“Department of Health Programs”

1. Adolescent and Youth Health and Development Program (AYHDP) In line with the global policy changes on adolescents and youth, the DOH created the Adolescent and Youth Health and Development Program (AYHDP) which is lodged at the National Center for Disease Prevention and Control (NCDPC) specifically the Center for Family and Environmental Health (CFEH). The program is an expanded version of Adolescent Reproductive Health (ARH) element of Reproductive Health which aims to integrate adolescent and youth health services into the health delivery systems. The DOH, with the participation of other line agencies, partners from the medical discipline, NGOs and donor agencies have developed a policy on adolescent and youth health as well as complementary guidelines and service protocol to ensure young peoples’ health needs are given attention. The Program shall mainly focus on addressing the following health concerns regardless of their sex, race and socioeconomic background: * Growth and Development concerns Nutrition Physical, mental and emotional status * Reproductive Health Sexuality Reproductive Tract Infection (STD, HIV/AIDS) Responsible Parenthood Maternal & Child Health * Communicable Diseases Diarrhea, Dengue Hemorrhagic Fever, Measles, Malaria, etc. * Mental Health Substance use and abuse * Intentional / non-intentional injuries Disability Other issues and concerns such as vocational, education, social and employment needs where the DOH has neither direct mandate nor control, shall be coordinated closely with other concerned line agencies, and NGOs. 2. Botika Ng Barangay (BnB) Botika ng Barangay Profile: currently being updated. The Botika ng Barangay (BnB) refers to a drug outlet managed by a legitimate community organization (CO/non-government organization (NGO) and/or the Local Government Unit (LGU), with a trained operator and a supervising pharmacist specifically established in accordance with Administrative Order No. 144 s.2004. The BnB outlet should be initially identified, evaluated and selected by the concerned Center for Health Development (CHD), approved by the National Drug Policy-Pharmaceutical Management Unit (NDP-PMU 50), and specifically licensed by the Bureau of Food and Drugs (BFAD) to sell, distribute, offer for sale and/or make available low-priced generic home remedies, over-the-counter (OTC) drugs and two (2) selected, publicly-known prescription antibiotic drugs (i.e. Amoxicillin and Cotrimoxazole). The BnB program aims to promote equity in health by ensuring the availability and accessibility of affordable, safe and effective, quality, essential drugs to all, with priority for marginalized, underserved, critical and hard to reach areas. 3. Promotion of Breastfeeding program / Mother and Baby Friendly Hospital Initiative (MBFHI) Realizing optimal maternal and child health nutrition is the ultimate concern of the Promotion of Breastfeeding Program. Thus, exclusive breastfeeding in the first four (4) to six (6) months after birth is encouraged as well as enforcement of legal mandates. The Mother and Baby Friendly Hospital Initiative (MBFHI) is the main strategy to transform all hospitals with maternity and newborn services into facilities which fully protect, promote and support breastfeeding and rooming-in practices. The legal mandate to this initiative are the RA 7600 (The Rooming-In and Breastfeeding Act of 1992) and the Executive Order 51 of 1986 (The Milk Code). National assistance in terms of financial support for this strategy ended year 2000, thus LGUs were advocated to promote and sustain this initiative. To

sustain this initiative, the field health personnel has to provide antenatal assistance and breastfeeding counseling to pregnant and lactating mothers as well as to the breastfeeding support groups in the community; there should also be continuous orientation and reorientation/ updates to newly hired and old personnel, respectively, in support of this initiative. 4. Philippine Cancer Control Program The Philippine Cancer Control Program, begun in 1988, is an integrated approach utilizing primary, secondary and tertiary prevention in different regions of the country at both hospital and community levels. Six lead cancers (lung, breast, liver, cervix, oral cavity, colon and rectum) are discussed. Features peculiar to the Philippines are described; and their causation and prevention are discussed. A recent assessment revealed shortcomings in the Cancer Control Program and urgent recommendations were made to reverse the anticipated ‘cancer epidemic’. There is also today in place a Community-based Cancer Care Network which seeks to develop a network of self-sufficient communities sharing responsibility for cancer care and control in the country. Sources: Department of Medicine, University of the Phil-Phil General Hospital and Jose R. Reyes Memorial Medical Center, Department of Health and 2Cancer Institute, Philippine General Hospital and Department of Orthopaedics, University of the Phil-Phil General Hospital, Manila, Philippines. 5. Cancer or Malignant Neoplasms Cancer is largely considered a lifestyle-related disease. Many chemical, biological, radioactive, and other naturally occurring and synthetic substances, as well as predisposing factors and high-risk behaviors like smoking, diet, sexual activity, pollution and occupational exposure have been linked to cancer. Many different types of cancers have been identified. In the Philippines, the most common sites of reported deaths from cancer are the trachea, bronchus and lung (8.4 deaths per 100,000 population), breast (4.4 per 100,000) and leukemia (2.9 per 100,000). Among males, the leading sites are the lungs, prostate, colorectal area and liver. Among females, the leading sites are the breast, uterus, cervix and lungs. Among children, the leading cancers are the leukemias and lymphomas. 6. Child Health and Development Strategic Plan Year 2001-2004 The Philippine National Strategic Framework for lan Development for CHildren or CHILD 21 is a strategic framework for planning programs and interventions that promote and safegurad the rights of Filipino children. Covering the period 2000-2005, it paints in borad strokes a vision for the quality of life of Filipino children in 2025 and a roadmap to achieve the vision. Children's Health 2025, a subdocument of CHILD 21, realizes that health is a critical and fundamental element in children's welfare. However, health programs cannot be implemented in isolation from the other component that determine the safety and well being of children in society. Children's Health 2025, therefore, should be able to integrate the strategies and interventions into the overall plan for children's development. Children's Health 2025 contains both mid-term strategies, which is targeted towards the year 2004, while long-term strategies are targeted by the year 2025. It utilizes a life cycle approach and weaves in the rights of children. The life cycle approach ensures that the issues, needs and gaps are addressed at the different stages of the child's growth and development. The period year 2002 to 2004 will put emphasis on timely diagnosis and management of common diseases of childhood as well as disease prevention and health promotion, particularly in the fields of immunization, nutrition and the acquisisiton of health lifestyles. Also critical for effective pallning and implementation would be addressing the components of the health infrastructure such as human resource development, quality assurance, monitoring and disease surveillance, and health information and education.

The successful implementation of these strategies will require collaborative efforts with the other stakeholdres and also implies integration with the other developmental plan of action for children. 7. Dengue Control Program One of the major health problems during rainy season is the incidence of Dengue Hemorrhagic Fever. It occurs in all age groups. This disease (transmitted by Aedes, a daybiting mosquito) is preventable but is prevalent in urban centers where population density is high, water supply is inadequate (resulting to water storage and a good breeding place for the vector), and solid waste collection and storing are also inadequate. The thrust of the Dengue Control Program is directed towards community-based prevention and control in endemic areas. Major strategy is advocacy and promotion, particularly the Four O’clock Habit which was adopted by most LGUs. This is a nationwide, continuous and concerted effort to eliminate the breeding places of Aedes aegypti. Other initiatives are the dissemination of IEC materials and tri-media coverage. 8. Dental Health Program ComprehensiveDental Health Program aims to improve the quality of life of the people through the attainment of the highest possible oral health. Its objective is to prevent and control dental diseases and conditions like dental caries and periodontal diseases thus reducing their prevalence. Targeted priorities are vulnerable groups such as the 5-12 year old children and pregnant women. Strategies of the program include social mobilization through advocacy meetings, partnership with GOs and NGOs, orientation/updates and monitoring adherence to standards. To attain orally fit children, the program focuses on the following package of activities: oral examination and prophylaxis; sodium fluoride mouth rinsing; supervised tooth brushing drill; pit and fissure sealant application; a-traumatic restorative treatment and IEC. The Program also integrates its activities with the Maternal and Child Health Program, the Nutrition Program and theGarantisadong Pambata activities of the WHSMP. 9. Emerging Disease Control Program Emerging infectious diseases are newly identified and previously unknown infections which cause public health problems either locally or internationally. These include diseases whose incidence in humans has increased within the past two decades or threatens to increase in the near future. 10. Environmental Health Environmental Health is concerned with preventing illness through managing the environment and by changing people's behavior to reduce exposure to biological and nonbiological agents of disease and injury. It is concerned primarily with effects of the environment to the health of the people. Program strategies and activities are focused on environmental sanitation, environmental health impact assessment and occupational health through inter-agency collaboration. An Inter-Agency COmmittee on Environmental Health was created by virute of E.O. 489 to facilitate and improve coordination among concerned agencies. It provides the venue for technical collaboration, effective monitoring and communication, resource mobilization, policy review and development. The Committee has five sectoral task forces on water, solid waste, air, toxic and chemical substances and occupational health. 11. Expanded Program on Immunization Children need not die young if they receive complete and timely immunization. Children who are not fully immunized are more susceptible to common childhood diseases. The Expanded

Program on Immunization is one of the DOH Programs that has already been institutionalized and adopted by all LGUs in the region. Its objective is to reduce infant mortality and morbidity through decreasing the prevalence of six (6) immunizable diseases (TB, diphtheria, pertussis, tetanus, polio and measles) Special campaigns have been undertaken to improve further program implementation, notably the National Immunization Days (NID), Knock Out Polio (KOP) and Garantisadong Pambata (GP) since 1993 to 2000. This is being supported by increasing/sustaining the routine immunization and improved surveillance system. 12. Family Planning Brief Description of Program A national mandated priority public health program to attain the country's national health development: a health intervention program and an important tool for the improvement of the health and welfare of mothers, children and other members of the family. It also provides information and services for the couples of reproductive age to plan their family according to their beliefs and circumstances through legally and medically acceptable family planning methods. The program is anchored on the following basic principles. * Responsible Parenthood which means that each family has the right and duty to determine the desired number of children they might have and when they might have them. And beyond responsible parenthood is Responsible Parenting which is the proper ubringing and education of chidren so that they grow up to be upright, productive and civic-minded citizens. * Respect for Life. The 1987 Constitution states that the government protects the sanctity of life. Abortion is NOT a FP method: * Birth Spacing refers to interval between pregnancies (which is ideally 3 years). It enables women to recover their health improves women's potential to be more productive and to realize their personal aspirations and allows more time to care for children and spouse/husband, and; * Informed Choice that is upholding and ensuring the rights of couples to determin the number and spacing of their children according to their life's aspirations and reminding couples that planning size of their families have a direct bearing on the quality of their children's and their own lives. 13. DOH WAGES WAR AGAINST PICCOLO Press Release/28 December 2010 The Department of Health (DOH) today launched an all-out war against the sale of piccolo as latest Kampanya Kontra Paputok Surveillance revealed that 48% of the total 173 fireworksrelated injuries were due to said firework. As of December 28, the DOH recorded a total of 173 fireworks-related injuries. Of the total, 162 were due to fireworks, six from stray bullets, and five from fireworks ingestion. This year’s reported 173 cases is 12% lower compared to last year’s figure. The National Capital Region reported the most (80) number of cases, followed by Central Luzon (15) and Western Visayas (12). Of the 162 injury cases reported due to fireworks, the most affected group belonged to the 1-10 years, composed of 140 males. Majority (107/162) were active users or directly handled firecrackers. There were no deaths reported. The number of stray bullets cases stand at six. Ages of cases ranged from 11-29 years. Of the total cases, five were males. Three of the injuries occurred at home. There were no deaths reported. Fireworks ingestion now rose to five from yesterday’s four. Of the total cases, three were due to piccolo. Ages of cases ranged from 1-44 years. Three of the cases were males. There was one fatality reported.

The leading fireworks which are causing injuries are piccolo (83), kwitis (15), five star (13, whistle bomb and boga (8), and triangle (7). “If we do not stop the sale of piccolo, we expect about a thousand casualties or more until January 1,” Health Secretary Enrique Ona said. Ona noted that the boga is also making a comeback as a source of injury, and warned that injury due to its use is also expected to increase. “There is still time to remind everybody on the dangers of exploding firecrackers/fireworks. I am calling on parents and caregivers, as well, not to let their children handle piccolo and other seemingly harmless firecrackers. Let us all welcome the New Year without injury,” Ona concluded. 14. Food and Waterborne Diseases Prevention and Control Program Food and Waterborne Diseases (FWBDs) are among the most common causes of diarrhea. In the Philippines, diarrheal diseases for the past 20 years is the number one cause of morbidity and mortality incidence rate is as high as 1,997 per 100,000 population while mortality rate is 6.7 per 100,000 population. From 1993 to 2002, FWBDs such as cholera, typhoid fever, hepatitis A and other food poisoning/foodborne diseases were the most common outbreaks investigated by the Department of Health. Also, outbreaks from FWBDs can be very passive and catastrophic. Since most of these diseases have no specific treatment modalities, the best approach to limit economic losses due to FWBDs is prevention through health education and strict food and water sanitation. The Food and Waterborne Disease Prevention and Control Program (FWBDPCP) established in 1997 but became fully operational in year 2000 with the provision of a budget amounting to PHP551,000.00. The program focuses on cholera, typhoid fever, hepatitis A and other foodborne emerging diseases (e.g. Paragonimiasis). Other diseases acquired through contaminated food and water not addressesd by other services fall under the program. 15. Human Resources for Health Network The Human Resources for Health Network (HRHN) is a multi-sectoral organization in the Philippines that is composed of government agencies and non-government organizations with the aim of addressing and responding to HRH issues and problems. The Department of Health (DOH) spearheaded the creation of this network which was formally established during its launching and signing of the Memorandum of Understanding among its member organizations last October 25, 2006. Prior to the creation of the HRHN, the DOH together with the World Health Organization (WHO) developed the Human Resources for Health Master Plan (HRHMP). The HRHMP serves as a conceptual framework and road map that will support HRH development and management in the Philippines. Included in the HRHMP is the creation of a network of different organizations with stake on HRH that will facilitate the implementation of programs, projects and activities needing multi-sectoral coordination. Hence the HRHN was conceived to achieve such purpose and to ensure that the HRHMP will be able to attain its goals. 16. Essential Newborn Care(ENC) Many initiatives, globally and locally, help save lives of pregnant women and children. Essential Newborn Care (ENC) is one. ENC is a simple, cost-effective newborn care intervention that can improve neonatal as well as maternal care. It is an evidence-based intervention that • • • emphasizes a core sequence of actions, performed methodically (step-by-step); is organized so that essential time bound interventions are not interrupted; and fills a gap for a package of bundled interventions in a guideline format.

Unang Yakap Campaign The Unang Yakap campaign seeks to engage national and local sectors, public and private health sectors, individuals and organizations, mothers, fathers and families, to embrace the Essential Newborn Care Protocol to ensure a bright and healthy future for our newborns. 17. Leprosy Control Program Leprosy Control Program envisions to eliminate Leprosy as a human disease by 2020 and is committed to eliminate leprosy as a public health problem by attaining a national prevalence rate (PR) of less than 1 per 10,000 population by year 2000. Its elimination goals are: reduce the national PR of <1 case per 10,000 population by year 1998 and reduce the sub-national PR to <1 case per 10,000 population by year 2000. Kilatis Kutis Campaign. Program thrust is towards finding hidden cases of leprosy and put them on Multi-Drug Therapy (MDT), emphasizing the completion of treatment within the WHO prescribed duration. Strategies are case-finding, treatment, advocacy, rehabilitation, manpower development and evaluation. 18. DOH, DILG, NAPC TIE-UP ON WATER AND SANITATION PROGRAM The Department of the Interior and Local Government (DILG), the Department of Health (DOH) and the National Anti-Poverty Commission (NAPC) on Wednesday agreed to jointly implement President Aquino’s water and sanitation program particularly in waterless municipalities of the country. Secretaries Jesse M. Robredo of the DILG, Enrique T. Ona of DOH and Secretary General Jose Eliseo M. Rocamora of NAPC signed the Memorandum of Agreement for a closer collaborative efforts among the parties as executing agencies of the priority water and sanitation program of the Aquino administration. The government is implementing the President’s Priority Program on Water (P3W) as part of the Medium-Term Philippine Development Plan (MTPDP), and to achieve the Millennium Development Goal (MDG) of reducing by half the proportion of people without sustainable access to safe potable water and basic sanitation Robredo said all partner agencies have agreed to prioritize the implementation of water and sanitation projects in waterless municipalities outside of Metro Manila, consistent with NAPC poverty criteria and DILG good-house-keeping criteria for LGUs. From the Philippine Water Supply Sector Roadmap, statistics showed that there are 432 waterless municipalities outside of Metro Manila, with more than 1.5 million households without access to safe drinking water. ‘Waterless municipalities” is defined as municipalities with less than 50% service coverage. The breakdown of the 432 per region are as follows: 12 are located in Region I; eight in the Cordillera Administrative Region (CAR); 29 in Region II; 10 in Region III; 18 in Region IV-A; 10 in Region IV-B; 28 in Region V; 74 in Region VI; 36 in Region VII; 22 in Region VIII; 34 in Region IX; 28 in Region X; 14 in Region XI; 19 in Region XII; 15 in Region XIII; and 75 in Autonomous Region in Muslim Mindanao (ARMM). Under the agreement, the NAPC shall serve as the lead coordinating agency in the implementation of the program, and shall ensure that priority be given to the barangays in municipalities with the highest density of poor households. Aside from monitoring the implementation of the program, the NAPC shall also ensure that the target water and sanitation projects in beneficiary LGUs are implemented according to the approved plan. The DOH shall provide the funding requirements for monitoring the implementation of the water and sanitation facilities in the waterless municipalities, and shall approve the guidelines for the utilization of funds for the implementation of the water supply and sanitation program.

At the same time, the DOH shall provide the funding requirements of NAPC and DILG corresponding to the agreed responsibilities and tasks under this joint programme for purposes of monitoring. Meanwhile, the DILG shall develop and implement capacity development interventions under the program, and shall establish collaborative partnerships and network among relevant agencies, non-governmental organizations, academe and other institutions in the implementation of the capacity development interventions. 19. World Health Report 2010 focusing on Health Systems Financing Health Secretary Enrique T. Ona, (3rd from left) presenting the World Health Report 2010 focusing on Health Systems Financing - The Path to Universal Coverage. Health Secretary Ona reiterated in the Alma-Ata Declaration that Health for All would contribute both to a better quality of life and also to global peace and security. He expressed optimism that President Benigno Aquino III’s marching order of universal healthcare coverage among the poorest of the poor Filipinos will soon be realize in two or three years. He added that strengthening rural health units, tapping private sector cooperation, sustaining health outcomes, expanding membership of informal sectors and scaling-up information campaign of Philhealth are some of the strategies the Department of Health should adopt in order to attain its objective. Also in photo from left to right are Philhealth President Dr. Rey Aquino, World Health Organization Country Representative to the Philippines Dr. Soe Nyunt-U, WHO Health Care Financing Team Leader Dr. Dorjsuren Bayarsaikhan, and WHO Health Sector Development Director Dr. Henk 20. Malaria Awareness Month - November 2007 Malaria is a disease caused by protozoan parasites called Plasmodium. It is usually transmitted through the bite of an infected female Anopheles mosquito. Malaria may also be transmitted through the following: • • • Transfusing blood that is positive for malaria parasites Sharing of IV needles (especially among IV drug users) Transplacenta (transfer of malaria parasites form an infected mother to her unborn child)

21. WORLD AIDS DAY 2010: “LIGHT FOR RIGHTS” Human Immunodeficiency Virus or HIV continues to be a potent threat to the health of our countrymen. Countries across the globe are facing this dreaded disease and its disastrous effects on individuals, their families, the health care delivery system, and society in general. Towards the end of 2008, an estimated total number of 33.4 million people were infected with HIV globally. Locally, there are now a total of 5,729 HIV positive cases in the country. This represents less than one percent of our total population which means that the country is still on track to meet our MDG target of halting the spread of HIV/AIDS by 2015. Despite this, Secretary Ona warned against complacency. “Efforts should be intensified to prevent its spread,” according the Health Secretary. Steady increases in the number of cases have been reported over the years. Twenty-two percent (22%) of all cases were recorded this year alone. This is primarily driven by risky behaviours which includes unprotected sex, among others. In every ten (10) HIV infections reported in the country, nine were acquired through unprotected sex. About of half of these infections were in men having sex with men. “Risky behaviours are fuelled by lack of awareness on HIV,” declared Secretary Ona as he emphasized the importance of focusing information and education campaigns on the most at risk populations (MARP). He also said that there is a need to inform people about the social impact of HIV/AIDS to correct the negative attitudes, biases, and stigma heavily associated with the disease.

Likewise, he stressed the importance of supporting the needs of people of living with HIV (PLHIV). At present, a total of 1,153 people living with HIV are currently on Anti-Retroviral treatment in the government’s 13 treatment hubs. These, together with the medical and social services are given for free. This is in keeping with our celebration of World AIDS Day aptly themed, “Light for Rights.” As health is a fundamental right, it is essential that every human being has access to accurate and appropriate information on HIV/AIDS, preventive services to halt its spread, and adequate treatment to fight the disease. “Let us all be beacons of light in the face of darkness that it is HIV/AIDS,” concluded the Health Chief. 22. MEASLES-RUBELLA SUPPLEMENTAL IMMUNIZATION ACTIVITY IN PASAY CITY Health Assistant Secretary Paulynn Jean Rosell-Ubial (right), with Pasay City Mayor Antonino Calixto (left) and Pasay City Congresswoman Imelda Calixto-Rubiano, led the ceremonial Measles-Rubella Supplemental Immunization activity held at Barangay 179 covered court in Pasay City as the country’s pilot area for the Philippines’ commitment to the 2008 World Health Assembly to achieve measles elimination. The DOH strategy of doorto-door measles elimination campaign will cover all children aged nine months to below eight years old. According to Asst. Sec. Ubial, the said measles vaccination campaign, if successful, will make Pasay City the first local government unit to be certified measles-free in the country and in the world. 23. DOH AND PHILIPPINE CANCER SOCIETY TO IMPROVE BREAST CANCER SURVIVAL IN THE PHILIPPINES In a bid to improve the survival rates of women diagnosed with breast cancer in the Philippines, the Department of Health (DOH) and the Philippine Cancer Society, Inc. (PCSI) will soon launch a medicines access program through a patient navigation scheme targeting indigent Filipino women diagnosed with early stage breast cancer. The new joint venture between DOH and the PCSI, which have been partners for almost three decades in combating cancer in the Philippines, was formally announced today through the signing of a Memorandum of Agreement (MOA) between PCSI Chairman Dr. Roberto Paterno and DOH Undersecretary Alexander Padilla represented by Assistant Secretary Elmer Punzalan who oversees all DOH-retained hospitals in Metro Manila. “We are very much elated with this new partnership with the DOH to strengthen efforts to help women with breast cancer by providing them support and free medicines. Cancer is an expensive disease and can really drive patients into poverty because of the huge out-ofpocket expenses it requires. We can never really stop women from dying until our efforts at early detection are linked to cost-effective care and treatment,” says Dr. Rachel Marie Rosario, PCSI Executive Director. Health Secretary Enrique T. Ona also expressed full support to the new partnership adding that providing medicine entitlements to poor and vulnerable sectors for priority diseases like cancer is a move that will be pursued by the DOH within the next five years. Cancer currently ranks third among the top killer diseases in the country. Both DOH and PCSI aim to promote early breast cancer screening particularly among poor women by providing assured access to medicines as well as other forms of support to the patient. The program is meant to highlight the advocacy that breast cancer is a curable disease when detected, treated and managed early. The Patient Navigation Program for poor patients with early stage breast cancer shall initially be implemented in four government hospitals covering the catchment areas of the Metro Manila Cancer Registry and the Rizal Cancer Registry which are the main sources of data for cancer incidence in the country. The four government hospitals include the East Avenue Medical Center (EAMC), Jose Reyes Memorial Medical Center (JRMMC), the Philippine General Hospital (PGH) and the Rizal Medical Center, all having the capacity, support facilities and a multidisciplinary team of experts for managing breast cancer.

In a ceremonial memorandum of agreement signing, the chief of hospitals of the pilot access sites also pledged support and cooperation in implementing the Patient Navigation Program in their respective institutions. Signing the agreement were Dir. Rolando Cortez, Medical Center Chief of EAMC; Dir. Ma. Alicia Lim, Medical Center Chief of JRMMC; Dir. Rolando Enrique Domingo, PGH Director; and Dir. Relito Saquilayan, Medical Center Chief of RMC. Also present during the event are other important partners of DOH from professional medical societies such as the Philippine College of Surgeons, the Philippine Society of Medical Oncologists (PSMO) and the Philippine Society of Pathologists (PSP) as well as practitioners from the four government hospitals who developed the standard treatment protocol that will be used in the access sites. Breast cancer is now the leading cancer site overtaking lung cancer for both sexes in the Philippines (i.e. 15% of all cancers). It is also the number one cause of cancer morbidity and mortality among Filipino women accounting for almost 30% of all female malignancies. It is estimated that there will be a total of 12, 262 new breast cancer cases in 2010 with 4,371 deaths. Latest data reveals that three out of every 100 Filipinas are likely to develop breast cancer in their lifetime and that one out of every 100 are likely to die from the disease before age 75 (Philippine Cancer Facts and Estimates 2010). In Asia, the Philippines is among the countries with the highest age standardized incidence rate for breast cancer. Survival rate for breast cancer in the Philippines is below 40% compared to the high survival rates of 80-98% already achieved in developed countries. Breast cancer cases are projected to increase in the Philippines in the coming years with factors such as smoking, unhealthy lifestyles and decreasing fertility. In August this year, the Philippine Cancer Society vowed to more strongly rally behind government efforts to improve care for cancer patients in response to the appeal of Secretary Ona to do something about the increasing burden of cancer in the Philippines. 24. MEMORANDUM OF AGREEMENT TO PROVIDE FREE MEDICINES TO BREAST CANCER PATIENTS The Department of Health, represented by Health Assistant Secretary Elmer Punzalan, and the Philippine Cancer Society, Inc. (PCSI) forged a Memorandum of Agreement to provide free medicines to breast cancer patients to be pilot initially in four hospitals, namely Philippine General Hospital (PGH), East Avenue Medical Center (EAMC), Rizal Medical Center (RMC) and the Jose R. Reyes Memorial Medical Center. The free medicines and services, worth approximately P45 M, will provide treatment for those cases detected early. Also in photo from left are PCSI Executive Director Dr. Rachel Marie Rosario, PGH Director Dr. Eric Domingo, PCSI Chairman Dr. Roberto Paterno, Dr. Ma. Victoria Abesamis from the EAMC, RMC Director Dr. Relito Saquilayan and Dr. Rolando Bautista from PITC Pharma. 29 October 2010, MRU-DOH 25. Knock Out Tigdas 2007 “Knock-out Tigdas 2007” is a sequel to the 1998 and 2004 “Ligtas Tigdas” mass measles immunization campaign. All children 9 months to 48 months old ( born October 1, 2003 – January 1,2007) should be vaccinated against measles from October 15 - November 15, 2007 , door-to-door. All health centers, barangay health stations, hospitals and other temporary immunization sites such as basketball court, town plazas and other identified public places will also offer FREE vaccination services during the campaign period. Other services to be given include Vitamin A Capsule and deworming tablet. 26. Vitamin A Supplementation Policy on Vitamin A Supplementation Program * The Philippine government is committed to virtually eliminate VAD * ECCD Law: DOH role is to ensure Vitamin A supplementation * Administrative Order No. 3-A, s. 2000: Guidelines of Vitamin A and Iron Supplementation

* Therapeutic supplementation: all cases of VAD * Preventive supplementation: 1. Universal - children 6-59 months 2. Regular/routine - Pregnant and Lactating women, High-risk children 3. Supplementation during emergencies 27. Food Fortifcation The Food Fortification program is the government's response to the growing micronutrient malnutrition, which is prevalent in the Philippines for the past several years. Food Fortification is the addition of Sangkap Pinoyor micronutrients such as Vitamin A, Iron and/or Iodine to food, whether or not they are normally contained in the food, for the purpose of preventing or correcting a demonstrated deficiency with one or more nutrients in the population or specific population groups. Sangkap Pinoy or micronutrients are vitamins and minerals required by the body in very small quantities. These are essential in maintaining a strong, healthy and active body; sharp mind; and for women to bear healthy children. Nutrition surveys since 1993 have been showing increasing prevalence of micronutrient malnutrition, particularly that of Vitamin A Deficiency Disorder (VADD) and Iron Deficiency Anemia (IDA) among children and women of reproductive age, who are the most at-risk groups to micronutrient malnutrition. 28. Garantisadong Pambata Garantisadong Pambata (GP) is a campaign to support the various health programs to reduce childhood illnesses and deaths by promoting positive child care behaviours. GP is a program of the Department of Health in partnership with the Local Government Units (LGUs) and other government and non-government organizations. 29. Newborn Screening Basic Information about Newborn Screening What are the disorders included in the Newborn Screening Package? 1. Congenital Hypothyroidism (CH) CH results from lack or absence of thyroid hormone, which is essential to growth of the brain and the body. If the disorder is not detected and hormone replacement is not initiated within (4) weeks, the baby's physical growth will be stunted and she/he may suffer from mental retardation. 2. Congenital Adrenal Hyperplasia (CAH) CAH is an endocrine disorder that causes severe salt lose, dehydration and abnormally high levels of male sex hormones in both boys and girls. If not detected and treated early, babies may die within 7-14 days. 3. Galactosemia (GAL) GAL is a condition in which the body is unable to process galactose, the sugar present in milk. Accumulation of excessive galactose in the body can cause many problems, including liver damage, brain damage and cataracts. 4. Phenylketonuria (PKU) 30. Occupational Health Program Vision/Mission Statement

Health for all occupations in partnership with the workers, employers, local government authorities and other sectors in promoting self-sustaining programs and improvement of workers' health and working environment.

Program Objectives and TargetsTo promote and protect the health and well being of the working population thru improved health, better working conditions and workers' environment. 31. Health Development Program for Older Persons (Elderly Health) Health Development Program for Older Persons Bureau or Office: National Center for Disease Prevention and Control Program Briefer Cognizant of its mandate and crucial role, the Philippine Department of Heallth (DOH) formulated the Health Care Program for Older Persons (HCPOP) in 1998. The DOH HCPOP (presently renamed Health Development Program for Older Persons) sets the policies, standards and guidelines for local governments to implement the program in collaboration with other government agencies, non-government organizations and the private sector. The program intends to promote and improve the quality of life of older persons through the establishment and provision of basic health services for older persons, formulation of policies and guidelines pertaining to older persons, provision of information and health education to the public, provision of basic and essential training of manpower dedicated to older persons and, the conduct of basic and applied researches. Target Population/Clients 1. Older persons (60 years and above) who are: a. Well and free from symptoms b. Sick and frail c. Chronically ill and cognitively impaired d. In need of rehabilitation services 2. Health workers and caregivers 3. LGU and partner agencies 32. Pinoy MD Program "Gusto kong Maging Doktor" A Medical Scholarship Grant for Indigenous People, Local Health Workers, Barangay Health Workers, Department of Health Employees or their children. This is a jJoint program of the Department of Health (DOH), Philippine Charity Sweepstakes Office (PCSO), and several State Universities and Medical Schools. 33. TB Control Program The rising incidence of tuberculosis has economic repercussions not only for the patient’s family but also for the country. Eighty percent of people afflicted with tuberculosis are in the most economically productive years of their lives, and the disease sends many self-sustaining families into poverty. The rise in the incidence of tuberculosis has been due to the low priority accorded to anti-tuberculosis activities by many countries. The unavailability of anti-TB drugs, insufficient laboratory networking, poor health infrastructures, including a lack of trained health personnel, have also contributed to the rise in the incidence of the diseases. According to the World Health Organization, the Philippines ranks fourth in the world for the number of cases of tuberculosis and has the highest number of cases per head in Southeast Asia. Almost two thirds of Filipinos have tuberculosis, and up to five million people are infected yearly in our country. 34. RUN FOR A CAUSE Health Secretary Enrique T. Ona, together with other DOH officers and staffs, join thousands of Filipinos in the 10-10-10 Run for the Pasig River yesterday, October 10, 2010.The event which aimed to raise funds for the rehabilitation of a heavily polluted Pasig River was participated by famous showbiz and political personalities.

Secretary Ona and the entire DOH delegation took part in the 10K run which started in Ayala Ave., Makati and ended at the SM Mall of Asia in Pasay. 35. Kalusugan ng Lahat, Philhealth ang Katapat President Benigno S. Aquino III and Health Secretary Enrique T. Ona distributes Philhealth cards to indigent residents of Baseco, Tondo, Manila. The Department of Health, along with other government agencies, observed October 2 as National Philhealth Registration Day in order to promote national insurance consciousness aimed at reducing out-of-pocket expenditiures of Filipinos during hospital confinement and out-patient treatment. The DOH believes that a strongsocial insurance system is a vital element towards progress and nation building. 36. ENERICS EXPO IN CLARK Healthy Lifestyle advocate Edna Nito, during the 2nd leg of the Philippine Generics EXPO 2010, lectures on the importance of engaging in regular exercise, eating healthy, balanced diet consisting of fruits, root crops, fish, and avoiding alcohol and tobacco as the natural way of preventing diseases and aging. The recent Generics EXPO was held in SM Clark, Pampanga and was participated by pharmaceutical companies promoting generic products. 37. ANTI-DENGUE CAMPAIGN IN LRT Health Secretary Enrique Ona explains to a young boy the Department of Health’s 4S strategy against dengue because the population most affected by the disease are the 1-10 years age group. The DOH’s 4-S campaign includes Search and destroy all mosquito breeding sites, Seek early consultation once dengue is suspected, wear Self-protective clothing to prevent mosquito bites, and Say no to indiscriminate fogging, because there are certain conditions that should be observed during fogging operation. Assisting Secretary Ona is Light Railway Transit Authority Division Chief Mr. Joseph Hagos. From January to August 21 this year, dengue cases nationwide reached 62,503 with 465 deaths. 39. COURT SAYS TO TOBACCO COMPANY: NO INJUNCTION to DOH AO The Department of Health won its first battle in what has become a long, drawn-out fight to protect the people’s right to health information. The Regional Tiral Court of Paranaque City denied Telengtan Brothers and Sons’ application for an injunction against the implementation of Administrative Order (AO) No. 2010-0013 last July 22, 2010. The AO requires tobacco manufacturers to put pictures of tobacco-related illnesses on cigarette packs, and prohibit manufacturers from using misleading descriptors on cigarettes, like “light”, “ultra-light” and “low tar”. It was issued in compliance with the Consumer Protection Act and the World Health Framework Convention on Tobacco Control that was ratified five years ago. Telengtan Brothers and Sons sought the injunction because of the “grave and irreparable damage” it believes it would suffer from the penalties that can be imposed for violations. Telengtan Brothers and Sons manufactures the cigarette brands, “Astro”, “Canon” and “Memphis”, and does business under the name and style La Suerte Cigar and Cigarette Factory. The RTC denied the injunction because it would preempt a decision on the validity of the AO, the principal issue in the case. It also said that as the penalties are not even operative yet, Telengtan Brothers and Sons’ “rouse of a possible violation of the law becomes a little bit imaginary in the meantime, and would not stand to prejudice petitioner.” According to the AO, tobacco companies are expected to comply by ensuring that all cigarette packs have graphic information within 90 days from its effectivity, or by September 10, 2010. “This order is a victory for the DOH and the Filipino public. It’s very tragic that we have all these tobacco companies filing cases left and right questioning the validity of an AO

that was crafted with nothing but the health of the Filipino people in mind. The fight is far from over, but this is a positive development.” Undersecretary Alex Padilla of the DOH said. Since the issuance of the Administrative Order, five tobacco companies have filed cases in various courts assailing its validity. “The DOH is mandated by law to promote the people’s constitutional right to health, and we intend to comply with our duty,” added Usec. Padilla. 40. DOH LAUNCHES OSPITAL PiNOY: MALINIS AT MABANGO CAMPAIGN In the government’s desire to further improve service to the people and be at par with its private counterparts, the Department of Health (DOH) today launched the “Ospital ng PiNOY: Malinis at Mabango” campaign. “Hospitals should be centers of wellness and not of sickness, hence the need to maintain always a clean environment,” Health Secretary Enrique T. Ona said, adding that the poor status of cleanliness and orderliness of DOH hospitals have always been a usual source of complaints among patients and caregivers, as well. Aside from providing health services, hospital authorities should make sure that the wards, rooms, lavatories, hallways, and corridors inside the hospital premises and its surroundings are always clean, orderly, and odor-free. The health chief challenged all hospital directors of DOH-retained hospitals and specialty hospitals to maintain the highest degree of hygiene in their work environment. Unclean, unkempt and smelly hospital premises pose a health risk to patients, their companions, and health workers. Oftentimes, this also causes the negative perception of the people on public hospitals. The “Ospital ng PiNOY: Malinis at Mabango” campaign specifically instructs hospitals to maintain cleanliness and orderliness inside hospital premises including driveways and parking areas at all times and pursue specific initiatives, mechanisms, and activities to achieve its goal. It should also mobilize its staff and health workers, as well as patients and their companions, to ensure that hospital cleanliness and orderliness is maintained. “Ospital ng PiNOY: Malinis at Mabango” stickers, posters, and tarpaulins should be set up in conspicuous areas such as entrances, corridors, hallways, offices, wards, rooms, lavatories, etc. A feedback mechanism such as grievance boxes, complaint desks, hotlines is a must in order to allow patients, clients and other stakeholders to lodge their complaints regarding the cleanliness and orderliness of the hospital so that corrective measures are implemented immediately. Ona directed the Assistant Secretary for Special Concerns and Regional Directors to ensure compliance to this campaign by conducting regular, random, unannounced spot checks of hospitals and by calling the attention of hospital chiefs, if necessary. 41. DOH AND PHILHEALTH TO LAUNCH NATIONWIDE REGISTRATION The Department of Health (DOH) and the Philippine Health Insurance Corporation (PHIC) will stage a massive open registration this September in response to President Benigno Simeon Aquino’s marching orders to attain universal Philhealth coverage in three years. This was disclosed by Health Secretary Enrique T. Ona in a press briefing today explaining that the nationwide registration shall take place by setting up Philhealth desks in public schools, municipal halls and all DOH-retained hospitals nationwide. “In keeping with P-Noys promise to give each and every Filipino access to quality healthcare in three years time, your Philhealth will open its doors across the country to reach out to the very poor Filipinos identified through the National Household targeting System – Proxy means test (NHTS-PMT) of Department of Social Welfare and Development (DSWD) and considered as true indigents,” Ona said.

Meanwhile, Philhealth President and CEO Dr. Rey B. Aquino also disclosed that all Philhealth regional and service offices and government as well as premiere commercial centers nationwide will also hold registration for non-members. The state-run health insurance program was made a priority item in the new Administration’s health agenda which aims to hit 100 percent of the Philippine population within three years. Secretary Ona who currently sits as the Chairman of the Philhealth Board, has organized a multi-sectoral task force to set things into motion and realize president Aquino’s directive the soonest time possible. Ona himself heads the said task force which is composed of the DOH, the Department of Interior and Local Government (DILG), the Department of Social Welfare and Development (DSWD) and the Department of Education (DepEd). The DILG shall help the DOH engage local chief executives in the enrolment of indigents in their respective jurisdictions as identified by the DSWD while DepEd shall help create Philhealth desks in all public schools to encourage students and their parents to register and become Philhealth members. The activity aims to enrol the remaining Filipino citizens who are at least 21 years of age and non-members of the program. It is also open to 18 to 20 year olds who may need to register; existing contributors who are still unregistered; those not issued their Philhealth Number Card or Family Health Card yet; and those already registered but who may want to update their membership profile with Philhealth. The program mainly targets those from the self-employed and informal sector who comprise some 53 percent of the population and of which a substantial portion can afford to pay for health insurance as individually paying members (IPMs). On the other hand, the low income as well as those without the means to pay shall benefit from sponsorships where the national and local governments and other sponsors shoulder the premiums for their annual coverage. Targeted citizens are also enjoined to go to any of Philhealth’s 17 regional offices and close to 100 service offices in their locality. “We are also tapping other means such as online registration via our website; via texting using their cell phones; in malls and other commercial centers; and through our partners such as Local Government Units, government hospitals and colleges and universities to ensure that they will be able to register with ease and convenience,” Philhealth President Aquino explained. Upon registration, enrolees will be advised to activate their membership by paying the required contribution of at least Php 300 for a quarter or Php 1,200 for a year’s payment at any accredited collecting partners nearest them. A duly activated membership and completion of all eligibility requirements shall entitle a member and his/her qualified dependents medical care subsidies when confined in accredited hospitals anywhere in the country. “I encourage all Filipinos, especially Philhealth non-members, to go out and avail of this opportunity to be registered with Philhealth and secure financial protection that they will need in times of emergencies and medical situations in the family,” Secretary Ona concluded. 42. PHILIPPINE PHARMACISTS ASSOCIATION SUPPORTS DOH ON HERBAL SUPPLEMENTS REGULATION The Philippine Pharmacists Association (PPhA), the accredited national organization of pharmacists in the Philippines, expressed its support for the Department of Health’s (DOH) issuance of Administrative Order (A.O.) No. 2010-0008, which will require herbal food and dietary supplements manufacturers to translate the cautionary statement “No Approved Therapeutic Claims” into Filipino in all their advertising and promotional materials. The English phrase will be replaced by the statement, “Mahalagang Paalala: Ang (name of product) ay hindi gamot at hindi dapat gamiting panggamot sa anumang uri ng sakit”.

“We believe that the move to modify and translate said phrase is appropriate for the reason that food/dietary supplements are really not supposed to be used for treatment or cure, simply because they are NOT DRUGS.”, the PPhA said in its statement. “The current use of the statement No Approved Therapeutic Claims used in promotion and advertisement of food supplements is not easily understood by the general public who have limited knowledge of the specific differences between drugs and food supplements, and as such has been used to the advantage of some business entities for marketing purposes.”, the statement added. The PPhA also rejected arguments of those opposed to the A.O. that it contravenes other laws and issuances. “The subject A.O. is not inconsistent with R.A. No. 8423 (The Traditional and Alternative Medicines Act of 1997). It does not stifle promotion and advocacy of alternative preventive and curative health modalities. However, these health care modalities must have been proven to be safe and effective by those who manufacture, advertise, promote and market them. These modalities must also be consistent with the standards of medical practice, and it must be noted that the establishment of said standards is part of the development process mentioned in Section 2 of R.A. 8423...the DOH as vanguard of the health of the nation must, and has all the right to intervene and make issuances such as the subject A.O. to ensure that health products in the market are safe and effective and their use properly guided through adequate information dissemination.”, the PPhA opined. The PPhA likewise rejected the notion that the A.O. “falsely presupposes that food/dietary supplements do not have curative and/or health benefits”. It reminded critics and oppositors that “..if ever there is a curative and/or health benefit in these products, the burden to prove such claim is still on the entity or person who makes such claims pursuant to existing laws, rules, regulations, and standards of classification of products”. The PPhA also made several recommendations in its statement, including the review of current regulatory policies and guidelines to on the integration of alternative and traditional medicine in the national healthcare system, the compulsory registration of ALL food supplements being marketed liberally all over the country and the participation of the Food and Drug Administration (FDA) in the evaluation of food/dietary supplement advertising materials by the Advertising Standards Council (ASC), under the Kapisanan ng mga Brodkaster ng Pilipinas (KBP). “We wholeheartedly thank the PPhA for supporting us on this move.”, said Health Secretary Esperanza Cabral. “As more and more professional societies in the health sector back our Administrative Order, it only proves that what we are doing is just and rational.”, she further added. 43. DOH ISSUES ADMINISTRATIVE ORDER ON DECEASED ORGAN DONORS The Department of Health and Secretary Esperanza Cabral announced the issuance of an Administrative Order (AO) on the Establishment of a National Program for Sharing of Organs from Deceased Donors to better serve the needs of the 9,000 Filipinos developing permanent kidney failure every year. This AO is in response to the Philippine Commitment to the 2008 Declaration of Istanbul on Organ Trafficking and Transplant Tourism and the 63rd World Health Assembly Resolution on Organ Donation for governments to take appropriate actions in increasing kidney/organ transplantation from the deceased donors. “We seek not only to improve an important service for many patients in need of organ transplantation, but also to assure that the illegal traffic of organs that has victimized many of our countrymen for many years until 2008 will not be repeated”, Secretary Cabral said. 44. SMOKE-FREE REPORTING IN METRO The DOH-Center for Health Development in Metro Manila launched the first-ever Smoke-free Reporting Package to provide venue for the general public to report tobacco violations in Metro Manila. The Smoke-free Reporting Package consists of NOSI SMS, NOSI Report Line and NOSI Website. Using the NOSI SMS package, the general public can send in their reports by

texting NOSI to 2256 which is open to Smart, Globe and Sun cellular Networks subscribers. The public can also report their complaints by dialling 661-3747 from 9:00am-5:00pm from Mondays to Fridays, or by visiting http://www.nosi.com.ph. 45.DOH ISSUES DEPARTMENT CIRCULAR ON BLOOD SERVICES FOR PREGNANT WOMEN Press Release/29 June 2010 The Department of Health (DOH), cognizant of the fact that postpartum hemorrhage accounts for a large number of maternal deaths in the Philippines, issued a Department Circular providing for the availability blood and blood transfusion services for pregnant women under the Maternal, Neonatal and Child Health and Nutrition Strategy (MNCHN). Department Circular 2010-0181 seeks to complement Administrative Order 2008-0029 (Implementing Health Reforms for Rapid Reduction of Maternal and Neonatal Mortality) and Department Circular 2010-0013 (Operation Guidelines for National Blood Voluntary Services Program), and was published on Sunday, June 27. The MNHCN is the national program driven under the auspices of the DOH that seeks to reduce maternal and child mortality rates in the entire country. At present, the Philippines is unlikely to meet the target for maternal mortality rate under Millennium Development Goal 5, necessitating more interventions on the part of the government. Under the circular, pregnant women and their husbands shall undergo blood typing during one of the prenatal visits. After passing donor selection and screening standards, the husbands and relatives of the pregnant women shall donate blood, with priority access to the blood pool going to the pregnant women in time of need.

MINDANAO SANITARIUM AND HOSPITAL COLLEGE School of Nursing

Assignment in COMMUNITY HEALTH NURSING

MUAMIR ALI ALINGAN BSN sec. 4A

LORIE NOVAL PACLIPAN, RN, MPH CHN-instructor