Reproductive Health and EINC

GROUP E

The Responsible Parenthood and Reproductive Health Act of 2012 (Republic Act No. 10354), informally known as the Reproductive Health Law, is a law in the Philippines which guarantees universal access to methods on contraception, fertility control, sexual education, and maternal care.

there is great debate on its key proposal that the Philippine government and the private sector will fund and undertake widespread distribution of family planning devices such as condoms, birth control pills(BCPs) and IUDs, as the government continues to disseminate information on their use through all health care centers.

On October 2012, a revised version of the legislation was renamed the Responsible Parenthood Act and was filed in the House of Representatives as a result of re-introducing the bill under a different impression after overwhelming opposition in the country, especially from the Catholic Bishops' Conference of the Philippines.

The law is highly divisive and controversial, with experts, academics, religious institutions, and major political figures supporting and opposing it, often criticizing the government and each other in the process. Debates and rallies proposing and opposing the bills, with tens of thousands of opposition particularly those endorsed by the bishops of the Roman Catholic Church and various other conservative groups, have been happening nationwide.

Summary of Major Provisions

The bill mandates the government to promote, without bias, all effective natural and modern methods of family planning that are medically safe and legal.
Although abortion is recognized as illegal and punishable by law, the bill states that the government shall ensure that all women needing care for postabortion complications shall be treated and counseled in a humane, nonjudgmental and compassionate manner

 The bill calls for a multi-dimensional approach integrates a component of family planning and responsible parenthood into all government antipoverty programs

Under the bill, age-appropriate reproductive health and sexuality education is required from grade five to fourth year high school using lifeskills and other approaches
The bill also mandates the Department of Labor and Employment to guarantee the reproductive health rights of its female employees. Companies with less than 200 workers are required to enter into partnership with health care providers in their area for the delivery of reproductive health services

 Employers with more than 200 employees shall provide reproductive health services to all employees in their own respective health facilities. Those with less than 200 workers shall enter into partnerships with health professionals for the delivery of reproductive health services. Employers shall inform employees of the availability of family planning services. They are also obliged to monitor pregnant working employees among their workforce and ensure they are provided paid half-day prenatal medical leaves for each month of the pregnancy period that they are employed The national government and local governments will ensure the availability of reproductive health care services, including family planning and prenatal care Any person or public official who prohibits or restricts the delivery of legal and medically safe reproductive health care services will be meted penalty by imprisonment or a fine

REPRODUCTIVE HEALTH PROGRAMS

Philippines is one of the signatory country to the International Conference Plan of Action of Reproductive Health in Cairo in 1994.

To support the effective implementation of the program, the DOH issued AO 1-A s, 1998 establishing the implementation of the Philippine Reproductive Health which define the RH service package consisting of 10 elements that included Family Planning.

In order to strengthen reproductive health AO 43,s. 1999 was issued adopting reproductive health policy to integrate RH services in all health facilities as part of basic package of health services and thus ensuring a more efficient and effective referral system from primary to tertiary, public and private facilities.

In 2004, harmonization and integration of the various approaches and different efforts in relation to womens health and reproductive health, it came up with integrated Reproductive Health and Womens Health Framework with an overall goal of achieving Better Quality Life among Filipinos.

Its main objectives are:

Reducing maternal mortality rate Reducing child mortality rate Halting and reversing spread of HIV/AIDS Increasing access to reproductive health information and services

There are 10 elements very crucial on Reproductive Health. These are: 1. Family Planning

-Family Planning is the foremost interventions in attaining reproductive health. It allows couples to freely decide on the number and proper spacing of births. The horizontal approach to the RH program ensures that the client is given health care and services in a holistic manner thus making the patient a client-centered taking into consideration on particular needs.

2. Maternal and Child Health and Nutrition The goal of attaining the optimum Maternal and Child Health and Nutrition can be achieved through the use of safe and effective family planning methods. Proper birth spacing of three to five years will give the mother ample time to regain her health and to render proper care to her newborn and other older children. The risk of pregnancy can be avoided. Thus maternal, neonatal and infant morbidity can be reduced.

3.Prevention and Management of Reproductive Tract Infections including Sexually Transmitted Infections (STIs) and HIV/AIDS 4. Adolescent Reproductive Health (ARH) 5. Prevention and management of Abortion and its Complications 6. Prevention and Management of Breast and Reproductive Tract Cancers and Gynecological Conditions

7. Education and Counselling on Sexuality and Sexual Health Mens Reproductive Health (MRH) and Involvement

8. Violence against Women and Children

9. Prevention and Management of Infertility and Sexual Dysfunction

Essential Newborn Care

Profile/Rationale of the Health Program

The Child Survival Strategy published by the Department of Health has emphasized the need to strengthen health services of children throughout the stages. The neonatal period has been identified as one of the most crucial phase in the survival and development of the child.

Goals: To reduce neonatal mortality rates by 2/3 from 1990 levels

Objectives:
To provide evidence-based practices to ensure survival of the newborn from birth up to the first 28 days of life. To deliver time-bound core intervention in the immediate period after the delivery of the newborn.

 To strengthen health facility environment for breastfeeding initiation to take place and for breastfeeding to be continued from discharge up to 2 years of life. To provide appropriate and timely emergency newborn care to newborns in need of resuscitation.

To ensure access of newborns to affordable life-saving medicines to reduce deaths and morbidity from leading causes of newborn conditions.
To ensure inclusion of newborn care in the overall approach to the Maternal, Newborn, Child Health and Nutrition Strategy.

 ENC is a simple cost-effective newborn care intervention that can improve neonatal as well as maternal care.

it is an evidence-based intervention that a. emphasizes a core sequence of actions,performed methodically (step -by-step);

b. is organized so that essential time bound interventions are not interrupted; and c. fills a gap for a package of bundled interventions in a guideline format.

Essential Newborn Care (ENC)

The ENC Protocol is a step-by-step guide for health workers and medical practitioners issued by the Department of Health for implementation under Administrative Order 2009-0025.

What are these step-bystep interventions? Immediate drying

-Using a clean, dry cloth, thoroughly dry the baby, wiping the face, eyes, head, front and back, arms and legs.

Uninterrupted skin-to-skin contact

-Aside from the warmth and immediate bonding between mother and child, it has been found that early skin-to-skin contact contributes to a host of medical benefits such as the overall success of breastfeeding/colostrum feeding, stimulation of the mucosaassociated lymphoid tissue system, and colonization with maternal skin flora that can protect the newborn from sepsis and other infectious disease and hypoglycemia.

Proper cord clamping and cutting

-Waiting for up three minutes or until the pulsations stop is found to reduce to chances of anemia in full term and pre-term babies. Evidence also shows that delaying cord clamping has no significant impact on the mother.

Non-separation of the newborn from the mother for early breastfeeding initiation and roomingin -The earlier the baby breastfeeds, the lesser the risk of death. Keeping the baby latched on to the mother will not only benefit the baby (see skin-toskin contact) but will also prevent doing unnecessary procedures like putting the newborn on a cold surface for examination (thereby exposing the baby to hypothermia),

administering glucose water or formula and foot printing (which increases risk of contamination from ink pads) and washing (the WHO standard is to delay washing up to 6 hours; the vernix protects the newborn from infection). On the other hand, necessary actions such as eye care, vitamin K administration must be timed. Eye care must be done after the infant has located the mothers breast.

Administrative Order 20090025

The current state of newborn care needs urgent action. To this end, the Department of Health has issued Administrative Order 2009-0025 which outlines specific policies and principles for health care providers with regard the prescribed systematic implementation of interventions that address health risks known to lead to preventable neonatal deaths.

This AO is consistent with AO No. 2008-0029 on Implementing Health Reforms for Rapid Reduction of Maternal and Newborn Mortality and supports all DOH initiatives and programs for newborn and child health.

Unang Yakap Campaign In September 2000, the Philippines committed to the UN Millennium Declaration, targeting reduction of poverty, hunger and ill health in the country, including reduction of maternal, newborn and child mortality. The Philippines is currently "on track" to reach its Millennium Development Goal #4 target of reducing under-five mortality. However, some 40,000 Filipino newborns still die every year. Half of these newborns die in the first two days of life.

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