DOH PROGRAMS RELATED TO FAMILY

HEALTH

PREPARED BY: DONA RUTH B. MORALES, RN

PHYLLICE A. BREBONERIA, MAN
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 LEARNING OUTCOMES:

Manage resources efficiently and

Evaluate specific components of
effectively.
health programs and Nursing.

Apply management and leadership principles in providing direction to

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manage community based program.

 Expanded Program on
Immunization

● established in 1976 to ensure that infants/ children

and mothers have access to routinely
recommended infant/ childhood vaccines.
● Six vaccines- preventable diseases were initially
included in the EPI: tuberculosis, poliomyelitis,
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diphtheria, tetanus, pertussis, and measles

 Over-all Goal:
To reduce the morbidity and mortality
among children against the most common
vaccine- preventable diseases.
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 Specific Goals:
To immunize all infants/ children against the most common
vaccine- preventable disease.
To sustain the polio- free status of the Philippines.
To eliminate measles infection.
To eliminate maternal and neonatal tetanus.
To control diphtheria, pertussis, hepatitis b and German measles.
To prevent extra pulmonary tuberculosis among children.
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 Mandates:
Republic Act No. 10152 “Mandatory Infants and Children
Health Immunization Act of 2011”, signed by President
Benigno Aquino III in July 26, 2010.
The mandatory includes basic immunization for children
under 5 including other types that will be determined by
the Secretary of Health.
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 Strategies:
• Conduct of Routine Immunization for Infants/ Children/
Women through the Reaching Every Barangay (REB)
strategy.
• Supplemental Immunization Activity (SIA)
• Strengthening Vaccine- Preventive Diseases Surveillance
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 Status of Implementation:
• Polio Eradication

 The Philippines has sustained its polio- free status

since October 2000

 The DOH announced a polio outbreak in the

Philippines on September 19, 2019, after 19 years of
being polio- free. On June 11, 2021, the WHO
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announced that the outbreak has ended.

 Status of Implementation:
• Measles Elimination

 4 rounds of mass measles campaign were

conducted: 1998, 2004, 2007 and 2011.

 Implemented the 2- dose measles- containing

vaccine (MCV) in 2009
MCV 1(monovalent measles) at 9-11 months old
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MCV 2(MMR) at 12- 15 months old

 Status of Implementation:
Maternal and Neonatal Tetanus Elimination

 After three decades, the Philippines through the

leadership of the DOH has achieved Maternal and
Neonatal Tetanus Elimination (MNTE) status.
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 Status of Implementation:
• Control of other common vaccine- preventable diseases
(Diphtheria, Pertussis, Hepatitis B and Meningitis/
Encephalitis secondary to H. influenza type B)

 Republic Act No. 10152 has been signed. It is otherwise

known as the “Mandatory Infants and Children Health
Immunization Act of 2011, which requires that all children
under five years old be given basic immunization against
vaccine- preventable diseases.
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 Integrated Management of
Childhood Illnesses (IMCI)
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 DID YOU KNOW?
● IMCI is an integrated approach to ● IMCI include curative and
child health that focuses on the preventive elements that are
well-being of the whole child. implemented by families and
● IMCI aims to reduce death, illness communities and by health
and disability and to promote facilities.
improved growth and development ● The strategy was developed by
among children under five years of World Health Organization and
age. UNICEF and is used by most
countries in the world.
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 FOCUS
 Improving case management skills of health
workers
 Improving over-all health systems
 Improving family and community health
practices
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 BENEFITS OF IMCI
 Addresses major child health problems because it systematically
addresses the most important causes of children’s illness and death.
 Responds to demands.
 Promotes prevention as well as cure because IMCI emphasizes
important preventive interventions such as immunization and
breastfeeding.
 Is cost- effective- most cost- effective interventions in low and
middle-income countries (World Bank).
 Promotes cost- saving.
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 Improves equity- IMCI improves inequity in global health care.

 PRINCIPLES
 All sick children aged up to 5 years are examined for general
danger signs and all sick young infants are examined for very
severe disease. These signs indicate immediate referral or
admission to hospital.
 The children and infants are then assessed for main symptoms.
For older children, the main symptoms include: cough or
difficulty breathing, diarrhea, fever and ear infection. For young
children, local bacterial infection, diarrhea and jaundice. All sick
children are routinely assessed for nutritional and immunization
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and deworming status and other problems.

 PRINCIPLES
 Only a limited number of clinical signs are used
 A combination of individual signs leads to a child’s classification
within one or more symptom groups rather than a diagnosis.
 IMCI management procedures use limited number of essential
drugs and encourage active participation of caretakers in the
treatment of children.
 Counseling of caretakers on home care, correct feeding and giving
of fluids, and when to return to clinic is an essential component of
IMCI.
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 STEPS IN IMCI CASE MANAGEMENT
PROCESS
1. Assess the child’s illness
2. Classify the illness based on signs
3. Identify treatment
4. Treat the child
5. Counsel the caretaker
6. Follow-up
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 Essential Intrapartum and
Newborn Care (EINC)
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 DID YOU KNOW?
● Essential Intrapartum and Newborn ● It is a basic component of the
Care (EINC) is a package of evidenced- DOHs Maternal, Newborn and
based practices recommended by the Child Health and Nutrition
Department of Health (DOH), (MNCHN) strategy.
Philippine Health Insurance Corporation ● The EINC practices for newborn
(Phil Health), and the World Health care constitute a series of time-
Organization (WHO) as the standard of bound, chronologically- ordered,
care in all births by skilled attendants in standard procedures that a baby
all government and private settings. receives at birth.
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 DID YOU KNOW?
● At the heart of the protocol are four 1. Immediate drying
time- bound interventions: immediate
○ Using a clean, dry cloth,
drying; skin to skin contact followed by
thoroughly dry the baby,
clamping of the cord after 1-3 minutes;
wiping the face, eyes, head,
non- separation of baby from mother;
front and back, arms and legs.
and breastfeeding initiation.
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 DID YOU KNOW?
2. Skin-to-skin contact
● If a baby is crying and breathing normally, avoid any
manipulation, such as routine suctioning, that may cause trauma
or introduce infection.
● Place the newborn prone on the mother’s abdomen or chest skin-
to-skin.
● Cover newborn’s back with a blanket and head with a bonnet.
Place identification band on ankle.
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 DID YOU KNOW?
3. Proper cord clamping and cutting
● Clamp and cut the cord after cord pulsations have stopped (typically at
1-3 minutes).
● Put ties tightly around the cord at 2 centimeters from the newborn’s
abdomen.
● Cut between ties with sterile instrument.
● Observe for oozing blood.
● Do not milk the cord towards the newborn.
● After cord clamping, ensure oxytocin 10 IU IM is given to the mother.
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 DID YOU KNOW?
4. Non-separation of baby from the mother and breastfeeding initiation
● Observe the newborn. Only when the newborn shows feeding cues (e.g.,
opening of mouth, tonguing, licking, rooting), make verbal suggestions
to the mother to encourage her newborn to move toward the breast (e.g.
nudging).
● Counsel on positioning and attachment
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 DID YOU KNOW?
4. Non-separation of baby from the mother and breastfeeding initiation
● When the baby is ready, advise the mother to:
● Make sure the newborn’s neck is neither flexed nor twisted.
● Make sure the newborn is facing the breast, with the newborn’s nose opposite her nipple
and chin touching the breast.
● Hold the newborn’s body close to her body.
● Support the newborn’s whole body, not just the neck and shoulders.
● Wait until her newborn’s mouth is opened wide.
● Move her newborn onto her breast, aiming the infant’s lower lip well below the nipple.
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 DID YOU KNOW?
4. Non-separation of baby from the mother and breastfeeding initiation
● Look for signs of good attachment:

o Mouth wide open

o Lower lip turned outward

o Baby’s chin touching breast

o Suckling is slow, deep with some pauses

o If the attachment or suckling is not good, try again and reassess.

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 DID YOU KNOW?
4. Non-separation of baby from the mother and breastfeeding initiation

Notes:
● Health workers should not touch the newborn unless there is a medical
indication.
● Do not give sugar water, formula or other prelacteals.
● Do not give bottles or pacifiers.
● Do not throw away colostrum.
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 Newborn Screening
Program
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 The Comprehensive Newborn Screening
(NBS) Program was integrated as part of
the country’s public health delivery
system with the enactment of the
Republic Act No. 9288 otherwise known
as Newborn Screening Act of 2004.
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 Vision
● The National Comprehensive Newborn
Screening System envisions all Filipino
children will be born healthy and well,
with an inherent right to life, endowed
with human dignity; and reaching their
full potential with the right opportunities
and accessible resources.
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 Mission
● To ensure that all Filipino children will
have access to and avail of total quality
care for the optimal growth and
development of their full potential.
Goal
● To reduce preventable deaths of all
Filipino newborns due to more common
and rare congenital disorders through
timely screening and proper management.
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 BEmONC/ CEmONC
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 Basic Emergency Obstetrics and Newborn
Care (BEmONC) Provider
 a capable health facility that can either be a
primary/ district hospital, RHU or BHS/ Lying-
in clinic with complete complement of
BEmONC trained personnel (doctor, nurse and
midwife) operating 24/7 or on- call basis after
regular office/ clinic hours.
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 Comprehensive Emergency Obstetric and
Newborn Care (CEmONC) services
 are the interventions provided to pregnant women and
newborns experiencing fatal complications, including
severe bleeding, infection, prolonged or obstructed labor,
eclampsia, and asphyxia in the newborn. CEmONC
interventions include safe blood transfusion, providing
oxytocin and antibiotics, performing cesarean sections,
manual removal of the placenta, assisted vaginal delivery,
abortion and resuscitation of the newborn.
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 WHO Mental health Gap
Action Programme (mhGAP)
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 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.
 The programme asserts that with proper care,
psychological assistance and medication, tens of
millions could be treated for depression, schizophrenia,
and epilepsy, prevented from suicide and begin to lead
normal lives- even when resources are scarce.
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 LET’S REVIEW SOME FACTS

Expanded Program on Integrated Management of Essential Intrapartum and

Immunization Childhood Illness Newborn Care (EINC)

Newborn Screening BEmONC/ CEmONC WHO Mental Health Gap

Program Action Program
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