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‡ SOURCE: Manual on Quality Integrated

Reproductive Health Service Protocol, 2001
1. Improve the general health status of the
population
- Reduce infant mortality rate
- Reduce child mortality rate
- Reduce maternal mortality rate
- Reduce total fertility rate
- Increase life expectancy and the quality of life
years
 

SOURCE: Manual on Quality Integrated

Reproductive Health Service Protocol, 2001
‡ Ô
#
  $%  
Combination of socio-cultural factors such
as:
-Harmful Practices (e.g. FGM)
-Poor Nutritional and Associated Factors
-Low Women¶s Status/Empowerment/
Decision-Making
-Frequent Pregnancies/High Fertility Rates/
Short Birth Intervals
 

Early Marriage and Adolescent Pregnancies

-Heavy Workload
-Reliance on Traditional Medicine and Healers
-Emotional Abuse/Violence

Unmet need for family planning services due to:

-Traditional Beliefs/Practices
-Lack of Knowledge
-Inaccessible or Poor Quality Services
 

Delay on problem recognition due to:

-Traditional Beliefs
-Low Perceived Risk
-Low Knowledge and Causes of Death, Danger
Signs and Complications
-Inadequate Screening Programs

Delay on deciding to seek care due to:

-Low Women¶s status/Participation in Decision-
Making
 

-Lack of Birth-Planning/Preparedness
-High Rates of Unattended Home Birth and
Untrained attendants
-Poor Quality (Perceived or Actual) of Health
Service

Delay in reaching the health facility due to:

-Geographical Distances
-Lack of Resources to Pay for Services
 

-Inadequate Communication/Transportation
System
-Inadequate knowledge of where to seek care
and how to get a facility

Delay in receiving quality treatment at the health

facility due to:
-Lack of Medicine, Supplies, Blood and
Equipment and Tools Complication
-Cumbersome Administrative Process
 

-Lack of Competent, Motivated Personnel

-Lack of adequate Supervision and
Management Information System
-Lack of Outreach and Follow-up Mechanisms
 

SOURCE: Manual on Quality Integrated

Reproductive Health Service Protocol, 2001
‡ Ô
&'(%

Combination of socio-cultural factors such as:
-Frequent pregnancies/High Fertility/Short
Birth Intervals
-Young Pregnancies

-Gender Discrimination Beginning Infancy

 

Delay in problem recognition due to:

-Traditional Beliefs
-Low Knowledge of Danger Signs
-Maternal Death
-High rates of Unattended Home Birth
with/without untrained

Delay in deciding to seek to care due to:

-Lack of Resources to Pay for Services
 

-Inadequate Communication and Transportation

System
-Low Knowledge to where to go and how to get
there
Delay in receiving quality treatment at the health
facility due to:
-Lack of Trained Personnel to Deal with LBW
and Neonatal Infections
-Lack of Supervision and Information System
-Lack of Medicines and Supplies to Properly
Treat Complications
 

SOURCE :
(http://www.childdeathreview.org/causes.htm)
‡ Ô
# 
-Accidental Firearm
-Child abuse and neglect
-Drowning
-Fires
-Motor Vehicle
 V) 

-Other Accidents:
-poisoning
-falls
-electrocutions
-sports
-agricultural injuries
-Suffocation
-Suicide
  
  

 

SOURCE: Manual on Quality Integrated

Reproductive Health Service Protocol, 2001
Administrative Order No. 79 S. 2000
Date: July 10, 2000
 %*
+#,

1. Rationale
WHO (1996): 150 M women in dev. Countries will
be pregnant annually (7 M will result to
stillbirths/infant deaths in 1st week of life)
SEA/SA: contribute 55 % (323,000 out of 600,000)
of maternal deaths in world
  
  

 

‡ PHILS: Reproductive age group (15-44 y.o.)

est. to be 14 M. 9 M have partners, 6 M is ³at
high risk.´
‡ TFR of 3.7 % (1998): 2.3 M are expected to be
pregnant/year
‡ MMR (1998): 172/100,000 or total of 3614
maternal deaths/year or 10 mothers dying/day
due to pregnancy related complication
‡ Leading cause: Postpartum hemorrhage,
hypertensive complications, sepsis, abortion
PDR: 18/1000 live births (lb); IMR: 36/1000 live
births <Malaysia:9.1/1000 lb, Singapore:
4.1/1000 lb>
  
  

 

2. Guiding Principles
‡ The Philippines is committed to pursuing the
principles enunciated in the Cairo and Beijing
conferences on Population and Women¶s
respectively, for the promotion of safe
motherhood and women¶s health, and to ensure
healthy newborns.
 
  

 

‡ The following principles form the basis for the

programming for the reduction of maternal and
perinatal mortality and morbidity in the country:
-Promotion of women¶s right and gender
sensitivity
-Access to quality health and nutrition services
-Establishing linkages and development
collaboration to ensure sustainability
-Mobilizing families and communities to address
family planning and maternal and newborn care
  
  

 

-Empowering communities to recognize and

correct gender discrimination and prevent
violent and abusive behavior towards women
and girls
-Reporting and reviewing all maternal deaths
3. Goal
To ensure safe motherhood & healthy newborns
General objectives:
Reduction of maternal and perinatal morbidity and
mortality
For complete copy of the law, please refer to
students¶ copy.
  
  

 

SOURCE:http://www.ncrfw.gov.ph/index.php/m
agna-carta-of-women
‡ Ô! %

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2

-comprehensive women's human rights law that

seeks to eliminate discrimination against
women by recognizing, protecting, fulfilling and
promoting the rights of Filipino women,
especially those in the marginalized sectors.
  
  

 

‡ SOURCE:
http://www.chanrobles.com/republicactno7600.
htm
‡ Ô! %

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AN ACT PROVIDING INCENTIVES TO ALL
GOVERNMENT AND PRIVATE HEALTH
INSTITUTIONS WITH ROOMING-IN AND
BREAST-FEEDING PRACTICES AND FOR
OTHER PURPOSES.
Approved: June 2, 1992
  
  

 

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SOURCE: FHSIS, n.d.

III. Maternal and Child Health Programs
3.1. Safe Motherhood
3.1.1 Pre-natal Care
3.1.1.1 Routine Pre-natal checkup
3.1.1.2 Identification of Abnormal/ high risk
pregnancy
3.1.1.3 Identification of signs and
symptoms of bleeding and early pregnancy
and immediate referral
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3.1.1.4 Identification of early signs and

symptoms of:
-antepartum hemorrhage
- abnormal presentation
-toxemia/ ecclampasia
- others e.g STD and immediate referral
when needed.
3.1.1.5 Counseling and Education on:
-Sexual Relationships
-Tetanus Toxoid (TT) Immunization
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- Family Planning
- Nutrition to include breastfeeding, diet, and
micronutrient supplementation
3.1.1.6 Presentation for home or hospital delivery
and partnership/husband participation
3.1.1.7 Dental care and referral as indicated
3.1.1.8 Provision of TT immunization and routine
micronutrient supplementation
3.1.1.9 Follow-up and home visit
3.1.1.10 Accomplishment of Home Based
Mother¶s Record.
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3.1.2 Labor and Delivery

3.1.2.1 Normal delivery at home at the BHS
Birthing Center
3.1.2.2 Monitoring of the progress of labor using
partograph
3.1.2.3 Identification of early signs and
symptoms of:
- abnormal/ difficulty
-antepartum hemorrhage
- postpartum hemorrhage
 g j
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- Ecclampasia
3.1.2.4 Immediate referral to appropriate facility
when indicated
3.1.2.5 Client education and preparation for
breastfeeding

3.1.3 Post Partum Care

3.1.3.1 Identification of early signs and symptoms
of post-partum hemorrhage; ecclampasia
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3.1.3.2 Post-partum advise on Family Planning

Service
3.1.3.3. Nutrition Services
-Breastfeeding Counseling
- Maternal and Child Nutrition Education
- Provision of micronutrient
supplementation( iron tabs, Vitamin A,
capsule)
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3.1.3.4. Facilitate registration of births

3.1.3.5 Monitoring of maternal morbidity and
mortality
3.1.3.6 Follow-up and home visits
3.1.3.7 Recording and Reporting

3.2 Infant and Child Care

3.2.1 New Born Care
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3.2.1.1 Free Air passages

3.2.1.2. Eye prophylaxis
3.2.1.3. Cord dressing
3.2.1.4 Take vital signs, height and weight
3.2.1.5 APGAR Scoring
3.2.1.6 Watch out any sign of abnormality

3.2.2 Health education, e.g.breastfeeding,

weaning, food supplementation, immunization
3.2.3 Expanded Program on Immunization
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3.2.4 Growth Monitoring

3.3 Accreditation listing and Monitoring of trained

Traditional Birth Attendants (TBAs)

Service providers:
Barangay Health Station Midwife (BHSM)
Rural Health Midwife (RHM)
Traditional Birth Attendants (TBA¶s)/Hilots
Community Volunteer Health Workers (CVHW)