DOH HEALTH PROGRAMS

I.FAMILY AND COMMUNITY HEALTH CLUSTER

A. 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
  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

Partner Institutions
 Local Government Units
 Civil Society Organizations
 Non-Government Organizations
 Private Sector
 Faith-based Organizations
 Development Partners

Policies and Laws

1. Republic Act No. 10354: Responsible Parenthood and Reproductive Health Act of 2012 (RPRH
Law)
2. Executive Order No. 12, s. 2017: Attaining and Sustaining “Zero Unmet Need for Modern Family
Planning” Through the Strict Implementation of the Responsible Parenthood and Reproductive
Health Act, Providing Funds Therefor, and for other Purposes
3. Administrative Order 2017-0005: Guidelines in Achieving Desired Family Size through
Accelerated and Sustained Reduction in Unmet Need for Modern Family Planning Methods
4. Administrative Order 2016-0005: National Policy on the Minimum Initial Service Package
(MISP) for Sexual and Reproductive Health (SRH) in Emergencies and Disasters
5. Administrative Order 2017-0002: Guidelines on the Certification of Free Standing Family
Planning Clinics
6. Department Order 2017-0345: Guidelines on the Forecasting, Procurement, Allocation and
Distribution of Modern Family Planning Commodities
7. Administrative Order 2015-0006: Inclusion of Progestin Subdermal Implant as One of the
Modern Methods Recognized by the National Family Planning Program.
8. Administrative Order 2014-0042: Guidelines on the Implementation of Mobile Outreach Services
for Family Planning
9. Department Memorandum 2015-0384: Establishment of the Family Planning Logistics Hotline

Strategies, Action Points and Timeline

Apart from the routine means of FP service delivery, the National Family Planning Program also employs
the following main strategies to ensure universal access to FP:
1. FP Outreach Mission – this maximizes opportunities where clients are and FP services are
delivered down to the community level.
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

B. ORAL HEALTH PROGRAM

The two most common oral health diseases affecting the Filipinos are Dental Caries (tooth decay) and
Periodontal Diseases (gum diseases). Based on the 2018 National Survey on Oral Health, 72% Filipinos
are suffering from dental caries, while 50% have gum disease. These diseases may lead to chronic mouth
and facial pain, inability to eat, and even infections that may cause serious complications.

As such, this program aims to:

1. reduce risk factors by promoting good oral hygiene and the negative effects of too much sugar;
2. to increase by 25% of population using fluoride toothpastes on a daily basis by 2021;
3. to achieve 70% coverage of public elementary schools and daycare centers implementing the
WinS/EHCP by 2021 and;
4. to attain at least 50% of the population with expressed needs to have access to Basic Oral Health
Care by 2021.

Vision
Empowered and responsible Filipino citizens taking care of their own personal oral health for an
enhanced quality of life.

Mission
The state shall ensure quality, affordable, accessible and available oral health care delivery.

Goal:

Attainment of improved quality of life through promotion of oral health and quality oral health care.

FREQUENTLY ASKED QUESTIONS

Why is oral health important?
Oral Health is fundamental to overall health, well-being and quality of life. A healthy mouth enables
people to eat, speak and socialize without pain, discomfort or embarrassment.
Pain from untreated dental diseases can lead to eating, sleeping, speaking, and learning problems in
children and adolescents, which affect child’s social interactions, school achievement, general health, and
quality of life. Rampant dental caries in children adversely affect the overall nutrition necessary for the
growth of the body specifically body weight and height. That begins with the first bite and chewing the
food efficiently.

What are the most common oral health illnesses of the Filipinos?
Dental Caries (tooth decay) and Periodontal Diseases (gum diseases) are the two most common oral
health diseases affecting the Filipinos. 87.4 % Filipinos are suffering from dental caries while 48.3 % has
gum disease (based on the 2011 National Monitoring and Evaluation Dental Survey).

How do we prevent these two dental diseases from occurring?

There are many ways these two most common dental diseases can be prevented. Dental caries can be
prevented through…
 regular visits to the dentist for early diagnosis and preventive care;
 professionally applied fluorides & sealants;
  well balanced diet;
 minimize eating sugary foods and
 good plaque control through regular toothbrushing and flossing.
Gum diseases can be prevented through…
 regular visits to the dentist for early detection and treatment;
 regular and proper toothbrushing and
 healthy lifestyle such as avoidance of tobacco smoking, drugs & excessive alcohol-intake
How can one avail of the services?
 The services of the DOH and the LGUs can be availed at the Rural Health Units (RHUs), urban
health centers, districts and provincial/city hospitals.
 For Pregnant women, you must visit the dentist during your pre-natal check-ups.
 DepEd Services can be availed in the school health clinics during school health days.

ORAL HEALTH SERVICES

1. 0-11 months (infants)
 0-8 months - Oral Examination, Instruction on infant’s oral health care, Advice on exclusive
breastfeeding
 9-11 months - same as above and topical fluoride application
2. 1-4 years old (11-59 months old children)
 Oral examination
 Topical Fluoride Application
 Supervised Tooth Brushing
 Oral Health Education
 Atraumatic Restorative Treatment (ART)
 Oral prophylaxis/scaling
3. 5-9 years old (school-aged children)
 Oral examination
 Supervised Toothbrushing
 Oral Health Education
 Pits and Fissure Sealant
 Temporary filling
 Permanent filling
4. 10-19 years old (adolescents)
 Oral examination
 Education and counselling on good oral hygiene, diet and adverse effects of tobacco/smoking and
alcohol and sweetened beverages & food
 Pit and fissure sealant application
 Temporary filling
 Permanent filling
 Oral prophylaxis/scaling
 Oral Urgent Treatment (OUT)
5. 20-59 years old (adults)
 Oral Examination
  Education and counseling on good oral hygiene, diet and adverse effects of tobacco/smoking and
alcohol and sweetened beverages & food
 Gum Treatment
 Oral prophylaxis/scaling
 Permanent filling
 Atraumatic Restorative Treatment (ART)
6. 60 years old and above (senior citizens)
 Oral Examination
 Education and counselling on good oral hygiene, diet and adverse effects of tobacco/smoking and
alcohol and sweetened beverages & food
 Oral Urgent Treatment (OUT): relief of pain, extraction of unsavable teeth and referral of
complicated cases to higher level
7. Pregnant women
 Oral examination
 Education and counselling on good oral hygiene, diet and adverse effects of tobacco/smoking and
alcohol and sweetened beverages & food
 Oral prophylaxis/scaling
 Gum treatment
 Temporary filling
 Permanent filling

The National Immunization Program, which was then known as Expanded Program for Immunization,
was launched by the Philippine government on July 12, 1976 with the assistance of World Health
Organization

C. NATIONAL IMMUNIZATION PROGRAM

(WHO) and the United Nations Children’s Fund (UNICEF) to ensure that infants/children and mothers
have access to routinely recommended infant/childhood vaccines. This program primarily aims to reduce
the morbidity and mortality among children against the most common vaccine-preventable diseases
(VPDs) which includes tuberculosis, poliomyelitis, diphtheria, tetanus, pertussis and measles. To date, the
Expanded Program on Immunization provides safe and effective vaccines against VPDs for newborns,
infants, older children, pregnant, and senior citizens.

Vision
Enabled and strong immunization system for everyone, everywhere at every age to attain a vaccine-
preventable disease-free and a healthier Philippines.

Mission
Guided by the Universal Health Care Law, the program commits to ensure that every Filipino is fully
immunized from vaccine-preventable diseases by building a strong and well-supported immunization
system that is equipped for routine immunization service delivery and backed with contingencies for and
response to public health crises related to VPDs, vaccines and immunization programs.
Program Objectives/Goals:
Over-all Goal:
To reduce the morbidity and mortality among children against the most common vaccine-preventable
diseases.

Specific Goals:
1. Strengthen immunization services within the primary health care and eventually contribute to
universal health coverage and sustainable development.
2. Leave no one behind by expanding equitable protection with vaccination for all ages.
3. Reduce mortality and morbidity by proactively preventing outbreaks of VPDs and providing
timely response to outbreak and other potential health crises related to immunization.
4. Effectively communicate and address hesitancies and misinformation regarding immunization.

Mandates:
Republic Act No. 10152“MandatoryInfants and Children Health Immunization Act of 2011Signed 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.

Strategies:
 Conduct of Routine Immunization for Infants/Children/Women through the Reaching
Every Barangay (REB) strategy
REB strategy, an adaptation of the WHO-UNICEF Reaching Every District (RED), was introduced in
2004 aimed to improve the access to routine immunization and reduce drop-outs. There are 5
components of the strategy, namely: data analysis for action, re-establish outreach services, ,
strengthen links between the community and service, supportive supervision and maximizing
resources.

 Supplemental Immunization Activity (SIA)

Supplementary immunization activities are used to reach children who have not been vaccinated or
have not developed sufficient immunity after previous vaccinations. It can be conducted either
national or sub-national –in selected areas.

 Strengthening Vaccine-Preventable Diseases Surveillance

This is critical for the eradication/elimination efforts, especially in identifying true cases of measles
and indigenous wild polio virus

 Procurement of adequate and potent vaccines and needles and syringes to all health facilities
nationwide

D. NATIONAL VOLUNTARY BLOOD SERVICES PROGRAM

Republic Act No. 7719, also known as the National Blood Services Act of 1994, promotes voluntary
blood donation to provide sufficient supply of safe blood and to regulate blood banks. This act aims to
inculcate public awareness that blood donation is a humanitarian act.

The National Voluntary Blood Services Program (NVBSP) of the Department of Health is targeting the
youth as volunteers in its blood donation program this year. In accordance with RA No. 7719, it aims to
create public consciousness on the importance of blood donation in saving the lives of millions of
Filipinos.

Based from the data from the National Voluntary Blood Services Program, a total of 654,763 blood units
were collected in 2009. Fifty-eight percent of which was from voluntary blood donation and the
remaining from replacement donation. This year, particular provinces have already achieved 100%
voluntary blood donation. The DOH is hoping that many individuals will become regular voluntary
unpaid donors to guarantee sufficient supply of safe blood and to meet national blood necessities.

Mission:
 Blood Safety
 Blood Adequacy
 Rational Blood Use
 Efficiency of Blood Services

Goals:
The National Voluntary Blood Services Program (NVBSP) aims to achieve the following:
1. Development of a fully voluntary blood donation system;
2. Strengthening of a nationally coordinated network of BSF to increase efficiency by centralized
testing and processing of blood;
3. Implementation of a quality management system including of Good Manufacturing Practice
GMP and Management Information System (MIS);
4. Attainment of maximum utilization of blood through rational use of blood products and
component therapy; and
5. Development of a sound, viable sustainable management and funding for the nationally
coordinated blood network.

E. NATIONAL NUTRITION PROGRAM

Component 1: INFANT & YOUNG CHILD FEEDING

I. Profile/Rationale of the Health Program

A global strategy for Infant and Young Child Feeding (IYCF) was issued jointly by the World Health
Organization (WHO) and the United Nations Children’s Fund (UNICEF) in 2002, to reverse the
disturbing trends in infant and young child feeding practices. This global strategy was endorsed by the
55th World Health Assembly in May 2002 and by the UNICEF Executive Board in September 2002
respectively.
In 2004, infant and young child feeding practices were assessed using the WHO assessment protocol and
rated poor to fair. Findings showed four out of ten newborns were initiated to breastfeeding within an
hour after birth, three out of ten infants less than six months were exclusively breastfed and the median
duration of breastfeeding was only thirteen months. The complementary feeding indicator was also rated
as poor since only 57.9 percent of 6-9 months children received complementary foods while continuing to
breastfed. The assessment also found out that complementary foods were introduced too early, at the age
of less than two months. These poor practices needed urgent action and aggressive sustained
interventions.

To address these problems on infant and young child feeding practices, the first National IYCF Plan of
Action was formulated. It aimed to improve the nutritional status and health of children especially the
under-three and consequently reduce infant and under-five mortality. Specifically, its objectives were to
improve, protect and promote infant and young child feeding practices, increase political commitment at
all levels, provide a supportive environment and ensure its sustainability. Figure 1 shows the identified
key objectives, supportive strategies and key interventions to guide the overall implementation and
evaluation of the 2005-2010 Plan of Action. The main efforts were directed towards creating a supportive
environment for appropriate IYCF practices. The approval of the National Plan of Action in 2005 helped
the Department of Health (DOH) and its partners, in the development of the first (1st) National Policy on
Infant and Young Child Feeding. Thus on May 23, 2005, Administrative Order (AO) 2005-0014:
National Policies on IYCF was signed and endorsed by the Secretary of Health. The policy was intended
to guide health workers and other concerned parties in ensuring the protection, promotion and support of
exclusive breastfeeding and adequate and appropriate complementary feeding with continued
breastfeeding. (1)

GUIDING PRINCIPLES
The IYCF Strategic Plan of Action upholds the following guiding principles:
1. Children have the right to adequate nutrition and access to safe and nutritious food, and both are
essential for fulfilling their right to the highest attainable standard of health. (5)
2. Mothers and Infants form a biological and social unit and improved IYCF begins with ensuring the
health and nutritional status of women. (5)
3. Almost every woman can breastfeed provided they have accurate information and support from
their families, communities and responsible health and non-health related institutions during critical
settings and various circumstances including special and emergency situations.(5)
4. The national and local government, development partners, non-government organizations, business
sectors, professional groups, academe and other stakeholders acknowledges their responsibilities
and form alliances and partnerships for improving IYCF with no conflict of interest.
5. Strengthened communication approaches focusing on behavioral and social change is essential for
demand generation and community empowerment.

GOAL:
Reduction of child mortality and morbidity through optimal feeding of infants and young children

MAIN OBJECTIVE:
To ensure and accelerate the promotion, protection and support of good IYCF practice

STRATEGIES, PILLARS AND ACTION POINTS

STRATEGY1: Partnerships with NGOsand GOs in the coordination and implementation of the IYCF
Program
1.1 Formalize partnerships with GOs and NGOs working on IYCF program coordination and
implementation
a. Strengthen the TWG to allow it to effectively coordinate the GOs and NGOs working for the IYCF
Program
The national TWG will remain but will be strengthened. It shall be constituted by: NCDPC as Chair,
FHO as secretariat and representatives from NCDPC,FHO, NCHP, FDA, DJFMH, DSWD,CWC,
NNC, ILO, WHO and UNICEF. This time, members of the TWG will be tasked to focus participation to
the intervention setting where it is most relevant.
The TWG shall be reporting regularly to the Service Delivery Cluster Head. At the Regional level,
the Regional Coordinators from the above offices shall collaborate in the implementation of the
IYCF Program. To ensure that GO and NGO IYCF partners work together, the composition of the
TWGs and AD Hoc committees shall be made up of representatives from the government and non-
government sectors and the Ad Hoc Committees shall be chaired by the relevant agency where the
intervention setting belongs.
At the provincial, municipal and barangay levels the existing Coordinating Committees which
has an interagency composition shall be the coordinating arm of the IYCF Program. This is where the
participation of non-government entities will be facilitated. Mechanisms for coordination shall be
devised to build a strong foundation for partnership between the LGU, the Coordinating Committees and
local NGOs or private entities.

A memorandum of agreement (MOA) shall be executed between DOH and other agencies invited to
become members of the TWG.

b. Organize functional Intervention Setting Committees (this is the same as the ad-hoc committee)

The years covered by this action plan will be marked with many developmental activities in
all the intervention settings. The TWG shall create a committee for each of the intervention setting.
The committees shall be chaired by the relevant agency/ office. Other government and non-government
agencies will be invited to the committees relevant to their mandate.

c. Return the MBFHI responsibility from NCHFD to NCDPC

The National Policy on IYCF created in 2005 has affirmed the MBFHI responsibility to NCHFD. Since
MBFHI is now under the umbrella of the IYCF Program, it is in a better position to consolidate efforts
towards MBFHI compliance. Thus the return of the MBFHI responsibility from NCHFD to NCDPC shall
be pursued. The collaboration of NCHFD is still needed though as it has a direct hand on health facility
development. At NCDPC the integration of IYCF in the MNCHN Action Plan shall be worked out in all
aspects of the program and at the different levels of implementation.
d. Augment human resource complement of NCDPC- FHO, IYCF program

NCDPC-FHO as the secretariat of the TWG and supervising and supporting the IYCF Program will
not be able to effectively carry out the technical, management and administrative roles and
responsibilities without additional human resource. Funds shall be allotted for job orders for this purpose.

e. Programmed contracting out of activities to organizations outside of DOH

To achieve the objectives and targets of the IYCF program, it shall be implemented
simultaneously in the different intervention settings and at a faster pace. This is a gargantuan task
considering the extent of the developmental work, the management requirements, and the
mobilization of the IYCF network and the sourcing of funds for implementation.

Organizations and consultants that possess the expertise and the commitment to the IYCF program
will be contracted out for complex activities that require time and effort beyond the capacity of the
TWG and the Ad Hoc committees. These contracts shall be arranged based on need and awarded based
on merit.

STRATEGY 2: Integration of key IYCF action points in the MNCHN Plan of Action/Strategy

2.1 Institutionalize the IYCF monitoring and tracking system for national, regional and LGU levels

a. Institutionalize the collection of PIR Data and generate annual performance report

The established IYCF data set that are being collected during PIRs shall be further reviewed, revised as
appropriate and institutionalized through a Department Circular and in collaboration with the other
programs in the FHO.

An IYCF Program annual performance report shall be generated at the end of every year based on
the PIR data, the consolidated data from the unified monitoring and related data coming from research
and studies as appropriate. Reports on the performance of developmental activities shall be collected
as part of the data base and to be reported as needed to the Service Delivery Cluster Head.

b. Maximize the use of the unified monitoring tool

The CHDs through its Regional Coordinators shall be required to use and consolidate the unified
monitoring tool. A simple data management program shall be developed to facilitate the
consolidation of data extracted from monitoring. Reports shall be required two weeks after the end of
every quarter.

c. Collaborate with the National Epidemiology Center (NEC) and Information Management Service
(IMS) regarding IYCF data
The current records and reports being collected by the DOH Field Health Information System will
remain as the main source of data from health facilities. However, collaboration with NEC and IMS
to improve data quality and include data on complementary feeding is essential.

2.2 Participation of the IYCF Focal person in MNCHN planning and monitoring activities

a. Designate the IYCF Focal Person as a regular member of the team working for the
development and implementation of the MNCHN Strategy

The IYCF Focal Person shall ensure that the IYCF action points become an agenda of the
MNCHN Strategy and thus ultimately the IYCF services forms a part of the integrated services for
mothers and children. In the MNCHN planning and monitoring, the IYCF Focal Person shall help
ensure that in the multitude of activities, critical IYCF action points and indicators are not overlooked.

STRATEGY 3: Harnessing the executive arm of government to implement and enforce the IYCF related
legislations and regulations (EO 51, RA 7200 and RA 10028)

3.1 Consultation mechanism with the IAC and DOJ for the enforcement of the Milk Code and with other
relevant GOs for other IYCF related legislations and regulations

a. Devise and implement a consultation mechanism to bring together the IAC, DOJ and other relevant
GOs for IYCF related legislations and regulations

The Committee for Industry Regulation shall devise and implement a consultation mechanism to
facilitate the implementation and enforcement of IYCF related laws and regulations. This will require
participation of higher levels of authority in the GOs.

The goal of the consultation mechanisms is to develop activities that will focus on facilitating the
process of monitoring of compliance and enforcement of IYCF related laws and regulations not only
at the national level but also at regional and local levels and in the five IYCF intervention settings.

3.2 Support Civil Society in the implementation and enforcement of IYCF related laws and regulations

a. Institutionalize enforcement of MBFHI compliance in the regulatory function of the DOH

The inclusion of the MBFHI requirements in the unified licensing/accreditation benchmarks of the
BHFS and the Licensing Offices shall be pursued more vigorously in collaboration with BHFS and the
Licensing offices of the CHDs. These offices are in a better position to enforce compliance in relation
to their regulatory function and in their power to promulgate penalties for violations.
b. Review and improve the processing of reports on violations on the Milk Code

The handling of reports on violations shall be reviewed for thoroughness and timeliness from the time a
report is submitted up to the final decision rendered on a case. Problematic areas and bottlenecks shall
be identified and threshed out. Measures to ensure that all reports on violations are acted upon shall be
devised.

To ensure speedy resolution of cases, it is necessary to set deadlines on the processing of reports on
violations.

c. Invite the Professional Regulatory Board as a resource agency of the IAC

Apart from companies who are actively marketing breastmilk substitutes, health professionals who
have direct access and influence on pregnant and postpartum women are also among the most common
violators of the law. The PRC as the legal authority that regulates the practice of the medical and allied
professions can contribute to the development and enforcement of the IAC’s regulatory function.

d. Augment human resource of FDA as secretariat of the IAC

The current load of violations cases being processed and the fulfillment of other responsibilities with
regards to the Milk Code at FDA require a full time legal officer who will also assist the CHDs.
Furthermore, the strengthened monitoring of compliance to the Milk Code will result in a surge on
violation reports. FDA should be prepared to process such reports. An additional full time legal officer
and an administrative/ clerical staff is required to facilitate and help speed up the process.

e. Engage professional societies to come-up with measures for self monitoring and regulation

Monitoring of overt advertisements and marketing of breast milk substitutes is a persistent

challenge. Monitoring of compliance to the Milk Code among health workers and medical and allied
professional organizations is much more difficult. Promotion of breast milk substitutes is more
personal and concealed.

The medical and allied professional societies are strong and active bodies that foster organizational
development and discipline among its members. An advocating stance over a punitive approach
may be the more prudent initial approach in this environment. There will be dialogue, negotiations and
forging of agreements to push the Milk Code and other policies on IYCF. The professional societies will
be engaged to participate in the development of the monitoring scheme within their ranks and in health
facilities. They are a good resource in the development of schemes for MBFHI and related technical
matters. Working arrangements/contracts may be forged to seal responsibilities and partnerships.
Representatives from the professional societies will constitute the Speaker’s Bureau which will be
organized for the information dissemination/awareness campaign on the Milk Code, the Expanded
Breastfeeding Promotion Act and the Policies on IYCF.

STRATEGY 4: Intensified focused activities to create an environment supportive to IYCF practices

4.1 Modeling the MBF system in the key intervention settings in selected regions

a. Set up Models of MBFHI and MNCHN implementation in key strategic hospitals and referral
networks

Regional Hospitals and selected private hospitals shall be developed as models of MBFHI and
MNCHN implementation to help create an impact and to serve as showcases for other health facilities.

If these hospitals are currently training facilities for obstetrics and pediatrics residency program,
the MBFHI environment will certainly add value to the training.

An itinerant team will facilitate the development of the hospital models. The team will be composed of
an Obstetrician with training/background on MNCHN, Pediatrician with training/background on
Lactation Management/Essential Newborn Care, Nurse trainer for breastfeeding counseling, Senior
IYCF Program person with administrative background who can deal with arrangements and
coordination with hospitals and local governments and who can be a trainer and an administrative
assistant who will facilitate administrative matters. The team will facilitate the activities leading to the
organization and maintenance of the MBFHI in the hospitals. This shall include planning, setting up
of operational details and physical structures when needed, training/coaching of personnel, keeping
records and completing reports and self assessment.

Regional hospitals shall be developed for IYCF capacity building. Trainings at Regional Hospitals
shall be conducted in collaboration with the CHDs. This is so that training is de-centralized and
monitoring and evaluation can be done more frequently at the provincial and municipal levels.

b. Establish protocols/standards on how to set-up and maintain MBF workplaces and integrated in
the standards for healthy workplace

The IYCF Program shall focus on the enforcement of the Expanded Breastfeeding Promotion Act of 2009
which mandates workplaces to establish lactation stations and/or grant breastfeeding breaks. Guidelines
for the establishment and maintenance of MBF workplace shall be developed. It will learn from
lessons of already established and successful MBF workplace. In as much as standards for the healthy
workplace are already established, the MBF guidelines shall be integrated into those standards.

The establishment of MBF workplaces initiated in factories shall be scaled up and efforts shall be
expanded to include government and private offices in line with Expanded Breasfeeding Act. The current
collaboration partners in the workplace setting may also need to be expanded to promote the
establishment of the MBF workplace in government and private offices. With the multitude of
workplaces scattered throughout the country, the expansion may require outsourcing of organizations to
continue the MBF workplace efforts.

c. Enhance the primary, secondary and tertiary education curricula on IYCF

The enhancement of the primary, secondary and tertiary education curricula on IYCF shall be
pursued. If necessary, a review of the curriculum will be done prior to the enhancement. Apart from the
curriculum enhancement, training materials, books and teachers’ guide shall also be updated.

The initial collaboration for the enhancement of the primary, secondary and tertiary education
curricula shall take place at the central office of DepEd (Bureau of Elementary Education and Bureau
of Secondary Education) and TESDA. The enhanced curriculum, training materials, books and teacher’s
guide shall be field tested province-wide in three selected provinces, evaluated and further enhanced
before a national implementation.

d. Develop policy on IYCF in emergencies (IFE) and guidelines on the management of

malnutrition, and IYCF in special medical conditions for the community

A clear policy on IYCF is necessary to allow the program to define the guidelines that can be easily
followed by GOs, NGOs and LGUs once such situations arise. The policy/guidelines shall address
among others the issue of milk donations. Guidelines on the Community Management of Malnutrition,
IYCF in special medical conditions such as errors of metabolism or HIV positive mothers shall also be
developed for implementation.

Camp managers and organized local nutrition clusters shall be oriented on the IFE guidelines.

Disaster prone areas will be prioritized in the orientation. Training/orientation shall be a collaborative
effort between the IYCF Program, HEMS and the NDCC.

4.2 Creation of a Regional and National incentive and awarding systems for the most outstanding IYCF
champions in the different sectors of society

a. Review and update the existing awarding system

The current awarding system shall be reviewed. The search protocol shall be further refined to allow a
wider search. The organization of the search committees in the local and national levels shall be
formalized. Funds for the awards shall be ensured.

b. Establish a recognition system for health facilities complying with EO51, RA10028 and the
MBFHI National Policy
Set up an annual recognition system for facilities, establishments complying with relevant IYCF
legislations and regulations. The benefits provided for by the Milk Code to compliant health facilities
shall be reviewed and improved/established parallel with the development of the incentive scheme for the
Expanded Breastfeeding Promotion Act. Procedures for claiming benefits shall be established and
made accessible in collaboration with PhilHealth, BIR and other relevant government offices.

4.3 Allocate/Raise /Seek resources for IYCF Research activities that document best practices in the
Philippines

a. Carry out an inventory of best practices on IYCF Identify best IYCF practices by allowing every
province
in the country to identify exemplary or creative activities
on IYCF that boosted program services/performance. Validate the reports through CHDs and select the
best practices for documentation and publication.

b. Allocate resources and conduct IYCF related researches focusing on the documentation and measure
of impact of noble experiences and interventions

The documentation of IYCF best practices is considered a critical area that allows the development of
models/ references for appropriate IYCF protocols and guidelines for implementation. Field
personnel who are able to establish and provide successful models of IYCF services are often deficient in
resources and skills to document the efforts. Resources to conduct IYCF related researchers, focusing
on the documentation and measure of impact of noble experiences and interventions, will have to be
allocated.

STRATEGY 5: Engaging the Private Sector and International Organizations to raise funds for the
scaling up and support of the IYCF program

5.2 Setting up of a fund raising mechanism for IYCF with the participation of International
Organizations and the Private Sector

a. Set-up the fund raising mechanism

The development and sustainability of IYCF activities partly depends on the availability of resources. At
the national level, where many developmental activities will take place, the regular sources of
funds are not sufficient. At the local levels, the poorer more problematic areas have the least resources to
promote, protect and support good IYCF practices. It is critical for the IYCF Program to determine
and actively source budgetary and other resource requirements. The availability of resources will
guide the scale and prioritization of IYCF activities in the annual operational planning.
To augment the funds for the IYCF program, a funding mechanism/body that will serve as a fund raising
arm for the elimination of child malnutrition shall be established.

The effort should be able to explore and proceed with the development of a funding mechanism
that can encourage public-private partnership and ensure resources to initiate and sustain critical
interventions nationwide. The arena of fund raising is not within the expertise of DOH, and it will be
important to discuss with the international and national partners on the most suitable mechanism that
can help attain such important goal.

PILLAR 1: Capacity Building

Capacity building shall take different forms and intensity in accordance to the requirement of the
intervention settings.

In health facilities, training on Lactation Management and Counseling shall continue. A system for
regular in- service or refresher training to address the fast turnover of health staff in hospitals and to
provide necessary program updates shall be put in place. Staggered training and self- enforcing programs
may also be devised to improve access to training when warranted. Periodic evaluation shall be
incorporated into the system to ensure effectiveness and efficiency of the trainings.

The Milk Code monitors at FDA, CHDs and local levels shall be trained on the latest guidelines to help
ensure that provisions on regulation and enforcement in the RIRR of the Milk Code are closely adhered
to. The monitors should be prepared to handle incidents of actual violation of the code during
inspection/monitoring. The local monitors shall be equipped with user friendly monitoring tools.

The competencies of teachers and administrators to teach the new IYCF updated curriculum and to
appreciate the importance of MBF environment shall be enhanced. A training/seminar program on
IYCF for teachers/ administrators will be developed. A core of teacher trainers in every region will be
developed and organized to conduct the training/seminars nationwide.

COMPONENT 2: FOOD FORTIFICATION PROGRAM

Objectives:
1. To provide the basis for the need for a   food fortification program in the   Philippines: The
Micronutrient   Malnutrition Problem
2.   To discuss various types of  food fortification strategies
3.   To provide an update on the current   situation of food fortification in the   Philippines

Fortification as defined by Codex Alimentarius

“the addition of one or more essential nutrients to food, whether or not it is normally contained in the
food, for the purpose of preventing or correcting a demonstrated deficiencyof one or more nutrients in the
population or specific population groups”

Vitamin A, Vitamin A Deficiency (VAD) and its Consequences

 Vitamin A - an essential nutrient as retinol needed by the body for normal sight, growth,
reproduction and immune competence
 Vitamin A deficiency - a condition characterized by depleted liver stores & low blood levels of
vitamin A due to prolonged insufficient dietary intake of vit. A followed by poor absorption or
utilization of vit. A in the body
 VAD affects children’s  proper  growth,   resistance    to  infection, and chances of survival (23
to 35% increased child mortality), severe deficiency results to blindness, night blindness and
bitot’s spot

Iron and Iron Deficiency Anemia (IDA) and its consequences 

 Iron - an essential mineral and is part of hemoglobin, the red protein in red blood cells that
carries oxygen from the lungs to the cells
 Iron Deficiency Anemia - condition where there is lack of iron in the body resulting to low
hemoglobin concentration of the blood
 IDA results in premature delivery, increased maternal mortality, reduce ability to fight  infection
and transmittable diseases and low productivity 

Prevalence of anemia by age, sex and physiologic state: Philippines, 2008

Iodine and Iodine Deficiency Disorders (IDD) 

 Iodine -a mineral and a component of the thyroid hormones
 Thyroid hormones - needed for the brain and nervous system to develop & function normally
 Iodine Deficiency Disorders refers to a group of clinical entities caused by inadequacy of
dietary iodine for the thyroid hormone resulting into various condition e.g. goiter, cretinism,
mental retardation, loss of IQ points

Policy on Food Fortification

 ASIN LAW
Republic Act 8172, “An Act Promoting Salt Iodization Nationwide and for other purposes”, Signed
into law on Dec. 20, 1995

 Food Fortification Law

Republic Act 8976, “An Act Establishing the Philippine Food Fortification Program and for other
purposes” mandating fortification of flour, oil and sugar with Vitamin A and flour and rice with iron by
November 7, 2004 and promoting voluntary fortification through the SPSP, Signed into law on
November 7, 2000
 
COMPONENT 3: EARLY CHILDHOOD CARE DEVELOPMENT PROGRAM
Early childhood refers to the foundational stage of child development. It is characterized by immense
development in physical-motor, cognitive, language, and socio-emotional realms from a mother’s
pregnancy through to the age of 3 of the child. These developmental effects last the rest of childhood, and
on into adolescence and adulthood. The Early Childhood Care Development (ECCD) system is a
comprehensive, integrated and multi-sectoral approach centered on providing children with nurturing
care. This program facilitates access to health services from pregnancy to 35 months old to promote the
physical growth and development of the child. It also includes providing responsive caregiving,
opportunities for early learning, and child’s safety and security to enhance holistic development of young
children.

COMPONENT 4: MICRONUTRIENT PROGRAM

The high prevalence of malnutrition is a significant problem that the country still faces. Micronutrient
deficiencies, which is the primary cause of malnutrition, are known to cause intergenerational
consequences especially to young children. Factors such as maternal nutrition and access to healthcare
before, during, and after pregnancy critically affect the growth and development of their children.
Moreover, the first years of their infants are crucial in creating strong health foundations. Hence, this
program aims to provide supplementation and nutrition programs for pregnant mothers, infants, and
children to reduce the prevalence of micronutrient deficiencies below public health significance.

Micronutrient deficiencies can cause inter-generational consequences. The level of health care and
nutrition that women receive before and during pregnancy, at childbirth and immediately post-partum has
significant bearing on the survival, growth and development of their fetus and newborn. Undernourished
babies tend to grow into undernourished adolescents. When undernourished adolescents become
pregnant, they in turn, may give birth to low-birth weight infants with greater risk of multiple
micronutrient deficiencies.

Micronutrient deficiencies have considerable impact on economic productivity, growth and national
development. Widespread iron deficiency is estimated to decrease the gross domestic product (GDP) by
as much as 2% per year in the worst affected countries. Conservatively, this translates into a loss of about
Php 172 per capita or 0.9% of GDP. Productivity losses for anemic manual laborers have been
documented to be as high as 9% for severely stunted workers and 5% and 17% for workers engaged in
moderate and heavy physical labor respectively (Micronutrient Supplementation Manual of Operations)

Vision:
Empowered healthy and well-nourished Filipino families

Mission:
DOH and partners to align their strategic actions and exert collective and unified efforts to create a
supportive environment for a sustainable and improved nutrition development

Goal:
Achievement of better health outcomes, sustained health financing and responsive health system
by ensuring that all Filipinos especially the disadvantaged group (lowest 2 income quantiles) have
equitable access to affordable health care.

Objectives:
 1. Contribute to the reduction of disparities related to nutrition through a focus on population groups
and areas highly affected or at risk to malnutrition
2. To provide vitamin A capsules, iron and iodine supplements to treat or prevent specific
micronutrient deficiencies
3. Go to scale with key interventions on micronutrient supplementation, food fortification, salt
iodization and nutrient education.
4. Revive, identify, document and adopt good practices and models for nutrition improvement.
5. Build Nutrition human resource in relevant departments/ agencies. 

Policies and Laws

Administrative Order No. 2010-0010(Revised Policy on Micronutrient Supplementation to Support
Achievement of 2015 MDG Targets to Reduce Under-Five and Maternal Deaths and Address
Micronutrient Needs of Other Population Groups)

E. 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
Partner Institutions
o Local Government Units
o Development Partners

Policies and Laws

Republic Act No. 10354: Responsible Parenthood and Reproductive Health Law (RPRH Act of 2012)
1. Administrative Order 2008-0029: Implementing Health Reforms to Rapidly Reduce Maternal and
Neonatal Mortality
2. Department Order 2009-0084: Guidelines Governing the Payment of Training Fees relative to the
Attendance of Health Workers to Basic Emergency Obstetric and Newborn Care Skills Training
Course at Duly Designated Training Centers
3. Administrative Order 2011-0011: Establishment of Basic Emergency Obstetric and Newborn Care
Training Centers in Regional Hospitals and Medical Centers
4. Administrative Order 2015-0020: Guidelines in the Administration of Life Saving Drugs During
Maternal Care Emergencies by Nurses and Midwives in Birthing Centers
 5. Administrative Order 2016-0035: Guidelines on the Provision of Quality Antenatal Care in All
Birthing Centers and Health Facilities Providing Maternity Care Services
6. Administrative Order 2018-0003: National Policy on the Prevention of Illegal and Unsafe
Abortion and Management of Post-Abortion Complications

Program Accomplishments/Status
The Department of Health through the National Safe Motherhood Program shall continue to update its
strategies to address critical reproductive health concerns including control of sexually transmitted
infections and mother to child transmission of HIV while confronting both demand and supply side
obstacles to access for disadvantaged women including indigenous women of reproductive age. Among
the changes, the following have been systematically mainstreamed into the safe motherhood service
delivery network (BEmONC-CEmONC network):

A. Strategic Change in the Design of Safe Motherhood Services

These changes involve (1) a shift in emphasis from the risk approach that identifies high-risk
pregnancies during the prenatal period to an approach that prepares all pregnant for the complications at
childbirth – this change brought about the establishment the BEmONC – CEmONC network within the
bigger Service Delivery Network (SDN), (2) improved quality of FP counseling and expanded service
availability of post-partum family planning in hospitals and primary birthing centers and (3) the
integration of  cervical cancer, syphilis, hepatitis B and HIV screening among others into the antenatal
care protocols.
o Action Point and Timelines:
o Continuous advocacy on:
o Importance of ANC and Facility Delivery is on-going at LGU level;
o National and regional advocacy every 2nd week of May, the safe Motherhood week
with support from the Health Promotion and Communication Service
o Continuous implementation of policies passed at LGU Health Systems
o Implementation of AO 2016-0035 on the Provision of Quality Antenatal Care
o On-going
o Distribution of ANC Tarpaulin within the last quarter of 2018
o Distribution of ANC Policy Implementation Manual by 2019

A. An Integrated Package of Women’s Health and Safe Motherhood Services

The above changes in service delivery also involved a shift from centrally controlled national programs
operating separately and governed independently at various levels of the health system to an LGU
governed system that delivers an integrated women’s health and safe motherhood service package.  This
service delivery strategy is focused on maximizing synergies among key services that influence maternal
and newborn health and on ensuring a continuum of care across levels of the referral system. At the
ground level, this implies that a woman, whatever her age and specially if she is disadvantaged, who
seeks care from a public health provider for reproductive health concerns, could expect to be given a
comprehensive array of services that addresses her most critical reproductive health needs.
o Action Points and Timelines
 o Culture and gender sensitive service delivery provision by LGU Health Systems is on-
going
o Updated AO 2008-0029 (MNCHN Policy) draft by last quarter of 2018
o The update involves the expansion of MNCHN to RMNCAHN (Reproductive
Maternal Newborn Child Adolescent Health and Nutrition)

C. Reliable Sustainable Support Systems

Support systems for Maternal-Newborn service delivery is anchored on Philhealth accreditation of
birthing centers and individual membership or enrolment into the Sponsored Program. This mechanism
ensures sustainable financing of quality maternal-newborn services efficiently eliminating out-of-pocket
expenditures for antenatal, facility delivery and postnatal care.  The system likewise includes systems
for safe blood supply and stakeholder behavior change, through a combination of advocacy and
interpersonal communication during clinic visits.
o Action Points and Timelines
o Continuous application and renewal of PhilHealth accreditation by Birthing Centers
o Continuous enrolment of poor families to PhilHealth Sponsored Program by LGUs
o Establishment of Safe Blood Supply Network in collaboration with the National Voluntary
Blood Services Program is on-going

D. Stronger Stewardship and Guidance from the DOH Program Manager and Regional
Coordinators
DOH provides stewardship and guidance through (1) evidence-based guidelines and protocols on
maternal - newborn services; (2) a system for recognizing providers of emergency obstetrics and newborn
care (BEmONC) training program; and (3) monitoring, evaluation and research on the new maternal-
newborn strategies.
o Action Points and Timelines
o Conduct of Maternal Death Surveillance and Response is on-going at Provincial and City
Health Systems is on-going
o Conduct of National MDSR Forum every 2 years. The second national forum shall
be conducted in 2019 (the first was conducted in 2017)
o Conduct of 4 Regional Maternal Death Surveillance and Response (MDSR) Fora
every 2 years (2018, 2020, etc)
o Drafting and passage of relevant policies with MDSR results as basis:
o National Policy on the Provision of Birthing Assistance of Primigravid and
Multigravid Women is targeted to commence implementation by 2019.
o Establishment of Safe Motherhood Program Monitoring and Evaluation System in collaboration
with Epidemiology Bureau and Health Policy Development and Planning Bureau by 2019

F. ENVIRONMENTAL HEALTH PROGRAM

Vision
Environmental Health (EH) related diseases are prevented and no longer a public health problem in the
Philippines (based on on-going Strategic Plan 2019-2022)
Mission
To guarantee sustainable Environmental Sanitation (ES) services  in every community

Objectives
1. Expand and strengthen delivery of quality ES services
2. Institute supportive organizational, policy and management systems
3. Increase financing and investment in ES
4. Enforce regulation policy and standards
5. Establish performance accountability mechanism at all levels

Program Components
 Drinking-Water Supply,
 Sanitation (e.g excreta, sewage and septage management)
 Zero Open Defecation Program (ZODP)
 Food Sanitation
 Air Pollution (indoor and ambient)
 Chemical Safety
 WASH in Emergency situations
 Climate Change for Health
 Health Impact Assessment (HIA)

Partner Institutions
 DENR
 DILG
 DPWH
 DA
 PIA
 World Health Organization (WHO)
 UNICEF
 USAID
 AusAID

Policies and Laws

1. PD No. 856 – Code on Sanitation of the Philippines
2. EO No. 489 s. 1991 – The Inter-Agency Committee on Environmental Health (IACEH)
3. National Objectives for Health (NOH) 2011-2016
4. DOH A.O. 2010-0021 - Sustainable Sanitation as a National Policy and a National Priority
Program of the DOH
5. DOH A.O. 2014-0027 – National Policy on Water Safety Plan (WSP) for All Drinking-Water
Service Providers
6. DOH A.O. 2017-0006 – Guidelines for the Review and Approval of the Water Safety Plans of
Drinking-Water Service Providers
 7. DOH A.O. 2017-0010 – Philippine National Standards for Drinking Water (PNSDW) of 2017

Strategies Per Objective

1. Design, promote and implement customized package of ES interventions and implementation
approaches responsive to communities of varying situations and needs
1. Generate demand for quality ES among targeted providers and intended beneficiaries
2. Harmonize and localize national policies and plans
2. Enhance organizational support structure at all levels for ES management and implementation
2. Establish and sustain strategic multi-sectoral alliances
3. Mobilize increased national government financing for ES
3. Secure LGUs’ budget support for ES implementation
3. Harness funding support from other sectors and partners
4. Strengthen coordination with national regulatory bodies
4. Develop capacity of LGUs in enforcing compliance to ES laws and guidelines
5. Establish performance accountability mechanism at all levels
5. Expand/Integrate recognition and incentives provision for good performance

G. NEWBORN HEARING SCREENING PROGRAM

Hearing loss is known to be one of the most common disabilities among newborns. Prevalence studies
worldwide revealed that approximately 1-4 infants per 1,000 live births are affected. A study conducted
in a rural population in Bulacan in 2004 also revealed that 1 per 724 babies are born with bilateral severe
to profound hearing loss. Thus, 0.14% or 8 of the babies born daily are estimated to have profound
deafness in our country alone. Republic Act 9709, or the Universal Newborn Hearing Screening and
Intervention Act of 2008 (UNHS), establishes a program whose primary thrust is for the prevention, early
diagnosis, and early intervention of hearing loss through requiring all newborns to have access to hearing
screening. This program helps facilitate the early detection of hearing loss experienced by the 0.14% of
newborn babies in the whole country.

Vision:
No Filipino newborn shall be deprived of a functional sense of hearing.

Mission:
1. To have all newborns undergo hearing screening prior to hospital discharge or within three
months of born outside the hospital;
2. To provide an accessible, effective and efficient system of services
3. To implement time-bound intervention: hearing screening within the first month, hearing
evaluation within the third month and early intervention by the sixth month
4. To provide the necessary services for hearing habilitation/ rehabilitation
5. To monitor the incidence and prevalence of hearing loss in the Philippines
6. To promote awareness and information campaign to the public about hearing loss

Goal
Every newborn shall be given access to physiologic hearing screening examination prior to hospital
discharge or at the earliest possible time for the detection of hearing loss.

Policies and Laws

Administrative Order No. 2010-0020 (Rules and Regulations Implementing Republic Act No. 9709
otherwise known as the Universal Newborn Hearing Screening Act of 2009)

Strategies, Action Points and Highlights

1.Ensuring Efficient Operations, Systems and Networks Management
This shall be upgraded to reach areas that need access to newborn care. This includes construction and/or
renovation of well-planned and equipped infrastructures to ensure quality service among patients and to
engage more health facilities to offer NBS services (human resource for health-trained and capacitated)

2.Expanding Package of Services and Delivery Network

In the next ten years, the program aims to shift fully into expanded newborn screening. Enrollment of
new facilities and sustaining the operations of existing facilities is critical in increasing the coverage of
service delivery. Strategic actions to increase the uptake of ENBS are critical to ensure nationwide
implementation, which involves strong promotion, advocacy and cooperation of the newborn screening
facilities.

3.Enhancing Health Promotion and Advocacy

This requires a developed and well-coordinated comprehensive health promotion and communication
plan targeting different audiences to increase awareness and uptake on expanded newborn screening. It
shall also focus on information campaign by strengthening communication strategies using different
media platforms.

4.Optimizing Health Information Management Systems for Expanded Newborn Screening

This aims to optimize current investments on health management information systems by adopting
interoperable, consensus-based, evidence—driven and standards-based vocabularies and system that
maximize the use of electronic health record systems that will automatically process and send information
and reports to (a) PhilHealth for verification of claims for NBS, and (b) the NBS registry for program
planning and research purposes, among others.

5. Strengthen Monitoring and Evaluation

Program monitoring and evaluation of procedures and systems, both for laboratory and administrative
units shall be undertaken to ensure smooth implementation of the program. Periodic review of and tools
should be done including quality assurance assessment.

6.Establishing Sustainable Financing Scheme

The DOH, as the lead agency of the NBS program shall allocate funds for the set-up of new strategically
located newborn screening centers. The National Comprehensive Newborn Screening System (NCNBSS)
also ensures funding for researches relevant to the implementation of newborn screening at the national
level that maybe utilized for policy recommendations The Philippine Health Insurance Corporation
(PHIC) also ensures full coverage of expanded newborn screening, while LGUs and other stakeholders
and partners are empowered to provide ways or means to make the NBS accessible and affordable,
particularly on the economically depressed areas.

H. ADOLESCENT HEALTH AND DEVELOPMENT PROGRAM

Description
In April 2000, DOH issued the Administrative Order 34- A s 2000, the Adolescent and Youth Health
(AYH) Policy, creating the Adolescent Youth Health Sub-program under the Children’s Health Cluster of
Family Health Office. In 2006, the department created the Technical Committee for Adolescent and
Youth Health ProgAram, composed of both government and non-government organizations dedicated to
uplifting the welfare of adolescents and tasked to revitalize the program. Due to an increasing health risky
behaviour among our Filipino adolescents.

DOH embarked on revising the policy and to focus on the emerging issues of the adolescents which are
the 10 – 19 years old.

In March 21, 2013, DOH with the support of the United Nations Population Fund (UNFPA) Philippines,
revised the policy and served the Administrative Order 0013 - 2013 National Health Policy and Strategic
Framework on Adolescent Health and Development (AHDP). The Strategic Framework 2013 is designed
in accordance with this goal.

In 2015, DOH AHDP Program revived the National External Technical Working Group (TWG) on
AHDP. This is composed of different stakeholders from the government, non-government, academe, and
youth – led organizations. In 2016, DOH recognized the need for harmonization of programs within the
department that caters 10 – 19 years old. The AHDP Program convened the first DOH – Internal
Technical Working Group. This aims to ensure that all programs are working together for the betterment
of the adolescents in the country. It is also an avenue to discuss indicators, policies, strategies, and service
delivery at the national and local implementation levels. The External and Internal TWGs on AHDP are
multi -sectoral, collaborative approaches to fulfil the goal, vision, and mission of the program. In 2017,
both TWGs revised the strategic framework, and developed a logical framework, and monitoring and
evaluation framework of the program.

Vision
The AHDP envisions a country with well informed, empowered, responsible and healthy adolescents who
are leaders in the society

Mission
Its mission is to ensure that all adolescents have access to comprehensive health care and services in an
adolescent-friendly environment.

Objective
Improve the health status of adolescents and enable them to fully enjoy their rights to health.
Program Components
1. Nutrition
2. National Safe Motherhood
3. Family Planning
4. Oral Health
5. National Immunization Program
6. Dangerous Drugs Abuse Prevention and Treatment
7. Harmful Use of Alcohol
8. Tobacco Control
9. Mental Health
10. Violence & Injury Prevention
11. Women and Children Protection
12. HIV/STI

Partner Institutions
Local & International Development Partners:
 Department of Education
 National Youth Commission
 Commission on Higher Education
 Commission on Population
 Council for the Welfare of Children
 Department of Social Welfare and Development
 Department of Interior and Local Government
 Linangan ng Kababaihan (Likhaan)
 The Family Planning Organization of the Philippines
 Technical Education and Skills Development Authority
 WomanHealth Philippines
 Save the Children
 ACT! 2015 Alliance
 Youth Peer Education Network
 Society of Adolescent Medicine in the Philippines Inc.
 Micronutrient Initiatives
 Child Protection Network
 National Nutrition Council
 Philippine National AIDS Council
 Philippine Society of Adolescent Medicine Specialist
 United Nations for Children’s Fund
 United Nations Population Fund
 United Nations Programme for HIV and AIDS
 United States Agency for International Development
 World Health Organization

Policies and Laws

  Republic Act 10354 (The Responsible and Reproductive Health Act of 2012)
 Administrative Order No. 2013-0013 (National Policy and Strategic Framework on Adolescent
Health and Development)
 Administrative Order No. 2017-0012 (Guidelines on the Adoption of Baseline Primary Health
Care Guarantees for All Filipinos)
 Proclamation 99 s.1992 (Linggo ng Kabataan)

Strategies, action Points and Timeline

 Health promotion and behavior change for adolescents
 Adolescent participation in governance and policy decisions
 Developing/transforming health care centers to become adolescent-friendly facilities
 Expanding health insurance to young people
 Enhancing skills of service providers, families and adolescents
 Strengthening partnerships among adolescent groups, government agencies, private sectors, Civil
Society organizations, families and communities
 Resource mobilization
 Regular assessment and evaluation

Program Accomplishments/ Status

Health Education and Promotion
 Advocacy and awareness raising activities such as Adolescent Health TV segment and Healthy
Young Ones
Provision of Health Services
 Establishment of Adolescent-Friendly Health Facilities Nationwide includes:
a. Core package of adolescent health services (AO 2017-0012) available at the different
levels of the health care system and in settings outside the health care system.
b. Institutionalize linkage between school, community, civil society organizations and health
facilities in a service delivery network (SDN).
c. Trained health and non-health personnel nationwide with the following:
 Competency Training on Adolescent Health
 Adolescent Job Aid (AJA) Training
 Adolescent Health Education and Practical Training (ADEPT)
 Healthy Young Ones (HYO) Training
 Adolescent Health and Development Program Manual of Operations (MOP)
Training
II. DISEASE PREVENTION & CONTROL CLUSTER
*COMMUNICABLE DISEASES
A. NATIONAL TUBERCULOSIS PROGRAM
Vision
TB -free Philippines

Mission
 To reduce TB burden (TB incidence and TB mortality)
 To achieve catastrophic cost of TB-affected households
 To responsively deliver TB service

Program Components
 Health Promotion
 Financing and Policy
 Human Resource
 Information System
 Regulation
 Service Delivery
 Governance

Partner Institutions
 Department of Health: Food and Drug Administration, Bureau of Quarantine
 Other Government: DepEd, DSWD, DILG (BJMP), DOJ (BuCor), PIA, DOLE
 Non Government Organizations: PhilCAT, PBSP
 International Organizations: WHO, USAID, GFATM, ICRC, HIVOS-KNCV

Policies and Laws

RA 10767 : Comprehensive TB Elimination Plan Act of 2016

Strategies, Action Points and Timeline

2017-2022 Philippine Strategic TB Elimination Plan
 Activate communities and patient groups to promptly access quality TB services
 Collaborate with other government agencies to reduce out-of-pocket expenses and expand social
protection programs
 Harmonize local and national efforts mobilize adequate and competent human resources
 Innovate TB information generation and utilization for decision making
 Enforce standards on TB care and prevention and use of quality products
 Value clients and patients through integrated patient-centered TB services
 Engage national, regional and local government units/ agencies on multi-sectoral implementation
of TB elimination plan
Implementation Support Materials
 NTP Manual of Procedures, 6th ed (This Manual consolidates all new policies and procedures
on Tuberculosis (TB) case finding and case holding and introduces a shift in the Program
approach)
 Updated Philippine Strategic TB Elimination Plan (The updated strategies will effectively
respond to the renewed and strengthened global response to end TB, and deliver on our
commitments through a focused, evidenced-based approach. We want to ensure that health
workers at all levels are abreast with current strategies and protocols)
 MOP Exercise Workbook (Contains exercises for the MOP training)
 MOP Facilitator’s Guide (Contains answers and rationale to the MOP exercise workbook)
 Guidelines on Infection Control for Tuberculosis and Other Airborne Infectious Diseases
(Provide guidance to decrease the risk of transmission of TB and other airborne infectious 
diseases among  patients  and staff in  the healthcare facilities, congregate  settings and household
settings)
 TB Laboratory Network Strategic Plan 2018-2022 (Provide directions and a roadmap outlining
the activities that need to be undertaken to successfully implement the plan ensuring the delivery
of high-quality assured laboratory services as defined in the PhilSTEP1)
 National TB Control Program Adaptive Plan for the COVID-19 Pandemic (Contains specific
guidelines on conduct of screening, testing and diagnosis, treatment, and prevention including
appropriate infection prevention and control measures to protect against COVID-19)
 National TB Health Promotion and Communication Strategy 2020 - 2023 (The strategy is
aligned with the PhilSTEP’s vision of a TB-free Philippines. Through a collaborative, cohesive
and comprehensive communication approach, the strategy envisions heightened attention to
TB,promotes people-centered care, and reduces stigma.)

B. HIV, AIDS AND STI PREVENTION AND CONTROL PROGRAM

The National HIV, AIDS and STI Prevention and Control Program (NASPCP) envisions ZERO new
infections, ZERO discrimination, and ZERO AIDS-related death. Its mission is to improve access and
utilization of preventive primary health care services for HIV and STI while its goal is to reverse the
trend of HIV epidemic by reducing the estimated annual infections to less than 7,000 cases by 2022.
Vision
To achieve ZERO new infections, ZERO discrimination, and ZERO AIDS-related death.
 
Mission
To improve access and utilization of preventive primary health care services for HIV and STI,

Goals
To reverse the trend of HIV epidemic by reducing the estimated annual infections to less than 7,000 cases
by 2022.

Objective
Reduce the transmission of HIV and STI among the Most At Risk Population and General Population and
mitigate its impact at the individual, family, and community level.

Program Activities
With regard to the prevention and fight against stigma and discrimination, the following are the strategies
and interventions:
1. Availability of free voluntary HIV Counseling and Testing Service;
2. 100% Condom Use Program (CUP) especially for entertainment establishments;
3. Peer education and outreach;
4. Multi-sectoral coordination through Philippine National AIDS Council (PNAC);
5. Empowerment of communities;
6. Community assemblies and for a to reduce stigma;
7. Augmentation of resources of social Hygiene Clinics; and
8. Procured male condoms distributed as education materials during outreach.

C. DENGUE PREVENTION AND CONTROL PROGRAM

BACKGROUND
Dengue is the fastest spreading vector-borne disease in the world endemic in 100 countries·
 Dengue virus has four serotypes (DENV1, DENV2, DENV3 and DENV4)
 First infection with one of the four serotypes usually is non-severe or asymptomatic, while second
infection with one of other serotypes may cause severe dengue.
 Dengue has no treatment but the disease can be early managed.
  The five year average cases of dengue is 185,008; five year average deaths is 732; and five year
average Case Fatality Rate is 0.39 (2012-2016 data).

TRANSMISSION
Dengue virus is transmitted by day biting Aedes aegypti and Aedes albopictus mosquitoes.

DENGUE CASE CLASSIFICATION AND LEVEL OF SEVERITY

 Dengue illness is categorized according to level of severity as dengue without warning signs,
dengue with warning signs and severe dengue.
 Dengue without warning warnings can be further classified according to signs and symptoms and
laboratory tests as suspect dengue, probable dengue and confirmed dengue.

a. dengue without warning signs     

a.1 suspect dengue
 a previously well individual with acute febrile illness of 1-7 days duration plus two of the
following: headache, body malaise, retro-orbital pain, myalgia, arthralgia, anorexia, nausea,
vomiting, diarrhea, flushed skin, rash (petechial, Hermann’s sign)
    
a.2 probable dengue
  a suspect dengue case plus laboratory test: Dengue NS1 antigen test and atleast CBC (leukopenia
with or without thrombocytopenia) or dengue IgM antibody test (optional) 
    
a.3 confirmed dengue
 a suspect or probable dengue case with positive result of viral culture and/or Polymerase Chain
Reaction (PCR) and/or Nucleic Acid Amplification Test- Loop Mediated Amplification Assay
(NAAT-LAMP) and/ or Plaque Reduction Neutralization Test (PRNT)

b. dengue with warning signs

 a previously well person with acute febrile illness of 1-7 days plus any of the following: abdominial
pain or tenderness, persistent vomiting, clinical signs of fluid accumulation (ascites), mucosal
bleeding, lethargy or restlessness, liver enlargement, increase in haematocrit and/or decreasing
platelet count 

c. severe dengue
severe plasma leakage leading to
 shock (DSS)
 fluid accumulation with respiratory distress
severe bleeding
 as evaluated by clinician

severe organ impairment

 Liver: AST or ALT ≥ 1000
 CNS: e.g. seizures, impaired consciousness
  Heart:and other organs (i.e. myocarditis, renal failure)

PHASES OF DENGUE INFECTION

a. Febrile Phase
  Usually last 2-7 days
 Mild haemorrhagic manifestations like petechiae and mucosal membrane bleeding (e.g nose
and gums) may be seen.
 Monitoring of warning signs is crucial to recognize its progression to critical phase.
b. Critical Phase
 Phase when patient can either improve or deteriorate.
 Defervescence occurs between  3 to 7 days of illness. Defervescence is known as the period
in which the body temperature (fever) drops to almost normal (between 37.5 to 38°C).
 Those who will improve after defervescence will be categorized as Dengue without Warning
Signs, while those who will deteriorate will manifest warning signs and will be categorized
as Dengue with Warning Signs or some may progress to Severe Dengue.
 When warning signs occurs, severe dengue may follow near the time of defervescence
which usually happens between 24 to 48 hours.
c. Recovery Phase
 Happens in the next 48 to 72 hours in which the body fluids go back to normal.
  Patients’ general well-being improves.
 Some patients may have classical rash of “isles of white in the sea of red”.
 The White Blood Cell (WBC) usually starts to rise soon after defervescence but the
normalization of platelet counts typically happens later than that of WBC. 

MANAGEMENT (based on patient type)

1. Group A- patients who may be sent home
These are patients who are able to:
 Tolerate adequate volumes of oral fluids
  Pass urine every 6 hours
 Do not have any of the warning signs particularly when the fever subsides
 Have stable hematocrit

2. Group B- patient who should be referred for in-hospital management

Patients shall be referred immediately to in-hospital management if they have the following conditions:
 Warning signs\
 Without warning signs but with co-existing conditions that may make dengue or its management
more complicated ( such as pregnancy, infancy, old age, obesity, diabetes mellitus, hypertension,
heart failure, renal failure, chronic haemolytic diseases such as sickle- cell disease and
autoimmune diseases, etc.)
 Social circumstances such as living alone or living far from health facility or without a reliable
means of transportation.
 The referring facility has no capability to manage dengue with warning signs and/or severe
dengue.

3. Group C- patient with severe dengue.requiring emergency treatment and urgent referral

These are patients with severe dengue who require emergency treatment and urgent referral because they
are in the critical phase of the disease and have the following:
 Severe plasma leakage leading to dengue shock and/or fluid accumulation with respiratory
distress;
 Severe hemorrhages;
 Severe organ impairment (hepatic damage, renal impairment,
 cardiomyopathy, encephalopathy or encephalitis

Patients in Group C shall be immediately referred and admitted in the hospital within 24 hours. 

LABORATORY TESTS
Test Description
1.      Dengue NS1  Requested between 1-5 days of illness
RDT  Use to detect dengue virus antigen
during early phase of acute dengue
infection
 Test is for free in all health centers and
selected public hospitals nationwide
2.      Dengue  Requested beyond five days of illness
IgM/IgG  Use to detect dengue antibodies during
acute late stage of dengue infection
(IgM) and to determine previous
infection (IgG)
 May give false positive result due to
antibodies induced by dengue vaccine
 May cross react with other arboviral
diseases such as Chikungunya and NATIONAL DENGUE
Zika PREVENTION AND CONTROL
 DOH augmentation is limited to PROGRAM
selected government hospitals only
3.      Polymerase  One of the gold standard laboratory Vision                    A dengue free
Chain Reaction tests to confirm dengue virus. Philippines
(PCR)  Molecular based test confirmatory test Mission                  Ensure healthy
 Available only in dengue sub-national lives and promote well-being for all at
and national reference laboratories all ages
4.      Nucleic Acid  A novel molecular-based confirmatory Goal                       To reduce the
Amplification Test- test used to detect dengue virus. burden of dengue disease
Loop Mediated  Work just like PCR but cheaper and Objectives/            1.) To reduce
Isothermal simpler in nature. dengue morbidity by atleast 25% by
Amplification Assay  In the pipeline to be introduced under 2022
(NAAT-LAMP) the National Dengue Prevention and Indicators       Morbidity rate = No. of
Control Program in district and suspect, probable & confirmed cases
provincial hospitals x100,000
5.      Plaque  Gold standard to characterize and                                 
Reduction quantify circulating level of anti- total population
Neutralization Test DENV neutralizing antibody (NAb)                               
(PRNT)  Available only at the dengue national (baseline: 198.1 per 100,000
reference laboratory population)
6.      Other tests:  Routinely used in hospitals as standard                             
-Total While Blood dengue diagnostic tests (2015 data: 200,145/100,981,437 x
Cell (WBC) count  Look for trend of decreasing WBC, 100,000)
-Platelet decreasing platelet and increasing
-Hematocrit hematocrit
 
                              2.) To reduce dengue mortality by atleaset 50% by 2022
                         Mortality rate = No of dengue (probable & confirmed) deaths x 100,000
                                                                                 total population
                                                              (baseline: 0.59 per 100,000 population)
                                                             (2015 data: 598/100,981.437 x 100,100)
 
                              3.) To maintain Case Fatality Rate (CFR) to < 1% every year.
                                              CFR = no. of dengue (probable & confirmed) deaths x 100
                                                                   no. of probable & confirmed cases

PROGRAM COMPONENTS
1. Surveillance
 Case Surveillance through Philippine Integrated Disease Surveillance and Response (PIDSR)
 Laboratory-based surveillance/ virus surveillance through Research Institute for Tropical
Medicine (RITM) Department of Virology, as national reference laboratory, and sub-national
reference laboratories.
 Vector Surveillance through DOH Regional Offices and RITM Department of Entomology
2. Case Management and Diagnosis
 Dengue Clinical Management Guidelines training for hospitals.
 Dengue NS1 RDT as forefont diagnosis at the h ealth center/ RHU level.
 PCR as dengue confirmatory test available at the sub-national and national reference laboratories.
 NAAT-LAMP as one of confirmatory tests will be available at district hospitals, provincial
hospitals and DOH retained hospitals.
3. Integrated Vector Management (IVM)
 Training on Vector Management, Training on Basic Entomology for Sanitary Inspector, Training
on Integrated Vector Management (IVM) for health workers.
 Insecticide Treated Screens (ITS) as dengue control strategy in schools.
 4. Outbreak Response
 Continuous DOH augmentation of insectides such as adulticides and larvicides to LGUs for
outbreak response.
5. Health Promotion and Advocacy
 Celebration of ASEAN Dengue Day every June 15
 Quad media advertisement
 IEC materials
6. Research

STRATEGIES
 Enhanced 4S Strategy
S - earch and Destroy
S - eek Early Consultation
S - elf Protection Measures
S - ay yes to fogging only during outbreaks

PROGRAM POLICIES AND GUIDELINES

AO 2016-
Guidelines for the nationwide Implementation of Dengue Rapid Diagnostic Test
0043   
AO 2012-
Revised Dengue Clinical Management Guidelines
006
AO 2001- Guidelines on the Application of Larvicides on the Breeding Sites of Dengue Vector
0045 Mosquitoes in Domestic Water
Implementation Guidelines for Initial Implementation of Nucleic Acid Amplification Assay -
DM 2017-
Loop Mediated Isothermal Assay (LAMP) as One of Dengue Confirmatory Tests to Support
0353
Dengue NSI RDT
DM 2015- Reactivation of Dengue Fast Lanes and Continuing Improvement of Systems for Dengue
0309 Case Management and Services
DM 2014- Technical Guidelines, Standards and other Instructions for Reference in the Implementation
0112 of Sentinel-based Active Dengue Surveillance

D. MALARIA CONTROL PROGRAM

DESCRIPTION
Malaria is a life-threatening disease caused by plasmodium parasites transmitted by anopheles mosquito
or rarely through blood transfusion and sharing of contaminated needles causing acute febrile illness and
symptoms in the form of fever, headache and chills. Untreated, P. falciparum malaria may progress to
severe illness and possibly, death.
The Philippines carry a high burden of malaria disease in the past but with the unrelenting efforts of the
DOH- National Malaria Control and Elimination Program, cases and deaths has been reduced
significantly, that the country is now inching towards elimination. DOH-NMCEP aims to eliminate
malaria by adopting a health system focused approach to achieve universal coverage with quality-assured
malaria diagnosis and treatment, strengthen governance and human resources, maintain the financial
support needed, and ensure timely and accurate information management.

The sub-national elimination strategy of the DOH–NMCEP has resulted to the declaration of 42 out of
the 81 provinces in the country as malaria-free. Currently, only 7 provinces remain with local
transmission of the disease. One of these provinces is Palawan, which holds more than 90% of the
country’s malaria cases. Despite these, the program remains optimistic of meeting its goals by instituting
effective measures of reducing transmission; working closely with regional offices, local government
units, line agencies, key affected population’s (KAP) representatives and also maintaining collaboration
with partners like the Pilipinas Shell Foundation, Inc. (PSFI) and the World Health Organization (WHO).
The Philippines aims to eliminate malaria by 2030.
VISION
A Malaria–Free Philippines by 2030

MISSION
Further accelerate malaria control and transition towards elimination

OBJECTIVES
Objective 1 (Universal Access)
To ensure universal access to reliable diagnosis, highly effective and appropriate treatment and
preventive measures

Objective 2 (Governance and Human Resources)

To strengthen governance and human resources capacity at all levels to manage and implement malaria
interventions

Objective 3 (Health Financing)

To secure government and non-government financing to sustain malaria control and elimination efforts at
all levels

Objective 4 (Health Information and Regulation)

To ensure quality malaria services, timely detection of infection and immediate response, and information
and evidence to guide malaria elimination

PROGRAM COMPONENTS
1. Program Management and Health System -
2. Diagnosis and Treatment
3. Vector Control
4. Advocacy and Social Mobilization
5. Surveillance, Outbreak Preparedness and Response
6. Monitoring and Evaluation
7. Partnerships
8. Assessment of Other Factors - assessment of the possible contribution of factors such as government
health expenditure, poverty, forest cover, etc

PARTNER INSTITUTIONS
 World Health Organisation (WHO)
 Filipinas Shell Foundation Inc. (PSFI)
 Asian Collaborative Training Network for Malaria (ACT Malaria)
 National Commission on Indigenous Peoples (NCIP)
 Bureau of Quarantine (BOQ)
 University of the Philippines-Philippine General Hospital (UP-PGH)
 Research Institute for Tropical Medicine (RITM)
 Asia Pacific Malaria Elimination Network (APMEN)
POLICIES AND LAWS
1966 : Republic Act 4832: Malaria Eradication Law; an act creating the malaria eradication service and
providing funds for the duration of the campaign.
1973 : cut-off from the support of USAID and WHO
1982 : EO 851, ordered the decentralization and integration of malaria control in “the general health
sevices”
1983 : “Malaria Eradication” to “Malaria control”
1986 : EO 119 : change in the bureaucracy of the Philippine government – revising the system of the
Department of Health
1987 : Department Circular No. 167 s. 1987: Semi-vertical Malaria programme1991: RA 7160 “Local
Government Code”
2009 : AO 2009-0001 “Revised Policy and Guidelines on the Diagnosis and Treatment of Malaria
2009:AO 2009-0024 “Reconstitution of the Country Coordinating Mechanism in Support of the Global
Fund to Fight Against AIDS, Tuberculosis and Malaria Grants in the Philippines”
2012: AO 2012-0026 “Guidelines in the Conduct of Border Operation”
2013: AO 2013-0007 “Guidelines on Establishment of Elimination Hub”
2013: AO 2013-0023 “Guidelines on Establishment of Collaborating Centers”
2014: AO 2014-0004: PhilMIS : Reporting and Recording of malaria cases

STRATEGIES, ACTION POINTS, AND TIMELINE

1. Early Detection and Prompt Treatment through a strengthened case-finding mode;
2. Foci investigation and Classification as a means to determine need for interventions;
3. Annual Stratification using Foci Classification;
4. Strengthened recording and reporting;
5. Use of Primaquine as a transmission-blocking agent;
6. Use of Artesunate ampoules and suppositories;
7. Expanded RDT and sustained microscopy services;
8. LLIN as continued cornerstone of vector control
9. IRS in border areas and as outbreak response mechanism;
10. Quality assurance monitoring to cover all aspects of malaria service delivery;
11. Structured capability-building of local health system staff; and
12. Adaption of specified IEC strategies and other social mobilization approaches for identified risk
groups

E. SCHISTOSOMIASIS CONTROL PROGRAM

Vision
Schistosomiasis Free Philippines
Mission
Synchronized and harmonized public and private stakeholders’ efforts in the elimination of
schistosomiasis in the Philippines

Objectives
Interruption of transmission of Schistosomiasis Infection by 2025.
1. All high endemic barangays will reach the target of criteria for Morbidity/Infection Control (<5%
prevalence of heavy intensity infection for 5 years).
2. All moderate endemic barangays will reach the target of criteria of Transmission Control (Elimination
as a Public Health Problem with <1% prevalence of heavy intensity infection for 5 years).
3. All low endemic barangays will reach the target criteria of Transmission Interruption (no local
infection in man and animals, no infection in snail for 5 years).
 
Program Components
Schistosomiasis is an acute and chronic disease caused by parasitic worms called trematodes or blood
flukes. It is endemic in the Philippines affecting 1,599 barangays (villages), in 189 municipalities (towns)
and 15 cities, in 28 endemic provinces, in 12 regions. The total population at risk is approximately 12
million with 2.5 million individuals directly exposed to the disease. It is transmitted through contact with
fresh water infested with the cercarial schistosome of the parasite that penetrates human skin. Given the
magnitude of the problem of schistosomiasis in the country, the Department of Health (DOH)
strengthened the Schistosomiasis Control and Elimination Program by adopting a multi- pronged multi-
stakeholders’ approach and fueling additional funding.

1. Preventive Chemotherapy
2. Intensified Case Management
3. Water, Sanitation and Hygiene (WASH)
4. Veterinary Public Health and the Promotion of Animal Health under One Health Approach.
5. Effective Intermediate Host Control and Surveillance

Partner Institutions
Research Triangle Institute (RTI) International, Save the Children, Plan International, WHO, DA, DepEd,
DILG, NIA, Academe, LGUs

Policies and Laws

-Schistosomiasis Clinical Practice Guidelines
-DM 2016-0212
-AO 2009-0013
-AO 2007-0015

Strategies, Action Points and Timeline

1. Preventive Chemotherapy through Mass Drug Administration
2. Intensified Case Management
3. Promotion of Animal Health and Veterinary Public Health under One Health Approach
4. Effective Intermediate Host Control and Surveillance
5. Water, Sanitation and Hygiene (WASH)

F. FILARIASIS ELIMINATION PROGRAM

DESCRIPTION
The Elimination started in 2001 after a pilot study using the combination drugs in 2000 in five selected
municipalities in five provinces.
Total no. of province: 81
Total population in the country: 103, 741, 330 as of 2018
Total Endemic Provinces: 46 Provinces in 12 Regions
Total Endemic Population: 8 Million
Parasite: Majority is Wuchereria bancrofti
Vectors incriminated: Aedes poecilius, Anopheles flavirostris

VISION
Healthy and productive individuals and families for Filariasis-Free Philippines

MISSION
Elimination of Filariasis as a public health problem thru comprehensive approach and universal access to
quality health services

OBJECTIVES
 To sustain transmission interruption in provinces through strengthening of surveillance
 To intensify interventions and interrupt transmission in persistent infection provinces
 To strengthen Morbidity Management & Disability Prevention (MMDP) activities and services to
alleviate suffering among chronic patients
 To strengthen the health system capacity to secure LF elimination
 Secure adequate investment from governmental and non-governmental sources to sustain all
program objective

PROGRAM COMPONENTS
Filariasis is a major parasitic infection, which continues to be a public health problem in the Philippines. 
It was first discovered in the Philippines in 1907 by foreign workers.  Consolidated field reports showed a
prevalence rate of 9.7% per 1000 population in 1998. It is the second leading cause of permanent and
long-term disability. The disease affects mostly the poorest municipalities in the country about 76% of
the case live in the 4th-6th class type of municipalities.

The World Health Assembly in 1997 declared “Filariasis Elimination as a priority” where the WHO’s
call for global elimination was created (WHA 50.29 Resolution: Elimination of lymphatic filariasis as a
public health problem). This was followed by the Global Program for Elimination of Lymphatic
Filariasis, launched by World Health Organization which has two main components that were adopted by
the national program:
1. INTERRUPTION OF TRANSMISSION: Elimination level prevalence of microfilaremia of
less than 1% and Antigen rate of < 1% through Mass Drug Administration (MDA)
2. CONTROL AND REDUCE THE MORBIDITY by alleviating the sufferings and disability
caused by its clinical manifestations through Morbidity Management Disability Prevention
(MMDP)
A sign of the DOH’s commitment to eliminate the disease, the program’s strategy shifted from control to
elimination strategies was evident in an Administrative Order #25-A, s.1998 issued in 2004. A major
strategy of the Elimination Plan was the Mass Annual Treatment using the combination drug,
Diethylcarbamazine Citrate and Albendazole for a minimum of 5 years to individuals ages 2 years old
and above living in established endemic areas after the issuance from WHO of the safety data on the use
of the drugs.  The Philippine Plan was approved by WHO which gave the government free supply of the
Albendazole (donated by GSK thru WHO) for filariasis elimination. An Administrative Order declaring
“November as Filariasis Mass Treatment Month was signed by the Secretary of Health was issued on that
same year.  In 2010, a guideline in the prevention of disabilities due to lymphatic Filariasis in support to
effective implementation of management of morbidity and prevention of disabilities due to Filariasis

PARTNER INSTITUTIONS
 University of the Philippines Manila- College of Public Health
 Glaxosmith Klein thru WHO
 USAID thru RTI ENVISION

POLICIES AND LAWS

 Administrative Order No. 24s.1998: Elimination of the disease
 Executive Order No. 369, 2004: Filariasis Mass Treatment Month
 World Health Assembly No. 50.29: Filariasis Elimination as public health problem
 Formula One for Health: Disease-Free Zones
 KP Roadmap 2014-2016
 Sustainable Development Goal No. 3: Good Health and Well being
 Philippine Health Development Agenda: Disease for Elimination

STRATEGIES, ACTION POINTS, AND TIMELINE

1. Mass Drug Administration
2. Disability Management
3. Monitoring thru Midterm Sentinel surveys and Evaluation thru Transmission Assessment Survey
4. Post Validation Surveillance
5. Private-Public Partnership

G. RABIES PREVENTION AND CONTROL PROGRAM

DESCRIPTION
Rabies is a human infection that occurs after a transdermal bite or scratch by an infected animal, like dogs
and cats. It can be transmitted when infectious material, usually saliva, comes into direct contact with a
victim’s fresh skin lesions. Rabies may also occur, though in very rare cases, through inhalation of virus-
containing spray or through organ transplants.
Rabies is considered to be a neglected disease, which is 100% fatal though 100% preventable. It is not
among the leading causes of mortality and morbidity in the country but it is regarded as a significant
public health problem because (1) it is one of the most acutely fatal infection and (2) it is responsible for
the death of 200-300 Filipinos annually.

VISION
To declare Philippines Rabies-Free by year 2022

MISSION
To eliminate human rabies by the year 2020

OBJECTIVES
To eliminate rabies as a public health problem with absences of indigenous cases for human and  animal

PROGRAM COMPONENTS
 Post Exposure Prophylaxis
 Pre- Exposure Prophylaxis (PrEP)
 Health Education and advocacy campaign
 Training/Capability Building
 Training on National Rabies Information System (NaRIS)
 Establishment of ABTCs by Inter-Local Health Zone
 DOH-DA joint evaluation and declaration of Rabies-free areas/provinces

PARTNER INSTITUTIONS
The following organizations/agencies take part in attaining the goal of the National Rabies Prevention
and Control Program:
 Department of Agriculture (DA)
 Department of Education (DepEd)
 Department of Interior and Local Government (DILG)
 Department of Environment and Natural Resources (DENR)
 World Health Organization (WHO)
 Animal Welfare Coalition (AWC)

POLICIES AND LAWS

1. Anti-Rabies Act of 2007 (Republic Act 9482) : An Act Providing for the Control and
Elimination of Human and Animal Rabies, Prescribing penalties for Violation Thereof and
Appropriating Funds Thereof.
2. Batas Pambansa Bilang 97: An Act Providing for the Compulsory Immunization of   Livestock,
Poultry and other Animals against Dangerous Communicable Diseases. The Act required the
Secretary of Agriculture to make compulsory the vaccination of susceptible animals and poultry
should there be a threat or existence of a highly communicable animal or avian disease in a certain
locality.
3. Executive Order No. 84: Declaring March as the Rabies Awareness Month, Rationalizing the
Control Measures for the Prevention and Eradication of Rabies and Appropriating Funds.
 4. Memorandum of Agreement on Interagency Implementation of the NRPCP: Signed in May
1991 by the Secretaries of Agriculture (DA), Health (DOH), Local Government (DILG) and
Education, Culture and Sports, now, Department of Education
5. Joint DA, DOH, DepEd, DILG Administrative Order No. 01 Series of 2008: Implementing
Rules and Regulations Implementing Republic Act 9482 An Act Providing for the Control and
Elimination of Human and Animal Rabies, Prescribing Penalties for Violation Thereof and
Appropriating Funds Therefor
6. Administrative Order No. 2014-0012 entitled New Guidelines on the Management of Rabies
Exposures: To provide new policy guidelines and procedure to ensure an effective and efficient
management for eventual reduction if not elimination of human rabies.
7. Administrative Order No. 2018-0013 entitled Revised Guidelines on the Management of Rabies
Exposures: Ensure availability of anti-rabies vaccines to allow the use of Non-WHO Prequalified
Rabies Vaccine but registered and approved by FDA only when there is shortage of vaccines.
8. Joint Department Administrative Order No. 01 entitled Guidelines for Declaring Areas as
Rabies-Free Zones: To provide the guidelines for declaring zones/areas as Rabies-Free by which
the DA, DOH and other concerned institutions and agencies that will administer programs and
activities on the control, prevention and elimination of Rabies

STRATEGIES, ACTION POINTS, AND TIMELINE

1. Provision of Post Exposure Prophylaxis to all rabies exposures/ animal bite victims (provided by
RA 9482).
2. ABTC/ABC certification as quality PEP providers-PhilHealth Package
3. Provision of Pre- Exposure Prophylaxis (PrEP) to high risk individuals and school children in
high incidence area- Provided by RA 1984.
4. Strengthened IEC campaign on:
o Responsible Pet Ownership (RPO)
o RA 9482 known as the “The Anti Rabies Act of 2007” and enactment of and strict
implementation of local rabies control ordinances.
o Early and proper management of animal bites.
o In coordination with DA-BAI: promotion of dog vaccination, dog population control and
control of stray animals.
5. Advocacy Campaign:
Rabies awareness and advocacy campaign is a year round activity highlighted on 2 occasions: March –
the Rabies awareness month and September 28 – World Rabies Day. The campaign focuses on three
target audiences; pet owners – to have their dog/s registered and vaccinated; animal bite victims- to
practice immediate washing of bites with soap and water for at least 10 minutes and receive appropriate
Post-Exposure Prophylaxis (PEP)if need from trained health workers and not from traditional healers;
and lastly Legislators, Local Chief Executives (LCEs), NGO’s Pos and other stakeholders to implement
(LCEs) and support a comprehensive rabies prevention and control program.
6. Training of Medical Doctors and Registered Nurses of ABTCs  on the guidelines on the
management of animal bite victims- A requirement for ABTC certification as providers of quality
PEP services and PHIC accreditation:
o Training course offered only to government and privately owned bite centers.
 o MHOS. CHOs, PHNs and residents physicians not functioning as ABTC are not invited to
attend the training
7. Disease free zone – Joint DOH-DA evaluation and declaration of Rabies-free islands (as provided
for in the DOH disease free zone initiative and the Joint DOH-DA AO).
8. Integration of rabies program in elementary curriculum- almost 50% of animal bite victims
are <15 years old
9. Post-mortem review – death review will be performed jointly by both human health workers from
the provinces/cities and hospitals with cases of human rabies by. This aims to review the
diagnostic history, clinical aspect, and outcome of the patient, status of biting animal and location
of biting incidence of human death cases due to rabies to be able to call for an action on how to
have a zero incidence of rabies.
10. Support to Department of Agriculture on Dog Vaccination

H. EMERGING AND RE-EMERGING INFECTIOUS DISEASE PROGRAM

Description
In the recent past, the Philippines has seen many outbreaks of emerging infectious diseases and it
continues to be susceptible to the threat of re-emerging infections such as leptospirosis, dengue,
meningococcemia, tuberculosis among. The current situation emphasizes the risks and highlights the need
to improve preparedness at local, national and international levels for against future pandemics. New
pathogens will continue to emerge and spread across regions and will challenge public health as never
before signifying grim repercussions and health burden. These may cause countless morbidities and
mortalities, disrupting trade and negatively affect the economy.

There are several social determinants contributing to the emergence of novel infectious diseases and
resurgence of controlled or eradicated infectious diseases in our country. These contributing factors are
namely: (1) Demographic factors like the population distribution and density, (2) international travel/
tourism and increased OFWs, (3) Socio-economic factors and (4) Environmental factors. The latter
includes our country’s vulnerability to disasters, increased livestock production, man- made ecological
changes or industries and lastly the urbanization which encroach and destroy the animal habitats.

Emerging and Re-emerging Infectious Diseases are unpredictable and create a gap between planning and
concrete action. To address this gap, there is a need to come up with proactive systems that would ensure
preparedness and response in anticipation to negative consequences that may result in pandemic
proportions of diseases. Proactive and multi- disciplinary preparedness must be in place to reduce the
impact of the public the health threats. 

Vision
A health system that is resilient, capable to prevent, detect and respond to the public health threats caused
by emerging and re-emerging infectious diseases

Mission
Provide and strengthen an integrated, responsive, and collaborative health system on emerging and re-
emerging infectious diseases towards a healthy and bio-secure country.
Goal
Prevention and control of emerging and re-emerging infectious disease from becoming public health
problems, as indicated by EREID case fatality rate of less than one percent

Program Strategies
The EREID Strategies are:
 Policy Development
 Resource Management and Mobilization
 Coordinated Networks of Facilities
 Building Health Human Resource Capacity
 Establishment of Logistics Management System
 Managing Information to Enhance Disease Surveillance
 Improving Risk Communication and Advocacy

Target Population/ Client

All ages; Citizen of the Philippines

Area of Coverage
Philippines and it’s international borders

Partner Institutions
DOH Central and Regional Bureau’s/Offices, Other Government and Non-Government Offices, Medical
Societies, Academe, Developmental Partners (World Health Organization, FAO-OIE, CDC, GPP-
Canada)

Policies and Laws

 Executive Order No. 168  -    Creating the Inter-Agency Task Force for the Management of
Emerging Infectious Diseases in the Philippines
 Administrative Order No. 10 s. 2011 - Creating the Philippine Inter-Agency Committee on
Zoonosis, Defining Its Powers, Functions, Responsibilities, Other Related Matters and Providing
Funds Thereof
Other Related Issuances/ Guidelines
 Administrative Order no. 2012-0022 - National Policy for the Implementation of on
International Health Regulation and Asia Pacific Strategy for Emerging Diseases in the
Philippines
 Department Memorandum No. 2017- 2558 - Creation of Functional Groups for the National
EREID Program
 Department Personnel Order No. 2005-1585 - Creation of a Management Committee on
Prevention and Control of Emerging and Re-emerging Infectious Diseases (DOHMC-PCREID)
 Department Memorandum No. 2017 - 0348 - Interim Technical Guidelines, Standards and other
Instructions in the Implementation of Enhanced Human Avian Flu Surveillance, Management,
and Infection Control in the Health Care Setting
  Department Memorandum No. 2016 - 0169 - Interim Guidelines on the Clinical Management
of Zika Virus Infection
 Department Memorandum No. 2014 - 0257 - Preparedness and Response Plan for the
Prevention and Control of Ebola Virus Disease
 Department Memorandum No. 2014 - 0075 - Interim Guidelines on the Preparedness and
Response to MERS-CoV
 Department Memorandum No. 2009 - 0144 - Technical Guidelines, Standards and other
Instructions for Reference in the Pandemic Response to Influenza A H1N1
 Department Memorandum No. 2009-0250 - Interim Guidelines on the Prevention of
Leptospirosis through the use of Prophylaxis in Areas affected by Floods
 Department Memorandum No. 2005-0021 - Case Guidelines on the Management and Control
of Meningococcal Disease

Strategies, Actions Points

To achieve this goal within the medium term, with a benchmark of less than one percent EREID case
fatality rate, the EREID Program Strategic Investment Plan highlights the seven Strategic Priorities, each
with the following goals:
1. Policy Development: Establish updated, relevant, and implementable policies on EREID
providing the overall direction in implementing the different Program components for all the
network of health providers and facilities.
2. Resource Management and Mobilization: Effectively manage and mobilize available resources
from the DOH and partners both local and international needed in EREID detection, preparedness,
and response.
3. Coordinated Networks of Facilities: Organize adequate and efficient systems of coordination
among network of facilities both public and private needed in EREID detection, preparedness, and
response within the context of integrated health service delivery system at national and sub-
national levels.
4. Building Health Human Resource Capacity: Health care professionals skilled, competent and
motivated in detection, prevention and management of EREID cases, with provision of supervised
psychosocial support and risk communication at the national and sub-national levels.
5. Establishment of Logistics Management System: Manage the systems of procurement and
distribution of logistics for EREID detection, preparedness and response under each mode of
disease transmission.
6. Managing Information to Enhance Disease Surveillance: Improve case detection and surveillance
of EREID to prevent and or minimize its entry and spread and to mitigate the possible impact of
widespread community and national transmission.
7. Improving Risk Communication and Advocacy: Institute a risk communication and advocacy
system that is factual, timely and context relevant implemented at the national and sub-national
levels.

I. NATIONAL LEPROSY CONTROL PROGRAM

DESCRIPTION
The National Leprosy Control Program (NLCP) is a multi-agency effort to control Leprosy in the country
with private and public partnership in achieving its goals to lessen the burden of the disease and its
mission to have a leprosy-free country.

VISION
Leprosy-free Philippines by the year 2022

MISSION
To ensure the provision of comprehensive, integrated quality leprosy services at all levels of healthcare

OBJECTIVES
 To further reduce the disease burden and sustain provision of high-quality leprosy services for all
affected communities ensuring that the principle of equity and social justice are followed
 To decrease by 50% the identified hyper endemic cities and municipalities

PROGRAM COMPONENTS
 Early diagnosis and treatment
 Integration of leprosy services
 Referral system
 Case detection and diagnosis
 Advocacy and IEC focusing on stigma discrimination and reduction
 Prevention of Deformity, self-care and rehabilitation
 Recording and reporting
 Monitoring, supervision and evaluation

PARTNER INSTITUTIONS
 World Health Organization
 Novartis Foundation
 Sasakawa Memorial Health Foundation
 Culion Foundation, Inc.
 Philippine Leprosy Mission
 Cebu Leprosy and TB Research Foundation Inc.
 Philippine Dermatological Society
 Coalition of Leprosy Advocates and Patients in the Philippines
 International Leprosy Association

POLICIES AND LAWS

 Administrative Order No. 167, s. 1965: Rules and Regulations of Leprosy Control in the
Philippines
 Republic Act No. 4073: An Act further liberalizing the treatment of leprosy by amending and
repealing certain sections of the revised Administrative Code
  Presidential Decree No. 384 January 30, 1974: Amending Republic Act No. 4073 entitled An Act
further liberalizing the treatment of leprosy by amending and repealing certain sections of the
revised Administrative Code
 Proclamation No. 467: Declaring the Last Week of February of every year as Leprosy Week
 Administrative Order No. 26 – A, s. 1997: Guidelines on Elimination of Leprosy as Public Health
Problem
 Administrative Order No. 5, s. 2000: Guidelines on the integration of leprosy services in hospitals
 Department memorandum No. 79, s. 2004: Recommendations to pursue Leprosy Elimination
Activities in all areas in the country
 Department Circular 366-B, s. 2003: First Leprosy Forum of the Philippine Dermatological
Society on November 12, 2003
 Department Circular 254, s. 2004: Second Leprosy Forum of the Philippine Dermatological
Society on November 9, 2004

STRATEGIES, ACTION POINTS AND TIMELINE

Strengthen local government ownership, coordination and partnership
 Ensuring political commitment and adequate resources for leprosy programs at all levels
 Contributing to UHC with a special focus on children, women and underserved populations
including migrants and displaced people.
 Promoting partnerships with state and non-state actors and promote inter-sectoral collaboration
and partnerships at the international, national and sub-national level  
 Facilitating and conducting basic and operational research in all aspects of leprosy and maximize
the evidence base to inform policies, strategies and activities.
 Strengthening surveillance and health information systems for program monitoring and evaluation
(including geographical information systems)
Stop leprosy and its complications
 Strengthening patient education and community awareness on leprosy.
 Promoting early case detection through active case-finding (e.g. campaigns) in areas of higher
endemicity and contact management.
 Ensuring prompt start and adherence to treatment, including working towards improved treatment
regimens
 Improving and management of disabilities.
  Strengthening surveillance for antimicrobial resistance including laboratory network.
 Promoting innovative approaches for training, referrals and sustaining expertise in leprosy such e-
Health (LEARNS)
 Promoting interventions for the prevention of infection and disease. -Chemoprophylaxis
Stop discrimination and promote inclusion
 Promoting societal inclusion through addressing all forms of discrimination and stigma
 Empowering persons affected by leprosy and strengthen their capacity to participate actively in
leprosy services. -CLAP
 Involving communities in actions for improvement of leprosy services.
 Promoting coalition-building among persons affected by leprosy and encourage the integration of
these coalitions and or their members with other CBOs.
   Promoting access to social and financial support services, e.g. to facilitate income generation, for
persons affected by leprosy and their families.
 Supporting community-based rehabilitation for people with leprosy related disabilities

J. INTEGRATED HELMNITH CONTROL PROGRAM

Soil-transmitted Helminthiasis (STH), caused by common roundworms, whipworms, and hookworms,
remains a public health concern in the Philippines. Considered among the neglected tropical diseases
(NTDs) or infectious diseases of poverty, STH are related to poor physical health, nutritional status, and
school performance in children. Disease burden of STH in the country among vulnerable and high-risk
groups is quite high and way above the global standard of less than 20% Cumulative Prevalence (CP). As
such, this program aims to reduce the Cumulative Prevalence of STH to less than 20% and Prevalence of
Moderate to Heavy Intensity Infection (MHII) to less than 2%.

Vision
STH-Free Philippines
 
Mission
Synchronized and harmonized public-private stakeholders’ effort in the control of Soil-transmitted
Helminthiasis (STH) in the Philippines.

Policies and Laws

 Administrative Order No. 30-F s.1999 (Implementation of STH Control Program)

 Administrative Order No. 2006-0028 (IHCP Operational and Strategic Framework)

Goals
 Elimination of Soil-Transmitted Helminthiasis as a Public Health Program in Pre-school Children
(PSAC) and School Age Children (SAC) by 2022

 Prevalence of Moderate to Heavy Intensity Infection (MHII) of less than 2% in PSAC and SAC

Comprehensive Packages
 Harmonized Schedule and Combined Mass Drug Administration (HSCMDA) for the month of
January and July in health centers, stations and schools.
 Diagnosis and selective treatment in health centers
 Provision of safe drinking water, basic sanitation and hygiene (WASH) in schools and community
 Health promotion and hygiene education

Partner Organizations
National/Government
 Department of Education (DepEd)
 Department of Interior and Local Government (DILG)  
 Public Information Agency (PIA)
  Kapisanan ng mga Broadkaster ng Pilipinas (KBP)
Local/Youth/CSOs/NGOs
 Local Government Units (LGUs)
 Vitamin Angels
International Partners
 Research Triangle Institute (RTI) International
 World Health Organization (WHO)
 Save the Children
 Plan International

K. FOOD AND WATERBORNE DISEASES PREVENTION AND CONTROL PROGRAM

DESCRIPTION
FWBDs refer to the limited group of illnesses characterized by diarrhea, nausea, vomiting with or without
fever, abdominal pain, headache and/or body malaise. These are spread or acquired through the ingestion
of food or water contaminated by disease-causing microorganisms (bacterial or its toxins, parasitic, viral).

VISION
Zero Mortality from FWBDs

MISSION
To reduce morbidity and mortality due to FWBDs

OBJECTIVES
 To guarantee universal access to quality FWBD-PCP intervention and services at all stages of the
life
 To guarantee financial risk protection of clients availing diagnosis, management and treatment for
FWBDs
 To guarantee a responsive service delivery network for the prevention and control of FWBDs

PROGRAM COMPONENTS
A. Policy, Plans and Organizational Support. This component ensures that supportive policies,
directional and annual plans are developed and updated to govern the design and implementation
of the FWBD-PCP. It shall ensure that organizational support to the FWBD-PCP is in place at
various levels of operations. This includes establishment of partnership between DOH and LGUs
and with other partners in the other sectors.
B. Diagnosis, Management and Treatment. This component ascertains the proper diagnosis as
well as prompt management and treatment of patients suffering from FWBDs. Focus will be given
to the development of clinical practice guidelines (CPGs) on FWBD diagnosis, management and
treatment. Diagnosis will encompass strengthening the laboratory services and the use of rapid
diagnostic test (RDTs). In the management and treatment, support for the establishment and
sustained operations of ORT corners in the hospitals and even in outpatient health facilities will
 be provided. Training of health providers will be undertaken on the CPGs and overall FWBD-
PCP management. 
C. Quality Assurance System. This component ensures the quality of diagnostic services of FWBD
cases. This requires regular test, validation and follow-up of laboratory capacities and
competencies of medical technologists as well as provision of the necessary laboratory supplies
and equipment.
D. Logistic Management. This component guarantees that essential drugs/medicines, supplies and
equipment are in place and available at the point of service. While the LGUs are mainly
responsible for placing-in these commodities and other logistics at their level, the DOH shall
design a system for forecasting the needs nationwide and design a procurement, allocation and
distribution system to ensure these reach the facilities with proper tracking and monitoring of their
utilization.
E. Capability Building. This component secures the quality of services by training the service
providers on the standards and protocols on the diagnosis, management and treatment of FWBDs.
It shall also develop the managerial and supervisory capability of FWBD-PCP
managers/coordinators at various levels of administration to ensure the efficient and effective
implementation of the Program.
F. Health Promotion and Advocacy. This component ensures the prevention of FWBDs which
hinges on the promotion of proper practices on water, sanitation and personal hygiene. It takes off
from the development of an overall Health Promotion and Communication Plan aimed at effecting
behavior change among community members and garnering support from key stakeholders
through advocacy. It also encompasses collaboration with the Environmental Health and
Sanitation Unit on the installation of safe water and sanitation facilities.
G. Monitoring and Evaluation, Research, Surveillance and Response.  Under this component,
necessary system and tools will be developed to ensure that quality and timely data are generated
as basis for decision-making, prioritization of resources and appropriate and immediate response
to any outbreak. A FWBD Surveillance System that will provide a comprehensive epidemiologic
information, on current situation on FWBD, in an area will be strengthened. Regular monitoring
of the status of FWBD-PCP implementation will be carried out including special researches or
studies as needed.
H. Outbreak Response/Disaster Management. This component ensures that any outbreak due to
FWBD in any area is properly monitored and immediately responded to especially during disaster
or emergency situations where the affected population became most prone to these infections as in
evacuation centers or flooded areas.

TARGET POPULATION/ CLIENT

FWBD by Sex
Based on EB’s data in 2016, there were slightly more males generally experiencing FWBDs (cholera,
typhoid, Hepa A, rotavirus and paralytic shellfish poisoning) than females. However, for acute bloody
diarrhea, there were more females than males reported experiencing the disease in the same year.     
FWBDs by Age Group
Majority of the reported acute bloody diarrhea in 2016 were among the 1-4 year old children. Rotavirus
as characterized occurs mainly among the same age group and those below 1 year old. As for Hepa A,
mostly affected are the 15 to 39 year olds and also notable among the younger age group (5-14 years old).
As for typhoid, cholera and paralytic shellfish poisoning, highest number of cases reported was among
the 5-14 years old.
FWBDs by Geographical Areas
The Visayas Region particularly Regions 7 and 8 came out as hosts of the highest incidence of FWBDs in
the country. Incidence of acute bloody diarrhea is highest in Region 7 and also the host of the highest
number of reported Hepa A and Typhoid cases in 2016.  Region 8 on the other hand had the highest
incidence of cholera and paralytic shellfish poisoning. Region 1 came out highest in the incidence of
rotavirus in the same year.

AREA OF COVERAGE
FWBDs are usually manifested as diarrhea. Based on the 2015 Global Health Observatory (GHO) data,
diarrhea accounts for 9% of the total deaths among children below 5 years old. In the Philippines, a total
of 11,876 cases of acute bloody diarrhea (ABD) were reported from sentinel sites nationwide in the same
year. In addition, 830 Hepatitis A cases and 74 cases of paralytic shellfish poisoning were also reported.
The Philippine Health Statistics data showed that diarrhea placed 5th as a leading cause of morbidity
among general population in 2010 from being the top or second leading cause in the 1990s. Morbidity
rate due to diarrhea has gone down from 1,520/100,000 population in 1990 to 347.3/100,000 population
in 2010. Despite this decline however, several notable outbreaks continue to occur. It is believed that
since the occurrence of FWBDs is essentially related to economic and socio-cultural factors.

PARTNER INSTITUTIONS
The management and implementation of the FWBD-PCP are shared responsibility among the following
offices:
A. Department of Health – Central Office
1. Infectious Disease Office (IDO) - Disease Prevention and Control Bureau (DPCPB)
The overall management and coordination of the FWBD-PCP is lodged in the IDO-DPCB.  It takes the
lead in setting the overall direction and focus of the Program.
 Formulate and disseminate national policies, standards and guidelines governing the management
and implementation of the FWBD-PCP
 Develop strategic plans  and cascade this to the regional offices for adoption
 Ensure the provision/delivery of quality diagnosis, management and treatment services of FWBDs
 Design and undertake training program on various components of the program
 Manage the logistics requirements of the Program
 Secure financing for the FWBD-PCP
 Establish partnership with other national government agencies and other partners in the private
sector
 Undertake monitoring and evaluation of the status and performance of the FWBD-PCP
 Coordinate with HPCS and other entities in promoting WASH practices and key messages on
prevention and control of FWBDs
 Monitor together with EB any outbreak due to FWBD and coordinate with HEMB for the
immediate response
2. Environmental Health and Sanitation
  Provide technical assistance to the regions and LGUs to comply with the provisions and
requirements of the Sanitation Code in the Philippines;
 Formulate policies, guidelines and standards in promoting increased access to safe water and
sanitation services
 Design strategic approaches to achieve zero open defecation areas nationwide
 Develop and promote guidelines on healthy wash, sanitation and hygiene practices among food
handlers, and other concerned institutions
 Coordinate with the Department of Environment and Natural Resources (DENR) for interventions
that will support the prevention and control of FWBDs
3. Epidemiology Bureau (EB)
 Establish, operate and sustain FWBD surveillance nationwide
 Support LGUs in case investigation of reported FWBD cases and in providing immediate and
proper response
 Inform/communicate with the DOH-IDO and other offices concerned of any impending or notable
FWBD outbreaks
 Generate timely FWBD surveillance reports and disseminate to concerned DOH offices
 Coordinate with RITM in taking the lead to develop a work and financial plan and/or proposal
funding for the surveillance.
 Provide assistance to RESUs and LESUs if needed in the investigation of cases of food and
waterborne illness.
 Notify the WHO through the National IRR (International Health Regulations) Focal Point when
the assessment indicates a food or waterborne disease event is notifiable pursuant to paragraph 1
of Article 6 and Annex 2 and to inform WHO as required pursuant to Article 7 and paragraph 2 of
Article 9 of IHR (Annex 3.8A).
4. Health Emergency Management Bureau (HEMB)
 Provide technical assistance in developing plans in times of emergencies and disasters.
 Mobilize WASH resources through Regional DRRM-H Manager to ensure adequate and safe
water through water quality surveillance, disinfection / treatment in coordination with DPCB-
EOH.
 Augment logistic support to FWBD during emergencies and disaster situations.
5. Health Promotion and Communication Services (HPCS)
 Formulate and design a communication plan to address the poor health seeking behavior of the
community and their unhealthy food and water practices including personal hygiene
 Develop key IEC messages for various groups of audiences relative to the prevention and control
of FWBDs
 Design appropriate media channels and materials to communicate the key FWBD prevention and
control messages
 Track improvement in the awareness, attitudes and practices of the targeted population on FWBD
prevention and control
6. Research Institute for Tropical Medicine (RITM) and National Reference Laboratories
(Parasitology, Bacterial Enterics and Viral Enterics)
 Perform laboratory testing for samples referred for the FWBD surveillance and outbreak
investigation
  Provides technical support for specimen collection, transport and storage for the referring
hospitals
 Provides laboratory technical support, training and quality assurance to the subnational, regional
and other laboratories
 Provides linelist of laboratory results to EB and RESU, and individual laboratory results to the
RESU, in the form of transmittals (for distribution to the DRUs)
 Refer a subset of samples to the designated Regional Reference Laboratory (RRL) for quality
assurance purpose
 Performs further studies to determine other etiologies of FWBD
 Maintain continuous coordination/communication with stakeholders to promote information
exchange
 Train laboratory personnel in the diagnosis of FWB pathogens
 Provide external quality assurance program for laboratory diagnosis for FWB pathogens
 Evaluate test kits and reagents in coordination with FDA
 Develop and offer confirmatory assays for other FWB pathogens
 Conduct research relevant to FWB program
 Provide recommendation to LRD office as to the need for activation of Outbreak Codes to mount
multidepartment, division-level response as appropriate
 Conduct laboratory surveillance for the FWB pathogens
7. Food and Drug Administration (FDA)
 Perform microbiologic tests on food samples submitted to the laboratory
 Provide EB with a monthly report of etiologic agents of food and waterborne diseases on food
samples tested
 Monitor the safety of pre-packaged food in the market and issue Public Advisory / Warning to
prevent consumption of contaminated food
 Undertake surveillance of microbiologic agents of food and waterborne diseases which are
transmissible to humans Alert the DOH offices in cases of unusual increases in the number of
reported organisms known to cause food and waterborne disease in humans. (To be deleted)
(Transfer to DA)
B. DOH – Regional Offices
1. Infectious Disease Prevention and Control Cluster
 Disseminate national policies, standards and guidelines governing the management and
implementation of the FWBD-PCP
 Develop local plans and cascade to LGUs
 Undertake training related to FWBD-PCP to local government unit
 Provide logistic support on FWBD-PCP to LGU
 Monitor and evaluate the implementation of the program to LGU
 Coordinate with the regional environmental and Occupational Health on the implementation of
the FWBD-PCP
 Assist RESU in monitoring incidence of FWBDs
 Coordinate with other partners in the region for the management of the FWBD-PCP
2. Regional Epidemiology and Surveillance Unit (RESU)
  Encode data on patients with laboratory confirmed Salmonella and other food and waterborne
infections
 Analyze surveillance data and activate EICT outbreak investigation when deemed necessary
 Provide technical assistance during trainings on laboratory-based surveillance to be conducted
among hospital staff or sentinel sites
 Fill up laboratory request forms and submit appropriately-labeled stool specimens from patients
and samples of suspected food/water vehicles to the appropriate DOH or DA laboratory for
microbiologic tests
 Encode and collate epidemiologic data from LGUs (Provincial/City Epidemiology Surveillance
Unit, P/CESU), and hospital sentinel sites on the occurrence of Salmonella and other food and
waterborne disease and submit to EB
 Submit monthly report to EB on notifiable diseases. (StratPlan – PIDSR Report)
 Notify EB through the National IRR (International Health Regulations) Focal Point when the
assessment indicates a food or waterborne disease event is notifiable pursuant to paragraph 1 of
Article 6 and Annex 2 and to inform WHO as required pursuant to Article 7 and paragraph 2 of
Article 9 of IHR (Annex 3.8A)
3. Environmental and Occupational Health Unit
 Provide technical assistance to LGUs to increase HHs with access to safe water and with sanitary
toilet, and achievement of zero defecation area
 Implement the preventive measures of FWBD
 Assist in the investigation of FWBD Outbreaks
 Support campaign of prevention and control of FWBD
4. Provincial DOH Office
 Advocate for LCEs’ support to FWBD-PCP
 Lobby to LGUs for funds/budget for FWBD-PCP through inclusion in the  annual budget
 Ensure adaption of DOH policy by LGU through ordinances
 Monitor implementation of FWBD
 Provide logistic / fund to EOH for FWBD prevention campaign.
C. Other Government Agencies
1. Department of Interior and Local Government (DILG)
 Support the DOH and DA in the collection and documentation of food-borne illness data,
monitoring and research
 Participate in training programs, standards development and other food safety activities to be
undertaken by the DA, DOH and other concerned national agencies
2. Department of Education
 Integrate messages on proper water, food and sanitary practices including personal hygiene in the
school curriculum
 Support and expand the implementation of WINS in public schools
 Integrate hand-washing practices during school feeding programs
3. Department of Agriculture
 Develop and transfer technologies that will improve and sustain the development of the livestock
industry which ensure food security and competitiveness of the local produce in the global market
  Plan, coordinate and implement research and development programs on swine, beef cattle,
poultry, small ruminants and equine on areas of genetics and breeding system, animal nutrition
and feed resources utilization, herd management, animal health and disease control, containment
and eradication of diseases, post-production, value-added meat products and by-products
technology and animal waste management
 Submit report of all investigations involving foodborne disease
 Alert the Department of Health agencies in cases of unusual increase in the number of reported
organisms known to cause foodborne disease in humans (DA, BAI)
4. Department of Social Welfare and Development
 Proper water, food and sanitary practices including personal hygiene of DSWD residential
centers, canteen, caterers
 Support and expand implementation of hand-washing practices during feeding programs
 Ensure that DSWD residential centers, canteen, caterers, and DSWD-food for work and feeding
programs use and serve fortified foods with Sangkap Pinoy Seal, if available
 Use and serve fortified foods such as rice, wheat, flour, oil and refined sugar in DSWD relief
operations and encourage LGUs and NGOs to follow the same
 Authorize food manufacturers to use the DOH seal of acceptance as guide for consumers in
selecting nutritious foods (DSWD)
5. Department of Environment and Natural Resources
 Control the construction and maintenance of waterworks, sewerage, and sanitation systems and
other public utilities
 Prohibiting dumping of waste products detrimental to the plants and animals or inhabitants therein
 Prohibiting of leaving an exposed or unsanitary conditions refuse or debris or depositing in
ground or in bodies of water
 Raise awareness on the importance of maintaining reliable and effective treatment of wastewater
 Endeavor to achieve social justice by ensuring the integrity of our ecosystems on which local
communities depend for food and livelihood
 Strive to recycle wastewater to benefit communities and not to allow untreated wastewater that
will harm people (DENR)
D. Local Government Units (LGUs)
The LGUs are primarily responsible in the delivery of quality FWBD diagnosis, management and
treatment and conduct of preventive and control interventions at the local level. Specifically, the LGUs
are expected to:
o Enforce the implementation of the “Code of Sanitation of the Philippines” (PD No. 856,
December 23, 1975): (i) sanitation particularly in public markets, slaughterhouses, micro and
small food processing establishments and public eating places, (ii) codes of practice for
production, post-harvest handling, processing and hygiene, (iii) safe use of food additives,
processing aids and sanitation chemicals and (iv) proper labeling of prepackaged foods
o Ensure access of households to safe drinking water, safe water and sanitation facilities
o Inspect food establishments on adherence to standards sanitation practices
o Provide training to food handlers and regulate
o Ensure proper waste disposal
o Establish, operate and sustain local epidemiology and surveillance units with the following tasks:
 o Register cases of laboratory confirmed Salmonella and other food and waterborne
infections identified from the local government unit (LGU) in the surveillance.
o Fill up laboratory request forms and submits appropriately labeled specimens from
patients and samples of suspected food/water vehicles to the appropriate DOH or DA
laboratory for microbiological tests
o Provide technical support for training on laboratory-based surveillance to hospital staff of
sentinel sites
o Encode and collate epidemiologic data on the occurrence of Salmonella and other food
and waterborne infections to the EB
o Submit monthly reports of food and waterborne diseases to RESU
o Notify RESU when the assessment indicates a food and waterborne disease event is
notifiable pursuant to paragraph 1 of Article 6 and Annex 2 of IHR and to inform WHO as
required pursuant to Article 7 and paragraph 2 of Article 9 of IHR (Annex 3.8A)
E. Hospitals
 Attend to cases of diarrhea (no signs, some signs, severe signs of dehydration)
 Request for basic laboratory workups  in case of complications
 Carry out further investigation as deemed necessary
 Refer cases appropriately to specialties/sub-specialties when needed
 Observe proper hydration and monitoring of hemodynamic status Encourage oral rehydrating
solution as soon as patient can tolerate
 Give appropriate anti-microbial if indicated
 Provide health education including handwashing, sanitation, hygiene will be provided
 Give IEC materials to patient/s prior to discharge
F. Laboratories
1. Subnational Laboratories
 Perform laboratory testing of samples from FWBD cases referred by the disease reporting units,
as well as from cluster/outbreak investigations. (we should refer this to our 'algorithm')
 Participate in monitoring and evaluation visits by the DOH FWBD Monitoring team
 Participate in the laboratory quality assurance program
 Provide laboratory results to the National Reference Laboratories and RESU
 Coordinate with the National Reference Laboratories for technical concerns (specimen collection,
transport, storage, testing and troubleshooting)
2. Regional Laboratories
 Perform direct fecal smear, modified acid fast staining, formalin ether concentration technique,
kato-katz and RDT for detection of FWB parasites
3. Tertiary Hospitals
 Perform direct fecal smear, modified acid fast staining, formalin ether concentration technique,
kato-katz and RDT for detection of FWB parasites
4. Level 3 Laboratories
 Perform direct fecal smear, modified acid fast staining, formalin ether concentration technique,
kato-katz and RDT for detection of FWB parasites
5. Level 2 Laboratories
  Perform direct fecal smear, kato-katz and modified acid fast staining for detection of FWB
parasites
6. Level 1 Laboratories
 Perform direct fecal smear and kato-katz for detection of FWB parasites
7. Rural Health Units
 Perform direct fecal smear and kato-katz for detection of FWB parasites

*NON-COMMUNICABLE DISEASES

A. LIFESTYLE-RELATED DISEASES

Description
Non-communicable diseases (NCDs) include cardiovascular conditions (hypertension, stroke), diabetes
mellitus, lung/chronic respiratory diseases and a range of cancers which are the top causes of deaths
globally and locally. These diseases are considered as lifestyle related and is mostly the result of
unhealthy habits. Behavioral and modifiable risk factors like smoking, alcohol abuse, consuming too
much fat, salt and sugar and physical inactivity have sparked an epidemic of these NCDs which pose a
public threat and economic burden.
Vision
A Philippines free from the avoidable burden of NCDs

Mission
Ensure sustainable health promoting environments and accessible, cost-effective, comprehensive,
equitable and quality health care services for the prevention and control of NCDs, and guided by the
principle of “Health in All, Health by All, Health for All” whereas Health in All refers to Health in All
Policies, Health by All involves the whole-of-government and the whole-of-society and the Health for All
captures the KP (Kalusugan Pangkalahatan) or the Universal Health Care (UHC).

Objectives
1. To raise the priority accorded to the prevention and control of non-communicable diseases in
national, regional and local health and development plans 
2. To strengthen leadership, governance, and multisectoral actions for the prevention and control of
non-communicable diseases
3. To reduce modifiable risk factors for non-communicable diseases and underlying social
determinants through creation of health-promoting environments
4. To strengthen health systems and increase access to quality medicines, products and services,
especially at the primary health care level, towards attainment of universal health coverage
5. To promote and support research and development for the prevention and control of non-
communicable diseases
6. To monitor the trends and determinants of non-communicable diseases and evaluate progress in
their prevention and control

Program Components
 1.  Cardiovascular Disease
2. Diabetes Mellitus
3. Cancer
4. Chronic Respiratory Disease

Policies and Laws

1. AO No. 2011-0003 or The National policy on Strengthening the Prevention and Control of
Chronic Lifestyle Related Non-Communicable Diseases
2. AO No. 2012-0029 or The Implementing Guidelines on the Institutionalization of Philippine
Package of Essential NCD Interventions (PhilPEN) on the Integrated Management of
Hypertension and Diabetes for Primary Health Care Facilities
3. AO No. 2013 – 0005 or The National Policy on the Unified Registry Systems of the Department
of Health (Chronic Non-Communicable Diseases, Injury Related Cases, Persons with Disabilities,
and Violence Against Women and Children Registry Systems)
4. AO 2015-0052: “National Policy on Palliative & Hospice Care in the Philippines
5. AO 2016-0001: “Revised Policy on Cancer Prevention and Control Program
6. AO 2016 – 0014 - Implementing Guidelines on the Organization of Health Clubs for Patients with
Hypertension and Diabetes in Health Facilities
B. SMOKING CESSATION/TOBACCO CONTROL PROGRAM

Rationale:
The use of tobacco continues to be a major cause of health problems worldwide. There is currently an
estimated 1.3 billion smokers in the world, with 4.9 million people dying because of tobacco use in a
year.  If this trend continues, the number of deaths will increase to 10 million by the year 2020, 70% of
which will be coming from countries like the Philippines. (The Role of Health Professionals in Tobacco
Control, WHO, 2005)

The World Health Organization released a document in 2003 entitled Policy Recommendations for
Smoking Cessation and Treatment of Tobacco Dependence. This document very clearly stated that as
current statistics indicate, it will not be possible to reduce tobacco related deaths over the next 30-50
years unless adult smokers are encouraged to quit.  Also, because of the addictiveness of tobacco
products, many tobacco users will need support in quitting.  Population survey reports showed that
approximately one third of smokers attempt to quit each year and that majority of these attempts are
undertaken without help.  However, only a small percentage of cigarette smokers (1-3%) achieve lasting
abstinence, which is at least 12 months of abstinence from smoking, using will power alone  (Fiore et al
2000) as cited by the above policy paper.

The policy paper also stated that support for smoking cessation or “treatment of tobacco dependence”
refers to a range of techniques including motivation, advise and guidance, counseling, telephone and
internet support, and appropriate pharmaceutical aids all of which aim to encourage and help tobacco
users to stop using tobacco and to avoid subsequent relapse.  Evidence has shown that cessation is the
only intervention with the potential to reduce tobacco-related mortality in the short and medium term and
therefore should be part of an overall comprehensive tobacco-control policy of any country.
The Philippine Global Adult Tobacco Survey conducted in 2009 (DOH, Philippines GATS Country
Report, March 16, 2010) revealed that 28.3% (17.3 million) of the population aged 15 years old and over
currently smoke tobacco, 47.7% (14.6 million) of whom are men, while 9.0% (2.8 million) are women. 
Eighty percent of these current smokers are daily smokers with men and women smoking an average of
11.3 and 7 sticks of cigarettes per day respectively.

The survey also revealed that among ever daily smokers, 21.5% have quit smoking.  Among those who
smoked in the last 12 months, 47.8% made a quit attempt, 12.3% stated they used counseling and or
advise as their cessation method, but only 4.5% successfully quit.  Among current cigarette smokers,
60.6% stated they are interested in quitting, translating to around 10 million Filipinos needing help to quit
smoking as of the moment. The above scenario dictates the great need to build the capacity of health
workers to help smokers quit smoking, thus the need for the Department of Health to set up a national
infrastructure to help smokers quit smoking.

The national smoking infrastructure is mandated by the Tobacco Regulations Act which orders the
Department of Health to set up withdrawal clinics. As such DOH Administrative Order No. 122 s. 2003
titled The Smoking Cessation Program to support the National Tobacco Control and Healthy Lifestyle
Program allowed the setting up of the National Smoking Cessation Program.

Vision:                 Reduced prevalence of smoking and minimizing smoking-related health risks.

Mission:            To establish a national smoking cessation program (NSCP).
Objectives:
The program aims to:
1.       Promote and advocate smoking cessation in the Philippines; and
2.       Provide smoking cessation services to current smokers interested in quitting the habit.
 
Program Components:
The NSCP shall have the following components:
1.          Training
The NSCP training committee shall define, review, and regularly recommend training programs that are
consistent with the good clinical practices approved by specialty associations and the in line with the
rules and regulations of the DOH.
All DOH health personnel, local government units (LGUs), selected schools, industrial and other
government health practitioners must be trained on the policies and guidelines on smoking cessation.

2.          Advocacy

A smoke-free environment (SFE) shall be maintained in DOH and participating non-DOH facilities,
offices, attached agencies, and retained hospitals. DOH officials, staff, and employees, together with the
officials of participating non-DOH offices, shall participate in the observance and celebration of the
World No Tobacco Day (WNTD) every 31st of May and the World No Tobacco Month every June.

3.          Health Education

Through health education, smokers shall be assisted to quit their habit and their immediate family
members shall be empowered to assist and facilitate the smoking cessation process.

4.       Smoking Cessation Services

5. Research and Development

Research and development activities are to be conducted to better understand the nature of nicotine
dependence among Filipinos and to undertake new pharmacological approaches. 

C. VIOLENCE AND INJURY PREVENTION PROGRAM

Background
The first global study on premature deaths in 2009 (WHO Report) revealed that road crashes, suicide and
violence were among the main causes of death worldwide for people aged 10 to 24 years. In 2011 (WHO
Report), injuries were reported to be responsible for 9% of all deaths with road traffic injuries claiming
nearly 3,500 lives each day, making it among the 10 leading causes of mortality globally. In response to
the foregoing, WHO called upon Member States to develop measures to prevent road traffic injuries and
violence. WHO recommended that such policies, strategies and plans of action be concrete and contain
objectives, priorities, timetables and mechanisms for evaluation.

In the Western Pacific, WHO called on its Member States to take firmer action to reduce the region's
more than 600 suicides per day. At the September 2011 Fifth Milestones in a Global Campaign for
Violence Prevention (GCVP) Meeting in South Africa, the Violence Prevention Alliance (VPA)
developed the plan of action geared towards increasing the priority of evidence-informed violence
prevention, building the foundations for violence prevention, and implementing violence prevention
strategies. Likewise, the United Nations General Assembly adopted Resolution 64/255 proclaiming
2011–2020 to be a Decade of Action for Road Safety to stabilize and reduce global road traffic fatalities
by 2020.

The Global Burden of Diseases, Injuries, and Risk Factors Study conducted in 2010  showed that
interpersonal violence, road injury, drowning, and self-harm (suicide) ranked sixth, 11th, 17th, and 27th,
respectively, on the leading causes of premature deaths in the Philippines. Accidents are the fifth leading
cause of mortality for the period of 2005-2010 as reported in the Philippine Health Statistics of the
National Epidemiology Center. The Online National Electronic Injury Surveillance System (ONEISS)
Fact Sheet for 2010-2012 revealed that transport or vehicular crash was the leading cause of unintentional
injuries and interpersonal violence (mauling/assault, contact with sharp objects, and gunshot) was the
leading cause of intentional injuries.

The Department of Health (DOH) shall serve as the focal agency with respect to violence and injury
prevention. As such, it shall design, coordinate and integrate plans, projects and activities of various
stakeholders into a more effective and efficient system geared towards violence and injury prevention.
The Violence and Injury Prevention Program has been institutionalized as one of the programs of the
Disease Prevention and Control Bureau (DPCB) formerly, National Center for Disease Prevention and
Control (NCDPC).
The program was the offshoot of Administrative Order No. 2007-0010 National Policy on Violence and
Injury Prevention which was issued in 2007. After seven years in January 2014, said AO was further
enhanced thru the issuance of AO 2014-0002 Revised National Policy on Violence and Injury Prevention
which serves as the overarching Administrative Order of different policies concerning violence and
injuries and shall include the service delivery mechanism and the well-defined roles and responsibilities
of the Department of Health and other major players. The program aims to reduce mortality, morbidity
and disability due to the following intentional and unintentional injuries:
1. road traffic injuries
2. interpersonal violence including bullying, torture and violence against women and children 
3. falls
4. occupational and work-related injuries
5. burns and fireworks-related injuries
6. drowning
7. poisoning and drug toxicity
8. animal bites and stings    
9. self-harm / suicide
10. sports and recreational injuries

For a comprehensive approach, the program shall coordinate with other programs like the Child Injury
Prevention Program, Violence Against Women and Children Program and other DOH Offices such as the
Health Facility Development Bureau, Health Emergency and Management Bureau, among others, solicit
active representation from public and private stakeholders that are involved in violence and injury
prevention.

VIP Program Objectives

1. To reduce the number of deaths from violence and injuries
2. To reduce disability caused by violence and injury
3. To enhance capacity of CHDs and other stakeholders in the prevention of violence and injury
4. To develop & implement evidence-based policies, standards and guidelines in the prevention of
violence and injury
5. To strengthen collaboration with stakeholders in the prevention violence and injury
6. To ensure reliable, timely, and complete data and researches on violence and injury
7. To advocate for alternative health financing schemes for trauma care

VIPP Program Strategies

A.Evidence-Based Research and Electronic Surveillance System – Multi-disciplinary and multi-
sectoral interventions shall be developed based on evidence-based research. DOH shall establish and
institutionalize a system of data reporting, recording, collection, management and analysis at the national,
regional, and local levels. An information system, that is, Online National Electronic Injury Surveillance
System (ONEISS) and Philippine Network for Injury Data Management System (PNIDMS), shall be
fully operationalized for this purpose.
B.Networking and Alliance Building – DOH shall promote partnerships with and among stakeholders
to build alliance and networks and to generate resources for activities related to VIPP.
C.Capacity Building and Community Participation - DOH shall develop and enhance the violence and
injury prevention capabilities of a wide range of sectors and stakeholders at the national, regional and
local levels.
D. Advocacy – DOH shall advocate to LGUs for ordinance development and lobby to Congress for
enactment of laws.
E. Equitable Health Financing Package – DOH, in collaboration with various stakeholders, shall
advocate to health financing institutions and financial intermediaries, i.e. the Philippine Health Insurance
Corporation (PHIC) and insurance companies, the development and implementation of policies that
would be beneficial for the victims of all forms of violence and injury.
F.Service Delivery – In collaboration with stakeholders, DOH shall institutionalize systems and
procedures for the integration and provision of services at the community level. In collaboration with
various stakeholders, DOH shall undertake advocacy, information and education, political support, and
multi-sectoral action on violence and injury prevention. Appropriate interventions at all levels of
prevention shall be crucially provided.
G. Six (6) E’s. Strategies shall utilize the concept of the six E’s (Education, Enactment / Enforcement,
Empowerment, Engineering, Emergency Medical Service, and Engagement in surveillance and research)
in the prevention of violence and injuries.
1. Education entails wide dissemination of information and communication related to violence and
injury prevention;
2. Enactment / Enforcement of laws and policies related to violence and injury     prevention;
3. Empowerment of all stakeholders in the implementation of VIPP. This also covers the provision
of psychosocial support to the victims of violence and injury to help them recover from the
psychological trauma;
4. Engineering control provides the most effective way of reducing the cause and impact of violence
and injuries. This involves the improvement of facilities and infrastructures to promote safe
environments;
5. Emergency Medical Services prior to hospital care. This is vital in providing pre-hospital trauma
life support to the injured on site at the soonest possible time so as to prevent needless mortality or
long-term morbidity or permanent disability; and
6. Engagement in surveillance and research to promote evidence-based, substantial, scientific, and
systematic approach to VIPP.
H. Monitoring and Evaluation – DOH, together with various stakeholders, shall identify indicators,
targets and milestones for program monitoring and evaluation purposes. There shall be a regular audit and
feedback mechanism of all VIPP-related strategies and activities. 

D. HEALTH AND WELLNESS PROGRAM FOR SENIOR CITIZENS

Description
In support of the RA 9257 (The Expanded Senior Citizens Act of 2003) and the RA 9994 (Expanded
Senior Citizen Act of 2010), the Department of Health issued Administrative Orders for health
implementors to undertake and promote the health and wellness of senior citizens as well as to alleviate
the conditions of older persons who are encountering degenerative diseases.  
With the goal of Health and Wellness Program for Senior Citizen of promoting quality of life among
older persons and contribute to the nation building, the HWPSC intends to provide the following:
 focused service delivery packages and integrated continuum of quality care,
 patient-centered and environment standard to ensure safety and accessibility for senior citizens,
 equitable health financing,
 capacitated health providers in the implementation of health programs for senior citizens,
 data base management, and
 strengthened coordination and collaboration with other stakeholders involved in the
implementation of programs for senior citizens.
In the current Philippine Health Agenda (2017 - 2022), guarantees that centralize health services for care
in all life stages, service delivery networks, and financial risk protection, geriatric health is mentioned as
an area of concern.  All senior citizens are mandatorily covered by the Philippine Health Insurance
Corporation by virtue of Republic Act No. 10642 “An act granting mandatory national health insurance
program of PhilHealth for all senior citizens”.

Vision
A country where all Filipino senior citizens are able to live an improved quality of life through a healthy
and productive aging.

Mission
Implementation of a well-designed program that shall promote the health and wellness of senior citizens
and improve their quality of life in partnership with other stakeholders and sectors.

Objectives
 To ensure better health for senior citizens through the provision of focused service delivery
packages and integrated continuum of quality care in various settings.
 To develop patient-centered and environment standards to ensure safety and accessibility of all
health facilities for the senior citizens.
 To achieve equitable health financing to develop, implement, sustain, monitor and continuously
improve quality health programs accessible to senior citizens.
 To enhance the capacity of health providers and other stakeholders including senior citizens group
in the implementation of health programs for senior citizens.
 To establish and maintain a database management system and conduct researches in the
development of evidence-based policies for senior citizens.
 To strengthen coordination and collaboration among government agencies, non-government
organizations, partner agencies and other stakeholders involved in the implementation of
programs for senior citizens.

Program Components
1. The Policy, Standards and Regulation component shall develop a unified patient-centered and
supportive environment standards to ensure safety and accessibility of senior citizens to all health
 facilities and to promote healthy ageing in order to prevent functional decline among senior
citizens.
2. The Health Financing component shall promote health financing schemes and other funding
support in all concerned government agencies and private stakeholders to provide programs that
are accessible to senior citizens.
3. The Service Delivery component shall ensure access of senior citizens to essential geriatric health
services including preventive, promotive, treatment, and rehabilitation services from the national
to the local level.
4. The Human Resources for Health component shall capacitate the health care providers in both
national and local government to be able to effectively provide technical assistance and
implement the program for senior citizens.
5. The Health Information component shall establish an information management system and
maintain a repository of data.
6. The Governance for Health component shall coordinate and collaborate with the local government
units and other stakeholders  to ensure an effective and efficient delivery  of health services at the
hospital and community level.

Partner Institutions
 Department of Geriatric Services (formerly known as the National Center for Geriatric Health) of
Jose R. Reyes Memorial Medical Center
 Institute for Aging of UP Manila
 Philippine College of Geriatric Medicine
 Philippine Health Insurance Corporation
 Department of Social Welfare and Development
 Coalition of Services of the Elderly
 Association of Department of Health Retired Employees

Policies and Laws

 Madrid International Plan of Action on Aging
 Regional Framework for Action on Aging and health in the Western Pacific 2014-2019
 The 1987 Philippine Constitution
 Aquino Health Agenda
 Philippine Plan of Action for Senior Citizens (2012-2016)
 Republic Act No. 9257 – “An Act Granting Additional Benefits and Privileges to Senior Citizens
amending for the purpose of Republic Act no. 7432, otherwise known as “An Act to Maximize
the Contribution of Senior Citizens to Nation Building, Grant benefits and Special Privileges and
for Other Purposes”
 Republic Act No. 9994 – “An Act Granting Additional Benefits and Privileges to Senior Citizens,
Further Amending Republic Act no. 7432”

Strategies, action Points and Timeline

1. Participatory Governance for health through the life course
2. Strengthened Service Delivery for older populations
 3. Advocacy and Promotion of healthy aging
4. Evidence-based Decision Making

E. PREVENTION OF BLINDNESS PROGRAM

Cataract
Cataract, the opacification of the normally clear lens of the eye, is the most common cause of blindness
worldwide. It is the cause in 62% of all blindness in the Philippines and is found mostly in the older age
groups. The only cure for cataract blindness is surgery. This is available in almost all provinces of the
country; however there are barriers in accessing such services. Interventions will therefore consist of
increasing awareness about cataract and cataract surgery; as well as improving the delivery of cataract
services. The parameter used worldwide to monitor cataract service delivery is the Cataract Surgical Rate.

Errors of Refraction
Errors of refraction is the most common cause of visual impairment in the country (prevalence is 2.06%
in the population). Errors of refraction are corrected either with spectacle glasses, contact lenses or
surgery. The services to address the problem of EOR are provided mainly by optometrists. However, the
provision of the eyeglasses or lenses (who should provide, how is it provided, etc.) has to be addressed.

Childhood Blindness
The prevalence of blindness among children (up to age 19) is 0.06% while the prevalence of visual
impairment in the same age group is 0.43%. The problem of childhood blindness is the highly specialized
services that are needed to diagnose and treat it. However, screening of children for any sign of visual
impairment can be done by pediatricians, school clinics and health workers.   

Government Mandates and Policies :

 Administrative Order No. 179 s.2004: Guidelines for the Implementation of the National
Prevention of Blindness Program
 Department Personnel Order No. 2005-0547: Creation of Program Management Committee for
the National Prevention of Blindness Program
Subcommittees: Refractive Error/Low Vision, Childhood Blindness, Cataract
 Proclamation No. 40 declaring the month of August every year as “Sight Saving Month”

Vision:        
 All Filipinos enjoy the right to sight by year 2020

Mission:     
The DOH, Local Health Unit (LGU) partners and stakeholders commit  to:
1. Strengthen partnership among and with stakeholder to eliminate avoidable blindness in the
Philippines;
2. Empower communities to take proactive roles in the promotion of eye health and prevention of
blindness;
3. Provide access to quality eye care services for all; and
 4. Work towards poverty alleviation through preservation and restoration of sight to indigent
Filipinos.
Goal:
Reduce the prevalence of avoidable blindness in the Philippines through the provision of quality eye care.

Interventions/Strategies employed or Implementation by the DOH

       1.     Advocacy and Health Education
   This includes patient information and education, public information and education and intersectoral
collaboration on eye health promotion and the nature and extent of visual impairments particularly its risk
factors and complications and the need/urgency of early diagnosis and management.       
       2.    Capability Building
     This component shall focus on ensuring the capability of national and local government health
facilities in delivering the appropriate eye health care services especially to the indigent sector of the
population. Program shall provide training for coordinators at regional and provincial levels; will ensure
the availability of and access to training programs by program implementers. It shall include
strengthening treatment/management capabilities of existing personnel and operating capabilities of
facilities conducting cataract operations etc., taking into outmost consideration basic quality assurance
and standardization of procedures and techniques appropriate to each facility/locality.
      3.      Information Management
      The program shall develop an information management system for purposes of reporting and
recording. As far as practicable, this system shall consider and will build on any existing mechanism. The
system shall be national in scope, although the mechanism shall consider the regional and local needs and
capabilities.
      4.      Networking, Partnership Building and Resource Mobilization
      An important component of the program is networking and partnership building to ensure that
services are available at the local level. This shall include public-private and public-public partnership
aimed at building coalition and networks for the delivery of appropriate eye health care services at
affordable cost especially to the indigent sector. This component shall also focus on ensuring that the
highest appropriate quality services are made available and accessible to the people.
     5.      Supervision, Monitoring and Evaluation
      The Program shall be coordinated by a national program coordinator from the Degenerative Disease
Office of the National Center for Disease Prevention and Control, Department of Health. The national
program coordinator shall oversee the implementation of program plans and activities with the assistance
of the regional coordinators from the Centers for Health Development.
    A system of monitoring program plans and activities shall be developed and implemented taking into
consideration the provision of the local government code as well as the organic act of Muslim Mindanao,
and any similar issuances/laws that will be passed in the future.
      A program review shall be conducted as needed. Result of program evaluation shall be used in
formulating policies, program objectives and action plans.
    6.      Research and Development
      The program shall encourage the conduct of researches for purposes of developing local competence
in eye health care and for other purposes that may be necessary. The development and dissemination of
clinical practice guidelines for eye health shall form part of the research agenda of the program.
      The program shall support researches/studies in the clinical behavior (KAP) and epidemiological
(trends) areas. It also aims to acquire information that is utilized for continuing public health information
and education, policy formulation, planning and implementation.
    7.      Service Delivery
      Service delivery for the prevention of Blindness Program shall be covered by the principle of best
practice. In collaboration with the local government units and stakeholders, the program shall develop
systems and procedures for the integration and provision of services at the community level. This means
primary eye prevention concentrating on health education, advocacy and primary eye interventions;
Secondary prevention; screening/early detection/basic management/ counseling, referral and/or definitive
care and tertiary prevention: management of complications, continuing care and follow up including
rehabilitation. The following areas will be the priority areas for services to be provided by the National
Prevention of Blindness Program:
a.       Cataract Surgeries
b.      Errors of Refraction
c.       Childhood Blindness
Activities for the Vitamin A Deficiency Disorder, for practical purposes, shall be led by the Family
Health Office also of the NCDPC.

A Referral System shall form part of services delivered by the program. This is to ensure that all patients
receive quality eye health care at appropriate levels of health care delivery system. All rural health units
should be linked to an eye care referral center.

F. MENTAL HEALTH PROGRAM

Republic Act 11036, otherwise known as the Mental Health Act, has been promulgated to enhance and
integrate mental health service delivery to Universal Health Care through promotion and protection of the
rights of persons using psychosocial health services and increasing investments in mental health. The
National Mental Health Program (NMHP) ensures the implementation of the law through the National
Mental Health Strategic Plan (2019-2023), including balanced scorecards with indicators. This affirms
the basic right of all Filipinos to mental health as well as the fundamental rights of people who require
mental health services.

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 overall 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.

Policies and Laws

  Administrative Order No. 8s.2001(National Mental Health Policy)
 Administrative Order No. 2016-0039(Revised Operational Framework for a Comprehensive
National Mental Health Program)

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

E. WOMEN & CHILDREN PROTECTION PROGRAM

Description
In 1997, Administrative Order 1-B or the “Establishment of a Women and Children Protection Unit in All
Department of Health (DOH) Hospitals” was promulgated in response to the increasing number of
women and children who consult due to violence, rape, incest, and other related cases.

Since A.O. 1-B was issued, the partnership among the Department of Health (DOH), University of the
Philippines Manila, the Child Protection Network Foundation, several local government units,
development partners and other agencies resulted in the establishment of women and child protection
units (WCPUs) in DOH-retained and Local Government Unit (LGU) -supported hospitals. As of 2011,
there are 38 working WCPUs in 25 provinces of the country. For the past years, there have been attempts
to increase the number of WCPUs especially in DOH-retained hospitals, but they have been unsuccessful
for many reasons.

As of 2016, a total of 94 WCPUs were established nationwide that served about 8,000 cases in the past
year.

“The DOH shall provide medical assistance to victims” through a socialized scheme by the Women and
Children Protection Unit (WCPU) in DOH-retained hospitals or in coordination with LGUs or other
government health facilities (RA 9262:Anti-violence Violence Against Women Against Women And
Their Children And Their Children Act Of 2004 )

The Department shall refer the child who is placed under protective custody to a government medical or
health officer for a physical/ mental examination and/or medical treatment (RA 7610: Special Protection
of Children Against Child Abuse, Exploitation and Discrimination Act)
Republic Act No. 10354 (The Responsible Parenthood and Reproductive Health Act of 2012) highlights
the elimination of violence against women and children and other forms of sexual and gender-based
violence.

Vision
A gender-fair and violence-free community where women and their children are empowered

Mission
Improved strategy towards a violence-free community through more systematic primary prevention,
accessible and effective response system and strengthened functional mechanisms for coordination,
planning, implementation, monitoring, evaluation and reporting

Goal
The goal of the WCPP is to increase the number of VAWC cases appropriately managed in health
facilities. To achieve this goal, the WCPP should focus on the primary prevention and response through
establishment and ensuring the functionality of WCPUs, strengthening management structures, capability
building of public health workers and hospital staff, health promotion and advocacy.

Objectives
To institutionalize and standardize the quality of service and training of all women and children
protection units. Specifically, the program aims to:

8. Prevent violence against women and children from ever occurring (primary prevention)
9. Intervene early to identify and support women and children who are at risk of violence (early
intervention); and
10. Respond to violence by holding perpetrators accountable, ensure connected services are
available for women and their children (response).
Program Components
 Violence & Injury Prevention
 Mental Health

Partner Institutions
Local & International Development Partners:
 Council for the Welfare of Children
 Philippine Commission of Women
 Department of Social Welfare and Development
 Department of Interior and Local Government
 Department of Justice
 Department of Labor and Employment
 Philippine National Police
 National Bureau of Investigation
 Civil Service Commission
 Commission on Human Rights
 Child Protection Network
 SAVE the Children
 World Health Organization
 UNICEF

Policies and Laws

 Republic Act 7610: Anti-Child Abuse Law
 Republic Act 9262: Anti-Violence Against Women and their Children Act
  Republic Act No. 8353: Anti-Rape Law
 Republic Act 10364: Expanded Anti-Trafficking in Persons (RA 9208: Anti-Trafficking in
Persons Act of 2003)
 Republic Act No. 8505: Rape Victim Assistance & Protect Act
 Republic Act 9710: Magna Carta of Women
 RA 7877: Anti-Sexual Harassment Act
 Republic Act 10354 (The Responsible and Reproductive Health Act of 2012)
 Administrative Order 1-B s. 1997: DOH Policy on the establishment of Women & Children’s
Protection Units (WCPU)
 Administrative Order 2013-0011: Revised guidelines on the establishment of WCPUs in all
hospitals
 Administrative Order 2014-0002: Violence and Injury Prevention

Strategies, Action Points and Timeline

 PRIMARY PREVENTION – address the underlying conditions that influence women and
children's health, building a gender responsive community (family as entry point)
 SERVICE DELIVERY - foster collaborative partnerships which improve health outcomes
 ADVOCACY & SOCIAL MOBILIZATION - expand the reach and influence of our work,
empowered communities
 RESEARCH & INNOVATION - research current and emerging issues affecting women and
children
 ORGANIZATIONAL EXCELLENCE - ensure quality systems and practices that promote
organizational sustainability, continuous improvement and innovation