ANGELES UNIVERSITY FO
UNDATION
Angeles City
College of Nursing
Module 5 for Community Health Nursing 1 (Individual and Family as Clients)
1st semester, A.Y. 2020-2021
MODULE 5: DOH PROGRAMS RELATED TO FAMILY HEALTH (National Safe Motherhood
Program)
National Safe Motherhood Program
Vision
For Filipino women to have full access to health services towards making their
pregnancy and delivery safer
Mission
Guided by the Department of Health FOURmula One Plus thrust and the Universal
Health Care Frame, the National Safe Motherhood Program is committed to provide
rational and responsive policy direction to its local government partners in the delivery
of quality maternal and newborn health services with integrity and accountability using
proven and innovative approaches
Objectives
The Program contributes to the national goal of improving women’s health and
well-being by:
1. Collaborating with Local Government Units in establishing sustainable,
cost-effective approach of delivering health services that ensure access of
disadvantaged women to acceptable and high quality maternal and newborn
health services and enable them to safely give birth in health facilities near their
homes
2. Establishing core knowledge base and support systems that facilitate the delivery
of quality maternal and newborn health services in the country.
Program Components
Component A: Local Delivery of the Maternal–Newborn Service Package
This component supports LGUs in establishing and mobilizing the service
delivery network of public and private providers to enable them to deliver
the integrated maternal-newborn service package. In each province and
city, the following shall continue to be undertaken:
1. Establishment of critical capacities to provide quality
maternal-newborn services through the organization and
operation of a network of Service Delivery Teams consisting of:
a. Barangay Health Workers
b. BEmONC Teams composed of Doctors, Nurses and
Midwives
2. In collaboration with the Centers for health Development and
relevant national offices: Establishment of Reliable Sustainable
Support Systems for Maternal-Newborn Service Delivery through
such initiatives as:
a. Establishment of Safe Blood Supply Network with support
from the National Voluntary Blood Program
b. Behavior Change Interventions in collaboration with the
Health Promotion and Communication Service
c. Sustainable financing of maternal - newborn services and
commodities through locally initiated revenue
generation and retention activities including PhilHealth
accreditation and enrolment.
Component B: National Capacity to Sustain Maternal-Newborn Services
1. Operational and Regulatory Guidelines
a. Identification and profiling of current FP users and
identification of potential FP clients and those with unmet
need for FP (permanent or temporary methods)
b. Mainstreaming FP in the regions with high unmet need for
FP
c. Development and dissemination of Information,
Education Communication materials
d. Advocacy and social mobilization for FP
2. Network of Training Providers
a. 31 Training Centers that provide BEmONC Skills Training
3. Monitoring, Evaluation, Research, and Dissemination with support
from the Epidemiology Bureau and Health Policy Development and
Planning Bureau
a. Monitoring and Supervision of Private Midwife Clinics in
cooperation with PRC Board of Midwifery and
Professional Midwifery Organizations
b. Maternal Death Reporting and Review System in
collaboration with Provincial and City Review Teams
c. Annual Program Implementation Reviews with Provincial
Health Officers and Regional Coordinators
Policies and Laws
Republic Act No. 10354: Responsible Parenthood and Reproductive Health Law (RPRH
Act of 2012)
DOH Program for Maternal and Child Health
MATERNAL, NEWBORN, CHILD HEALTH AND NUTRITION
(MNCHN)
UNANG YAKAP
PRENATAL
● At least 4 prenatal visits
● Ideally, prenatal check-ups are done once a week, but due to the pandemic:
● 1-6 months → once a month
● 7-9 months → refer for them to have a record at the hospital
● Provision of vitamins (FeSO4 + Folic Acid, Calcium Carbonate, Multivitamins)
○ FERROUS SULFATE + FOLIC ACID
■ 1 TAB/DAY
■ OD, HS
■ S/E: DIZZINESS
■ is recommended for pregnant women to prevent maternal
anaemia, puerperal sepsis, low birth weight, and preterm birth.
○ Calcium Carbonate
■ 1 tab/OD
■ for 5 months and above
■ There is clear evidence to show that daily supplementation with 1.5
grams to 2 grams of elemental calcium is beneficial to reduce the
risks of gestational hypertension, preeclampsia, and preterm birth.
■ (1000-1300mg RDA) The use of calcium carbonate in more than the
recommended amount can lead to lower fetal weight and has
been associated with milk-alkali syndrome.
■ Note: Inadequate calcium consumption by pregnant women can
lead to adverse effects in both the mother and the fetus and
produce osteopenia, tremor, paraesthesia, muscle cramping,
tetanus, delayed fetal growth, low birth weight, and poor fetal
mineralization.
● 2 doses of Tetanus Toxoid (0.5 ml) to prevent Acute Flaccid Paralysis
● Laboratory requests every month (UA, CBC)
● Collaboration with Rural Health Physician, Public Health Nurse, Medical
Technologist
● Test for Syphilis and HIV
● EMERGENCY SIGNS
○ vaginal bleeding.
○ convulsions/fits.
○ severe headaches with blurred vision.
○ fever and too weak to get out of bed.
○ severe abdominal pain.
○ fast or difficult breathing.
○ ruptured bag of water.
POSTPARTUM
● At least 2 visits from the CHN
● Vitamin A and FeSO4 supplementation
● Breastfeeding
● Family planning
10 STEPS TO SUCCESSFUL BREASTFEEDING
WHO and UNICEF launched the Baby-friendly Hospital Initiative (BFHI) to help
motivate facilities providing maternity and newborn services worldwide to implement
the Ten Steps to Successful Breastfeeding. The Ten Steps summarize a package of
policies and procedures that facilities providing maternity and newborn services should
implement to support breastfeeding. WHO has called upon all facilities providing
maternity and newborn services worldwide to implement the Ten Steps.
The implementation guidance for BFHI emphasizes strategies to scale up to
universal coverage and ensure sustainability over time. The guidance focuses on
integrating the programme more fully in the health-care system, to ensure that all
facilities in a country implement the Ten Steps. Countries are called upon to fulfill nine
key responsibilities through a national BFHI programme:
1a. Comply fully with the International Code of Marketing of Breast-milk
Substitutes and relevant World Health Assembly resolutions.
1b. Have a written infant feeding policy that is routinely communicated to staff
and parents.
1c. Establish ongoing monitoring and data-management systems.
2. Ensure that staff have sufficient knowledge, competence and skills to support
breastfeeding.
3. Discuss the importance and management of breastfeeding with pregnant
women and their families.
4. Facilitate immediate and uninterrupted skin-to-skin contact and support
mothers to initiate breastfeeding as soon as possible after birth.
5. Support mothers to initiate and maintain breastfeeding and manage common
difficulties.
6. Do not provide breastfed newborns any food or fluids other than breast milk,
unless medically indicated.
7. Enable mothers and their infants to remain together and to practise rooming-in
24 hours a day.
8. Support mothers to recognize and respond to their infants’ cues for feeding.
9. Counsel mothers on the use and risks of feeding bottles, teats and pacifiers.
10. Coordinate discharge so that parents and their infants have timely access to
ongoing support and care.
Infant feeding for the prevention of mother-to-child transmission of HIV
WHO recommendations
Mothers known to be HIV-infected should be provided with lifelong antiretroviral
therapy or antiretroviral prophylaxis interventions to reduce HIV transmission through
breastfeeding.
National or sub-national health authorities should decide whether health services will
principally counsel mothers known to be HIV-infected to either breastfeed and take
antiretrovirals, or, avoid all breastfeeding.
In settings where national health authorities are recommending breastfeeding for
HIV-infected mothers:
Mothers known to be HIV-infected (and whose infants are HIV uninfected or of unknown
HIV status) should exclusively breastfeed their infants for the first 6 months of life,
introducing appropriate complementary foods thereafter, and continue breastfeeding.
Mothers living with HIV should breastfeed for at least 12 months and may continue
breastfeeding for up to 24 months or longer (similar to the general population) while
being fully supported for ART adherence (see the WHO Consolidated guidelines on the
use of antiretroviral drugs for treating and preventing HIV infection for interventions to
optimize adherence).
In settings where health services provide and support lifelong ART, including adherence
counselling, and promote and support breastfeeding among women living with HIV, the
duration of breastfeeding should not be restricted.
Breastfeeding should then only stop once a nutritionally adequate and safe diet
without breast milk can be provided.
National and local health authorities should actively coordinate and implement
services in health facilities and activities in workplaces, communities and homes to
protect, promote and support breastfeeding among women living with HIV.
National Family Planning Program
Vision
For Filipino women and men achieve their desired family size and fulfill the reproductive
health and rights for all through universal access to quality family planning information
and services.
Mission
In line with the Department of Health FOURmula One Plus strategy and Universal Health
Care framework, the National Family Planning Program is committed to provide
responsive policy direction and ensure access of Filipinos to medically safe, legal,
non-abortifacient, effective, and culturally acceptable modern family planning (FP)
methods.
Objectives
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
Program Components
Component A: Provision of free FP Commodities that are medically safe, legal,
non-abortifacient, effective and culturally acceptable to all in need of the FP service:
● Forecasting of FP commodity requirements for the country
● Procurement of FP commodities and its ancillary supplies
● Strengthening of the supply chain management in FP and ensuring of
adequate FP supply at the service delivery points
Component B: Demand Generation through Community-based Management
Information System:
● Identification and profiling of current FP users and identification of
potential FP clients and those with unmet need for FP (permanent or
temporary methods)
● Mainstreaming FP in the regions with high unmet need for FP
● Development and dissemination of Information, Education
Communication materials
● Advocacy and social mobilization for FP
Component C: Family Planning in Hospitals and other Health Facilities
● Establishment of FP service package in hospitals
● Organization of FP Itinerant team for outreach missions
● Delivery of FP services by hospitals to the poor communities especially
Geographically Isolated and Disadvantaged Areas (GIDAs):
● Provision of budget support to operations by the itinerant teams including
logistics and medical supplies needed for voluntary surgical sterilization
services
● FP services as part of medical and surgical missions of the hospital
● Partnership with LGU hospitals for the FP outreach missions
Component D: Financial Security in FP
● Strengthening PhilHealth benefit packages for FP
● Expansion of PhilHealth coverage to include health centers providing No
Scalpel Vasectomy and FP Itinerant Teams
● Expansion of Philhealth benefit package to include pills, injectables and
IUD
● Social Marketing of contraceptives and FP services by the partner NGOs
● National Funding/Subsidy
STRATEGIES:
1. FP Outreach Mission – this maximizes opportunities where clients are and 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 with appropriate FP services.
3. Intensive Demand 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
MENTAL HEALTH PROGRAM
Description
Mental health and well-being is a concern of all. Addressing concerns related to
MNS contributes to the attainment of the SDGs. Through a comprehensive mental
health program that includes a wide range of promotive, preventive, treatment
and rehabilitative services; that is for all individuals across the life course especially
those at risk of and suffering from MNS disorders; integrated in various treatment
settings from community to facility that is implemented from the national to the
barangay level; and backed with institutional support mechanisms from different
government agencies and CSOs, we hope to attain the highest possible level of
health for the nation because there is no Universal Health Care without mental
health
Vision
A society that promotes the well-being of all Filipinos, supported by transformative
multi-sectoral partnerships, comprehensive mental health policies and programs,
and a responsive service delivery network
Mission
To promote over-all wellness of all Filipinos, prevent mental, psychosocial, and
neurologic disorders, substance abuse and other forms of addiction, and reduce
burden of disease by improving access to quality care and recovery in order to
attain the highest possible level of health to participate fully in society.
Objectives
1. To promote participatory governance and leadership in mental health
2. To strengthen coverage of mental health services through multi-sectoral
partnership to provide high quality service aiming at best patient
experience in a responsive service delivery network
3. To harness capacities of LGUs and organized groups to implement
promotive and preventive interventions on mental health
4. To leverage quality data and research evidence for mental health
5. To set standards for compliance in different aspects of services
Program Components
1. Wellness of Daily Living
● All health/social/poverty reduction/safety and security programs
and the like are protective factors in general for the entire
population
● Promotion of Healthy Lifestyle, Prevention and Control of Diseases,
Family wellness programs, etc
● School and workplace health and wellness programs
2. Extreme Life Experience
● Provision of mental health and psychosocial support (MHPSS)
during personal and community wide disasters
3. Mental Disorder
4. Neurologic Disorders
5. Substance Abuse and other Forms of Addiction
● Provision of services for mental, neurologic and substance use
disorders at the primary level from assessment, treatment and
management to referral; and provision of psychotropic drugs
which are provided for free.
● Enhancement of mental health facilities under HFEP
Policies and Laws
DOH Administrative Order No. 8 series of 2001 The National Mental Health Policy
DOH Administrative Order No. 2016-0039 Revised Operational Framework for a
Comprehensive National Mental Health Program
Republic Act No. 11036 Mental Health Act
Program Accomplishments/Status
1. Passage of the Republic Act No. 11036 dataed June 20, 2018 "An Act
Establishing a National Mental Health Policy for the Purpose of Enhancing
the Delivery of Integrated Mental Health Services, Promoting and
Protecting the Rights of Persons Utilizing Psychiatric, Neurologic and
Psychosocial Health Services, Appropriating Funds Therefore and for Other
Purposes"
2. DOH Administrative Oreder No. 2016-0039 dated October 28, 2016 "
Revised Operational Framework for a Comprehensive National Mental
Health Program"
3. National Mental Health Program Strategic Plan 2018-2022
4. Harmonized MHPPS Training Manual
5. Development of the Implementing Rules and Regulation of the RA No.
11036 also known as The Mental Health Act
6. Conduct of the Advocacy Activities such as 2nd Public Health Convention
on Mental Health, Observance of the World Health Day, World Suicide
Prevention Day, National Mental Health Week and Mental Health Fairs
7. Training on Mental Health Gap Action Programme
8. Conduct of The National Prevalence Survey on Mental Health
9. Establishment of the Medicine Access Program for Mental Health
Calendar of Activities
September 10 - World Suicide Prevention Day
October 10 -World Mental Health Day
2nd Week of Ocotber - National Mental Week
Dangerous Drugs Abuse Prevention and Treatment Program
DOH LAUNCHES SUBSTANCE ABUSE 1550 HELPLINE
● the hotline will provide support and intervention to Persons Who Use Drugs
(PWUDs), their families and the public.
● the hotline was established to heighten awareness to the public and to allow
easy access to information regarding substance abuse related problems,
despite the pandemic.
The WHO Mental Health Gap Action Programme (mhGAP)
● aims at scaling up services for mental, neurological and substance use disorders
for countries especially with low- and middle-income.
● asserts that with proper care, psychosocial assistance and medication, tens of
millions could be treated for depression, schizophrenia, and epilepsy, prevented
from suicide and begin to lead normal lives– even where resources are scarce.
mhGAP-IG Master Chart: Which priority condition(s) should be assessed?
1. These common presentations indicate the need for assessment.
2. If people present with features from more than one condition, then all relevant
conditions need to be assessed.
3. All conditions apply to all ages, unless otherwise specified.
References
Books
Lundy, K. S. & Janes, S. (2016). Communtiy Health Nursing: Caring for the Public’s
Health. Jones & Bartlett Learning. Burlington, MA.
Cuevas, F. P. L. (Ed). (2007). Public Health Nursing in the Philippines. Manila:
Publications Committee, National League of Philippine Government Nurses, Inc.
Gesmundo, M. H. et al. (2010). The Basics of Community Health Nursing: A Study
Guide for Nursing Students and Local Board Examinees. Quezon City.
Carroll, Patricia L. (2009). Community Health nursing: A practical guide. Thomson
Learning Inc. New York, USA.
Bailon-Reyes, S. (2006). Community Health Nursing: The Basics of Practice. National
Bookstore. Mandaluyong city.
Web resources
https://www.doh.gov.ph/national-safe-motherhood-program
http://centralluzon.doh.gov.ph/index.php?option=com_content&view=article&id=12&It
emid=116
https://www.doh.gov.ph/national-mental-health-program
https://www.doh.gov.ph/family-planning
https://www.paho.org/mhgap/en/master_chart.html
Prepared by:
Shannon Rey P. Pelayo, RN, MAN
Nadine Victoria L. Layson-Lising, RN
Instructors
Peer Evaluated by:
Bianca Margarita E. Tizon, RN, LPT, MSN
NCM 104 - RLE Instructor
Review and Evaluated by:
Hydee M. Pangilinan, RN, MAN
CHN Coordinator
Jennie C. Junio, RN, MAN
Level II Academic Coordinator
Approved by:
ZENAIDA S. FERNANDEZ, RN, Ph.D.
Dean, CON
