SDL: 1 DOH PROGRAMS

DOH Programs related to Family Health

1. EPI (expanded program of Immunization)

This program is all about in improving and broaden immunization programs around the world, this
program Expanded Program on Immunization (EPI) was implemented in 1974. It was concluded in 1977
that by the year 1990, every child in the world would be able to receive diphtheria, pertussis, tetanus,
poliomyelitis, measles, and tuberculosis vaccines. The Program has faced several challenges, such as a lack
of government and public understanding of the scope and gravity of the target diseases, ineffective program
management, inadequate tools and knowledge for handling and storing vaccines, and insufficient ways to
track the program's success as measured by rising rates of immunization coverage and declining incidence
of the target diseases. Less than 5% of children in developing economies were receiving a third dose of the
DPT and poliomyelitis vaccines during their first year of life when the EPI was started in 1974. In
developing nations, these coverage rates have now surpassed 50%, preventing millions of cases of the
target disease. In developing economies, vaccination prevented more than 700,000 measles deaths in 1987,
and maternal immunization and better childbirth practices are now preventing an increasing number of
neonatal tetanus deaths. Although the Program's accomplishments are a significant contribution to public
health, much work needs to be done.  Neonatal tetanus kills about 800,000 newborns each year, measles
nonetheless kills close to 2 million children annually, and pertussis kills close to 600,000. Annually, there
are still 250 000 cases of paralytic poliomyelitis. The EPI is currently facing significant difficulties in
maintaining and advancing national immunization efforts.  

The Overall Objective/Goals of EPI:

To lower child mortality and morbidity from the most prevalent diseases that can be prevented through
vaccination.

Specific Goals:
1.   To immunize all infants/children against the most common vaccine-preventable diseases.
2.   To sustain the polio-free status of the Philippines.
3.   To eliminate measles infection.
4.   To eliminate maternal and neonatal tetanus
5.   To control diphtheria, pertussis, hepatitis b, and German measles.
6.   To prevent extrapulmonary tuberculosis among children.

Mandates:

Republic Act No. 10152“MandatoryInfants and Children Health Immunization Act of 2011Signed by
President Benigno Aquino III on July 26, 2010. The mandatory includes basic immunization for
children under 5 including other types that will be determined by the Secretary of Health.

REFERENCES: https://pubmed.ncbi.nlm.nih.gov/3176515/ 
https://doh.gov.ph/expanded-program-on-immunization#:~:text=The%20Expanded%20Program%20on%20Immunization,%2C%20tetanus%2C
%20pertussis%20and%20measles.
2. IMCI (Integrated Management of Childhood Illnesses)

Since 1995, an increasing number of nations in the region have adopted the Integrated Management of
Childhood Illness approach. However, IMCI began as a pilot program in the Philippines in 1996. It is the
main plan of action developed by the World Health Organization (WHO) and the United Nations Children's
Fund (UNICEF) to strengthen children's health. It emphasizes the care of young children under the age of
five, paying attention to both their general health status and any diseases that may periodically affect them.
As a result, it lessens the chance that health professionals and parents will miss early-stage disease
diagnosis and treatment opportunities, increasing the likelihood that the illness will worsen and cause
complications. In addition, IMCI emphasizes prevention and wellness promotion as essential elements of
treatment. As an outcome, among other advantages, it aids in improving awareness and home-care
techniques for children under the age of five and increasing vaccination coverage, ultimately promoting
growth and healthy development.

Communal, healthcare industry, and family involvement are required for IMCI implementation. Three
methods are used to accomplish this:

1. Improving the performance of health workers in the prevention and treatment of childhood diseases.
2. Improving the organization and operation of health services so they provide quality care.
3. Improving family and community care practices

IMCI is a framework that incorporates all approaches to disease prevention, early identification, and
treatment of health issues that arise in childhood, as well as community and family promotion of healthy
lifestyles.

IMCI provides the knowledge and skills needed to sequentially assess and integrate the state of children's
health and, in doing so, identify the diseases or issues that frequently affect it in accordance with local
etiologic patterns. Based on this assessment, IMCI provides precise guidance on disease classification and
concerns, identifying the appropriate treatment for each. The strategy also outlines how to monitor the
effectiveness of treatment, determine when preventive measures should be taken, and educate and inform
parents about disease prevention and child health promotion.

Objectives and Goals

IMCI has three objectives:

1. Reducing infant mortality.

2. Reducing the incidence and seriousness of illnesses and health problems that affect boys and girls.
3. Improving growth and development during the first five years of a child's life.

Its main goal is to facilitate healthy development and growth throughout the first five years of life. 

Reference: https://www3.paho.org/english/ad/dpc/cd/imci-aiepi.htm
3.EEINC Early Essential Intrapartal and Newborn Care

Early Essential Intrapartal and Newborn Care (EEINC) are practices that are evidence-based guidelines for
providing birthing mothers and their newborns with safe, high-quality care during the first week of their
lives as well as the first 48 hours after delivery (labor and delivery). The unang yakap after a baby is
delivered is part of this program. A set of standardized procedures given to a baby at birth that are time-
bound, chronologically ordered, and predictable. At least half of newborn deaths can be avoided without
increasing the cost to hospitals or families. This program is a set of guidelines backed by evidence that the
Department of Health has advised (DOH). This was implemented in December 2009, which was signed by
the Secretary of the Department of Health, Administrative Order 2009-0025. This administrative order
requires the creation of the Unang Yakap Campaign and the Essential Intrapartum Newborn Care (EINC)
Protocol. This campaign aims to spread awareness of newborn care techniques for both the mother and the
child. The Unang Yakap campaign or the EINC protocol should be adhered to in order to protect both the
mother's and the unborn child's health. There is an easy, research-supported intervention that could help to
guarantee the survival of every newborn and young infant. This includes measures to promote warmth,
breastfeeding, love, safety, and infection prevention. It is crucial for a newborn baby's growth and
development to put their health first.

Objectives and Goals:

 The DOH Administrative Order 2008-0029 aims to swiftly reduce maternal and newborn morbidity and
mortality.
 In order to achieve the UN MDGs 4 and 5
 To provide health facilities the basic and comprehensive emergency obstetric and Newborn Care
(BEmONC and CEmONC). Incorporating newborn care into the delivery of these service capabilities.
 ENC Protocol aims to establish a solid foundation for an environment that complies with the "Ten (10)
Steps to Successful Breastfeeding" of the Mother-Baby Friendly Hospital Initiative (MBFHI). 10028.

Based on recent research showing a decrease in neonatal mortality and morbidity, the wide variations in
newborn care practices in health facilities, both public and private, as well as the proper sequence or
order of newborn care services, need to be standardized. Reducing under-5 child mortality is MDG 4 of
the United Nations Millennium Development Goals (through reduction of neonatal deaths).

References: https://doh.gov.ph/book/export/html/1125

https://www.slideshare.net/MukeshSah1/essential-intrapartumnewborncare-123487825
4. Newborn Screening

The term "newborn screening" refers to a series of specialized examinations, such as blood, hearing, and
heart screening, performed on one-to two-day-old babies, typically prior to their discharge from the
hospital. It has been a service offered in the Philippines since 1996. This is done to look for any severe
medical conditions that do not manifest at birth. The examinations frequently look for conditions that could
impede their development, such as genetic and metabolic abnormalities, hearing issues, specific heart
problems, and others. Babies who are sick at birth might not show any symptoms for a long time. Untreated,
the infant may experience serious issues. For this reason, newborn screening is crucial because it aids in the
early diagnosis of these conditions, allowing infants to start treatment as soon as possible—before the
illness even becomes serious or in order to enable early interventions.

Program objectives include screening all newborns in the Philippines by 2030; improving service quality
while stepping up monitoring and evaluation of NBS implementation; and strengthening patient
management. The goal is to eliminate preventable newborn deaths by 2030 by screening and treating
common and rare congenital disorders in all newborn Filipinos.

References: https://doh.gov.ph/newborn-screening#:~:text=DESCRIPTION%3A%20Newborn%20screening%20(NBS),mental%20retardation%20and%2For
%20death. 

https://www.makatimed.net.ph/blogs/newborn-screening-how-can-it-benefit-your-baby/#:~:text=Newborn%20screening%20refers%20to%20a,not%20show
%20signs%20at%20birth.

5. BEmONC/CEmONC

Basic Emergency Obstetrics and Newborn Care (BEmONC) Provider is a competent private medical facility
or an adequately upgraded public medical facility that is a Rural Health Unit (RHU) and/or its satellite
Barangay Health Station (BHS) or hospital, which was initiated in April 2013, capable of carrying out the
following emergency obstetric functions: 

(1) intravenous administration of oxytocin during the third stage of labor;

(2) giving an anti-convulsant loading dose;

(3) giving an initial intravenous dose of antibiotics;

(4) carrying out assisted deliveries when the baby is breech;

(5) removing any residual placental products; and

(6) removing the retained placenta manually

Additionally, it could offer neonatal emergency interventions, which at the very least include newborn
resuscitation, warmth allocation, and recommendation. Blood transfusion systems must also be available at
the hospital BEmONC. Additionally, these accommodations can provide IUD (intrauterine device) and VSC
(voluntary surgical contraception) services in high volumes. Furthermore, it may be a separate, stand-alone
facility or a component of a facility in an area of inter-local health.

Comprehensive Emergency Obstetrics and Newborn Care (CEmONC) provider is a provincial hospital, a
district hospital that has been appropriately upgraded, or a regional hospital or medical center with tertiary
level care. It might also be a competent medical facility run by a private company. It can carry out obstetric
emergency duties similar to those in BEmONC provider facilities. Besides that, it offers blood donor
transfusion services, surgical delivery (caesarean section), as well as other specialized obstetric therapies. It
can also offer neonatal emergency care, which must at least include:

(1) newborn resuscitation;

(2) Treatment of neonatal sepsis/infection

(3) oxygen assistance; and

(4) Prenatal (maternal) steroid administration to reduce the risk of preterm birth.

Furthermore, it can provide services for IUDs and voluntary surgical contraception (VSC) in large volume.
which was implemented in September 2004. A Government Order was passed to establish the CEmONC
Centre.

 Objectives and Goals:

 To focus more on the biological connection between mother and child in order to achieve the twin
objectives of reducing maternal mortality and neonatal mortality.
 To ensure the continuum of care for children and adolescents starts before pregnancy and continues
through pregnancy, childbirth, and after delivery.
 With the ultimate objective of improving health and in order to achieve MDGs 4 and 5 within the
designated time frame, we must quickly reduce maternal, newborn, and child mortalities.
 Services for mothers, new babies, and kids are delivered using an integrated approach that aims to
maximize client interactions, prevent missed opportunities, and guarantee the affordability of crucial
interventions.

 References: https://doh.gov.ph/sites/default/files/publications/maternalneonatal.compressed.pdf 

https://tnhsp.org/tnhsp/CEmONC-services.php

6. Nutrition

A vital component of health and development is nutrition. Stronger immune systems, safer pregnancies and
deliveries, a decreased risk of non-communicable diseases (like diabetes and cardiovascular disease), and
longer life spans are all associated with better nutrition. Nutrition is the study of how food impacts bodily
health. Food is necessary for survival because it gives the body the nutrients it needs to function and stay
healthy. Food is made up of macronutrients like protein, carbs, and fat that not only provide calories to fuel
and energize the body, but also have specific functions in preserving health. In addition to providing
calories, food also contains phytochemicals and micronutrients (vitamins and minerals) that are essential
for the body's proper operation.

Many pieces of legislation have been put into effect, and one of these laws is Presidential Decree 491 of
1974, also known as the Nutrition Act of the Philippines, which was signed on June 25, 1974, and
established the National Nutrition Council (NNC).

Since nutrition is a broad subject, here are just a few objectives and goals:

Aims and objectives for nutrition awareness:

 To understand how to meet our service users' nutritional needs
 To have an awareness of food hygiene regulations and to be able to put them into practice
 Understand the importance of a well-balanced diet, including the importance of fluids
 Understand the legislation relating to food hygiene and nutritional requirements for service
users
 Understand the basics of food hygiene and the consequences if they are not adhered to

National Goals for Nutrition and Health- Healthy People 2020:

1.  To promote longer lives free of preventable disease, disability, injury, and premature death. 
2. In order to promote quality of life, healthy development, and healthy behaviors throughout all life
stages, Healthy People 2020 will work to create social and physical environments that support good
health for al

Objectives for nutrition and Health-Healthy People 2020:

 Improve health, fitness, and quality of life through daily physical activity.
 Increase the quality, availability, and effectiveness of educational and community-based programs
designed to prevent disease and injury, improve health, and enhance the quality of life.
 Improve the development, health, safety, and well-being of adolescents and young adults
 Reduce the consumption of calories from solid fats and added sugar (SoFAS) in the population aged
two years and older.

7. MhGap(Mental Health Gap Action Programme )

Everyone is concerned about their mental health and wellbeing. The SDGs can be achieved in part by
resolving MNS-related issues. A thorough mental health program, which is for all people across the life
course, but especially for those who are at risk of and experiencing MNS disorders, and which includes a
broad range of promotive, preventive, treatment, and therapeutic services, WHO established the mental
health gap action program (mhGAP) in 2008. Because there is no Universal Health Care without mental
health care, we aim to achieve the highest level of health for the country by integrating mental health
services across a range of care environments, from community to institutional that are incorporated at the
national to barangay level.

 
Objectives/Goals of mhGAP

In order to close this gap by providing more care for mental health and substance use disorders, WHO
developed the mental health action program (mhGAP). The action program's primary goals are:

 to increase the financial and human resources allocated for the treatment of mental health and
substance use disorders and to strengthen the commitment of governments, international
organizations, and other stakeholders to do so.
 It is critical to significantly expand coverage of critical interventions in low- and lower-middle-
income countries, which bear a disproportionately large share of the global burden of mental health
and substance use disorders.
 Through these goals, the mhGAP offers evidence-based recommendations and instruments to help
achieve the objectives of the mental health action plan 2013–2020.

8. INFANT AND YOUNG CHILD FEEDING PROGRAM (Other related programs)

The first National IYCF Plan of Action was created to address these issues with infant and young child
feeding habits. It sought to enhance children's health and nutrition, especially for those under three, and
subsequently lower infant and under-five mortality rates. Its goals were to strengthen political commitment
at all levels, safeguard infant and young child feeding practices, and promote them. It also sought to create a
supportive environment and ensure their sustainability. The focus was on developing a setting that was
conducive to appropriate IYCF practices. To halt the alarming trends in infant and young child feeding
practices, the World Health Organization (WHO) and UNICEF jointly released a global infant and young
child feeding (IYCF) strategy in 2002. This global strategy received approval from the UNICEF Executive
Board in September 2002 and the 55th World Health Assembly in May 2002, respectively.
The Department of Health (DOH) and its partners were able to produce the first (1st) National Policy on
Infant and Young Child Feeding thanks to the National Plan of Action's 2005 approval. So, on May 23, 2005,
the Secretary of Health signed and approved Administrative Order (AO) 2005-0014: National Policies on
IYCF.

GOAL:

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

MAIN OBJECTIVE:

To ensure and accelerate the promotion, protection, and support of good IYCF practice.