AN ORDINANCE ESTABLISHING THE RHU BAMBANG BIRTHING FACILITY, DEFINING ITS

FUNCTIONS, OPERATION AND ADMINISTRATION

(with inclusion of Dr. Cortez recommendations & LHB Reso. #1, 2020
POST Feb. 19,2020 Committee Hearing)

Author: ARNEL GAMPONIA MAGDIRILA, MD, MPH

EXPLANATORY NOTE

Pursuant to Section 16 of R.A. 7160 which mandates that every local government unit shall
exercise the powers expressly granted, those necessarily implied therefrom, and those which are
essential to the promotion of the general welfare. Section 17 part A and B 2.III of R.A. 7160 also
mandates that every local government unit likewise exercise such other powers and discharge
such other function and responsibilities as are necessary, appropriate or incidental to efficient and
effective provision of the basic services and facilities to health services which include the
implementation or programs and projects on primary health care, maternal and child care and so
forth,

World Health Organization (WHO) data as of February 16, 2018 revealed that; Every day,
approximately 830 women die from preventable causes related to pregnancy and childbirth.
Ninety-nine (99%) of all maternal deaths occur in developing countries. Maternal mortality is
higher in women living in rural areas and among poorer communities. Young adolescents face a
higher risk of complications and death as a result of pregnancy than other women. Skilled care
before, during and after childbirth can save the lives of women and newborn babies. Between
1990 and 2015, maternal mortality worldwide dropped by about 44%. And, as part of the
Sustainable Development Goals, the target between 2016 and 2030 is to reduce the global
maternal mortality ratio to less than 70 per 100 000 live births.

Philippines maternal mortality ratio is still high at level of 121 deaths/100,000 live births
in 2017 making it crucial to follow a woman from prenatal to postnatal stage. The MMR in 2016
was 124 deaths per 100,000 live birth.

Causes of Maternal Deaths include; Complications related to pregnancy occurring in the

course of labor, delivery and puerperium; Hypertension complicating pregnancy, childbirth and
puerperium; Postpartum hemorrhage; Pregnancy with abortive outcome; and Hemorrhage in
early pregnancy

In an attempt to curb MMR, the DOH - under President Gloria Macapagal-Arroyo -passed
Administrative Order 2008-0029 titled, “Implementing Health Reforms towards Rapid Reduction
in Maternal and Neonatal Mortality,” or the “No Home Birthing Policy.” Advocating facility-based
deliveries where women can get timely and correct diagnosis, early intervention, and access to
emergency obstetric care under the supervision of a licensed SBA or doctor is considered to be a
crucial factor in lowering MMR.

The vision of the Safe Motherhood Program of the Philippines is “for Filipino women to
have full access to health services towards making their pregnancy and delivery safer” and one of
its components is “Local Delivery of the Maternal–Newborn Service Package”

Steadfast on its duties and commitment to uphold and protect the lives of its constituents,
the Municipality of Bambang, Nueva Vizcaya deems it necessary and appropriate to adopt and
establish measures to reduce and finally eliminate maternal deaths in the municipality.

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Section 2. TITLE. – This Ordinance shall be known as “An Ordinance Establishing the RHU
Bambang Birthing Facility (RBBF), Defining its Functions, Operation and Management.”

Section 3. OFFICIAL NAME AND ADDRESS OF THE BIRTHING FACILITY

The birthing facility shall officially named as RHU BAMBANG BIRTHING FACILITY with
official address at Bambang Municipal Compound, Buag, Bambang, Nueva Vizcaya.

Section 4. FUNCTION. – To provide assured quality family planning, prenatal, and birthing
services, thus ensuring safety of the life of both mother and child.

Section 5. DEFINITION OF TERMS

BEMONC - Basic Emergency Obstetrics and Neonatal Care
Birthing Facility - A health facility staffed by BEMONC trained nurses, midwives, and
doctors, for mother in labor.
DOH - Department of Health
Gravida - the total number of confirmed pregnancies that a woman has had,
regardless of the outcome.
Job Order - Shall mean the job order worker assigned at the Municipal Health
Worker Office.
MCP - Maternity Care Package Is a PhilHealth benefit that covers the complete
essential health care services for women about to give birth throughout
their pregnancy and normal delivery (during antenatal, intrapartum,
and immediate postpartum periods) regardless of the type of health
care institution where the services are rendered. The services shall
include antenatal care, intrapartum monitoring, assist in normal
delivery and postpartum care within 72 hours and 7 days after delivery.
MHO - Municipal Health Officer
Midwife - A licensed midwife employed on a regular or permanent appointment.
MMR - Maternal mortality ratio the ratio between the number of women who
died (for reasons of pregnancy, childbirth and puerperium) to the
number of reported livebirths in a given year, expressed as the number
of maternal deaths per 100,000 live births
Nurse - A licensed one employed on a regular or permanent appointment.
NDPs - Nurses under the Nurse Deployment Program of the DOH
Patient - A pregnant woman who avails the birthing services
PhilHealth / - Philippine Health Insurance Corporation
PHIC
PhilHealth - (PCF) is the fund paid by PHILHEALTH Corporation to the Rural Health
Capitation Fund Unit for Specific services it provides on a particular period, which is
arrived at based on a predetermined criteria under the condition that
any savings from the agreed amount accrues to the benefit of the RHU
and that in case of insufficiency thereof, the particular services due to
the covered beneficiaries shall be delivered at the cost of the RHU.
RBBF - RHU Bambang Birthing Facility with Basic Emergency Obstetric and
Newborn Care (BEMONC) Services
Section 6. COVERAGE.
The RHU Bambang Birthing Facility shall cater non-complicated pregnancies with mothers
from multi Gravida 2 to Gravida 4 only. However, the facility shall provide initial services to
all pregnant women and refer further to a higher facility for evaluation especially to
complicated cases.

Section 7. LICENSE TO OPERATE – the RBBF shall have a DOH issued License to Operate as a
birthing facility before its operation.

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Section 8. PHILHEALTH ACCREDITATION – to maximize Philhealth benefit delivery, the facility
shall be accredited annually to the Maternity Care Package (MCP) and Newborn Screening
Package of the PHIC.
Section 9. DELIVERY OF QUALITY CARE
8.1. The facility shall follow the policy-based DOH Manual of Operation for Basic
Emergency and Neonatal Care (BEmONC)

8.2 The RBBF will provide safe and aseptically clean environment during labor, delivery
and recovery of the mother by a trained and skilled health personnel. The delivery
quality care to the mothers and babies shall be provided.
Section 10. SUPERVISION AND CONTROL OF THE RBBF. – The operation of the RBBF shall be
under the supervision and control of the Municipal Health Officer.
Section 11. TIME AND DAY OF OPERATION. – The Municipal Health Officer shall see to it that the
RBBF shall operate twenty-four (24) hours a day, Monday to Sunday.
Section 12. STAFFING AND MANAGEMENT. –
12.1. The RBBF shall be administered and operated by the Municipal Health Office
personnel, namely:
a. Municipal Health Officer – as Officer-In-Charge of the RBBF
b. Midwives – as regular personnel to attend to the patient
c. Nurse – as Senior Staff or Team Leader of the regular personnel who’ll attend to
the patient
d. Casual or Job Order Midwife/Nurse or Volunteer Midwife/Nurse - who’ll assist
the regular personnel of RBBF
e. Utility Worker – person responsible for the cleanliness of the RBBF and such
other minor tasks to be assigned from time to time by his/her immediate
superiors
f. Ambulance Driver- who shall transport the patient from and to their home.
g. Birthing Clinic Manager – nurse that runs the day to day operations of the
Birthing Clinic
12.2. The MHO shall see to it that:
a. The midwives/ nurses assigned in the different barangays shall rotate in
rendering duty to the RBBF as they attend to their respective pregnant
clients.
b. The day-to-day delivery of other health services at the Bambang Rural
Health Unit shall not be interrupted.
c. Designation and shifting of personnel are in order to ensure efficient and
effective operation of the RBBF
d. Duty hours of health personnel shall be 40 hours a week.
Section 13. DUTIES AND RESPONSIBILITIES OF THE RBBF STAFF;
13.1. To provide quality health care delivery services during the antenatal care.
13.2. To allocate funds for medicines needed to provide quality services
13.3. To strictly implement and support the RBBF Activities on safe motherhood and
responsible parenting activities.
13.4. To conduct massive Information Dissemination Campaign on safe motherhood
during antenatal care.
13.5. To distribute leaflets about the RBBF and its services
13.6. To conduct Information Education Campaign in all Barangays in the municipality.
13.7. Early detection referral and management of complicated cases to prevent
unnecessary maternal and child mortality
13.8. Conduct advocacy meeting with local officials, private sector and NGOs

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Section 14. SERVICE FEE. – Fee for services rendered by RBBF shall be in accordance to
PhilHealth guidelines.
Section 15. FUNDING
15.1. Income derived from PhilHealth payments
15.2. From MLGU augmentation – additional operation expenditures may be needed and
shall be included in the regular budget of the RHU…… REFER TO LFC
Section 16. CREATION TRUST FUND FROM MCP & NBS PACKAGES – for LFC COMMENT
16.1. For efficient administration of funds from PhilHealth, separate trust fund shall be
created for each PhilHealth packages where all fees collected shall be deposited.
16.2. Open the trust fund at Landbank of the Philippines with Two (2) accounts for;
16.2.a. Administrative or Professional Fee Component
16.2.b. Facility Component

Section 17. DISPOSITION OF THE FUNDS FROM MCP & NBS PACKAGES shall be in accordance
to Philhealth guidelines….. (PHIC Circular No. 022-2014)

17.1. Forty Percent (40%) of the package rate is for professional fee.
17.1.1. 10% - MHO
17.1.2. 10 % - Personnel on Duty:
a) RBBF Manager - 2.5%
b) Midwife ---------- 2.5%
c) Ambulance Driver – 2.5%
d) Utility -------------- 2.5%
17.1.3. 20% - In charge personnel
a) Sector Nurse /Midwife – 15 %
b) Sector BHW -------------- 10 %
c) Medical Technologist – 3 %
d) Dentist --------------------- 2 %
17.2. Sixty Percent (60%) of the package rate is for the facility fee.
17.2.1. Procurement of drugs, medicines and supplies necessary for the operation of
the RBBF;
17. 2.2. Purchase of equipment for the improvement of RBBF s services;
17. 2.3. Fuel, oil and maintenance cost of the ambulance and generator assigned to
the RBBF; and
17. 2.4. Repairs and maintenance of the RBBF facilities and equipment

Section 18. CONTINUING EDUCATION AND ADVOCACY PROGRAM. – The MHO shall include in
their annual plans and programs the continuing education and advocacy program regarding the
benefits of RBBF to ensure safety of the life of both mother and child.

Section 19. PROHIBITED ACTS- The following are hereby prohibited;

1) Conduct of surgical procedures such as dilatation and curettage (D&C) and Bilateral
Tubal Ligation (BTL)
2) Soliciting non-prescribed fees from clients
3) Encouraging home deliveries
4) Non-compliance to the Manual of Operation for Basic Emergency and Neonatal Care
(BEmONC)
5) Non-compliance to protocols set forth by the RBBF management
6) Utilization of RBBF funds not in accordance to prescribed disposition funds

Section 20. PENALTY. – RHU personnel who shall violate this Ordinance shall be penalized as
follows:
20.1. Job Orders & Casuals
First Offense - P1,500.00
Second Offense - P 2,000.00
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 Third Offense - P 2,500.00, and dismissal from the service

20.2. Permanent employees & NDPs

First Offense - P1,500.00
Second Offense - P 2,000.00
Third Offense - P 2,500.00, and Administrative sanctions which shall be in
accordance with the Civil Service guidelines and the Supreme Court
Memorandum Circular on the Guidelines in the Application of Penalties in
Administrative Cases.

Section 21. COMPLIANCE OF MINIMUM REQUIREMENT. – The Local Chief Executive (LCE) shall
see to it, through the SUPERVISION of the MHO, that the RBBF complies with the minimum
requirement set by the DOH regarding the operations of birthing facility.

Section 22. APPROPRIATION- To effectively implement this ordinance, an initial amount of

P500,000 shall be allocated, then annual funding shall be determined by the Local Health
Board. ----- to be REFERRED TO LFC

Section 23. REPEALING CLAUSE. – All Ordinances, rules and regulations, or part thereof, whose
provisions are in conflict with or contrary to the provisions of this Ordinance are hereby deemed
repealed, amended or modified accordingly.

Section 24. SEPARABLITY CLAUSE. – If any provision of this Ordinance or part thereof is declared
unconstitutional or invalid by a court of competent jurisdiction, the other provisions or part
thereof not affected shall continue to be in full force and effect.

Section 25. EFFECTIVITY. This Ordinance shall take effect fifteen (15) days after a copy hereof is
posted in a bulletin board at the entrance of the municipal hall and in at least two (2) other
conspicuous places and after publication in a locally circulated newspaper.