CHN MIDTERMS - Mumps

Eligible Population
IMMUNIZATION PROGRAM OF THE - 0 – 12 MONTHS: newborns / infants
PHILIPPINES Concept / Importance
- Program means different solutions and - The process by w/c vaccines are introduced into
interventions the body before infection sets in.
- Example prevention of mortality for children we Principles
have immunization, 1. Epidemiological Situation
the mother is attending the prenatal visit, family is 2. Mass Approach
giving enough 3. Basic Health Service
nutrition to the children
Legal Basis Vax. Types, Forms, & Contents
• We will not be able to perform our job without Attenuated Vaccine - Live but altered (LAV)
legal basis. - Attenuated means “weakened.”
• Expanded Program on Immunization (EPI) - contains small amount of weakened live pathogen
- Presidential Decree 996 (PD 996) - doesn’t
- Started noong panahon ni Marcos cause disease. It triggers immune system
- In 1976 – six diseases Examples
o Tuberculosis - MMR vaccine (measles, mumps & rubella)
o Diptheria - Anti-Measles Vaccine / Measles Containing
o Pertussis Vaccine
o Tetanus - Rotavirus
o Poliomyelitis - smallpox
o Measles - chickenpox.
4 strategies Advantage
1. Sustain high routine Full Immunized Child - - Very effective, provides lifelong protection in 1 or
coverage of at least 90% - all provinces & cities. (In 2 shots.
our survey we asked if the child have complete Disadvantage
vaccination) - can’t give to weak immune system (like children
2. Sustain polio - free country for global certification with
3. Eliminate measles - 2008 HIV infection)
4. Eliminate neonatal tetanus – 2008 - takes long time to manufacture.
- d/t poliomyelitis infection Vaccine
• Compulsory Immunization against Hepatitis B - Bacteria: Tuberculosis (BCG)
Republic Act 7846 Inactivated Vaccine - Killed
- Year 1995 - use killed or dead pathogen
- Infants & children 8 y/o & below - patay na vaccine
- w/in 24hr after birth Hepa B immunization if mo. Example
Has Hepatitis B - wP – whole cell Pertussis
• Republic Act – 7846 - IPV – inactivated polio vaccine
- In 1995 – 7 diseases Advantage
o Tuberculosis - doesn’t take time in manufacturing.
o Diphtheria - safer than LAV
o Pertussis Disadvantage
o Tetanus - Less effective than LAV
o Poliomyelitis - Not lifetime protection. Needs multiple doses over
o Measles time
o Hepatitis B Vaccine
• National Immunization Program R.A No. 10152 - Bacteria: Whole-cell pertussis (wP)
(NIP) - Virus: Inactivated Polio Virus (IPV)
- Panahon naman ito ni Pres. Noynoy Aquino TOXOID VACCINE
- In 2011 - Inactivated or Altered exotoxins of bacteria
Example
- Tetanus Toxoid
- Diptheria Toxoid
- Td - tetanus and diphtheria toxoids vaccine
Advantage
- Safe - can’t cause disease, no possibility of
reversion to virulence
Conjugate subunit vaccines
- Create response against the molecules in the
pathogen’s Capsule
Example
- Haemophilus influenzae type b conjugate (Hib)
- Pneumococcal conjugate
- Hepatis B (HepB)
Vaccine Storage
- 2 degree C to 8 degree C
- Liquid formulations
- vaccines containing diphtheria, pertussis, tetanus,
hepatitis B,
Hemophilus influenzae type b, IPV & their
combinations
should not be frozen.
- OPV - kept frozen bet - 15oC to -25oC
- Freeze-dried vaccines (i.e., BCG, measles, MMR
& yellow fever) may also be kept frozen at -15oC to
-25oC if cold chain space permits but is neither
essential nor recommended.
- Measles and OPD - most sensitive to heat, lalo na
ung OPD una itong masisira kaya dpt laging
nakadikit sa yelo at dpt may yelo
- BCG and measles – are freeze dried vaccine at
dahil freeze na sila pwede siyang ikabit na lang sa
body of the refrigerator but
make it sure na malapit sa freezer
Routine Schedule of Immunization
• WED – Nationwide Immunization Day (means
Luzon,
Visayas and Mindanao)
• MONTHLY – Barangay Health Station (was
created because
of increased population and in other places it is by
weekly sa
sobrang dami na talaga ng population)
• QUARTERLY – Far Flung Area (needs outreach
immunization)
• EVERY DAY – Some Areas, to cover all targets
Procedures Giving in Vaccination
Reconstituting freeze-dried vaccine
BCG - Keep diluent cold
- Aspirate 2ml of saline soln from ampule of diluent
- Use 5ml syringe w/ long needle
- Inject the 2ml. Saline in the ampule of freeze-dried
BCG.
Measles Vaccine
- aspirate 5ml. Of special diluent from the ampule
- Use 10 ml. Syringe fit w/ long needle
- Empty the diluent from the syringe into the vial
with the vaccine.
Reconstituting
- mix diluent & vaccine – draw mixture back into the
syringe & expel it slowly in the ampule several
times
Routine Immunization
Rotavirus – for diarrhea, but not highly effective, so
we have to teach the mother to prepare the foods
and bottle properly
(TT) Tetanus toxoid –is a monovalent vaccine
means isa lang laman na vaccine nung vials
(TD) Tetanus and Dipterrhea – is bivalent means
dalawa laman na vaccine nung vials
Hepatitis B – is also for liver cancer
Yellow Fever – is not in the Ph so hindi siya
makikita s health center
TB – can lead infection to the brain (meningitis)
Bacille Calmette-Guérin - BCG
- at birth (after birth)
- ID (Right Deltoid area)
- 0.05ml
- Given only once
- earliest protects TB meningitis & other TB
infection
EPI - Procedures in giving BCG
- make a wheel
Hep B Vaccine (HbV)
- at birth
- IM Intramuscular (kapag hindi pa nag lalakad ang
baby wag
bibigyan sa may pwet dorsogluteal kase baka ma
hit ang
sciatic nerve hindi na siya mkapag lakad. Kaya sa
vastus
lateralis lang ito pwede)
- 0.5 ml
Anti-Measles Vaccine/Measles Containing monitoring chart, ice packs, safety collector box)
Vaccine • Freezer / refrigerator
AMV/MCV Transport box
- 9th month • Vaccine carrier/bags
- SC 0.5 ml • Cold chain monitors
- 12mons • Thermometers
- outer part upper arm • Cold packs
- 85% protection • Cold chain officer (nurse, kase siya ang nag
Oral Polio Vaccine – OPV babakuna)
- 6 wks • Cold chain manager
- 10 wks • PHN
- 14 wks Open – Vial Policy
- Per Orem - (DOH)/ MULTI – DOSE VIAL
- 2 to 3 drops (make sure na 3 droops na ang - Any vial of applicable vaccines opened/used in
ibibigay dahil session (fixed
naglalaway si babay kaya nalalabas na ung iba) or outreach) - can be used at more than one
- Mouth immunization
Updates In 2016 session up to 4 wk (28 days) provided
Inactivated Poliomyelitis Vaccine (IPV) - Multi dose liquid vaccines
- tetravalent OPV (tOPV) was replaced by a Protect
bivalent OPV • BCG protects from sunlight
(bOPV) • Rotavirus protects from light
Pneumococcal Conjugate Vaccine (PCV13) • dark brown glass means destroyed in sunlight
- also, part of immunization • BCG, measles, MR, MMR and rubella vaccines
- 6th, 10th and 14th week • Outreach immunization program is done sa
- 0.5 mL covered court or under the tree bawal ung walang
- IM administration. yero o wala sa lilim
Pentavalent Vaccines - (Diphtheria, Pertussis, Exposure to UVL – Loss of Potency
Tetanus, - protected against sunlight or fluorescent (neon)
Hepatitis B and Haemophiles Influenza Type B) light.
- at 6, 10, 14 weeks - BCG, measles, MR, MMR and rubella vaccines
- 0.5 mL - equally sensitive to light (as well as to heat)
- IM route EPI Target Disease
Cold Chain 1. Tb
- A system for ensuring potency of vaccine from 2. Diphtheria
time of manufacturer 3. Pertussis
- Very Sensitive at various temp (correct temp) 4. Tetanus -
- to avoid spoilage, maintain potency 5. Poliomyelitis
- meron kaseng vaccine na kahit gagamitin na 6. Measles
kailangan pa rin nasa malamig na temperature. 7. Hepatitis
Cold Chain Logistics • Fully Immunized Child – FIC
When handling, transport & storing - Should be Complete bef. 1 yr old:
- Cold Chain equip. – (cold room, freezer, ref, - BCG
transport box, vaccine carrier) - hePbV
- Vaccines are mostly manufactured abroad and - Pentavaccine 1, 2, 3
put inside the Cold room → deliver sa DOH → - OPV 1, 2, 3
munisipyo (freezer) → health center (vaccine - IPV
refrigerator) - PCV
- Transport box and vaccine carrier – kase may - AMV 1, AMV 2 (MCV1, MCV2)
mga vaccine na dinadala pa sa ibang lugar • Completely Immunized Child – CIC
- Other logistics (thermometer, cold chain monitor, - Complete at 12 months
temp.
- Kpag naibigay na ung second dose ng MMR ito
na angtawag sa bata
- Panahon ito ni noynoy acquino
• Child Protected at birth – CPD
- Ung bata nung ipinanganak may proteksyon na
against Tetanus toxoid
Computation: Target Setting & Vaccine
Requirements
NIP Target Setting
Infants = Total pop x 2.7 % (ganito dapat karami
ang nabakunahan mo)
- 12 to 59 mon-old Children = Total Pop x 10.8 %
- Pregnant = total pop x 3.5 %
The following are given Wastage Multiplier for
some EPI
vaccines:
- DPT, OPV, TT = 1.25
- HbV = 1.20
- AMV = 2.00
- BCG = 2.50
- Kapag kukuha ng vaccine sa munisipyo mag papa
sobra kakase may mga natatapon
- BCG and measles itatapon na after 4 - 6 hours
kapag nareconstitute
FORMULA:
Wastage multiplier = total no. doses per unit/
no.of dose needed
INTEGRATED MANAGEMENT OF
CHILDHOOD ILLNESS
- WHO and United Nations Children’s Fund
(UNICEF)
- Philippines – pilot in 1996
- Implement the strategy at the frontline level
Rationale for an integrated approach in the
management ofsick children
- Deaths from pneumonia, diarrhea, malaria,
measles, and malnutrition – preventable and
treatable.
- 3 out of 4 childhood illness are by these. (kasi
may ibibigay
tayo sakanila na preventive measures)
- Most children – more than one illness at one time.
Objectives of IMCI
- Reduce death, frequency, severity of illness,
disability.
- Contribute to improved growth and development.
Components of IMCI
- Improving case management skills of health
workers.
- Improving over-all health systems.
The case management process
The chart describes the following steps
1) Assess – child or young infant
2) Classify the illness (this is appropriate para sa
mga hindi doctor)
3) Treatment
4) Counsel mother (Tuturuan natin si nanay)
5) Follow up care (Para malaman natin kung
effective ba ung
gamot natin sa bata)
Basis for Classifying the Child’s illness
Pink – severe illness
Yellow – moderate illness
Green – mild illness
Assess and classify two age groups
1) Age birth up to 2 months (0 month – 2 months)
- Iba ang kanyang s&s. pagnagka fever yung baby,
severe na agad yon.
2) Age 2 months up to 5 years (2 months – 5 years
old)
- Icaclassify pa natin yung fever. Saan nagmula,
gaana katas.
The two groups
1) Young infants: from birth up to 2 months of age
2) Older children: from 2 months up to 5 years of
age
Strategies / Principle of IMCI
1) sick children
- 2 months up to 5 years old: examined for general
danger signs.
2) Sick youth infants
- Birth up to 2 months: examined for very severe
disease and local bacterial infection.
3) Children and infants
- Assessed for main symptoms. (iuubo, nilalagnat,
nagtatae)
4) All sick children
- Routinely assessed: nutritional, immunization, and
deworming status, and other problems.
- Hindi pa natin ipapauwiin.
- Checheck natin yung tyan, deworming
5) Limited numbers of clinical signs are used.
6) Combination of individual signs
- Leads to classification within 1 or more symptom
groups rather than diagnosis.
7) IMCI management procedures
- Limited number of essential drugs
8) Counseling of caretakers
- Home care, correct feeding, giving of fluids, when
to
return to clinic. DENGUE HEMORRAGIC FEVER
Summary of the integrated case - Dengue is not included in generic IMCI algorithm,
but it is important differential diagnosis of fever in
management process:
children presenting to first-level health facilities in
1) Assess the child:
tropical Asia and Latin America.
• Danger signs or possible bacterial infection.
Treatment for Severe dengue hemorrhagic fever
• Main symptoms.
• If skin petechiae, persistent abdominal pain,
• Check nutrition and immunization status.
persistent vomiting, or positive tourniquet test are
• Check for the other problem.
the only positive signs give ORS.
2) Ask monthly: what is the problem of the child:
• If any other sign of bleeding is positive, give fluids
• Initial visit.
rapidly as in PLAN C.
• Following – up visit.
• Treat the child to prevent the lowering of his or
3) Check for any danger signs:
her blood sugar level. (para hindi bumaba ang
• Convulsion (now/ had)
kanyang blood sugar, kailangan magpakain muna
• Abnormally sleepy
ng bata, breastmilk/ milk or sugar
• Not able to drink or eat
water – 100 ml clean water and 20grams of sugar)
• Severe vomiting
• Refer the child urgently to a hospital
4) Ask about the 4 symptoms:
• Do not give aspirin. (because this will further
• Cough or difficult breathing
cause bleeding)
• Diarrhea
WHO – DHF
• Fever
- Fever or history of acute fever, lasting 2-7 days,
• Ear problem
occasionally
biphasic.
Classify Measles – 3 Possible Classifications
- Bleeding (hemorrhagic tendencies), evidenced by
1) Severe Complicated Measles
at least one
2) Measles w/ Eye or Mouth Complications
of the following:
3) Measles
• Thrombocytopenia (100,000 cells per mm3 or
less) –
Severe complicated measles (Pink)
abnormally low level of platelets is observed.
- Any general danger sign
• Evidence of plasma leakage – drop in hematocrit.
- Clouding of cornea (mabubulag na) or
MALNUTRITION AND ANEMIA
- Deep or extensive mouth ulcers (marami ng
Check for Acute Malnutrition and Anemia
singaw na malalim sa bibig, kaya hindi na
Look and Feel:
makakain ang bata)
• Look for oedema of both feet
Measles w/ eye or mouth complications (Yellow)
• Determine WFH/L z-scores
- Pus draining from the eyes
- Less than 3? Between -3 and -2? -2 or more?
- Mouth ulcers
• Child 6 months or older measure MUAC
Measles (Green)
• Look for palmar pallor
- Measles now or w/ in the last 3 months
• Any medical complication
- Give Vitamin A treatment
• General danger sign
Complications: 30% of all cases
• Any severe dehydration, pneumonia with chest
• Diarrhea (including dysentery and persistent
indrawing
diarrhoea)
• Child 5 months or older, offer RUTF to eat, is the
• Pneumonia
child: not
• Stridor
able to finish? Or able to finish?
• Mouth ulcers
• Child less than 6 months: is there a bleeding
• Ear infection & severe eye infection - lead to
problem? (dapat may breastmilk)
corneal
• Measure MUAC _____ mm in a child 6 months for
ulceration, blindness
older
• Encephalitis - occurs one in one thousand cases.
• If WFH/L less than -3 z-scores or MUAC less than
• Contributes to malnutrition. Interfere with feeding
115 mm, then
• WFH/L is Weight-for-height or Weight-Length Asses, Classify and Treat Anemia
determined by 1) Severe Anemia
using the WHO growth standards charts 2) Anemia
• MUAC is Mid-Upper Arm Circumference measure 3) No Anemia
by MUAC Severe Anemia (Red)
tape in all children 6 months or older Assess and classify
• RUTF is Ready-to-Use Therapeutic Food for - Sign: severe palmar pallor
conducting the - All white
appetite test and feeding children with severe acute - Assess for sickle cell anemia if common in area
malnutrition Treatment
Kwashiorkor • Refer urgently
- Edema of both foot (kulang ng protein) Anemia (Yellow)
- Severe malnutrition – less than 115 mm Assess and Classify
- Mid-upper Arm circumference (MUAC) - Sign: some palmar
Maramus - Pallor – pink and white
- Severe muscle wasting No Anemia (Green)
- Folds of skin - Sign: no palmar pallor
- Buggy pants – fold of skin in the gluteal part of the YOUNG INFANT MALNUTRITION, DIARRHEA,
child. AND FEEDING PROBLEM
- Skin and bone - Sick young infant age up to 2 months
- Old man face - 1 week to 2 months (update: birth – 2 months)
Severe Malnutrition Very severe disease (Pink)
Check if with or without complication Treatment
- Check for any medical complication present: • Give first dose of IM antibiotics. (kasi ung bata
- Any general danger signs hindi pa
- Any severe classification umiinom ng syrup)
- Pneumonia with chest indrawing • Treat to prevent low blood sugar
Classify Nutritional Status • Refer urgently to hospital
1) Complicated severe acute malnutrition • Advise mother how to keep the infant warm on the
2) Uncomplicated severe malnutrition way to the Hospital
3) Moderate acute malnutrition Local Bacterial Infection (Yellow)
4) No acute malnutrition - Umbilicus red or draining pus
Complicated Severe Acute Malnutrition (Pink) - Skin pustules
Assess and Classify Skin pustules
- Edema of both feet or - wash pus/crust
- Weight for height / length (WFH/L) less than -3 z- - Soap and water
scores or - Dry
MUAC < 115 mm Red umbilicus/Pus draining
Uncomplicated Severe Acute Malnutrition - Clean 70% alcohol
(Yellow) - Paint – G. Violet
Assess and Classify Severe disease or local infection unlikely
-WFH/L < -3 z-scores or (Green)
- MUAC < 115 mm and - None of the signs of very severe disease or local
- Able to finish RUTF bacterial infection
Moderate Acute Malnutrition (Yellow) - Treatment: Advise mother to give home care
Assess and Classify Severe dehydration (pink)
- WFH/L bet. -3 and -2 z-scores or Two of the ff signs:
- MUAC 115 up to 125 mm - Movement only when stimulated or no movement
No Acute Malnutrition (Green) at all.
Assess and Classify - Sunken eyes
- WFH/L -2 z-scores or more or - Skin pinch goes back very slowly
- MUAC 125 mm or more
Some Dehydration (Yellow)
Two of the ff signs:
- Restless, irritable
- Sunken eyes
- Skin pinch goes back slowly
No Dehydration (Green)
- Not enough signs to classify as some or severe
dehydration.
- 2 signs dapat makita para masabing dehydrated
MATERNAL, NB, CHILD HEALTH AND
NUTRITION
Department of Health MNCHN Strategy
- Department Memorandum 2009-0110 dated May
10, 2009
“Implementing Health Reforms towards Rapid
Reduction in Maternal and Neonatal Mortality”.
- Goal: Rapidly reduce maternal & neonatal
mortality through local implementation of an
integrated MNCHN strategy.
- Maternal mortality – death that occur during the
time the woman is pregnant and postpartum period.
- Neonatal mortality – wala pang 1 month
Causes of Maternal and Neonatal Deaths
Risk Factors:
• Unplanned, mistimed, unwanted, unsupported
pregnancy
• No adequate prenatal care during pregnancy
• No skilled Birth attendant
• No proper postpartum/ postnatal care for mother
&newborn.
Operation of MNCHN Service Delivery Network
First Tier – Community Level Service Provider
- RHU, health centers, BHS, private facilities
- Led by midwife, nurse – Women Health Team,
Brgy Health Team – provide MNCHN services,
promote facility-based delivery, etc.
Second Tier – Basic emergency maternal obstetric
newborn care (BEmONC)
- Example walang delivery service ang RHU kaya
irerefer sya sa BEmONC.
• An assigned to serve an ILHZ or health district
• District hospital or similar public facility
- Private hospital
- If GIDA (geographically isolated & disadvantaged
areas or in
densely populated area)
• RHU, BHS, lying – in clinics or birthing homes.
(manghihilot – nilagay na sa women health team)
• (Capable of performing 6 signal OB function &
neonatal
emergency) may be designated as BEmONC
6 signal OB Function:
1) Parenteral administering of oxytocin in the third
stage of labor
2) Parenteral administering of loading dose of
anticonvulsants
3) Parenteral administering of initial dose of
antibiotics
4) Performance of assisted deliveries.
- Forceps
- Vacuum
- Hindi natin to magagawa in an ordinary first tier.
Ginagawa lang ito sa hospital setting.
5) Removal of retained products of conception.
(Raspa –dilatation and curettage)
6) Manual removal of retained placenta.
Third Tier – CEmONC
- Hindi na sya pwede iforcep or vacuum kaya
ilalagay na natin si nanay sa CEmONC
(Comprehesive emergency)
MNCHN Strategy
1) Universal access to & Utilization of Core
Package (may serbisyo kay nanay)
2) Service delivery network – the BEmONC –
CEmONC network is established in all provinces for
maternal and newborn health service delivery
3) Organized use of instruments for health systems
development Build-up of capability of DOH & Phil
health
Prenatal Package
4 prenatal
• 1 in 1st & 2nd
• 2 in third trimester
- 1-1-2 rule (4ANC)
- Kung gusto mag avail ng Phil Health, kailangan
ung 4 prenatal check up
8 Essential Antenatal Care (ANC) Function
• Monitoring of height & weight
• Taking BP
• Blood testing
• Urine testing
• Iron & folate supplement
• Tetanus toxoid immunization
• Malaria prophylaxis –if appropriate
• Birth planning
Prenatal Visit
Prenatal Assessment
• Monitoring -Height & weigh
• BP monitoring
• Measurement of fundic height against AOG
• FHR, Fetal movement
Diagnostic / Screening Tests: (BEmONC/
CEmONC facility)
• CBC – complete blood count - Within 72 hrs (3 days)
• Blood typing - On the 7th day postpartum check for
• Urinalysis infection/bleeding
• Screening for STIs (VDRL or RPR, HIV Test), - Identify early s/s of postpartum complications
• Blood sugar screening (OGCT) – optional - Maternal problems:
• Pregnancy test • hemorrhage,
• Cervical cancer • infection and hypertension
Maternal Nutrition – Micronutrient Supplementation P-P Maternal Nutrition (Micronutrient
• Libreng ibibigay supplementation)
• Iron & folate 60mg/400mcg, OD x 6 mons or 180 - Iron w/ folate x 3 months
tablets - Vit A 200,000 IU (ii-squeeze natin ung laman ng
• Vit A 10,000 IU twice a week; start at 4thmon (for vit A sa bibig ni nanay) (medyo may
clinicall diagnosed xerophthalmia) OR Multivitamin mararamdaman na headache si nanay)
(pagsumobra tau sa pag bibigay neto, posibleng - Iodine
magkaroon ng complication ang bata like - Deworming tablet: Mebendazole or Albendazole
anencephaly) (maximum 25,000 IU) (kapag nag- - Promotion of iodized salt
multivitamin si nanay, hindi na natin bibigyan ng vit Essential NB care after 90 mins to 6 hrs.
A) 1) Vit K prophylaxis
• Iodine 200mg once during pregnancy 2) Hepa B, BCG Vaccination
Prenatal visit promotes: 3) Assessment of birth injuries, malformation,
• Exclusive Breastfeeding defects
• NB Screening & Infant immunization 4) Additional care for SGA (less 2,500g) or twin
• Prevention and management of other diseases: Care prior to discharge
HPN, Anemia, a) BF -unrestricted, per demand, day/ night
TB, Malaria, Schistosomiasis & STI, HIV / AIDS b) Warmth -Kangaroo mother care (KMC) –
• Early detection of danger signs / complications of effective to meet
pregnancy warmth, BF, protect from infection, safety, love
(management of early bleeding in pregnancy) c) Hygiene –washing / bathing
• Antenatal administration of steroids in preterm d) Look for signs of jaundice, local infection
labor e) Perform NB screening (blood spot), NB hearing
• IEC / Counseling on FP methods especially LAM screening
• IEC / Counsel HL: safe sex and STI, HIV f) Instructions on discharge
prevention, smoking PhilHealth Benefits
cessation, Healthy diet & nutrition, physical activity Postpartum Package
(reg. Warrants Referral for further management.
exercise) - PhilHealth Circular 20, s 2008 shall not be
• IEC / Counseling on health caring & seeking reimbursed in non-
behavior hospital facilities
Support Services
1) Support from community (e.g., pregnant women) Benefits package for women about to birth
2) Antenatal registration with Mother – Child Book Benefit packages provided by PhilHealth. A
3) Assist in filling-up Birth planning (& promotion of Maternity Care
facility-based delivery) Package (MCP)
4) Home visit & ff-up - Covers essential health services during antenatal
5) Safe Blood supply period,
Home – Based Mother’s Record/ Mother entire stages of labor, normal delivery and
and Child Record(HBMR) immediate
2 records of pregnant Mother Definition of Terms
1) Facility-based record (ITR) – ung naiiwan sa HC Antenatal care coverage
2) HBMR (Home –Based Mother’s Record) - An indicator of access & use of health care during
Postpartum Visit preg.
Constitutes screening for health & socioeconomic
cond. likely
to increase possibility of specific adverse
pregoutcomes,
providing therapeutic interventions known to be
effective; &
educating pregabtplanning for safe birth,
emergencies
INFANT AND YOUNG CHILD FEEDING
legal Basis
Executive Order No. 51 – National Code of
Marketing of Breastmilk Substitutes
- Breastmilk Supplement & Other Related Products
“Milk Code”
- Prohibits advertising, promotion, marketing.
- Implies bottle milk is superior/equivalent
superior/equivalent
RA 7600
- Rooming-in and breastfeeding Act
- Act providing incentives to all govt & private health
institutions w/ rooming-in & breastfeeding practice
RA 8172 – Act or salt iodization Nationwide
(ASIN law)
- All producer of food-based salt to iodize it.
- Hindi tau nagbibigay nito sa health center,
pinopromote lang natin sila na gumamit ng iodize
salt.
Executive order No. 382
- November 7
- National Food Fortification Day
AO No. 2011-0303
- Micronutrient powder supplementation for children
6-23 months
- Nilalagay lang ito sa pagkain ng bata.
AO 32, S2010
- Expanded Garantisdadong Pambata
- Comprehensive and integrated
- Health, nutrition,
AO 2005-0014
- National Policy on Infant and Young Child
Feeding
- May 23, 2005