REFERENCE AND RESEARCH BUREAU LEGISLATIVE RESEARCH SERVICE

HISTORY OF PUERICULTURE CENTERS1

EARLY BEGINNING AND PERTINENT LEGISLATION IN DIFFERENT COUNTRIES OF THE WORLD As early as 1860, a French physician advocated a special branch of hygiene devoted to promoting the health of infants and children. Under the term puericulture, knowledge about the nutrition and development of small children was extended in France, Germany and England. In France, infant consultation centers were widely established. These clinics were set up under the authority of local public health agencies. Great Britain enacted a Maternity and Child Welfare Act in 1918. In the United States, the Sheppard-Towner Act of 1921 authorized federal grants to the states to finance the establishment of well-baby clinics and pre-natal clinics for expectant mothers. Although this US legislation was terminated in 1929 because of opposition from the organized medical profession, it was reinstated in 1935 as a section of the US Social Security Act.

AS PART OF MATERNAL AND CHILD HEALTH (MCH) LEGISLATION Recognition of the importance of this maternal and child health (MCH) legislation was underscored by its definition as a special title within the Social Security Act, separate from all the other provisions. Since the end of World War II, MCH legislation has become a standard feature of the health laws of virtually every country. Under official policies, the provision of routine examinations, immunizations, nutritional counselling, and often treatment of minor illness, has become a prominent service given at community health centers and small health stations everywhere. Several countries have enacted legislation defining MCH services very broadly, to encompass not only the health protection of infants and mothers, but also the health of school children, adolescents, the extension of family planning, and the education of health personnel on these matters.

Milton Roemer, National Health Systems of the World, Vol. II, Oxford University Press (1993), p. 193.

In Italy for example, a Regional Law of 1979 calls for general preventive health services to mothers and children, multidisciplinary specialized services, emergency obstetric and neonatological care, refresher training for pediatric personnel, and encouragement of breast feeding. Legislation in Bolivia details requirements for MCH services at primary, secondary and tertiary levels. The quality of care by traditional birth attendants and health promoters is regulated. Agencies providing this care must be licensed and supervised by the Ministry of Health. Mothers are ensured legal protection during their reproductive life and the "internationally recognized rights of children" are protected. ESTABLISHMENT OF PUERICULTURE CENTERS IN THE PHILIPPINES 2 It was the first Secretary of Health, Dr. Jose Fabella, who enlisted women's clubs to help him organize puericulture centers all over the country and help raise funds for the support of the centers. The first actual center to serve babies and mothers was set up in 1905 by a group of women led by Concepcion Felix, wife of Felipe Calderon, author of the Malolos Constitution. The women called the center La Gota de Leche. In 1911 when the Hospicio de San Jose was organized to house orphans, babies were cared for, too. Another organization, Liga Nacional Filipina, was seriously working on the reduction of infant mortality, which was 350 deaths for every 1,000 babies born. Dr. Jesus Gabiera in 1913 organized the first formal puericulture (pueri means child and culture means care of).

ACT NO. 2633 (AN ACT APPROPRIATING THE SUM OF ONE MILLION PESOS FOR CERTAIN WORK IN RELATION TO THE PROTECTION OF EARLY INFANCY IN THE PHILIPPINE ISLANDS, INCLUDING THE ESTABLISHMENT OF "GOTAS DE LECHE") In 1916, Act No. 2633 was enacted, directing health officials to organize puericulture centers all over the country. By December 21, puericulture centers had been set up in the provinces. In 1921, the Public Welfare Commission was tasked to supervise and organize puericulture centers. It was mandated that all centers should have a doctor, a nurse, a midwife and a social worker, all to be paid by the government. Between 1921 and 1926, Fabella mobilized members of the National Federation of Women's Clubs of the Philippines (NFWCP) and put in place 329 puericulture centers in the country. On February 25, 1961, Paz Mendoza Catolico of the NFWCP, with the support of then President Carlos Garcia, organized the National League of Puericulture and Family Planning Centers at a national convention in San Sebastian College in Manila. After 1961, the World Health Organization, the United Nations Children's Fund,

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the Philippine Charity Sweepstakes Office and provincial governors funded the construction of puericulture center buildings. When Imelda Marcos was governor of Metro Manila, all the puericulture centers in the area were administered by the Metro Manila Commission. Today, pueriuculture centers and the women who used to run them are surviving, but barely. Politicians took advantage of the disarray after the EDSA revolution of 1986. Some took over the buildings and supervision of the centers, while others removed the name puericulture center on billboards and replaced them with day care and health centers. Today, there are 380 active puericulture centers all over the country, including 80 in Rizal and Metro Manila.

HEALTH:HISTORY OF PUERICULTURE CENTERS RRB/LRS RHAB/JGPC/mti 2.06.03