CHN – M5 – DOH PROGRAMS r/t FAMILY HEALTH (National Safe Motherhood Program)

🍏 National Safe Motherhood Program

VISION 3. Monitoring, Evaluation, Research, & Dissemination w/ support from the Epidemiology Bureau & Health Policy Development
For Filipino women to have full access to health services towards making their pregnancy & delivery safer r & Planning Bureau
MISSION i. Monitoring & Supervision of Private Midwife Clinics in cooperation w/ PRC Board of Midwifery
Guided by the Department of Health FOURmula One Plus thrust & the Universal Health Care Frame, the National Safe & Professional Midwifery Organizations
Motherhood Program is committed to provide rational & responsive policy direction to its local government partners in the ii. Maternal Death Reporting & Review System in collaboration w/ Provincial & City Review Teams
delivery of quality maternal & newborn health services w/ integrity & accountability using proven & innovative approaches iii. Annual Program Implementation Reviews w/ Provincial Health Officers & Regional Coordinators
Objectives
The Program contributes to the national goal of improving women’s health & well-being by: POLICIES & LAWS
1. Collaborating w/ Local Government Units in establishing sustainable, cost-effective approach of delivering health
🖸Republic Act No. 10354: Responsible Parenthood & Reproductive Health Law (RPRH Act of 2012)
services that ensure access of disadvantaged women to acceptable & H↑GH quality maternal & newborn health
services & enable them to safely give birth in health facilities near their homes
DOH Program for Maternal & Child Health
○MATERNAL, NEWBORN, CHILD HEALTH & NUTRITION (MNCHN)
2. Establishing core knowledge base & support systems that facilitate the delivery of quality maternal & newborn
○UNANG YAKAP
health services in the country.

PRENATAL CHECK -UP

□ @ least 4 prenatal visits IDEALLY [42:50 CHECK MO BC MAYS UMN SA QUIZ/ MIDTERMS]
PROGRAM COMPONENTS □ Ideally, prenatal check-ups are done once a week, but due to the PANDEMIC:
◑Component A: Local Delivery of the Maternal–Newborn Service Package o 1-6 months → once a month
This component supports LGUs in establishing & mobilizing the service delivery network of public & private providers to enable o 7-9 months → refer for them to have a record @ the hospital
them to deliver the integrated maternal-newborn service package. In each province & city, the ff shall continue to be undertaken: □ Provision of vitamins (FeSO4 + Folic Acid, Calcium Carbonate, Multivitamins)

1. Establishment of critical capacities to provide quality maternal-newborn services ○ FERROUS SULFATE + FOLIC ACID
thru the organization & operation of a network of Service Delivery Teams consisting of: ■ 1 TAB/DAY
i. Barangay Health Workers ■ OD, HS [once a day, b4 bedtime]
ii. BEmONC Teams composed of Doctors, Nurses & Midwives ■ S/E: DIZZINESS
■ is recommended for pregnant women to prevent maternal anemia, puerperal sepsis,
2. In collaboration w/ the Centers for health Development & relevant national offices: ↓low birth weight, & preterm birth.
Establishment of Reliable Sustainable Support Systems for Maternal-Newborn Service Delivery thru such initiatives as: ○ Calcium Carbonate = 5 mos/ ↑
i. Establishment of Safe Blood Supply Network w/ support from the National Voluntary Blood Program ■ 1 tab/OD [once a day]
ii. Behavior Change Interventions in collaboration w/ the Health Promotion & Communication Service ■ for 5 mo2s & ↑above
iii. Sustainable financing of maternal - newborn services & commodities thru locally initiated revenue generation & ■ There is clear evidence to show that daily supplementation w/ 1.5 grams to 2 grams of
retention activities including PhilHealth accreditation & enrolment. elemental calcium is beneficial to reduce the risks of gestational hypertension, preeclampsia,
& preterm birth.
■ (1000-1300mg RDA) The use of calcium carbonate in more than the recommended amount can lead to
◑Component B: National Capacity to Sustain Maternal-Newborn Services
lower fetal weight & has been associated w/ milk-alkali syndrome.
1. Operational & Regulatory Guidelines !! Note: Inadequate calcium consumption by pregnant women can lead to adverse effects in both the mother & the fetus &
i. Identification & profiling of current FP users & identification of potential FP clients & those w/ unmet need for FP produce osteopenia, tremor, paraesthesia, muscle cramping, tetanus, delayed fetal growth, low birth weight, & poor fetal
(permanent/ temporary methods) mineralization.
ii. Mainstreaming FP in the regions w/ high unmet need for FP
iii. Development & dissemination of Information, Education Communication materials o 2 doses of Tetanus Toxoid (0.5 ml) to prevent Acute Flaccid Paralysis
iv. Advocacy & social mobilization for FP o Laboratory requests every month (UA, CBC)
o Collaboration w/ Rural Health Physician, Public Health Nurse, Medical Technologist
2. Network of Training Providers o Test for Syphilis & HIV
i. 31 Training Centers that provide BEmONC Skills Training
 [46;40,,.,. sumn w/ Vit C + ?? for FAST ABSORPTION] 3. Discuss the importance & management of breastfeeding w/ pregnant women & their families.

4. Facilitate immediate & uninterrupted skin-to-skin contact & support mothers to initiate breastfeeding as soon as
possible after birth.

5. Support mothers to initiate & maintain breastfeeding & manage common difficulties.

● EMERGENCY SIGNS 6. Do not provide breastfed newborns any food or fluids other than breast milk, unless medically indicated.
○ vaginal bleeding.
○ convulsions/fits. 7. Enable mothers & their infants to remain together & to practice rooming-in 24 hours a day.
○ severe headaches w/ blurred vision.
○ fever & too weak to get out of bed. 8. Support mothers to recognize & respond to their infants’ cues for feeding.
○ severe abdominal pain.
○ fast or difficult breathing. 9. Counsel mothers on the use & risks of feeding bottles, teats & pacifiers.
○ ruptured bag of water.
10. Coordinate discharge so that parents & their infants have timely access to ongoing support & care.

POST-PARTUM
10 STEPS to SUCCESSFUL BREASTFEEDING
□ At least 2 visits from the CHN
□ Vitamin A & FeSO4 supplementation → given to mother 1. Hospital Policies
□ Breastfeeding Hospitals support mothers to breastfeed by not promoting infant formula, bottles or teats, making breastfeeding care standard
□ Family planning practice & keeping track of support for breastfeeding

2. Staff Competency
[54,., sumn code of MILK CODE] Hospitals support mothers to breastfeed by training staff on supporting mothers to breastfeed and assessing health workers'
knowledge and skills
10 STEPS TO SUCCESSFUL BREASTFEEDING
WHO & UNICEF launched the Baby-friendly Hospital Initiative (BFHI) to help motivate facilities providing maternity & newborn 3. Antenatal Care
services worldwide to implement the Ten Steps to Successful Breastfeeding. Hospitals support mothers to breastfeed by discussing the importance of breastfeeding for babies & mothers and preparing
Ten Steps summarize a package of policies & procedures that facilities providing maternity & newborn services should women in how to feed their baby
implement to support breastfeeding. WHO has called upon all facilities providing maternity & newborn services worldwide to
implement the Ten Steps. 3. [56;05,., helpful for BREASTFEEDING] bc EXAM

The implementation guidance for BFHI emphasizes strategies to scale up to universal coverage & ensure sustainability over
BENEFITS: Economical,
time. The guidance focuses on integrating the programme more fully in the health-care system, to ensure that all facilities in a ↑d Immune system on the baby,
country implement the Ten Steps. Countries are called upon to fulfill nine key responsibilities through a national BFHI programme: Causes less stomach upset, diarrhea & constipation than formula
1a. Comply fully w/ the International Code of Marketing of Breast-milk
↓d in Body wt./ obesity
Substitutes & relevant World Health Assembly resolutions.
Breastfeeding positions: Cradle, Cross-cradle, Clutch , Side-lying
1b. Have a written infant feeding policy that is routinely communicated to staff & parents.
4. Care Right [ After Birth ]
1c. Establish ongoing monitoring & data-management systems. Hospitals support mothers to breastfeed by encouraging skin to- skin contact between mother and baby soon after birth and
helping mothers to put their baby to the breast right away
2. Ensure that staff have sufficient knowledge, competence & skills to support breastfeeding.
#UnangYakap
 Breastfeeding should then only stop once a nutritionally adequate & safe diet w/out breast milk can be provided.
5. Support Mothers w/ Breastfeeding Hospitals support mothers to breastfeed by checking positioning, attachment & suckling,
giving practical breastfeeding support & helping mothers w/ common breastfeeding problems National & local health authorities should actively coordinate & implement services in health facilities & activities in workplaces,
communities & homes to protect, promote & support breastfeeding among women living w/ HIV.
#5 [57;45 breastfeeding position]
National Family Planning Program
VISION
6. Supplementing Hospitals support mothers to breastfeed by giving only breast milk unless there are medical reasons, prioritizing
donor human milk when a supplement is needed & helping mothers who want to formula feed to do so safely For Filipino women & men achieve their desired family size & fulfill the reproductive health & rights for all through universal
access to quality family planning information & services.
[d ako nakinig ohnoes]
MISSION
In line w/ the Department of Health FOURmula One Plus strategy & Universal Health Care framework, the National Family
7. Rooming-In Hospitals support mothers to breastfeed by letting mothers & babies stay together day & night and making sure
Planning Program is committed to provide responsive policy direction & ensure access of Filipinos to medically safe, legal, non-
that mothers of sick babies can stay near their baby
abortifacient, effective, & culturally acceptable modern family planning (FP) methods.

8. Responsive Feeding Hospitals support mothers to breastfeed by helping mothers know when their baby is hungry & ✗t limiting Objectives
breastfeeding times
1. To increase modern Contraceptive Prevalence Rate (mCPR) among all women from 24.9% in 2017 to 30% by 2022
2. To reduce the unmet need for modern family planning from 10.8% in 2017 to 8% by 2022
9. Bottles, Teats & Pacifiers Hospitals support mothers to breastfeed by counselling mothers on the use and risks of feeding
bottles, teats & pacifiers
Program Components
10. Discharge Hospitals support mothers to breastfeed by referring mothers to community resources for breastfeeding support Component A: Provision of free FP Commodities that are
& working with communities to ↑mprove breastfeeding support services medically safe, legal, non-abortifacient, effective & culturally acceptable to all in need of the FP service:
o Forecasting of FP commodity requirements for the country
Infant feeding for the prevention of mother-to-child transmission of HIV o Procurement of FP commodities & its ancillary supplies
WHO recommendations o Strengthening of the supply chain management in FP & ensuring of adequate FP supply at the service
delivery points
• Mothers known to be HIV-infected should be provided w/ lifelong antiretroviral therapy or antiretroviral prophylaxis interventions Component B: Demand Generation through Community-based Management Information System:
to reduce HIV transmission through breastfeeding. o Identification & profiling of current FP users & identification of potential FP clients & those w/ unmet need
for FP (permanent or temporary methods)
• National or sub-national health authorities should decide whether health services will principally counsel mothers known to be o Mainstreaming FP in the regions w/ high unmet need for FP
HIV-infected to either breastfeed & take antiretrovirals,/, avoid all breastfeeding. o Development & dissemination of Information, Education Communication materials
o Advocacy & social mobilization for FP
In settings where national health authorities are recommending breastfeeding for HIV-infected mothers:
Component C: Family Planning in Hospitals & other Health Facilities
Mothers known to be HIV-infected (& whose infants are HIV uninfected or of unknown HIV status) should exclusively breastfeed o Establishment of FP service package in hospitals
their infants for the first 6 months of life, introducing appropriate complementary foods thereafter, & continue breastfeeding. o Organization of FP Itinerant team for outreach missions
o Delivery of FP services by hospitals to the poor communities especially Geographically Isolated &
Mothers living w/ HIV should breastfeed for at least 12 months & may continue breastfeeding for up to 24 months or longer Disadvantaged Areas (GIDAs):
(similar to the general population) while being fully supported for ART adherence (see the WHO Consolidated guidelines on the o Provision of budget support to operations by the itinerant teams including logistics & medical supplies
use of antiretroviral drugs for treating & preventing HIV infection for interventions to optimize adherence). needed for voluntary surgical sterilization services
o FP services as part of medical & surgical missions of the hospital
In settings where health services provide & support lifelong ART, including adherence counselling, & promote & support o Partnership w/ LGU hospitals for the FP outreach missions
breastfeeding among women living w/ HIV, the duration of breastfeeding should not be restricted.
Component D: Financial Security in FP
 o Strengthening PhilHealth benefit packages for FP
o Expansion of PhilHealth coverage to include health centers providing No Scalpel Vasectomy & FP Itinerant
Teams
o Expansion of Philhealth benefit package to include pills, injectables & IUD
o Social Marketing of contraceptives & FP services by the partner NGOs
o National Funding/Subsidy

STRATEGIES:
1. FP Outreach Mission – this maximizes opportunities where clients are & FP services are delivered down to the
community level. (USAPAN SESSIONS)
2. FP in hospitals – this address missed opportunities where women especially those who recently gave birth are offered
w/ appropriate FP services.
3. Intensive Dem& generation through house-to-house visits by the community health volunteers, Family Development
Sessions, Usapan sessions, among others

USAPAN SESSIONS
1. USAPANG KUNTENTO NA - BIRTH LIMITING
2. USAPANG PWEDE PA - BIRTH SPACING
3. USAPANG BUNTIS - FP USE AFTER DELIVERY
4. USAPANG MAGINOO - MEN

[ 70;,., na dapat CAREFUL]

🍏MENTAL HEALTH PROGRAM
Description
- Mental health & well-being = a concern of all 2. Extreme Life Experience
- Provision of mental health & psychosocial support (MHPSS) during personal & community wide
- Addressing concerns r/t MNS (Mental, Neural & Substance Abuse disorders) contributes to the attainment of the SDGs
disasters
- Thru a comprehensive mental health program that includes a wide range of promotive, preventive, Tx & rehabilitative services; 3. Mental Disorder
- that is for all individuals across the life course especially those at risk of & suffering from MNS disorders; 4. Neurologic Disorders
- integrated in various Tx settings from community to facility that is implemented from the national to the brgy lvl; & backed w/ 5. Substance Abuse & other Forms of Addiction
- Provision of services for mental, neurologic & substance use disorders at the primary level from
institutional support mechanisms from diff gov’t agencies & CSOs, we hope to attain the highest possible lvl of health for the
assessment, treatment & management to referral; & provision of psychotropic drugs w/c are provided
nation bc there is NO Universal Health Care w/out mental health for free.
- Enhancement of mental health facilities under HFEP (Health Facilities Enhancement Program)
VISION
A society that promotes the well-being of all Filipinos, supported by transformative multi-sectoral partnerships, DRUG DEPENDENCE/SUBSTANCE ABUSE CONTROL
comprehensive mental health policies & programs, & a responsive service delivery network ○The DOH launched its nationwide healthy lifestyle movement Pilipinas Go4Health which encourages Filipinos to commit to a
MISSION healthy lifestyle thru physical activity, proper nutrition, & the prevention/ cessation of smoking & alcohol consumption.
To promote over-all wellness of all Filipinos, prevent mental, psychosocial, & neurologic disorders, substance abuse & ○The health lifestyle program was launched to help prevent and control noncommunicable diseases (NCDs) in the country.
other forms of addiction, & ↓reduce burden of disease by improving access to quality care & recovery in order to attain
the highest possible level of health to participate fully in society. Program Accomplishments/Status
1. Passage of the Republic Act No. 11036 dated June 20, 2018 "An Act Establishing a National Mental Health
OBJECTIVES Policy for the Purpose of Enhancing the Delivery of Integrated Mental Health Services, Promoting &
1. To promote participatory governance & leadership in mental health Protecting the Rights of Persons Utilizing Psychiatric, Neurologic &
2. To strengthen coverage of mental health services through multi-sectoral partnership to provide high quality service Psychosocial Health Services, Appropriating Funds Therefore & for Other Purposes"
aiming at best patient experience in a responsive service delivery network 2. DOH Administrative Oreder No. 2016-0039 dated October 28, 2016 " Revised Operational Framework for a
3. To harness capacities of LGUs & organized groups to implement promotive & preventive interventions on mental health Comprehensive National Mental Health Program"
4. To leverage quality data & research evidence for mental health 3. National Mental Health Program Strategic Plan 2018-2022
5. To set standards for compliance in different aspects of services 4. Harmonized MHPPS Training Manual
5. Development of the Implementing Rules & Regulation of the RA No.
Policies & Laws 11036 also known as The Mental Health Act
○DOH Administrative Order No. 8 series of 2001 The National Mental Health Policy 6. Conduct of the Advocacy Activities such as 2nd Public Health Convention on Mental Health, Observance of
○DOH Administrative Order No. 2016-0039 Revised Operational Framework for a the World Health Day, World Suicide Prevention Day, National Mental Health Week & Mental Health Fairs
○Comprehensive National Mental Health Program 7. Training on Mental Health Gap Action Programme
🖸Republic Act No. 11036 Mental Health Act 8. Conduct of The National Prevalence Survey on Mental Health
9. Establishment of the Medicine Access Program for Mental Health
Calendar of Activities
Sept 10 - World Suicide Prevention Day Dangerous Drugs Abuse Prevention & Treatment Program
Oct 10 - World Mental Health Day DOH LAUNCHES SUBSTANCE ABUSE 1550 HELPLINE
2nd Wk of Oct - National Mental Week o the hotline will provide support & intervention to Persons Who Use Drugs (PWUDs), their families & the public.
o the hotline was established to heighten awareness to the public & to allow easy access to information regarding
Program Components substance abuse related problems, despite the pandemic.
1. Wellness of Daily Living
- All health/social/poverty reduction/safety & security programs & the like are protective factors in !! substance abuse = drinks advil
general for the entire population
- Promotion of Healthy Lifestyle, Prevention & Control of Diseases, Family wellness programs, etc
- School & workplace health & wellness programs
🍏mhGAP, Mental Health Gap Action Programme
The WHO Mental Health Gap Action Programme (mhGAP) Common Presentation of BEHAVIORAL DISORDERS ❀children & adolescent
o aims at scaling up services for mental, neurological & substance use disorders for countries 1. Excessive inattention and absent-mindedness, repeatedly stopping tasks before completion and switching to other activities
especially w/ low- & middle-income. 2. Excessive over-activity: excessive running around, extreme difficulties remaining seated, excessive talking/ fidgeting
o asserts that w/ proper care, psychosocial assistance & medication, tens of millions could be treated for depression, 3. Excessive impulsivity: frequently doing things w/o forethought
schizophrenia, & epilepsy, prevented from suicide & begin to lead normal lives– even where resources are scarce. 4. Repeated and continued behaviour that disturbs others
(e.g. unusually frequent & severe temper tantrums, cruel behaviour, persistent & severe disobedience, stealing)
mhGAP-IG Master Chart: W/c priority condition(s) should be assessed? 5. Sudden changes in behavior/ peer relations, including withdrawal & anger
1. These common presentations indicate the need for assessment.
2. If people present w/ features from more than one condition, then all relevant conditions need to be assessed. Common Presentation of DEMENTIA ❀older ppl
3. All conditions apply to all ages, unless otherwise specified. 1. Decline or problems with memory (severe forgetfulness) & orientation (awareness of time, place and person)
2. Mood or behavioural problems such as apathy (appearing
Common Presentation of DEPRESSION -> [□condition to be assessed] uninterested) or irritability
1. ↓ Low energy; fatigue; sleep/ appetite probs 3. Loss of emotional control – easily upset, irritable or tearful
2. Persistent sad/ anxious mood; irritability 4. Difficulties in carrying out usual work, domestic or social activities
3. ↓Low interest/ pleasure in activities that used to be interesting/ enjoyable
4. Multiple symptoms w/ ✗clear physical cause (Ex. ✰aches & pains, ✰palpitations, ✰numbness) Common Presentation of ALCOHOL USE DISORDERS
5. Difficulties in carrying out usual work, school, domestic/ social activities 1. Appearing to be under the influence of alcohol (e.g. smell of alcohol, looks intoxicated, hangover)
2. Presenting with an injury
3. Somatic symptoms associated with alcohol use
Common Presentation of PSYCHOSIS -> [□condition to be assessed] (e.g. insomnia, fatigue, anorexia, nausea, vomiting, indigestion, diarrhoea, headaches)
1. Abnormal/ disorganized behaviour 4. Difficulties in carrying out usual work, school, domestic or social activities
Ex. incoherent/ irrelevant speech, unusual appearance, self-neglect, unkempt appearance
2. Delusions (a false firmly held belief/ suspicion) Common Presentation of DRUG USE DISORDERS
3. Hallucinations (hearing voices/ seeing things that are NOT there) 1. Appearing drug-affected Ex. ↓low energy, agitated, fidgeting, slurred speech
4. Neglecting usual responsibilities related to work, school, domestic/ social activities 2. Signs of drug use (injection marks, skin infxn, unkempt appearance)
5. Manic symptoms (several days of being abnormally happy, too energetic, too talkative, 3. Requesting prescriptions for sedative medication (sleeping tablets, opioids)
very irritable, NOT sleeping, reckless behaviour) 4. Financial difficulties or crime-related legal problems
5. Difficulties in carrying out usual work, domestic/ social activities
Common Presentation of EPILEPSY/ SEIZURES
1. Convulsive movement or fits / seizures Common Presentation of SELF-HARM/SUICIDE
2. During the convulsion: 1. Current thoughts, plan/ act of self-harm or suicide
3. loss of consciousness or impaired consciousness 2. Hx of thoughts, plan or act of self-harm or suicide
4. stiffness, rigidity
5. tongue bite, injury, incontinence of urine or faeces
6. After the convulsion: fatigue, drowsiness, sleepiness, confusion, abnormal behaviour, headache, muscle aches,/
weakness on 1 side of the body
[16;55] cerebrall pasy pts.

Common Presentation of DEVELOPMENTAL DISORDERS ❀children & adolescent

1. Delayed development: much slower learning than other children of same age in activities
like: smiling, sitting, standing, walking, talking / communicating and other areas of dev’t, such as reading & writing
2. Abnormalities in communication; restricted, repetitive behaviour
3. Difficulties in carrying out everyday activities normal for that age