calibo: philippines

7/28/2019 Calibo: Philippines

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Facility-Based Newborn Care: Philippines Successes and Challenges

Unang Yakap: The FirstEmbrace to Reforms in

Newborn Care Practice

ANTHONY CALIBO, MD, DPPSNational Center for Disease Prevention and Control (NCDPC),

Department of Health (DOH), Republic of the Philippines

Manila

17 April, 2013


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The Way We Were


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Births Attended by Skilled Health Professionals

and Place of Delivery

Philippines National Demographic and Health Survey (NDHS) 88, 93, 98, 03, 08

Births Attended by Skilled Health

Professionals (Physicians, Midwives and

Nurses)

Proportion of Births Occurring at Health

Facilities and At Homes


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1988-1998: 40%

1998-2008:

20% Stagnant NMR

Neonatal Mortality Rate

Under-5 and

Neonatal Mortality Rates (NMRs)

#of

deathsper1000liv

ebirths

20 19

15 15

10

0

5

10

15

20

25

Lowest Second Middle Fourth Highest#

ofdeaths

per

1000

live

births

Wealth Quinti le

High NMR forRich and Poor

Under Five Mortality Rate

Philippines National Demographic and Health Survey (NDHS) 88, 93, 98, 03, 08


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Formative research, 2008

Potentially harmful NB care practices(N = 481 in 51 Philippine hospitals; Acta Pediatrica 2011)


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Policy Reforms

Maternal, Newborn, Child Health and Nutrition(MNCHN) Strategy (Department of Health AdministrativeOrder 2008-0029)

Adopting Policies and Guidelines on EssentialNewborn Care (DOH AO 2009-0025)

Universal Healthcare / Kalusugang Pangkalahatan(DOH AO 2010-0036 )

Essential Newborn Care Protocol (DOH/WHO/UNICEFClinical Pocket Guide)

Clinical Practice Guidelines on Essential Intrapartumand Immediate Postpartum Care (DOH/WHO/POGS )


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The Unang Yakap Campaign

VISAYAS (1): Eastern Visayas Regional Medical Center

(EVRMC)

MINDANAO (2): General Santos City Hospital,

Cotabato Regional and Medical Center (CRMC)

LUZON (8): Quirino Memorial Medical Center (QMMC), Philippine

General Hospital (PGH), Dr Jose Fabella Memorial Hospital,

JRRMMC, EAMC, TMC, SLRWH, JNRMH

Project

Sites

Board of MedicineBoard of NursingBoard of Midwifery

Professional Regulations Commission

Association of Deans of Philippine Colleges of

Nursing (ADPCN)

Association of Philippine Schools of

Midwifery (APSOM)

Association of Philippine Medical Colleges(APMC)

Academic Organizations in the PHL


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Philippines DOH/WHO Philippines/Joint Programme on Maternal and Neonatal Health, 2011 (33,421 livebirths)

Where We Are: State of the Art Interventions

at Philippine Health Facilities


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40

343029

2522

17 1614

0

5

10

15

20

25

30

35

40

45

NDHS 2003 NDHS 2008 FHS 2011

Under-five Mortality Rate Infant Mortality Rate Neonatal Mortality Rate

Attendant at birth and place of delivery,

Philippines 2006, 2008 and 2011

Philippines Family Health Survey 2011: National Statistics Office, Department of Health, USAID Philippines

Skin-to-Skin Contact Practices at Birth in

Health Facilities at subnational levels

Under-Five, Infant and Neonatal Mortality Rates (2003-2011)

Per1000L

ive

Births

MDG Targets for2015 (U5MR 26.7and IMR 19) are

ACHIEVABLE


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Challenges

Resistance and inertia to practice among specialists Slowed momentum to scale-up Limited number of trainors and advocacy partners to

scale-up efforts

Paucity of models for institutionalization of reform in adecentralized health system

Inconsistent guidelines between licensing andaccreditation

Inadequate local capacity for supportive supervision andmonitoring

Inconsistent / incomplete engagement and commitmentof private sector

The Way Forward:


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How We Address These

Strong policy and administrative support Renewed high-level commitment to scale-up National roadmap for scaling-up Strong team of private sector advocacy partners and

champions Strengthened Social Marketing campaign Increase utilization of Newborn Care Package (NCP)

under the National Health Insurance Program

Incorporation in the licensing appendix and checklist Partnership with health professional organizations

The Way Forward:

calibo: philippines

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