Policies for einc* care

• 3.4 million pregnancies occur every year• 11 mothers die of pregnancy - related causes

everyday• Leading cause of maternal deaths:– PPH– HPN d/o – Abortion related complications– Obstructed labor

• 40, 000 newborns die each year from causes that are most preventable such as complications of:– Prematurity (41%)– Birth asphyxia (15%)– Severe infection (16%)

NATIONAL POLICIES FOR MATERNAL AND

NEWBORN CAREThe Philippine government, along with the

international community, has made legislative efforts to ensure that care of a certain standard is accessible to all mothers and babies.

NATIONAL POLICIES FOR MATERNAL AND

NEWBORN CAREThe state specifically recognizes the vulnerability of mother and child and demands that measures be enacted to ensure access to care for all mothers and children that is the most current and of the highest standard such that in providing care, the dignity of every mother and child is respected and maintained, and when receiving care, all women and children, regardless of social or economic status, are treated equally.

HEALTH POLICIES FOR ESSENTIAL INTRAPATUM

AND NEWBORN CARE (EINC)The Department of Health has issued

directives to ensure the highest quality of care for mothers and their newborns. DOH policies describe methods for providing standard maternal and newborn care to the general population and demand that monitoring and evaluation systems be put in place for these strategies.

HEALTH POLICIES FOR ESSENTIAL INTRAPATUM

AND NEWBORN CARE (EINC)

Similarly, the Philippine Health Insurance Corporation (Philhealth), insists on the importance of safety and quality care that is patient-centered in its hospital accreditation process.

DOH POLICIES

DOH POLICIESA. Revitalization of the

Mother-Baby Friendly Hospital Initiative in Health Facilities with Maternity and Newborn Care ServicesAdministrative Order No. 2007-0026

• Main objective is to transform all health institutions with maternity and newborn services into facilities that fully PROTECT, PROMOTE AND SUPPORT rooming – in, breastfeeding and mother-baby friendly practices.

DOH POLICIESB. Implementing Health

Reforms for the Rapid Reduction of Maternal and Neonatal MortalityAdministrative Order No. 2008-0029

• Issued on September 9, 2008.• End GOAL is to rapidly reduce maternal and

neonatal death.• 3 major pillars in reducing MMM:– Emergency obstetric care– Skilled birth attendants– Family planning

DOH POLICIESC. Adopting New Policies

and Protocol on Essential Newborn CareAdministrative Order No. 2009-0025

• Issued on December 7, 2009• Outlines specific policies & principles to follow

for all health care providers involved in newborn health care.

• 4 steps to save newborn lives:– Immediate and thorough drying of the newborn– Early skin-to-skin contact b/n mother & newborn– Properly timed cord clamping and cutting– Non-separation of newborn and mother for early

breastfeeding.

DOH POLICIESD. The Aquino Health

Agenda: Achieving Universal Health Care for All FilipinosAdministrative Order No. 2010-0036

• Millennium Development Goal – 8 international development goals that all 193 United Nation Member have agreed to achieve by the year 2015.

Millennium Development 4 & 5

• MDG 4 – to reduce child mortality by 2/3 between 1990 and 2015 the under five mortality rateMDG 5 - Target 5A: Reduce by three quarters, between 1990 and 2015, the maternal mortality ratio.

• Target 5B: Achieve, by 2015, universal access to reproductive health

WORLD HEALTH ORGANIZATION (WHO)

GUIDELINESA. Baby Friendly Hospital

Initiative: Revised, Updated and Expanded for Integrated CareSection 4: Hospital Self-Appraisal and Monitoring, January 2006

• Launched by WHO and UNICEF in 1991.• Promotes practices that PROTECT, PROMOTE

and SUPPORT breastfeeding.

WORLD HEALTH ORGANIZATION (WHO)

GUIDELINESB. Pregnancy, Childbirth,

Postpartum and Newborn Care: A Guide for Essential PracticeIntegrated Management of Pregnancy and Childbirth, 2006

• Aims to provide evidence-based recommendations to guide health care professionals in giving high-quality care during pregnancy, delivery and in the postpartun period, thereby making pregnancy and childbirth SAFER.

WORLD HEALTH ORGANIZATION (WHO)

GUIDELINESC. WHO

Recommendations for the Prevention of Postpartum Hemorrhage, 2006

• 1. Active management of the 3rd stage of labor should be offered by skilled attendants;

• 2. Use of oxytocin for prevention of PPH;• 3. Cord should not be clamped earlier than is

necessary• 4. Delivery of placenta by controlled traction.

WORLD HEALTH ORGANIZATION (WHO)

GUIDELINESD. Newborn Care until the

First Week of Life Clinical Practice Pocket Guide, 2009

• This pocket guide is intended to provide health professionals with a simple, to-the-point, user-friendly, globally accepted evidence-based protocol to essential newborn care focusing on the first week of life which can fit in one’s pocket.

PHILHEALTH CIRCULARS AND BENCHBOOK

GUIDELINESA. Philhealth Benchbook

B. New Philhealth Case Rates for Selected Medical Cases and Surgical Procedures and the No Balance Billing PolicyPhilhealth Circular No. 011-2011