Vision

For Filipino women to have full access to health services towards making their pregnancy and delivery safer

Mission

Guided by the Department of Health FOURmula One Plus thrust and the Universal Health Care Frame, the National Safe Motherhood Program is committed to provide rational and responsive policy direction to its local government partners in the delivery of quality maternal and newborn health services with integrity and accountability using proven and innovative approaches

Objectives

The Program contributes to the national goal of improving women’s health and well-being 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 near their homes
2. Establishing core knowledge base and support systems that facilitate the delivery of quality maternal and newborn health services in the country.

Program Components

Component A: Local Delivery of the Maternal–Newborn Service Package

This component supports LGUs in establishing and mobilizing the service delivery network of public and private providers to enable them to deliver the integrated maternal-newborn service package. In each province and city, the following shall continue to be undertaken:

1. Establishment of critical capacities to provide quality maternal-newborn services through the organization and operation of a network of Service Delivery Teams consisting of:
   1. Barangay Health Workers
   2. BEmONC Teams composed of Doctors, Nurses and Midwives

2. In collaboration with the Centers for health Development and relevant national offices: Establishment of Reliable Sustainable Support Systems for Maternal-Newborn Service Delivery through such initiatives as:
   1. Establishment of Safe Blood Supply Network with support from the National Voluntary Blood Program
   2. Behavior Change Interventions in collaboration with the Health Promotion and Communication Service
   3. Sustainable financing of maternal – newborn services and commodities through locally initiated revenue generation and retention activities including PhilHealth accreditation and enrolment.

Component B:  National Capacity to Sustain Maternal-Newborn Services

1. Operational and Regulatory Guidelines
   1. Identification and profiling of current FP users and identification of potential FP clients and those with unmet need for FP (permanent or temporary methods)
   2. Mainstreaming FP in the regions with high unmet need for FP
   3. Development and dissemination of Information, Education Communication materials
   4. Advocacy and social mobilization for FP

2. Network of Training Providers
   1. 31 Training Centers that provide BEmONC Skills Training

3. Monitoring, Evaluation, Research, and Dissemination with support from the Epidemiology Bureau and Health Policy Development and Planning Bureau
   1. Monitoring and Supervision of Private Midwife Clinics in cooperation with PRC Board of Midwifery and Professional Midwifery Organizations
   2. Maternal Death Reporting and Review System in collaboration with Provincial and City Review Teams
   3. Annual Program Implementation Reviews with Provincial Health Officers and Regional Coordinators

Partner Institutions

• Local Government Units
• Development Partners

Policies and Laws

Republic Act No. 10354: Responsible Parenthood and Reproductive Health Law (RPRH Act of 2012)

1. Administrative Order 2008-0029: Implementing Health Reforms to Rapidly Reduce Maternal and Neonatal Mortality
2. Department Order 2009-0084: Guidelines Governing the Payment of Training Fees relative to the Attendance of Health Workers to Basic Emergency Obstetric and Newborn Care Skills Training Course at Duly Designated Training Centers
3. Administrative Order 2011-0011: Establishment of Basic Emergency Obstetric and Newborn Care Training Centers in Regional Hospitals and Medical Centers
4. Administrative Order 2015-0020: Guidelines in the Administration of Life Saving Drugs During Maternal Care Emergencies by Nurses and Midwives in Birthing Centers
5. Administrative Order 2016-0035: Guidelines on the Provision of Quality Antenatal Care in All Birthing Centers and Health Facilities Providing Maternity Care Services
6. Administrative Order 2018-0003: National Policy on the Prevention of Illegal and Unsafe Abortion and Management of Post-Abortion Complications

Program Accomplishments/Status

The Department of Health through the National Safe Motherhood Program shall continue to update its strategies to address critical reproductive health concerns including control of sexually transmitted infections and mother to child transmission of HIV while confronting both demand and supply side obstacles to access for disadvantaged women including indigenous women of reproductive age. Among the changes, the following have been systematically mainstreamed into the safe motherhood service delivery network (BEmONC-CEmONC network):

1. Strategic Change in the Design of Safe Motherhood Services

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 the BEmONC – CEmONC network within the bigger Service Delivery Network (SDN), (2) improved quality of FP counseling and expanded service availability of post-partum family planning in hospitals and primary birthing centers and (3) the integration of  cervical cancer, syphilis, hepatitis B and HIV screening among others into the antenatal care protocols.

• Action Point and Timelines:
  • Continuous advocacy on:
    • Importance of ANC and Facility Delivery is on-going at LGU level;
    • National and regional advocacy every 2^nd week of May, the safe Motherhood week with support from the Health Promotion and Communication Service
  • Continuous implementation of policies passed at LGU Health Systems
  • Implementation of AO 2016-0035 on the Provision of Quality Antenatal Care
    • On-going
    • Distribution of ANC Tarpaulin within the last quarter of 2018
    • Distribution of ANC Policy Implementation Manual by 2019

2. An Integrated Package of Women’s Health and Safe Motherhood Services

The above changes in service delivery also involved a shift from centrally controlled national programs 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 that influence maternal and newborn health 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.

• Action Points and Timelines
  • Culture and gender sensitive service delivery provision by LGU Health Systems is on-going
  • Updated AO 2008-0029 (MNCHN Policy) draft by last quarter of 2018
    • The update involves the expansion of MNCHN to RMNCAHN (Reproductive Maternal Newborn Child Adolescent Health and Nutrition)

3. Reliable Sustainable Support Systems

Support systems for Maternal-Newborn service delivery is anchored on Philhealth accreditation of birthing centers and individual membership or enrolment into the Sponsored Program. This mechanism ensures sustainable financing of quality maternal-newborn services efficiently eliminating out-of-pocket expenditures for antenatal, facility delivery and postnatal care.  The system likewise includes systems for safe blood supply and stakeholder behavior change, through a combination of advocacy and interpersonal communication during clinic visits.

• Action Points and Timelines
  • Continuous application and renewal of PhilHealth accreditation by Birthing Centers
  • Continuous enrolment of poor families to PhilHealth Sponsored Program by LGUs
  • Establishment of Safe Blood Supply Network in collaboration with the National Voluntary Blood Services Program is on-going

3. Stronger Stewardship and Guidance from the DOH Program Manager and Regional Coordinators

DOH provides stewardship and guidance through (1) evidence-based guidelines and protocols on maternal – newborn services; (2) a system for recognizing providers of emergency obstetrics and newborn care (BEmONC) training program; and (3) monitoring, evaluation and research on the new maternal-newborn strategies.

• Action Points and Timelines
  • Conduct of Maternal Death Surveillance and Response is on-going at Provincial and City Health Systems is on-going
    • Conduct of National MDSR Forum every 2 years. The second national forum shall be conducted in 2019 (the first was conducted in 2017)
    • Conduct of 4 Regional Maternal Death Surveillance and Response (MDSR) Fora every 2 years (2018, 2020, etc)
    • Drafting and passage of relevant policies with MDSR results as basis:
      • National Policy on the Provision of Birthing Assistance of Primigravid and Multigravid Women is targeted to commence implementation by 2019.

• Establishment of Safe Motherhood Program Monitoring and Evaluation System in collaboration with Epidemiology Bureau and Health Policy Development and Planning Bureau by 2019

Program Accomplishments/Status

The Program shall continue to monitor the implementation of its policies and evaluate effectiveness in improving maternal outcomes and consequently translate these to maternal and newborn mortality reductions. LGUs shall be continuously encouraged to address local health system’s gaps identified during maternal death reviews.

Relevant policies that responds to maternal needs have been passed that include among others for 2018, the policy of prevention of illegal and unsafe abortions and management of post – abortion complication. Implementation of this policy is expected to reduce maternal death by at least 21%. The Program shall continue to pass policies based on death review results.

To date, 95% of Birthing Centers have teams trained on basic emergency obstetric and newborn care.

Calendar of Activities

• Conduct of BEmONC Training by Training Centers – on-going
• Conduct of Maternal Death Surveillance and Response – on-going
• Safe Motherhood Week Celebration at Regional level every 2^nd week of May
• Enhancement of Positive Birthing Experience Protocol: First Quarter of 2019
• MHO Forum: BEmONC Updates tentatively May 2019
• Maternal Sepsis Elimination Campaign: May 2019
• Program Implementation Reviews: third quarter and 4^th quarter of 2019

Statistics

Program Manager

Ms. Zenaida Dy Recidoro, RN, MPH

e-mail address: [email protected]

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updated October 17, 2018