GEORGIANA S. GALUTERA,MDGEORGIANA S. GALUTERA,MDCity Health OfficerCity Health Officer

NILDA DEL ROSARIO,MDNILDA DEL ROSARIO,MDMCH Medical CoordinatorMCH Medical Coordinator

LGU Initiatives on Maternal Health

City of Pasig

Pasig City is one of the most fast developing cities in Metro Manila, however, with the different problems of this city like potential flooding, various reforms were made especially more on infrastructure focusing on the drainage system, education, health, roads and barangay projects.

INTRODUCTION

• Since the beginning of the City Mayor Robert C. Eusebio’s term, health was one of his priority projects. The City Mayor clustered barangay health centers into 4 clusters called “Super Health Center”. Each Super Health Center is equipped with ultrasound machines, ecg machines, complete dental equipments, nebulizers and defibrillation machines, including availability of generic and branded medicine including free flu vaccinations among all senior citizens.

MISSION

Towards Pasig City’s sustainable development through an efficient, pro-active progressive Primary Health Care Delivery System responsive to the needs of Pasigueños through the provision of highly accessible, cost efficient and effective preventive and managed health services enhanced by continuing professional education, update with the current trends and proficient technical training.

VISION

Pasig as a City of wellness anchored on health service excellence of the Pasig City Health Office. Health for all Pasig City constituents regardless of age, race, color, socio-economic status, religious and other affiliations.

The Pasig City Health Office is an office with a health system of programs and services that upholds efficient and quality services. It has the component of health promotion, disease control and prevention and health care provision. It also has the component of treatment and rehabilitation, primary home care and auxiliary services. These services include vaccinations, consultations, laboratory work-ups like; ultrasound and reflexology, sanitation, nutrition, family planning and maternal & child health. Our health program also includes education dissemination and advocacy. We would like to be effective, efficient and empowered through the support of our local government, national government and other services-foreign funding. Our office has the role of the following:

1. Access to diagnostic test – ultrasound, x-ray, blood test and ECG and test for determination of infectious and non- infectious diseases.

OBJECTIVE

2. Availability of drugs and medicines for both government and non-government organizations/people’s organization.

3. Addressing the nutritional problem of our children through actual feeding programs especially among school children.

4. Addressing our goal of providing primary health care through vaccination of infants and children, senior citizens, government employees and high risk patients. This is because we believe that prevention is better than cure.

5. Expansion of coverage and benefits of Philhealth and our local system for provision of free hospitalization and services through our blue and white card.

6. Strengthening health education and advocacy through our Kalusugan Patrol.

7.Implementation of computerization in health facilities for data processing and development

8.Providing special medicines at 50% discount from drugstore prices through our Pharmacia ng Pasigueños which addresses debilitating diseases like diabetes and coronary heart diseases and other degenerative and lifestyle diseases.

9.Improving and upgrading health facilities and health system.

10.Addresses core public health programs – safe motherhood, Family Planning & Child Care.

11. Conducts regular blood program activities as life saving program for our patients needing blood.

12. Compliments programs and the regulatory function as embodied in the Sanitation Code of the Philippines and our local sanitation ordinances and by-laws.

NUTRITION PROGRAM:•Best in Barangay Nutrition Program Implementation given by the National Nutrition Council (NNC) held at EDSA Shangrila on August 18, 2011.

•2nd runner-up as Most Outstanding Barangay Nutrition Scholar given To MS. Nilda Aguila, BNS of Napico given by NNC.

CITY EPIDEMILOGY & SURVEILLANCE UNIT ( CESU )•Performance of Excellence awarded by Department of Health-Center for Health & Development (DOH-CHD,MM) to Pasig CESU for their exemplary performance and commitment to vaccine preventable diseases held at the Sunrise Mansion Holiday in Cavite City on December 3, 2011.

SMOKING CESSATION PROGRAM•Pink Orchid Award for having garnered a total score within the range of 65-84% based on the DOH’s criteria & following the WHO’s “MPOWER” Framework given on May 31, 2011 at Crowne Plaza Galleria Manila Ortigas Avenue, Pasig City.

PROFILE OF PASIG

1.One of the seventeen (17) towns and cities comprising Metropolitan Manila and used to be the capital of the then premier Province of Rizal before the creation of Metropolitan governance in November 7, 1975 under Presidential Decree # 824.  2.A highly urbanized city through Republic Act 7829, An Act. converting the Municipality of Pasig into a Highly Urbanized City 

passed by Congress on July 26, 1993signed into Law by the President of the Philippines on December 8, 1993ratified through a plebiscite on January 21, 1994.

 3.A city with a land area of 31 sq. km., the 10th largest among Metro Manila towns and cities. 4.The 4th biggest city in the National Capital Region in terms of population.  5.Ranks 4th among the highest income earning cities of Metro Manila. 6.Previously an industrial city transforming into a business, financial and trade canter. 7.The seat of unified Philippine Stock Exchange. 

City of City of PASIGPASIG

Location :

Geographically, Pasig lies approximately 12 kms. East of Manila sprawled along the banks of Marikina and Pasig Rivers, on the southeastern end of the Pasig River, bounded by:

North : Quezon City and Marikina City West : Mandaluyong City South : Makati City, Pateros and Tagig East : Cainta and Taytay

(Province of Rizal)

From an industrial town during the period it served as the capital Rizal Province in the sixties and seventies, Pasig has evolved into one of the highly urbanized cities of the country attaining cityhood in 1994. It has maintained its 4th ranking position among Metro Manila cities in the terms of income for several years and again this year earning total revenues of Php 4.2B in 2008 from Php 184M in 1991 before the passage of the Local Government Code.

Pasig’s income is mostly derived from Services sector which accounted for 96.55% of the 22,000 business establishments all over the city, mostly in banks and other financial lending institutions, big and small scale wholesalers, restaurants, fast food chains supermarkets and shopping malls. Trade, financial transactions and other commercial activities abound and are expanding while agriculture, fishery and forestry are practically non-existent. Much of the lands that existed in the 60’s and 70’s had been developed into residential subdivisions and influence by the industry dispersal policy of the government, a number of large industries have relocated outside Metro Manila. At present Pasig has a total of 771 small, medium and large industries.

The seat of business and commerce is the Ortigas Business Center approximately 50 hectares high intensity commercial development located at the western side of Pasig. The site of the United Philippine Stock Exchange, Meralco building and The New Medical City , the Ortigas Center is host to about 90 high rise condominiums housing different offices, banks, hotels, restaurants, residences and shopping stalls.

ECONOMIC CHARACTERISTICS

Facility No.

Health Centers

District 1 22

District 2 16

Super Health Centers 4

Public Health Laboratory 1

Social Hygiene Clinic 1

Drug Abuse Clinic 1

Animal Bite Clinic 1

Smoking Cessation Clinic 1

Lying-In Clinic 0

Healthy Lifestyle Clinic 1

LGU Hospital

PhilHealth Accred. 1

DOH Retained Hospital

PhilHealth Accred. 1

NAME OF PUBLIC HOSPITALS

LOCATION NO. OF BEDS

1. Pasig City General Hospital

F. Legaspi St. Maybunga

200

2. Rizal Medical Center

Shaw Blvd., Pineda

300

NAME OF PRIVATE HOSPITAL

LOCATION NO.OF BEDS

1. Javillonar laboratory & Hospital

Sagad, Pasig City

2. Mary Immaculate Hospital

E.Rodriguez Ave.,Bagong Ilog

25

3. Mission Hospital E.Rodriguez Ave.,Bagong Ilog

30

4.Mother Regina Hospital #2 Ruby St. Dona Juana Subd. #101 London St Pasig Greenpark Village Manggahan

2

6

NAME OF PRIVATE HOSPITAL

LOCATION NO.OF BEDS

6.Pasig Medical & Maternal Hospital & Foundation

7. Rosario Specialist Hospital

Rosario

8. Sabater General Hospital

Market Ave. Sto.Tomas

15

9. Salve Regina General Hospital

Marcos Highway, Dela Paz

50

10. St. Therese Hospital

C. Raymundo Ave., Maybunga

25

11. The Medical City

NAME OF HEALTH CENTER ESTIMATED PDP ESTIMATED NO. OF HOUSEHOLD

Bagong Ilog PC 7,944 1,589

Bagong Lipunan 11,190 2,238

Bambang 19,798 3,960

Buting 9,327 1,866

Dela Paz 13,413 2,683

Kalawaan 14,460 2,892

Manggahan 14,093 2,819

Maybunga HC 14,650 2,930

Oranbo 4,518 904

Palatiw PC 17,404 3,481

Kapasigan HC 6,753 1,351

Sta. Rosa 1,557 312

Pinagbuhatan HC 21,678 4,336

Pineda 15,434 3,807

Rosario HC 26,056 5,212

Rosario PC 26,056 5.212

Sagad 11,993 1,416

LIST OF SUPER HEALTH CENTERS

NAME OF HEALTH CENTER ESTIMATED PDP ESTIMATED NO. OF HOUSEHOLD

San Antonio 11,993 2,399

San Joaquin HC 12,848 2,570

San Miguel HC 15,456 3,092

San Nicolas 1,585 317

Santolan HC 35,600 7,120

Sta. Lucia HC 20,845 4,169

Sto.Tomas 6,554 1,311

Sumilang HC 5,543 1,109

Ugong HC 22,890 4,578

Caniogan PC 11,189 2,238

Bagong Ilog HC 7,943 1,589

Dona Betang 8,900 1,780

Malinao 6,124 1,225

Kapitolyo 10,744 2,149

San Jose 2,413 483

Karangalan HC 21,138 4,228

Katipunan HC 1,218 244

Napico 41,095 8,219

NAME OF HEALTH CENTER ESTIMATED PDP ESTIMATED NO. OF HOUSEHOLD

Pinagbuhatan 21,678 4,336

Sta. Cruz 4,489 898

Floodway 21,976 4,396

Ismar 9,639 1,928

Sta. Lucia Mini 20,845 4,169

Nagpayong 48,777 9,756

E.Santos 16,529 3,252

LIST OF SUPER HEALTH CENTERS

NAME LOCATION

District I 1. Sumilang Super Health Center

Dr. Garcia St., Sumilang

District II 1. Nagpayong Super Health Center 2. Rosario Super Health Center 3. Santolan Super Health Center

Centennial 2, Nagpayong, Pinagbuhatan

LIST OF PUERICULTURE CENTERS

Name of Puericulture Center Location District

1. Bagong Ilog Pook Maligaya,Bagong-Ilog

I

2.Pinagbuhatan M.H. Del Pilar Street II

CategoryPermane

ntCasu

al

Health Center Based

Office Based

Total

RHP 39 2 36 5 41

Nurses 33 40 25 48 73

Midwives 72 8 64 16 80

Dentists 25 10 34 1 35

Med Techs 7 17 7 10 24

RSI 19 1 11 8 20

Nutritionists

6 4 8 2 10

Pathologists

1 0 0 1 1

Radiologists

2 0 0 2 2

Personnel Pasig City DOH Standard

Doctors 1:16,744 1:20,000

Nurses 1:24,112 1:10,000

Midwives 1:9,418 1:5,000

Dentists 1:17,729 1:20,000

Med Techs 1:86,114 1:50,000

RSI 1:54,800 1:20,000

Nutritionists 1:75,300 1:50,000

BNS 1:17,729 1:5,000

Total Population 2012: 602,800

INDICES

2006Cases Rate

2007Cases Rate

2008Cases Rate

CRUDE BIRTH RATE

7,937 14.42 7,991 14.33 4,855 7.65

Crude Death Rate

2,837 5.15 2,652 4.75 2,846 4.48

Infant Mortality Rate

179 22.55 144 18.0 184 37.90

Maternal Mortality Rate

10 1.26 12 1.5 42 0.44

Child Mortality Rate

230 2.78 38 0.45 18 3.71

INDICES

2009Cases Rate

2010Cases Rate

2011Cases Rate

CRUDE BIRTH RATE

5,503 9.46 11,639 19.76 8,141 13.45

Crude Death Rate

3,114 5.36 2,945 500.01 2,807 4.64

Infant Mortality Rate

183 33.25 134 11.51 184 22.60

Maternal Mortality Rate

12 2.18 31 2.66 15 1.84

Child Mortality Rate

67 0.77 57 0.64 45 0.50

NATALITY2006

No. of RateCases

2007

No. of RateCases

2008

No. ofCase Rate

1.Total Number of Livebirths Male Female

7,937 = 4,102 = 516.83,835 = 483.2

7,991 =4,092 = 512.073,899 = 487.92

4,855 =2,530 = 3.992,325 = 3.66

2.Livebirths by Weight < 2,500grams > 2,500grams Unknown

772 = 97.37,131 = 898.434 = 4.3

7,493 = 937.67456 = 57.0642 = 5.25

4,604 = 7.25247 =0.394 =0.01

3.Livebirth by Medical Attendance Doctors Nurses Midwife Trained Hilots Untrained Hilots Others Unknown

3,372 = 424.812 = 1.53,719 = 468.5490 = 61.7320 = 40.3 24 = 3.0

3,387 = 423.853 =0.37543,797 =475.15369 =46.176423 =52.9343 =0.3754

1,971 = 405.976 =1.242,225 = 458.29233 = 47.99418 = 86.101 = .211 = .21

4.Livebirths by Place of Delivery Homes Lyingn- In Gov’t.Hospital Private Hospital / Clinic Others

3,491 = 424.8

2,597 = 1.51,815 = 228.6 34 = 4.28

3,556 = 445.0189 =23.652,491 =311.721,638 =204.98108 =13.51

2,231 = 459.53

1,517 = 312.461,104 = 227.393 = 0.62

5.Numbers of Maternal Deaths 10 = 1.26 12 = 1.50 18 = 3.71

6.Number of Infant Deaths< 1yr.old

179 = 22.55

184 = 37.90 184 = 37.90

7.Number of Still Birth (late fetal) 33 = 4.16 31 = 3.89 35 = 7.0

NATALITY2009No. ofCases Rate

2010No. of Cases Rate

2011No. of Cases Rate

1.Total Number of Livebirths Male Female

5,5032,867 = 520.992,636 = 479.01

11,6396,090 = 523.245,549 = 476.76

8,1414,165 = 511.613,976 = 488.39

2.Livebirths by Weight < 2,500grams > 2,500grams Unknown

5,201 = 945.12284 = 51.6118 = 3.27

10,873 = 934.19753 = 64.6913 = 1.12

7,588 = 932.07547 = 67.196 = 0.74

3.Livebirth by Medical Attendance Doctors Nurses Midwife Hilots Others

2,563 = 465.744 = 0.732,431 = 441.76239 = 43.43266 = 48.34

7,674 = 659.3352 = 4.473,288 = 282.50352 = 30.24273 = 23.46

4,902 = 602.1413 = 1.60 2,693 = 330.79 283 = 34.76246 = 30.224 = 0.49

4.Livebirths by Place of Delivery Homes Hospital Others

2,647 = 481.012,304 = 418.68552 = 100.31

3,429 = 294.617,516 = 645.76694 = 59.63

2,403 = 295.174,687 = 575.731,051 = 129.10

5.Numbers of Maternal Deaths

12 = 2.18 31 = 2.66 15 = 1.84

6.Number of Infant Deaths< 1yr.old

183 = 33.25

134 = 11.51 184 = 22.60

7.Number of Still Birth (late fetal)

43 = 7.81

37 = 3.18 34 = 4.18

LCR DATA :2009 POPULATION: 581,395 Total Live Births : 15,564 Rate: 26.77

2011 POPULATION: 605,473 Total Live Births : 15,851 Rate: 26.18

National Baseline: 33% in 2006National Target: 70% by 2010

National Baseline: 33% in 2006National Target: 70% by 2010

National baseline: 54% in 2006National target: 70% by 2010

National baseline: 54% in 2006National target: 70% by 2010

MDG Goal: 52/100,000 Live BirthsMDG Goal: 52/100,000 Live Births

National Baseline: 39% in 2006National Target: 70% by 2010

National Baseline: 39% in 2006National Target: 70% by 2010

Indicator

Baseline 2006

National Target

2010

Pasig 2009

Pasig 2010

Int.Benchmark

Ext. Bench mark

Prenatal 80 80 64.6% 60.82%

TT2 Immuniz

ation80 80 45% 48%

Given Iron with

FA80 80 44.3% 69.97%

Post partum 80 80 61% 63%

FBD 33% 70% 51.9% 70.54

SBA 54% 70% 90.8 94.63

CPR 39% 85% 15.54 7.79

Indicator

Baseline 2006

National Target

2010

Pasig 2009

Pasig 2010

Int.Benchmark

Ext. Bench mark

IMR 25 17 33.25% 11.51%

UFMR 34 32 0.77% 0.64%

MMR 162 90 220 266

Indicator

Baseline 2006

National Target

2010

Pasig 2009

Pasig 2010

Int.Benchmark

Ext. Bench mark

Average Hospital Gross Death Rate from

Maternal causes

1% 1% 1.5% 2.1%

BEMOC to Pop ratio

1:511,767

1:125,000

0% 0%

ULTRASOUND

FREE ECGFREE ULTRASOUND

SUMILANG SUPER CENTER

BREAST FEEDING CORNERBREAST FEEDING CORNER

DENTAL SERVICES DENTAL SERVICES

SUMILANG SUPER CENTER

SANTOLAN SUPER CENTER

SANTOLAN SUPER CENTER

SANTOLAN SUPER CENTER

NAGPAYONG SUPER CENTER

NAGPAYONG SUPER CENTER

ROSARIO SUPER CENTER

NAGPAYONG SUPER CENTER

KALUSUGAN PATROLpromoting

SAFE MOTHERHOOD in the community

Regulation of Private Lying In Clinics

Meeting with Private Lying In Owners regarding facility

regulation, PhilHealth Accreditation,

Incentive system to TBAs

Dialogue with TBAs (Traditional Birth

Attendant) on Maternal Health updates and DOH policies their role in tracking down and properly referring pregnant women

Conduct of Gandang Buntis, Simultaneous

Breastfeeding and Buntis Exercise

Issuance of Revised Mother and Baby Booklets

Safe Motherhood Flipcharts

Conduct of regular program implementation review

Maternal death monitoring and review Partnerships with CEmONC facility Strengthening blood donation activities

Facility enhancement/ upgrading of HC equipment

Capability building of public health midwives (Basic Emergency Obstetric and Newborn Care / NBS)

Deployment of Community Health Teams to 4Ps areas to identify unmet needs and facilitate health plans and referrals

• Provision of Free Hepatitis B Immunoglobulins to newborns of Hepa B (+) mothers

• Provision of initial doses of Methyldopa for hypertensive cases

• Intensify activities for adolescent health• Monitoring and intervention of teen

pregnancies• Improve access to and utilization of

modern Family Planning Methods • Strengthen Public Private partnership

(PPMs)

Conduct special activities for pregnant mothers

PhilHealth accreditation of several health centers

PhilHealth sponsorship of indigent families ( quintile 2)

Creation of a City Ordinance regulating all birthing facilities to ensure quality service delivery

Involvement of Barangay Officials and other sectors in promoting safe motherhood and facility delivery

ANNUAL OPERATIONAL PLAN FOR 2012

1. Promotion of Women’s Health Team a. Advocacy of proper birth spacing. b. At least 4 pre-natal visits c. Basic oral health services2. Setting up of a BEMONC/CMONC facility3. Contraceptive prevalence rate program

a. Information and access to natural and modern family planning.

b. Contraceptive Self Reliance 1. Conduct Responsible Parenthood

2. Provision of FP commodities and services. 3. CSR Plan 4. Strengthen Private/Public Partnership

a. Training of private midwife b. Establish/strengthen referral system ( annual

meetings with MD )c. Institutionalization of MNCHN

1. Provide optimum pre-natal care.a. Reproduction of Mother and baby Bookletb. Patient’s record/chartc. Pregnancy test Kitd. BH s Ag screeninge. Provision of Methyldopa 250 mg tabletf. Immuno globulins for newborns of Hepa B

positive motherg. Purchase of fetal Doppler monitorh. Tetanus toxoid

2. Promotion of safe motherhooda. Conduct Buntis Bingo

b. Conduct of bench classes/group discussion promoting safe motherhoodc. Provide oral contracptive pills for lactating mothers

3. MCH Program Implementation a. Semi annual program review b. For documentation of MCH Activities c. Consolidation and submission of reports for MCH4. Establishment of a BEMONC facility5. Capability building a. Proper technique on visual inspection using acetic acid technique.b. NEMONC/CEMONC Training of Health Personnelc. Training of CHTsd. Training of Private Midwife on Maternal and Child Healthe. Training of Basic Family Planning for new health personnelf. Family Planning Updates6. Promote Adolescent Reproductive Health

a. Create youth health teamsb. Conduct youth health symposiac. Monitoring of Teenage pregnancies

7. Pre-marriage counseling8. Conduct of FDS classes to the community.9. Conduct of FDS classes to 4P’s members.10. Advocacy meeting with Private lying in clinic11. Mid year annual PIR12. Conduct Blood Donations.

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