fit child is a child who meets the following conditions upon oral examination and /or completion of treatment a.) caries-free
or all carious tooth/teeth must be restored either temporary or permanent filling materials

b.) have healthy gums

c.) has no oral debris

d.) no dento-facial anomaly that limits oral cavity’s normal function.

NCDPC have allotted 8.5 million pesos each year to implement the programin day care centers. Activities include both tooth brushing activities,
training of day care workers, awards, IEC materials among others. The DOH is hoping to attain 12% OFC in 2016 and 20% in 2020. To date
more or less 3.20% pre-schoolers are OFC.

· 2013 Budget (23.6 million)

-Commodities (Dental Sealant and ART Filing materials for pre-school children) = 20 million

· 2014 Budget (35 million)

6. Other Significant Information

Policy/ Standards/ Guidelines formulated/ developed:

• AO 101 s. 2003 dated October 14, 2013- National Policy on Oral Health
• AO 2007-0007 dated January 3, 2013 - Guidelines in the Implementation of Oral Heaalth Program for Public Health Services in the Philippines
• AO 4 s. 1998 - Revised Rules and Regulations and Standard Requirements for Private School Dental services in the Philippines.
• AO 11-D s. 1998 - Revised Standard Requirements for hospital Dental services in the Philippines.
• AO 3 s. 1998 - Revised Rules and Regulations and Standard Requirements for Occupational Dental Services in the philippines
• AO 4-A s. 1998 - Infection Control Measures for Dental Health Services
Existing Working Group for Oral Health:

National Technical Working Group (TWG) on Oral Health (DPO 2005-1197)

Member Agencies: Department of Health (NCDPC, HHRDB, NCHP

DOH-Center for Health Development for NCR, Central Luzon and Calabarzon

Philippine Dental Association

Department of Education

UP - College of Public Health

Department of Interior and Local Government

Department of Social Welfare and Development

Local Government Units (Makati, Quezon City)

Print Materials:

- Leaflets (Malakas and dating Buo ang Ngipin) for Children, Adolescent, Pregnant Women, and Older Persons

- Training Module on Basic Course on Management of Oral Health Program

Persons with Disabilities

HEALTH AND WELLNESS PROGRAM FOR PERSONS WITH DISABILITIES

BACKGROUND

Persons with disabilities (PWDs), according the UN Convention on the Rights of Persons With Disabilities, include those who have long-term
physical, mental, intellectual or sensory impairments which in interaction with various barriers may hinder their full and effective participation in
society on an equal basis with others.

The International Classification of Functioning, Disability and Health (ICF) refers to disability as “an umbrella term covering impairments, activity
limitations, and participation restrictions. An impairment is a problem in body function or structure; an activity limitation is a difficulty
encountered by an individual in executing a task or action; while a participation restriction is a problem experienced by an individual in
involvement in life situations”. The ICF’s definition of disability denotes a negative interaction between a person (with a health condition) and
his or her contextual factors (environmental and personal factors). A comprehensive approach in interventions is then necessary for persons
with disabilities (PWDs) as it entails actions beyond the context of health, but more on helping them to overcome difficulties by removing
environmental and social barriers (WHO, 2013).

Globally, over 1 billion people, or approximately 15% of the world’s population, have some form of disability. About 110 to 190 million people 15
years and older have significant difficulties in functioning. Moreover, the rapid spread of chronic diseases and population ageing contribute to
the increasing rates of disability. About 80% of the world’s PWDs live in low-income countries, wherein majority are poor and cannot access
basic services. With their conditions, PWDs need greater attention and considerations in terms of health needs, without discrimination. However,
reports show that PWDs have less access to health services and therefore have greater unmet needs (WHO, 2012.)

In the Philippines, the results of the 2010 Census of Population and Housing (CPH, 2010) show that of the household population of 92.1 million,
1.443 million Filipinos or 1.57%, have a disability. Region IV-A, with 193 thousand PWDs, was recorded to have the highest number of PWD
among the 17 regions, while the Cordillera Administrative Region (CAR) had the lowest number with 26 thousand PWDs. There were more
males, who accounted for 50.9% of the total PWD in 2010, compared to females, with 49.1% with disability. For every five (5) PWD, one
(18.9%) was aged 0 to 14 years, three (59.0%) were in the working age group (15-64 years old), and one (22.1%) was aged 65 years and
above (NSO, 2013).

The mandate of the DOH to come up with a national health program for PWD was based on Republic Act No. 7277, “An Act Providing for the
Rehabilitation and Self-Reliance of Disabled Persons and Their Integration into the Mainstream of Society and for Other Purposes” or otherwise
known as “The Magna Carta for Disabled Persons” andthe Implementing Rules and Regulations (IRR) of RA 7277. This document stipulated that
the DOH is required to: (1) institute a national health program for PWDs, (2) establish medical rehabilitation centers in provincial hospitals, and
(3) adopt an integrated and comprehensive program to the Health Development of PWD, which shall make essential health services available to
them at affordable cost. In response to this, the DOH issued Administrative Order No. 2006-0003, which specifically provides the strategic
framework and operational guidelines for the implementation of Health Programs for PWDs.

In 2013, a MediumTerm Strategic Plan (2013-2017) was developed to strengthen the existing health program for PWDs. However, in the review
done for the purpose, it was noted that in the implementation of the program in the past years, there were operational issues and gaps
identified that need to be addressed. These include among others, the need to strengthen multi-sectoral action to harmonize efforts of
stakeholders; clarify delineation of roles and responsibilities of concerned government agencies working for PWDs; strengthen national capacity,
both facilities and manpower, to provide rehabilitation services for PWDs from primary to tertiary level of care; provide access to health facilities
and services for PWDs; and, strengthen registration database for PWDs.

Recently, the World Health Organization released the Global Disability Action Plan 2014-2021. This document intends to help countries direct
their efforts towards specific actions in order to address health concerns of persons with disabilities. The Action Plan identified three major
objectives: to remove barriers and improve access to health services and programmes; (2) to strengthen and extend rehabilitation, habilitation,
assistive technology, assistance and support services, and community-based rehabilitation; (3) to strengthen collection of relevant and
internationally comparable data on disability and support research on disability and related services.

Considering all of the above, the Health and Wellness Program of Persons with Disabilities currently has been configured to address all the
issues discussed above, and aligned with the thrusts and goals of Kalusugang Pangkalahatan or Universal Health Care, the Global Disability
Action Plan 2014-2021, and, the direction the program should take in the succeeding years as articulated in the newly developed strategic plan.

II. HEALTH AND WELLNESS PROGRAM FOR PERSONS WITH DISABILITIES

A. Vision:A country where all persons with disability, including children and their families, have full access to inclusive health and
rehabilitation services.
B. Mission:A program designed to promote the highest attainable standards of health and wellness for PWDs by fostering a multi-sectoral
approach towards a disability inclusive health agenda.

C. Objectives:

• To address barriers and improve access and reasonable accommodations of PWDs to health care services and programs.
• To ensure the accessibility, availability, appropriateness and affordability of habilitation and rehabilitation services for PWDs, including
children with disabilities.
• To ensure the development and implementation of policies and guidelines, health service packages, including financing and provider
payment schemes for health services of PWDs.
• To enhance capacity of health providers and stakeholders in improving the health status of PWDs.
• To strengthen collaboration and synergy with and among stakeholders and sectors of society to improve response to a disability inclusive
health agenda through regular dialogues and interactions.
• To provide the mechanism in facilitating the collection, analysis and dissemination of reliable, timely and complete data and researches on
health-related issues of PWDs in order to develop and implement evidence-based policies and interventions.
D. Action Framework for the Health and Wellness Program of Persons with Disabilities

The Action Framework for the Health and Wellness Program of Persons with Disabilities is adapted from the three major objectives of the WHO
Global Disability Action Plan 2014-2021. As applied in the country, program actions or interventions shall focus on the following areas: 1)
removal of barriers and improve access to health services and programs; (2) strengthening and expansion of rehabilitation, habilitation, assistive
technology, and community-based rehabilitation; (3) strengthen collection of relevant and internationally comparable data on disability and
support research on disability and related services.

Figure 1 depicts the Action Areas that the Health and Wellness Program for Persons with Disabilities shall focus its interventions along the
thrusts and goals of Kalusugang Pangkalahatan or Universal Health Care.

Action Area 1:Removal of barriers and improve access to health services and programs. People with disabilities, including children,
encounter a range of attitudinal, physical and systemic barriers when they attempt to access health care such as physical barriers related to the
architectural design of health facilities or health providers’ lack of adequate knowledge and skills in providing services for persons with
disabilities, among many others.

Therefore, actions or interventions should be under taken to ensure that persons with disabilities have access, on an equal basis with others, to
health facilities and services. It is important to identify all of these barriers and institute collective actions to remove these barriers and improve
access of persons with disabilities to health services and programs.

Action Area 2: Strengthening and expansion of rehabilitation, habilitation, assistive technology, and community based
rehabilitation. Habilitation and rehabilitation are “sets of measures that assist individuals, who experience or are likely to experience
disability, to achieve and maintain optimal functioning, in interaction with their environments”. Encompassing medical care, therapy and
assistive technologies, they should begin as early as possible and be made available as close as possible to where people with disabilities live.

Increasing government investments in habilitation, rehabilitation and provision of assistive technologies are expected actions or interventions
that must be put in place. This is going to be beneficial in the long run because they build human capacity and can be instrumental in enabling
people with limitations in functioning to remain in or return to their home or community, live independently, and participate in all aspects of life.
They can reduce the need for formal support services as well as reduce the time and physical burden for caregivers.

Action Area 3: Strengthening collection of relevant and internationally comparable disability data and support disability
researches. Data is needed to strengthen health care systems, as it informs policy and interventions. These can be collected through
dedicated disability surveys, or disaggregating data from other data collection efforts by disability status, and research.

Interventions along this action area should ensure that data collected would be internationally comparable and results of researches and studies
done are used for informing policy and resource allocation. The use of the Philippine Registry for Persons with Disability is an intervention that
should be strengthened and made fully operational.

Figure1: Action Framework for the Health and Wellness Program for Persons with Disabilities
Ms. Frances Prescilla Cuevas, RN, MAN
 Chief Health Program Officer
Degenerative Disease Office
 National Center for Disease Prevention and
Control, Department of Health, San Lazaro Compound, Sta. Cruz, Manila, Philippines
 (062) 7322492

First Public Health Convention on the Health and Wellness of PWDs - November 6-7, 2014
 PowerPoint Presentation of
Speakers

Day 1
 - Current Developments in the Philippine Rehabilitation Services
 - Current Innovative Approaches to Increasing Access to Rehabilitation
Services
 - First Survey on Disabilities as part of NNHeS
 - Access to SRH Services
 - Opening: DOH Disability and Health Summit
 - Community
Based Inclussive Health; A Vision
 - Perspective on Health and Wellness for Persons with Disabilities
 - National Perspectives: Philippine
Framework for Action on the Health and Wellness Program for PWDs
 - Personal Perspectives on Health and Wellness for PWDs

Day 2
 - Issues on Screening for Developmental Disabilities: Health Promotion Issues and Challenges
 - Issues on Sexual and Reproductive Health
of Persons with Disabilities
 - Health Promotion Issues on Increasing Access to Health and Wellness of PWDS
 - Promoting Physical Activity
Among PWDS
 - Mental Health and Psychosocial Support for PWDs
 - 1st Public Health Convention on the Health and Wellness of Persons with
Disabilities
 - Expanding the ZMORPH Benefit Package - The Product Team for Special Benefits

Philippine Medical Tourism Program

Vision:

"The global leader in providing quality health care for all through universal health care"

Mission:

To ensure that the Philippines is globally competitive through implementation of quality standards in both public and private sector.

Goal:

1. The local Global Health Care industry will contribute a noticeable and quantifiable amount to the Philippine economy and improvement in the
quality of life.

2. Increase the number of institutions offering advanced medical services suitable for Global HealthCare, the generation of jobs in the Medical
Services industry and other related industries, thereby increasing the productivity of the workforce and enabling it to expand and upgrade.

3. Attract increased numbers of visitors from other countries availing of medical services and at the same time ensure that quality of those
currently offering services suitable for Global Health Care is on the same level as with globally-recognized standards, and making these services
equitably available for both Medical Travellers and local patients.

Objectives:

1. To increase competitiveness by compliance to recognized bodies that implement national and international healthcare organization
accreditation

2. Institutionalize policies and enact legislation for high level quality healthcare and patient safety standards in all health facilities

3. Continue collaboration with national government agencies, LGUs, private sector organizations and academe involved in quality healthcare and
patient safety, international medical travel and wellness services, retirement, trade and tourism

4. Continue advocacy in all regions of the country on quality healthcare and patient safety, international medical travel and wellness services,
retirement, trade and tourism through quad media approach, capacity building activities and collaborative participation in international forum
and conferences

Stakeholders/Beneficiaries:

Private clinics/centers, Public and Private Hospitals, National Government Agencies, Private Specialty Clinics/Centers providing Dermatology,
plastic surgery, ophthalmology and dental medicine, Geriatric and Treatment and Rehabilitation Centers for substance abuse

Partner Organizations/Agencies:

• Department of Tourism (DOT)

• Department of Foreign Affairs (DFA)
• Department of Trade and Industry (DTI)
• Department of Public Works and Highways (DPWH)
• Department of Interior Local Governments (DILG)
• Department of Justice (DOJ)
• Department of Finance (DFA)
• Department of Science and Technology (DOST)
• Department of Labor and Employment (DOLE)
• DTI - Board of Investments (BOI)
• DTI - Philippine Export Zone Authority (PEZA)
• DOT - Tourism Infrastructure Enterpise Zone Authority (TIEZA)
• DOJ - Bureau of Immigration (BI)
• DOF - Bureau of Customs (BoC)
• Subic Bay Metropolitan Authority (SBMA)
• Clark Development Corporation (CDC)
• Philippine Health Insurance Corporation (PhilHealth)
• Philippine Retirement Authority (PRA)
• Cebu Health and Wellness Council (CHWC)
• Development Academy of the Philippines (DAP)
• National Economic Development Authority (NEDA)
• Technical Education and Skills Development Authority (TESDA)
• Commission on Higher Education Development (CHED)
• Philippine Information Agency (PIA)
• Public Private Partnership Center (PPPC)
• Joint Foreign Chambers of Commerce in the Philippines
• European Chamber of Commerce in the Philippines (ECCP)
• American Chamber of Commerce in the Philippines (ACCP)
• Canadian Chamber of Commerce (CCC)
• Australian New Zealand Chamber of Commerce in the Philippines (ANZCHAM)
• Japanese Chamber of Commerce in the Philippines (JCCP)
• Korean Chamber of Commerce in the Philippines (KCCP)
• Philippine Association of Multinational Companies Regional Headquarters, Inc. (PAMURI)
• Professional Regulations Commission (PRC)
• Philippine Medical Association (PMA)
• Philippine Nurses Association (PNA)
• Philippine Hospital Association (PHA)
• Philippine Council for the Accreditation of Health Care Organizations (PCAHO)
• International Society for Quality in Healthcare (ISQUA)
• Joint Commission International (JCI)
• National Accrediting Body for Hospitals (NABH - India)
• TUV Rheinland
• Private Sector
• Health and Wellness Alliance of the Philippines (HEAL Philippines)
• Health Core and HIM Communications
• Retirement and Healthcare Coalition (RHC)
• Spas and Wellness Association of the Philippines (SAPI)
• Philippine Dental Association (PDA)

Program Manager:

Emmanuel A. Tiongson, MD

2ndflr, Bldg16, San Lazaro Compound, Department of Health Compound, Sta. Cruz, Mla

6517800 local 2024-2025 fax 7110871

Email: butchiongson@yahoo.com

Philippine Cancer Control Program

Contact Person:
Franklin C. Diza, MD, MPH
Cancer is predicted to be an increasingly important cause of morbidity and mortality in the next few decades, in all regions of the world. The
challenges of tackling cancer are enormous and when combined with population ageing -increases in cancer prevalence are inevitable,
regardless of current or future actions or levels of investment.

GOAL: Reduce morbidity, mortality and disability due to common preventable cancers

OBJECTIVES:

1. To reduce the exposure of population to risk related factors primarily smoking, unhealthy diet, physical inactivity and harmful use of
alcohol, cancer related infections, chemical and ultra violet rays exposure.

2. To increase the number of patient given appropriate screening, diagnosis and treatment of cancer.

3. To increase the number of patient given appropriate pain relief and support care services with cancer.
INTERNATIONAL SUPPORT, POLICIES AND MANDATES

· International Policies and Mandates

ØWHA58.22 cancer prevention and control

ØWHA57.12 on the reproductive health strategy, including control of cervical cancer screening

ØWHA57.16 on health promotion and healthy lifestyles

ØWHA57.17 on the Global Strategy on diet, physical activity and health

ØWHA56.1 on tobacco control

· International Support

In 2011, the UNFPA had donated three (3) units of cryotherapy machines for use in the treatment of pre-cancerous lesion in the cervix. This
partner also provided funds in the development of the Training Module on Cervical Cancer Prevention and Control together with the support of
Women’s Health and Safe Motherhood Project II.

INTERVENTIONS/ STRATEGIES EMPLOYED OR IMPLEMENTED BY DOH

Packages of Services

· Free cervical cancer screening provided every year in 58 DOH Hospitals done during the month of May to screen women ages 30-
45 years of age.

· Free adjuvant chemotherapy for women diagnosed stage 1 to 3A breast cancer in 4 pilot hospitals (Jose Reyes Memorial Medical Hospital,
East Avenue Medical Center, Rizal Medical Center, UP-PGH) funded by NCPAM

· Free chemotherapy for acute lymphatic leukemia (ALL) among children with cancer funded by NCPAM

Strategies

· Promotion of Healthy Lifestyle

ØIncrease avoidance of the risk factors

ØVaccinate against human papilloma virus (HPV) and hepatitis B (HBV)

ØControl occupational hazards

ØReduce exposure to sunlight

· Improve screening/ diagnosis and treatment

· Improve rehabilitation and palliative care

· Improve cancer registry

FUTURE PLAN/ ACTION

1. Strengthen the implementation of an Integrated Lifestyle related disease control program for the promotion of healthy lifestyle and avoid
population risk exposure.

2. Maintain the operation of an integrated chronic non-communicable disease registry system in all health facilities.

3. Development of service package for cancer control program

4. Development of clinical practice guidelines for cancer control program.

5. Development of strategic framework and five year strategic plan for cancer control program

OTHER SIGNIFICANT INFORMATION WORTH MENTIONING

Vision: Improve quality of life for all Filipinos

Mission: To provide quality, effective and accessible services for the prevention and control of cancer.

Rural Health Midwives Placement Program (RHMPP) / Midwifery Scholarship Program of the Philippines (MSPP)

Rationale:

The Philippines’ maternal and infant morbidity and mortality rates have been marked despite its efforts to assist local government units for the
past decade. An important factor identified was the lack of trained healthcare providers particularly, in the far flung areas of the country. This
hinders the recognition of basic obstetric needs and delivery of quality health service to the community.

To intensify the country’s capacity in the provision of quality health service to the people, the Department of Health (DOH) has adopted the
facility-based basic emergency obstetric care strategy. The midwives, being the frontline healthcare providers, have been identified by the DOH
to serve as the link between health service delivery and the community in the reduction of maternal and neonatal morbidity and mortality.

The RHMPP aims to provide competent midwives to areas that have not performed well in terms of facility-based deliveries, fully immunized
child and contraceptive prevalence rates, hence, improve facility-based health services. By augmenting health staff to selected government
units, the DOH may improve maternal and child health and attain the Millennium Development Goals (MDGs).

In order to ensure a constant supply of competent midwives and to deliver their services to the people in dire need, the DOH created the MSPP
that aims to produce competent midwives from qualified residents of priority areas.

Program Description:
The World Health Organization (WHO) affirms that approximately 15% of all pregnant women develop a potentially life-threatening complication
that calls for either skilled care or major obstetrical interventions to survive. Readily accessible Emergency Obstetric Care may thus reduce
maternal and perinatal morbidity and mortality.

The DOH is restating its commitment towards a health nation through more aggressive safe motherhood initiatives, hence, the upgrading of
obstetric deliveries to strategic facility-based Basic Emergency Obstetric Care (BEmONC), where these facilities are manned by a team
composed of a licensed physician, public health nurse, and a rural health midwife at the primary level.

Since the rural health midwives are considered as the frontline health workers in the rural areas and have progressed to become multi-task
personnel in the delivery of healthcare services, amidst migration of other healthcare professionals, the DOH created the Rural Health Midwife
Placement Program (RHMPP) to address the inequitable distribution of midwives and equip them for facility-based BEmONC practice. In support
to the RHMPP, thus, ensure constant supply of competent midwives, the DOH created the Midwifery Scholarship Program of the Philippines
(MSPP).

Career Track/ Return Service Obligation

Upon completion of the MSPP and obtaining the midwife’s Certificate of Registration and license, the scholars shall render two (2) years of
service to the DOH for every year of scholarship granted as form of return service.

Expected Output:

The MSPP aims to produce and ensure constant supply of competent midwives who are ready to serve the DOH identified priority areas of the
country.

The RHMPP addresses the inequitable distribution of midwives and equip them for facility-based BEmONC practice. Likewise, it provides
competent midwives to areas that have not performed well in terms of facility-based deliveries, fully immunized child and contraceptive
prevalence rates, hence, improve facility-based health services. The DOH ultimately aims in the attainment of the Millennium Development
Goals (MDGs).

Program Status:

For the MSPP, a hundred scholars are currently pursuing the Midwifery Course. On April of this year, 11 scholars graduated and passed the
Board Examination by the Professional Regulation Commission (PRC). These scholars were deployed to DOH identified priority areas starting
July 2011. This coming November, 37 other scholars will take the Board Examination.

For the RHMPP, 23 Registered Midwives were already deployed for the first batch (2008-2010). In addition to that, 175 Registered Midwives
(batch 2, 2010-2012) and 11 scholars (batch 3, 2011-2013) are currently being deployed in the DOH (BEmONC/CCT) identified priority areas.

Partner Schools:

Currently, the MSPP has four partner schools:

Area Partner School Total # of Scholars

Batch 1: 16 scholars (2008-2010)

Batch 2: 11 scholars (June 2009-May

2011)
National Capital
Dr. Jose Fabella Memorial Hospital, School of Midwifery Batch 3: 21 scholars (June 2010-May
Region
2012)

Batch 4: 17 scholars (June 2011-May

2013)

Batch 1: 19 scholars (June 2011-May

Luzon Naga College Foundation, Naga City
2013)
Batch 1: 37 scholars (June 2009-May
2011)
University of the Philippines, School of Health Science, Palo,
Visayas
Leyte Batch 2: 29 scholars (June 2010-May
2012)

Batch 1: 14 scholars (June 2011-May

Mindanao Tecarro College Foundation, Inc., Davao City
2013)
The RHMPP has deployed midwives in the different DOH identified priority areas of the country:

Batch/ Year Total Number of Midwives

Batch 1
23 RHMs
2008-2010

Batch 2 175 RHMs

2010-2012 (to include the 16 scholars from MSPP for Return Service)

Batch 3 11 RHMs

2011-2013 Return service of scholars

III. Career Track / Return Service Obligation

Upon completion of the MSPP and obtaining the midwife's Certificate of Registration and license, the scholars shall render two (2) years of
service to the DOH for every year of scholarship granted as form of return service.

IV. Expected Output

The MSPP aims to produce and ensure constant supply of competent midwives who are ready to serve the DOH identified priority areas of the
country.

The RHMPP addresses the inequitable distribution of midwives and equip them for facility-based BEmONC practice. Likewise, it provides
competent midwives to areas that haver not performed well in terms of facility based deliveries, fully immunized child and contraceptive
prevalence rates, improve facility-based health services. The DOH ultimately aims in the attainment of the Millenium Development Goals
(MDGs).

V. Program Status:

A. MSPP

• 11 scholars graduated on April 2011 and passed the Board Examination by the Professional Regulation Commission will be deployed starting
July 2011 to DOH identified priority areas.
• 37 scholars will take the November 2011 Board Examination by the Professional Regulation Commission
• 100 scholars pursuing the Midwifery Course
B. RHMPP

• 175 Registered Midwives are currently deployed in the DOH (BEmONC/CCT) identified priority areas
• Deployment of 11 scholars

Program Manager:

Dr. Josephine H. Hipolito / Ms. Winselle Joy C. Manalo

Program Coordinators

Department of Health-Health Human Resource Development Bureau (DOH-HHRDB)

Contact Number: 651-78-00 local 4204/4227

Email: hhrdb_doh@yahoo.com

Schistosomiasis Control Program

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.

Goal: To reduce the disease prevalence by 50% with a vision of eliminating the disease eventually in all endemic areas

Objectives:

The Schistosomiasis control Program has the following objectives:

1. Reduce the Prevalence Rate by 50% in endemic provinces; and

2. Increase the coverage of mass treatment of population in endemic provinces.

Program Strategies:

The Schistosomiasis Control Program employs the following key interventions:

1. Morbidity control: Mass Treatment

2. Infection control: Active Surveillance

3. Surveillance of School Children

4. Transmission Control

5. Advocacy and Promotion

Its enabling activities include; linkaging and networking; policy guidelines and CPGs; institutional capacity building; competency enhancement of
frontline service provider; and monitoring and supervision.

Program Manager:

Ms. Ruth M. Martinez

 Department of Health-National Center for Disease Prevention and Control (DOH-NCDPC)

Contact Number: 651-78-00 local 2353

Soil Transmitted Helminthiasis Control Program

Profile/Rationale of the Health Program

Given the relatively high prevalence rate of STH infections in the country and the existing issues confronting the implementation of
the STHCP nationwide, there is a need to integrate all related efforts and strengthen coordination of those involved to ensure better
complementation of resource, obtain higher coverage and generate better health outcomes. Within the Department of Health (DOH), several
programs exist which are viable mechanisms to operationalize an integrated approach in preventing and controlling STH infections more
effectively and efficiently. This needs to expand to the other national and local agencies and organizations engaged in the same endeavor.

The IHCP envisions healthy and productive Filipinos. It aims to reduce the deaths and diseases due to STH infections by reducing the
prevalence of the infection among population groups found most at risk. Helminth infections adversely affect the health of the children and
women. Program interventions and related measures have to be focused on them. Children are classified into preschoolers and school children
while women include adolescent females and pregnant women. In addition, there are also special groups, which by the nature of their work and
situation, are gravely exposed to helminthes infection. These include the soldiers, farmers, food handlers and operators as well as indigenous
people. They also require the necessary attention.

The IHCP interventions consist primarily of chemotherapy, WASH and several behavior changing approaches. Chemotherapy remains as the
core package in helminth infection control. The IHCP identifies the corresponding approach of deworming that must be applied for each
identified population group. Water, sanitation and hygiene (WASH) serves as the cornerstone in reducing the prevalence of worm infection. The
expansion of these measures reduces more effectively the transmission of worm infection. The promotion of desired behaviors ensures that
these efforts on chemotheraphy and WASH are translated into actual healthy practices and better utilization of these facilities.

These interventions only become viable and effective if they are carried out in a supportive environment. Enabling mechanisms must therefore
be established to support their implementation. An enabling environment entails good governance of the IHCP at all levels of operations. The
political will and support of national and local leaders are essential to propel the cause of the IHCP. Quality of deworming services and
expansion of service outlet to increase access must be given due to consideration. Financing reforms must likewise introduce. The LGUs must
begin to allocate budget for their own deworming program. A more equitable or rationalized allocation of deworming assistance from the DOH
must be established. Local financing mechanisms to sustain the delivery of STHCP services need to be explored and established. Strict
monitoring of LGUs compliance to national laws and policies must be undertaken while several program support systems (e.g., procurement and
logistics management, information management system, surveillance and research) have to be installed.

Central to the achievement of the IHCP vision is the commitment and participation of all sectors concerned considering that helminth infection is
a multi-faceted problem. While the LGUs are expected to be primarily responsible for the controlling helminth infection, the support of DOH,
DepEd and other national government agencies including the private sector, civil society and the community is very critical to the success of
IHCP.

Vision: Healthy and Productive Filipinos in the 21st Century

Mission: To reduce the morbidity and mortality due to STH infections.

Goals/Objectives

The program aims to reduce the prevalence of STH infection to below 50.0% among the 1-12 years old children by 2010 and lower STH
infection among adolescent females, pregnant women and other special population group.

Stakeholders/Beneficiaries:

The DOH is the lead agency in the deworming of children while the Department of Education (DepEd) is in charge of deworming all children
aged 6-12 years old enrolled in public schools (Grade 1-VI). Deworming is done by teachers under the supervision of school nurses or any
health personnel.

Program Strategies:

1. Improve governance through:

a. Policies/resolutions;

b. Securing budget for STH prevention and control;

c. Mobilization and coordination of sectoral support; and

2. Improve service quality and scale-up coverage.

a. Capacity building

1. Areas for training

· Epidemiology, life cycle etc.

· Proficiency training on lab diagnosis for med techs/lab techs

· Annual/biannual updates on current technology in lab diagnosis

· Training on drug administration, side effects, etc

2. Target participants
 3. Training mechanisms

b. Development and issuance of protocols and guidelines

c. Expansion of service delivery points

d. Availability and affordability of deworming drugs

3. Institute financing reforms

a. Efficiency in program implementation

b. Mobilization of resources

c. Strengthening LGU financing schemes

4. Strengthen regulations

5. Installation of management support systems

a. Drug procurement

b. Research

c. Surveillance

Targets and Doses

1. Children aged 1 year to 12 years old

For children 12 – 24 months old

Albendazole - 200 mg, single dose every 6 months. Since the preparation is 400mg, the tablet is halve and can be chewed by the child or
taken with a glass of water

Or

Mebendazole - 500 mg, single dose every 6 months

For children 24 months old and above

Albendazole - 400 mg, single dose every 6 months

Or

Mebendazole - 500 mg, single dose every 6 months

Note: If Vitamin A and deworming drug are given simultaneously during the GP activity, either drug can be given first.

2. Adolescent females

It is recommended that all adolescent females who consult the health be given anthelminthic drug

Albendazole 400 mg once a year

Or

Mebendazole 500 mg once a year

3. Pregnant women

It is recommended that all pregnant women who consult the health be given anthelminthic drug once in the 2nd trimester of pregnancy.

In areas where hookworm is endemic:

Where hookworm prevalence is 20 – 30%

Albendazole 400 mg once in the 2nd trimester

Or

Mebendazole 500 mg once in the 2nd trimester

Where hookworm prevalence is > 50%, repeat treatment in the 3rd trimester

4. Special groups, e.g., food handlers and operators, soldiers, farmers and indigenous people

Selective deworming is the giving of anthelminthic drug to an individual based on the diagnosis of current infection. However, certain groups of
people should be given deworming drugs regardless of their status once they consult the health center.

Special groups like soldiers, farmers, food handlers and operators, and indigenous people are at risk of morbidity because of their exposure to
different intestinal parasites in relation to their occupation or cultural practices.

For the clients who will be dewormed selectively, treatment shall given be anytime at the health centers.

Guidelines/Administrative Orders

AO No. 2010-0023 – guidelines on deworming drug administration and the management of adverse events following
 deworming (AEFD)

AO No.2006-0028 – Strategic and operational framework for establishing integrated helminth control program (IHCP)

Status of the program

Deworming of target population during:

1-5 years old – during Garantisadong Pambata (GP) April and October

6-12 years old (school children Grade 1-6 enrolled in public schools) every January and July

Partner Organizations/Agencies:

• World Health Organization (WHO)

• University of the Philippines-National Institutes of Health (UP-NIH)
• United Nations Children’s Fund (UNICEF)
• World Vision
• Feed the Children International
• Helen Keller International (HKI)
• Council for the Welfare of Children
• Department of Science and Technology-Food and Nutrition Institute (DOST -FNRI)
• Department of Education (DepEd)
• Plan International
• Save the Children

Program Managers:

Dr. Yvonne CF Lumampao

Program Manager

Department of Health-National Center for Disease Prevention and Control (DOH-NCDPC)

Contact Number: 651-78-00 local 2352

Dr. Ernesto ES Villalon III

Assistant Program Manager

Department of Health-National Center for Disease Prevention and Control (DOH-NCDPC)

Contact Number: 651-78-00 local 2352

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: Reduced prevalence of smoking and minimizing smoking-related health risks.

Mission: 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 31st of May and the World No Tobacco Month every June.

3. Health Education

Through health education, smokers shall be assisted to quit their habit and their immediate family members shall be empowered to assist and
facilitate the smoking cessation process.

4. Smoking Cessation Services

Below is the National Smoking Cessation Framework detailing Smoking Cessation services at different levels of care:

LEVEL OF
STAFFING Intervention Package DRUGS/MEDS EQUIPMENTS
CARE
• Risk assessment/ Risk
screening (Note:
Use Risk
Assessment
Form)
• Assess for Tobacco Use • Risk Assessment Tool
• If smoker, do Brief • Quit Contract
PRIMARY
Intervension
LEVEL BHW
Advice (5 A's) None
I. Barangay RM
See Attached • Referral Form
Health Station
Protocol
• If non-smoker,
Congratulate
and advice
continue
Healthy Lifestyle
activity
Above Plus

• Quit Clinic
(Use DOH Protocol or Patient Assessment Tool:
other suggested protocols
e.g. Motivational • Stages of change
Interview, SDA Protocol, • WHO Mental Health
PRIMARY etc. as available) Checklist
LEVEL • Motivation and
• DOH Protocol provides: Confidence to
• Assessment of client's quit
II. RHU
Smoking • Smoking History and
• Use of Nicotine
History, Current Current Smoking
Replacement
Above Plus Smoking Status Status
therapy
and Readiness • Self-test for reason for
SECONDARY particularly
Nurses Doctors and to stop smoking smoking (Horn's
LEVEL Nicotine
other health • Planning for clients Smoker's Selt-
patch and
personnel Readiness to test)
Nicotine
stop smoking • Fagerstrom Nicotine
Gum is
• Quit day: Dependencetest
advocated
Pharmacologic, • Self-test on Readiness
Psychological to stop smoking
TERTIARY and Behavioral • Previous attempts to
LEVEL Interventions stop smoking
- Identifying and address Form:
triggers for going back
into smoking • Quit Contract

- Dealing with cravings to

smoke

- Managing withdrawal
 syndromes

• Monitoring and
Prevention of
Relapse
Quit Lines

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

Urban Health System Development (UHSD) Program

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(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. Specific objectives:
 1. To establish awareness on the challenges of Urban Health;
 2. To initiate inter-sectoral approach to Urban Health
Systems Development; and
 3. 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 city’s 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.

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 -by-step);

• 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 2011–2020 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 2005-2010 as reported in the Philippine Health Statistics of the National Epidemiology
Center. The Online National Electronic Injury Surveillance System (ONEISS) Fact Sheet for 2010-2012 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 – Multi-disciplinary 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) E’s. Strategies shall utilize the concept of the six E’s (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 injury-related 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 gender-

responsive 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)

Contact Number: 651 – 7800 loc. 1750, 1752, 1754 / 732-2493 (direct line)

Email: dokclar@yahoo.com

Links

Updated data on the incidence of accidents and injury cases is available quarterly at the DOH Website:

http://uhmis1.doh.gov.ph/unifiedhmis
 http://uhmis2.doh.gov.ph/pnidms

Links:

1. Administrative Order No. 2014-0002 - Revised National Policy on Violence and Injury Prevention
 2. Admiistrative Order No. 2014-0007 -
National Policy on the Establishment of Prehospital Emergency Medical Service System
 3. APEC Concept Note
 4. Dissecting the Anti-Drunk and
Drugged Driving Act of 2013
 5. Road Safety Forum 2014
 6. Statistics on Orthopedic-Related Injuries
 7. Pillar 1: Improve Road Safety
Management

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 women’s 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. Women’s Health Teams

b. BEmONC Teams

c. CEmONC Teams

d. Itinerant Teams

2. Establishment of Reliable Sustainable Support Systems for WHSM Service Delivery:

a. Drug and Contraceptive Security

b. Safe Blood Supply

c. Behavior Change Interventions

d. Sustainable financing of local WHSM services and commodities

Component B: National Capacity

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 Women’s Health and Safe Motherhood Project 2 introduces new strategies to address critical
reproductive health concerns while confronting both demand and supply side obstacles to access for disadvantaged women of reproductive age.
Among the changes that the Project introduced and has systematically mainstreamed into the current National Safe Motherhood Program are
the following:
• Strategic Change in the Design of Women’s Health and Safe Motherhood Services
WHSMP2 brought about strategic changes in the way services are delivered to clients particularly the disadvantaged and underserved. These
changes involve (1) a shift in emphasis from the risk approach that identifies high-risk pregnancies during the prenatal period to an approach
that prepares all pregnant for the complications at childbirth – this change brought about the establishment of the BEmONC – CEmONC
network, which is now part of the MNCHN service delivery network; (2) improved quality of FP counseling and expanded service availability,
including the organization of more Itinerant Teams providing permanent methods and IUD insertion on an outreach basis and (3) the
integration of STI screening into the maternal care and family planning protocols.

• An Integrated Package to Women’s Health Services

The above changes in service delivery will likewise involve a shift from centrally controlled national programs (MC, FP, STI and AH) operating
separately and governed independently at various levels of the health system to an LGU governed system that delivers an integrated women’s
health and safe motherhood service 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:

2011
Baseline (2010) 2011
Outcome Indicators Target
Accomplishments Accomplishments
Values
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%
5% points
Increase CPR by 10 percentage points 36% 3% points increase 39%
increase
100% of LGUs have passed an ordinance on the
47% 100% 70%
Contraceptive Self Reliance
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 Teams Done

2009
Regional Blood Centers equipment upgrade Done

73%

Ongoing:

Albay: 90%

2009- Masbate: 80%

Facility upgrade: Infrastructure and Equipment
2011
Catanduanes: 60%

Surigao del Sur: 53%

Sorsogon: 84%
 Currently undergoing procurement
2009- Training Centers Insfrastructure and equipment
13 Training Centers already provided with equipment and other
2010 enhancement
training logistics

Ensuring environmental Safeguards

2009-
• Organization of EMU in CEmONCs Done
2010
• Designation of Waste Management Focal
Persons in BEmONCs
BEmONC Skills: 60%

Sorsogon: 73%

Albay: 103%
2008-
Capability Enhancement: Women's Health Teams
2012 Catanduanes: 55%

Masbate: 73%

Surigao del Sur: 63%

2008-
BEmONC Teams
2010
2008-
Midwives on BEmONC Skills Module currently being finalized
2010
2011-
CEmONC Doctors (non-specialists) Module currently being finalized
2012
2010 Provincial Review Teams Done
Behavior Change Interventions

Performance-based Grants:
2009-
2013
• Facility based Deliveries
• Universal Social Health Insurance Coverage
• Essential Drugs and Contraceptive Security
Advocacy for Positive Behavior Change
2010- 4 Infomercials produced and aired in 2011; another 4 being produced
2013 for airing in 2012.
• TV Infomercials
52%

Albay: 31% (5/16)

Catanduanes: 17% (1/6)

2009-
BEmONC Facility MCP Accreditation
2013 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

Telephone Number: 651-7800 locals 1726-1730

(As stated in the Women’s Health and Safe Motherhood Project 2 Implementation Plan)

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 women’s 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. Women’s Health Teams

b. BEmONC Teams

c. CEmONC Teams

d. Itinerant Teams

2. Establishment of Reliable Sustainable Support Systems for WHSM Service Delivery:

a. Drug and Contraceptive Security

b. Safe Blood Supply

c. Behavior Change Interventions

d. Sustainable financing of local WHSM services and commodities

Component B: National Capacity

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 Women’s Health and Safe Motherhood Project 2 introduces new strategies to address critical
reproductive health concerns while confronting both demand and supply side obstacles to access for disadvantaged women of reproductive age.
Among the changes that the Project introduced and has systematically mainstreamed into the current National Safe Motherhood Program are
the following:

• Strategic Change in the Design of Women’s Health and Safe Motherhood Services
WHSMP2 brought about strategic changes in the way services are delivered to clients particularly the disadvantaged and underserved. These
changes involve (1) a shift in emphasis from the risk approach that identifies high-risk pregnancies during the prenatal period to an approach
that prepares all pregnant for the complications at childbirth – this change brought about the establishment of the BEmONC – CEmONC
network, which is now part of the MNCHN service delivery network; (2) improved quality of FP counseling and expanded service availability,
including the organization of more Itinerant Teams providing permanent methods and IUD insertion on an outreach basis and (3) the
integration of STI screening into the maternal care and family planning protocols.

• An Integrated Package to Women’s Health Services

The above changes in service delivery will likewise involve a shift from centrally controlled national programs (MC, FP, STI and AH) operating
separately and governed independently at various levels of the health system to an LGU governed system that delivers an integrated women’s
health and safe motherhood service 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:

2011
Baseline (2010) 2011
Outcome Indicators Target
Accomplishments Accomplishments
Values
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%
5% points
Increase CPR by 10 percentage points 36% 3% points increase 39%
increase
100% of LGUs have passed an ordinance on the
47% 100% 70%
Contraceptive Self Reliance
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 Teams Done

2009
Regional Blood Centers equipment upgrade Done

73%
2009-
Facility upgrade: Infrastructure and Equipment
2011 Ongoing:
 Albay: 90%

Masbate: 80%

Catanduanes: 60%

Surigao del Sur: 53%

Sorsogon: 84%

Currently undergoing procurement

2009- Training Centers Insfrastructure and equipment
13 Training Centers already provided with equipment and other
2010 enhancement
training logistics

Ensuring environmental Safeguards

2009-
• Organization of EMU in CEmONCs Done
2010
• Designation of Waste Management Focal
Persons in BEmONCs
BEmONC Skills: 60%

Sorsogon: 73%

Albay: 103%
2008-
Capability Enhancement: Women's Health Teams
2012 Catanduanes: 55%

Masbate: 73%

Surigao del Sur: 63%

2008-
BEmONC Teams
2010
2008-
Midwives on BEmONC Skills Module currently being finalized
2010
2011-
CEmONC Doctors (non-specialists) Module currently being finalized
2012
2010 Provincial Review Teams Done
Behavior Change Interventions

Performance-based Grants:
2009-
2013
• Facility based Deliveries
• Universal Social Health Insurance Coverage
• Essential Drugs and Contraceptive Security
Advocacy for Positive Behavior Change
2010- 4 Infomercials produced and aired in 2011; another 4 being produced
2013 for airing in 2012.
• TV Infomercials
52%

Albay: 31% (5/16)

Catanduanes: 17% (1/6)

2009-
BEmONC Facility MCP Accreditation
2013 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

Telephone Number: 651-7800 locals 1726-1730

(As stated in the Women’s Health and Safe Motherhood Project 2 Implementation Plan)

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:

• 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;
• 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;
• A consistent and adequate budget is necessary to sustain a women and children protection unit once it is established;
• 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;
• There is no standard quality of service;
• 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;
• 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;
• Women and child protection work is a new field and a pool of professionals must be recruited and trained to sustain the work; and
• Women and children protection work has gone beyond being a health advocacy to becoming an essential health service addressing the
needs of victims of violence against women and children.
The strategies espoused by the AHA, specifically the service delivery network (SDN) and public-private partnership (PPP), will be utilized
in the institutionalization of the women and children protection program nationwide. A health SDN is composed of a network of health service
providers at different levels of care from levels 1: health centers or women and children’s desks offering primary services, 2: district health
facilities offering secondary care and 3: regional and national hospitals with tertiary care. An SDN can be as small as an Inter-Local Health Zone
or as large as a regional SDN with a regional hospital serving as the end-referral hospital. The most efficient system for women and child
protection facilities follows the SDN model where a complete and integrated women and child protection unit is located in a strategic hospital.

The primary goal is to identify where the women and children protection units will be located across the country and to ensure that there
will be at least one in each province. Hospitals, whether public or private, which do not have a women and child protection unit may be trained
to refer the victims to women and children protection coordinators (WCPCs) and WCPUs in other hospitals where the staff is trained in
recognizing, recording, reporting and referring abuse cases. This will ensure that all women and children victims of violence who seek medical
care have access to health services provided by trained, competent, and caring health personnel.

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 children’s protection unit programs through appropriate organizational and budgetary support;

5. Create and maintain a centralized and harmonized database for all reports submitted by the different women and children protection units.

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 Anti-Violence Against
Women and Their Children’s Act of 2004,[4] Anti-Rape Act of 1998,[5] the Rape Victim Assistance and Protection Act of 1998[6], and the Magna
Carta of Women (2009).[7]

The DOH shall thereby contribute to the realization of the country’s goal of eliminating all forms of gender-based violence and promoting social
justice.[8]

V. GUIDING PRINCIPLES

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 children’s best
interests. All decisions regarding children shall be based upon the needs of individual children, taking into account their development and
evolving capacities so that their welfare is of paramount importance. This necessitates careful consideration of the children’s physical,
emotional/psychological, developmental and spiritual needs. Adequate care shall be provided by multidisciplinary child protection teams when
the parents and/or guardians fail to do so. In cases whether there is doubt or conflict, the principle of the best interest of the child shall prevail.

3. Holistic service delivery. – Care focused on the whole person addressing the bio-medical, psycho-social, and legal concerns.

4. Respect for diversity and non-discrimination. – Holistic and appropriate health care delivered shall be coupled with respect for cultural,
religious, developmental (including special needs), gender and sexual orientation, and socio-economic diversity. All women and children victims
of violence shall have a right to receive medical treatment, care, and psycho-social interventions.

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 former’s
absence.

The Committee shall designate from among its members a program manager who will be given appointment by the Undersecretary of
Health through a Department Personnel Order.

The Committee may create a technical working group, as the need arises, to help it in the performance of its functions.

3. Term. – The Committee shall hold office for three (3) years and may be reappointed or until their successors shall have been appointed.

4. Functions. The Committee shall have the following functions:

• Identify and recommend strategically-located DOH-retained and LGU-supported hospitals for WCPU establishment using geographical and
population ratio criteria;
• Formulate standard protocols and procedures and the manual of operations for multidisciplinary care for women and children victims of
abuse and violence;
• 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);
• 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;
• Monitor and evaluate the efficacy, effectiveness and sustainability of creation, operations, and maintenance of WCPUs;
• Recommend policy reforms and new guidelines anchored on evidence-based interventions and approaches;
• Harmonize existing databases and create a central databank for women and children protection cases; and
• 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.

VIII. ROLES AND RESPONSIBILITIES OF PARTNER AGENCIES

A. Department of Health at the National Level

• The Committee shall be under the direct supervision of the Office of the Undersecretary for Health Services Delivery.
• 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

• Disseminate the policy for adoption and implementation by LGU health systems in the different localities within their respective regions;
• Provide technical assistance to LGUs in organizing WCPU activities and developing relevant technical references and information, education
and communication (IEC) materials;
• Generate resources to strengthen the implementation of the policy and manual of operations for WCPUs;
• Formulate and implement advocacy plans to generate stakeholders’ support, particularly the local officials;
• Monitor the implementation of the policy and guidelines in both public and private hospitals, and in different localities in their respective
regions;
• 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.

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

• Provide expertise and technical assistance on gender-responsive delivery of services by the WCPU service providers and the central database
on women’s cases;
• Assist the DOH in monitoring the implementation of the WCPU using the Performance Standards and Assessment Tools for Services
Addressing VAW in the Philippines;
• 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.
IX. 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.

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
(4R’s) of cases of violence against women and children.

B. Women and Children Protection Coordinator. – Hospitals without a women and children protection unit shall have a women and children
protection coordinator (WCPC) responsible for coordinating the management and referral of all violence against women and children cases in
the hospital.

II. The minimum standard criteria shall be maintained by all WCPUs.

A. Organizational Structure - The WCPU shall:

• Be an integral part of the hospital;

• Be under the Office of the Chief of Clinics;
• 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:

• Be permanently situated in a designated area, preferably near the emergency room of the hospital;
• 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;

• Have its own toilet or comfort room;

• 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

• Have readily available supplies and equipment for medical examination, including:
a. Digital camera
 b. Rape kit
 c. Speculum of different sizes
 d. Blood tubes
 e. Syringes,
needles and sterile swabs
 f. Examination gloves
 g. Pregnancy testing kits
 h. Microscope
slides
 i. Measuring devices like rulers and calipers
 j. Urine specimen containers
 k. Refrigerator for storage of
specimens
 l. Analgesics, medicines for STI prophylaxis, and emergency contraceptives
 m. Labels
 n. Medical forms
including consent forms and anatomical diagrams
 o. Colposcope (Optional)
 p. Video camera for recording the forensic
interview (optional)
 q. Tape recorder (optional)

III. LEVELS OF CARE DELIVERED BY WCPUs

a. Level I WCPU

2. Personnel

• A trained physician, and

• A trained and registered social worker.
3. Services. – A level I WCPU provides

• 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
4. Training Capability

Training on 4Rs

5. Research

• Proper documentation of experiences which will serve as inputs for policy research, formulation and program improvement
b. Level II WCPU

1. Personnel

• A trained physician;
• A trained and registered social worker, also with full-time coverage of duties at the WCPU; and
• A trained police officer or a trained mental health professional.
2. Services

• Medical services similar to a Level I WCPU including rape kits and surgical intervention.
• In the preparation of the medico-legal certificate and report, the WCPU shall utilize the terminology and the form attached as Annexes “A”
and “B,” respectively, to this Manual of Operations
• Full coverage, 24/7
• Social work intervention similar to that of a Level I WCPU plus case management and case conferences
• Additional services in the form of police investigation or mental health care
• Proper documentation and record-keeping using the Child Protection Management Information System (CPMIS)
• Expert testimony in court
• Peer review of cases
• Availability of specialty consultations (ENT, ophthalmology, surgery, OB-Gyne, pathology)
• Networks with other disciplines and agencies.
6. Training Capability
• Training on 4Rs
• Residency training
7. Research

• Proper documentation of experiences which will serve as inputs for policy research, formulation and program improvement
c. Level III WCPU

1. Personnel

• At least two (2) trained physicians;

• At least two (2) trained and registered social workers;
• A registered nurse;
• A trained police officer; and
• A mental health professional
2. Services

• Medical services of a Level 2 WCPU

• In the preparation of the medico-legal certificate and report, the WCPU shall utilize the terminology and the form attached as Annexes “A”
and “B,” respectively, to this Manual of Operations
• Full coverage, 24/7
• Social work intervention of a Level 2 WCPU capacity plus long-term case management
• Mental health care
• Police investigation
• Nursing services
• Peer review of cases
• Death review
• Proper documentation and record-keeping using the CPMIS
• Expert testimony in court
• Availability of specialty consultations (i.e., ENT, ophthalmology, surgery, OB-gyne, pathology)
• Other support services (i.e., livelihood, educational)
• Networks with other discipline and agencies
• Availability of subspecialty consultations (e.g., child development, forensic psychiatry, forensic pathology)
3. Training Capability

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

• Proper documentation of experiences which will serve as inputs for policy research, formulation and program improvement;
• Conduct of empirical investigations on women and children protection work;
• Publication of such research studies in reputable journals and/or presentation in scientific conferences or meetings.

IV. TRAINING AND EDUCATION IN WOMEN AND CHILDREN PROTECTION

A multi-disciplinary training program will address human resource needs of women and child protection units and women’s and
children’s 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:

• For trainees to acquire/enhance attitudes necessary in the management of acute and chronic causes of crisis such as sensitivity,
compassion, confidentiality and empathy.
• For the trainees to develop/strengthen their skills in early detection, screening, interviewing, physical examination, use of appropriate
diagnostic procedures, management, counseling and referral.
• 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

Phone: 651-7800 locals 1726-1730

Email: norway_es_santos@yahoo.com