Module 1.

The Civil Code of the Philippines

What Will You Learn From This Module?

The Civil Code is defined as the collection of laws which regulate the private relations of the
members of the society, determining their respective rights and obligations, with reference to
persons, things and acts.
The Civil Code of the Philippines is the product of the codification of private law in the
Philippines. It is the general law that governs family and property relations in the
Philippines.
Lesson 1. Features of the Civil Code

The Civil Code is divided into 5 “books”, with specific book covering on:

1. Persons and family relations;

2. Property;
3. Succession;
4. Obligations and contracts; and
5. Special contracts

A. Family Code
The Family Code covers field of significant public interest, especially the law of
marriage: the definition and requisites for marriage, as well as the grounds for its annulment
of marriage. Also in the Family Code is the law on conjugal property relations, the rules on
establishing filiations, and the governing provisions on support, parental authority, and
adoption

Purposes of the Family Code

1. It revises the provisions of the Civil Code on marriage and family relations bringing
them closer to Filipino customs, values, ideals and reflects contemporary trends and
condition.
2. It implements policies embodied in the new constitution that strengthen marriage and
family as a basic social institutions and ensure equality between men and women.

B. Contract
It is a meeting of minds between two persons whereby one binds himself, with respect to the
other, to give something or to render services. The contract must bind both contracting
parties and contract should contain some stipulation in favor of a third person, he may
demand its fulfillment provided he communicated his acceptance to the obligator before its
revocation.

Consent of Contracting Parties

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Consent is manifested by the meeting of the offer and the acceptance upon the thing and the
cause which are to constitute the contract.

Offer is a proposal made by one party to another into a contract. The offer must be certain
and the acceptance absolute.

Acceptance is the manifestation of the offeree of his assent to the terms of the offerer. A
qualified acceptance maybe made by letter or telegram does not bind the offerer except from
the time it came to his knowledge.

Requisites of Contract

a. There must be two or more parties;

b. The parties must be of legal capacity to enter a contract. Each party must ne of legal
age; of sound mind; not suffering physical disability (mental incompetence); and not
under the influence of drugs;
c. There is no vitiation of consent. Vitiation of consent maybe caused through:
 Mistakes as to identity or qualifications of one of the parties only when it is the
principal cause of the contract;
 Violence as to serious or irresistible force is employed to wrest the contract;
 Intimidation as when one of the contracting parties is compelled by a
reasonable and well grounded fear of an imminent and grave evil upon his
person or property, or upon the person or property of his spouse, descendants
or ascendants to give his consent.
 Undue influence or fraud. There is undue influence when a person takes
improper advantages of his power over the will of another, depriving the latter
of reasonable freedom of choice. There is fraud when, through insidious words
or machinations of one of the contracting parties
d. There must be no conflict between what is declared and what is intended.

Persons who are not Qualified to Enter into a Contract

a. Unemancipated minors are those who have bot reach the age of 18 years.
b. Insane or demented persons unless they acted during, lucid interval. Contracts
entered under this condition are valid.
c. Deaf-mutes who do not know how to write.
d. Those who are in the state of drunkenness or during hypnotic spell.

Objects of the Contract is the subject matter of the contract. This is the content which both
the parties have agreed upon.

Requisites of the Object of Contract

a. All things which are in the commerce of men, including future things;
b. It must be transmissible or transferrable from one person to another;
c. Not contrary to the law, moral, good customs, public order, or public policy.
d. Only physically, legally and possible things are the subject of the contract.

Cause of the Contract

The cause is understood to be, for each contracting party the prestation or promise of a thing
or service by the other. If the cause of the contract is remuneratory ones, the service or the
benefit is remunerated; and in contracts of pure beneficence, the mere liberty of the
benefactor is stated.

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Forms of Contract

Contracts shall be obligatory, in whatever form they may have been entered into, provided all
the essential requisites for their validity are present. The following must appear in a public
document:

a. Acts and contracts which have for their object the creation, transmission, modification
or extinguishment of real rights over immovable property; sales of real property or of
an interest therein a governed by Articles 1403, No 2, and 1405;
b. The cession, repudiation or renunciation of hereditary rights or of those of the
conjugal partnership of gains;
c. The power to administer property, or any other power which has for its object an act
appearing or which should appear in a public document, or should prejudice a third
person;
d. The cession of actions or rights proceeding from an act appearing in a public
document.

Kinds of Contracts

Informal Contracts are those which maybe entered into in whatever form provided that all
requisites are present for validity. This maybe written or oral contract. While formal contracts
are those which require special formalities or a certain specified form. It may also contain the
perfected form of consent, subject matter and cause. The implied contract on the other hand
is a contract that is concluded as the result of the acts of parties to which the law an objective
intention to enter into a contract (Venzon, p 73). Expressed contract is one which conditions
of the contract are expressed through writing or orally by both parties. Void contracts are
those that do not have effects at all or invalid due to the fictitious content; the cause of the
object do not exist at the time of transaction; object of the contract cannot be ascertained; and
the object of the contract is contrary to the law, policies, regulation public laws, or policy.
Lastly, illegal contracts are those that are contrary to the law because of consent obtained
through fraud; threatened violence to get consent; and consent taken through material
misinterpretation.

C. Succession and Wills

Succession is a mode of acquisition by virtue of which the property., rights and
obligations to the extent of the value of the inheritance, of a person are transmitted
through his death to another or through either by his will or by operation of law.
Descendant is the general term applied to the person whose property is transmitted
through succession, whether he left a will.

Inheritance includes all the property, rights and obligations of a person which are not
extinguished by his death.

Kinds of Succession

Testamentary Succession is the one that which results from the designation of an
heir, made in a will executed in the form prescribed by the law.

Legal or Intestate Succession occurs when a person does not make a will before his
death, if his will is void; the law vests the inheritance to the proper persons such as the
legitimate or illegitimate relatives of the deceased.

Mixed Succession is that partly affected by will and partly by operation of law.

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A will is an act whereby a person is permitted, with the formalities prescribed by law, to
control to a certain degree the disposition of the estate, to take effect after his death.

Testator is the one making a will.

Heir is a person called to the succession either by the provision of a will or by operation of
law.

Devises and Legatees are persons to who gifts of real and personal property are respectively
guiven by virtue of will.

Forms of Wills

Ordinary or Natural Will

 Every will must be in writing and executed in a language or dialect known to the
testator.
 Every will, other than a holographic will, must be subscribed at the end thereof by the
testator himself or by the testator himself or by the testator’s name written by some
other person in his presence, and by his express direction.
 It must be attested and subscribed by three or more credible witnesses in the
presence of the testator and of one another.
 Every will must be acknowledged before a notary public by the testator and the
witnesses.
 If the testator be deaf, or a deaf-mute, he must personally read the will, if able to do
so; otherwise, he shall design two persons to read it and communicate to him, in some
practical manner, the contents thereof.

Holographic Wills

 The disposition of the testator written below his signature must be dated and signed
by him in order to make them valid as testamentary dispositions.
 When a number of dispositions appearing in a holographic will are signed without
being dated.
 The last disposition has a signature and a date, such date validates the dispositions
preceding it, whatever be the time of prior disposition.
 In case of any insertion, cancellation, erasure, or alteration in a holographic will, the
testator must authenticate the same by his full signature.

Persons Qualified to Make a Will

1. All persons who are not expressly prohibited by the law may make a will.
2. The testator is of sound mind at the time of its execution. To be of sound mind, it is
necessary that the testator be in full possession of all of his reasoning faculties, or
that his mind be wholly unbroken, unimpaired by disease, injury of the other cause.
3. A married woman may make a will without the consent of her husband, and without
the authority of the court.
4. Persons of either sex above eighteen years of age.

Witness to Wills
The following are qualified to be a witness to a will:

1. Any person of sound mind;

2. Age of eighteen years or more;
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 3. Not blind, deaf or dumb;
4. Able to read and write.

The following are disqualified from being a witness to a will:

1. Any person not domiciled in the Philippines;

2. Those who have been convicted of falsification of a document, perjury or false
testimony.

Lesson II.Issues and Trends Affecting Midwifery Practice

Republic of the Philippines

OFFICE OF THE PRESIDENT
COMMISSION ON HIGHER EDUCATION

CHED MEMORANDUM ORDER (CMO) No. 33 Series of 2007

SUBJECT: POLICIES AND STANDARDS FOR MIDWIFERY

EDUCATION

In accordance with pertinent provisions of Republic Act (RA) No. 7722, otherwise
known as the Higher Education Act of 1994 and in view of Commission en Banc
Resolution No. R008-2007 and for the purpose of rationalizing Midwifery Education
in the country in order to maintain relevant health services locally and
internationally, the following policies and standards for Midwifery Education are
hereby adopted and promulgated by the Commission, thus:

Article I INTRODUCTION

Section 1. Midwifery practice in the Philippines has been recognized as one of the
primary health care services for the people. The role of midwives has
been expanded to address the basic health service needs of mothers
and their children. Midwifery Education must be able to respond to
those need by producing midwives who have upto-date knowledge and
skills and appropriate attitude necessary to render midwifery services
with competency and dedication.

It is therefore a declared policy of the CHED that midwifery education shall be

relevant and responsive to the emerging national and global midwifery
practice and development. Hence, quality educational standards shall
be attained through accreditation.

Article II AUTHORIZATION

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Section 2. All private higher education institutions (PHEIs) intending to offer the
Midwifery Education program must first secure proper authority from
the Commission in accordance with the existing rules and regulations.
State universities and colleges (SUCs), and local colleges and
universities should likewise strictly adhere to the provisions in these
policies and standards. Existing schools with two (2) year program
should secure permit prior to the offering of the Bachelors Degree
program.

Article III
PROGRAM SPECIFICATIONS

Section 3. Graduates of this program shall be conferred the title/degree – Diploma

in Midwifery/Bachelor of Science in Midwifery

Section 4. Program Description

a. Diploma in Midwifery is a two-year program consisting of general

education and professional courses which prepare students for
entry-level midwifery competencies. This 2-year direct entry
program includes Clinical Practicum in Foundations of Midwifery,
Normal Obstetrics and Care of the Newborn, Introduction to High
Risk Obstetrics, Basic Care of Infants and Feeding, Basic Family
Planning, Primary Health Care and Midwifery Ethics, Law and
Practice. Graduates of the program are qualified to take the
government licensure examination.

b. Bachelor of Science in Midwifery is a four-year degree program

consisting of general education and professional courses which
prepare registered midwives for higher level midwifery
competencies. The program includes Clinical Practicum in
Management of OB Emergencies and High Risk Pregnancies, Care
of Infants and Children, Comprehensive Family Planning,
Community Health Service Management, Community Health Care
Facility Management, Midwifery Pharmacology, Research,
Entrepreneurship, Administration and Supervision. Students of the
program may select from any of the following Midwifery Majors:
Education, Community Health, Reproductive Health,
Administration and Supervision or Health Care Facility
Management.

a. Objectives

The Diploma in Midwifery aims to:

1. develop the knowledge, attitude and skills of first level midwives

in the care of the girl-child, the adolescent, and the adult woman

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 prior to, during, and following pregnancy. This prepares the
midwives to:

give the necessary supervision, care and advice to women during pregnancy, labor
and post-partum period; manage normal deliveries on her own responsibility and
care for the child.

2. Specifically, graduates of the 2-year program are expected to:

perform primary health care services within the community (promotive and
preventive care);
counsel and educate women, family and community regarding family planning
including preparation for parenthood/parenting; detect abnormal conditions in the
mother and infant; procure specialized assistance as necessary (consultation or
referral).

The Bachelor of Science in Midwifery aims to:

1. Develop higher level competencies of a midwife as a health care

provider: educator, researcher, supervisor and health care facility
manager /entrepreneur.

2. Specifically, this enables the graduates to:

2.1give the necessary supervision, care and advice to highrisks

parturient;
2.2execute emergency measures in the absence of medical
practitioners;
2.3provide family planning services;
2.4provide Integrated Management of Childhood Illness (IMCI)
services;
2.5manage MCH clinics at the community level;
2.6facilitate community organizing and social mobilization for
community development;
2.7engage in independent, entrepreneurial health activities
including management of primary health care facilities; 2.8
implement/manage midwifery programs;
2.9 perform other health related functions as may be deemed
necessary by appropriate agency.

b. Specific professions/careers, occupations or trades that the graduates of

the Diploma in Midwifery and B.S. in Midwifery may be engaged as:

Diploma in Midwifery
1. Staff Midwife
2. Domiciliary Midwife
3. Rural Health Midwife
4. Clinical Instructor

Bachelor of Science in Midwifery

1. Faculty/Trainer
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 2. Supervisor
3. Principal
4. Health Facility Administrator
5. Researcher
6. Entrepreneur/Clinic Owner/Manager
7. Health Program Manager

Article IV COMPETENCY STANDARDS

Section 5.

1. Reproductive Health Services Primarily Maternal and Child Care

1.1 Provision of Maternal Care
1.2 Provision of Newborn and Child Care
1.3 Provision of Family Planning Services

2. Early Detection of Deviations and Complications

2.1 Recognition of Deviations and Complications of Pregnancy,
Labor, Delivery and Post Partum Period
2.2 Recognition of Minor and Serious Disorders in the Newborn
3. Health Education and Counseling (Women, Family, Community,
Parenthood and Parenting)
3.1 Provision of Health Education and Counseling of Patients

4. Provision of Emergency Care and Measures

4.1 Provision of Emergency Management in Life Threatening
Conditions which may arise
4.2 Provision of emergency management to Newborn

5. Provision of Primary Health Care Supervision (Prevention, Health

Promotion and Maintenance)
5.1 Maternal and Child Care
5.2 Environmental Sanitation
5.3 Vital Statistics and Epidemiology

6. Referral in Case of Deviations for Specialized Care

6.1 Referral of Maternal Cases
6.2 Referral to Newborn

TERMINAL COMPETENCIES

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 Graduates of the Diploma in Midwifery Program are expected to be able to:

1. Provide the necessary supervision, care and advise to low-risk women during
pregnancy, labor and puerperium. Specifically, they should be able to:

 Obtain pertinent history;

 Perform physical assessment including vital signs taking;
 Do simple laboratory examinations such as hemoglobin determination
and urine test for sugar and albumin;
 Assess the progress of labor;
 Perform relevant midwifery procedures;
 Provide appropriate care to the mother and the newborn;
 Provide life-saving measures during obstetrical emergencies such as
administering IV fluids and cardiopulmonary resuscitation; Detect
abnormal conditions of the mother and/or newborn; and Facilitate
referrals as necessary.

2. Perform primary health care services within the community. Specifically, they
should be able to:

 Implement government health programs following proper protocols;

 Administer first aid measures as needed;
 Give appropriate health teachings to individuals, families and the
community;
 Supervise barangay health workers; and Manage a barangay health
station.

Graduates of the B S in Midwifery Program are expected to have acquired the

competencies of a Graduate Midwife. In addition, they should be able to:

1. Provide the necessary supervision, care and advise to woman with a highrisk
pregnancy in the absence of a specialist.
2. Correctly interpret diagnostic examinations related to midwifery care and act
accordingly.
3. Execute life-saving obstetrical management during emergency cases.
4. Assist in a cesarean section procedure as a scrub/circulating assistant.
5. Provide post cesarean section care.
6. Provide basic and comprehensive family planning services.
7. Administer appropriate drugs according to proper protocol.
8. Manage a Midwifery Educational Program and Reproductive Health Care
Facility/Program.
9. Conduct classes in Midwifery courses.
10. Prepare a project/research proposal.

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 Article V CURRICULUM

Section 6. Curriculum – Higher education institutions offering Midwifery

education programs may exercise flexibility in their curricular offering.
However, midwifery courses as prescribed in the sample program of
study shall be implemented.

The Diploma in Midwifery program consists of general education, core,

and professional courses, totaling 118 units. This includes at least
1,275 hours of clinical practicum. A holder of Diploma in Midwifery
program is eligible for admission to the Bachelor of Science in
Midwifery program.
The Bachelor of Science in Midwifery consists of 188 units of general
education, core and professional courses. This includes a total of 2,346
hours of Clinical Practicum.

Section 7. Curriculum Outline for the Bachelor of Science in Midwifery

Program -----------------------------------------------------------188 units
For Graduate in Midwifery 118
I. General Education (GE) courses: 59

A. Language and Humanities ---------------------------------- 21 units

English 1(Comm Skills 1)…… 3
English 2(Comm Skills 2)…... 3
English 3(Tech Writing).……. 3
Filipino 1(Pakikipagtalastasan). 3
Filipino 2 (Panitikan)..……….. 3
Logic (Critical Thinking)…….. 3
Philosophy of Human Person…. 3

B. Mathematics, Natural Science & Information Technology--- 9 units

Math 1 (Algebra) …………….. 3
General Zoology ……………… 3
Information Technology ……… 3

C. Social Sciences ---------------------------------------------- 9 units

General Psychology -------------- 3
Socio-Anthropology W/ STS----- 3
Health Economics ----------------- 3

D. Mandated Subjects ------------------------------------------ 6 units

Phil. Government ----------------- 3
Rizal --------------------------------- 3

E. Physical Education------------------------------------------- 8 units

PE 1 ---------------------------------- 2

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 PE 2 ---------------------------------- 2
PE 3 ---------------------------------- 2
PE 4 ---------------------------------- 2

NSTP ----------------------------------------------------------
F. 6
NSTP 1 ------------------------------ 3
NSTP 2 ------------------------------ 3
II. Core Courses 22

Primary Health Care 1 ------------ 4

Primary Health Care 2 ------------ 3
Anatomy & Physiology ----------- 5
Micro & Parasitology ------------- 4
Teaching Strat in Health Educ -- 3
Nutrition --------------------------- 3

III. Professional Courses 37

M 100 ---------------------------- 3
M 101 ---------------------------- 3
M 102 ---------------------------- 3
M 103 ---------------------------- 3

Clinical Practicum 25 units x 51 hours/unit 1,275 hours

For Bachelor of Science in Midwifery (3rd and 4th year) 70

I. General Education Courses ………………………………… 9

A. Language and Humanities

Foreign Language (Elective)------- 3
English 4 (Literature) -------------- 3
B. Mathematics
Biostatistics ------------------------- 3

II. Core Courses ……………………………………………….. 10

Gen Physics -------------------------- 5
Gen Chemistry ----------------------- 5

III. Professional Courses ……………………………………… 51

M 104 -------------------------------- 3
Comm Health Service Mgm’t ---- 3
Midwifery Pharmacology --------- 3
M 105 -------------------------------- 3
Midwifery Entrepreneurship ------ 3
Early Childhood Care ------------- 3
Midwifery Research 1 ------------ 3
Midwifery Research 2 ------------ 3
M 106 ------------------------------- 3
Midwifery Major ------------------ 3

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 Clinical Practicum 21 units x 51 hours/unit 1,071 hours

Section 8. Sample programs of study

DIPLOMA IN MIDWIFRY PROGRAM FIRST YEAR

1st Semester

Subjects Lecture Laboratory/Clinical Units

Units
English 1(Communication - - 3
Skills) 3
Filipino I 3 - -
(Sining ng Pakikipagtalastasan)
Philosophy of Human Person 3 - -
Math 1 3 - -
(College Algebra)
General Zoology 2 1 3
Midwifery 100 3 - -
(Foundation of Midwifery
Practice)
CP 100 - 3 3
PE 1 3 - 3
NSTP-1 3 - 3

2nd Semester

Subjects Lecture Laboratory/Clinical Units

Units
English 2 (Speech and Oral 3 - 3
Communication)
Filipino 2 3 - 3
General Psychology 3 - 3
Human Anatomy & 3 2 5
Physiology
Midwifery 101 (Normal OB, 3 - 3
Immediate Care of the
Newborn)
Logic & Critical Thinking 3 - 3
CP 101-A - 3 3
P.E. 2 3 - 3

Summer

Subjects Lecture Laboratory/Clinical Units

Units
Nutrition & Dietetics 3 - 3
Sociology & Anthropology 3 - 3
CP 101-B - 1 1
NSTP-2 3 - 3

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 SECOND YEAR
1st Semester

Subjects Lecture Laboratory/Clinical Units

Units
Principles, Methods & 3 - 3
Strategies of Teaching in
Health Education
Information Technology 3 - 3
Microbiology & Parasitology 3 1 4
Midwifery 102 (Pathologic 3 - 3
OB,
Basic Gynecology, FP
Technology
Care of Infants & Feeding)
CP 102-A - 6 6
Primary Health Care I 4 - 4
CP PHC 1 - 3 3
P.E. 3 2 - 2

2nd Semester

Subjects Lecture Laboratory/Clinical Units

Units
Life, Works & Writings of 3 - 3
Rizal
English 3 (Technical Writing) 3 - 3
Health Economics with TLR 3 - 3
Philippine Governance & 3 - 3
Constitution
Midwifery 103 3 - 3
(Prof. Growth &
Development and Bio-
Ethics)
Primary Health Care 2 - 7 7
CP PHC 2 3 - 3
CP 102-B - 2 2
P.E. 4 2 - 2

Upon completion of the above program, the graduate shall be conferred the title of
Graduate Midwife and shall be eligible to take the licensure examination. Likewise,
the registered midwife may be admitted to the BS Midwifery Program.

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 BACHELOR OF SCIENCE IN MIDWIFERY

THIRD YEAR
1st Semester
Subjects Lecture Laboratory/Clinical Units
Units
General Chemistry 3 2 5
English 4 (Literature) 3 - 3
Midwifery 104 3 - 3
(Clinical Mgmt.-OB
Emergencies,
High Risk Preg. Mgmt)
CP 104 - 3 3
Midwifery Pharmacology 3 - 3
Community Health Service 3 - 3
Mgmt. (Programs)
CP CHM - 3 3

2nd Semester
Subjects Lecture Laboratory/Clinical Units
Units
Physics 3 2 5
Biostatistics 3 - 3
Midwifery 105 (Comprehensive 3 - 3
Family Planning)
CP 105 - 3 3
Midwifery Entrepreneurship 3 - 3
Early Childhood Care 3 - 3
CP ECC - 3 3

FOURTH YEAR
1st Semester
Subjects Lecture Laboratory/Clinical Units
Units
Midwifery Research 3 - 3
1(Proposal Writing)
Midwifery 106 3 - 3
(Administration
&Supervision)
CP 106 - 3 3
Elective (Foreign Language) 3 - 3

2nd Semester
Subjects Lecture Laboratory/Clinical Units
Units
Midwifery Research 2 3 3
(Paper Writing &
Presentation)
Select 1 from any 3 6 9
Midwifery Majors)

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Midwifery Education
Program Mgt.

Community Health
Service Mgt.
Reproductive Health

Health Care Facility

Management (Application of
Entrepreneurship)

Section 9. Clinical Practicum Requirements

The clinical practicum is viewed in terms of ends to be reached or changes in

the behavior of the students and not just in terms of selecting CP that will provide
for continuity, sequence, and integration of principles, concepts, skills and values
that have been previously learned in the classroom and other areas.

The formula in determining cost of CPs per student is based on (a) Policies
and Standards for Midwifery Education, (b) faculty preparation and competence, (c)
overhead expenses of the school administration related to CPs other than salaries.

Basis for Computation to Determine Clinical Practicum Fee:

No. of hours assigned to faculty X hourly rate = Practicum Fee

Computation of Practicum Hours

1 unit = 51 hrs

A. 1. Class is composed of maximum of 50 students

2.Clinical Practicum hours required

For whole two year course---------------------------------------1,275 hours
For the whole four year course -------------------------------2,346 hours

Subject Clinical Hours Required

Practicum Unit
CP 100 3 153 hours
CP 101 3 153 hours
CP 101 B 1 51 hours
CP 102 6 306 hours
CP PHC 1 3 153 hours
CP 102 B 7 357 hours
CP PHC 2 2 102 hours

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 Total 1,275 hours
CP 104 3 153 hours
CP CHM 3 153 hours
CP105 3 153 hours
CP ECC 3 153 hours
CP106 3 153 hours
CP Major 6 306 hours
Total 1,071 hours
TOTAL = 2,346 hours

3. Clinical practicum should be 8-10 students per group for 1st and 2nd levels, and
maximum of 5 students per group for 3rd and 4th levels.

B. The Clinical Practicum should be handled by full-time faculty who are

qualified and competent to handle the teaching responsibility in as many
related situations as the course requires. Clinical practicum should
compliment the classroom instruction.

C. Affiliation fees are not included in the Computation of Clinical Practicum fees.

Affiliation fees are fees charged by the school and intended to pay agencies
used for clinical practicum.

Clinical Practicum fees are fees charged by the school and intended to pay
Instructors handling clinical practicum. (See Annex for sample computation)

OTHER REQUIREMENTS
Article VII OTHER REQUIREMENTS

Section 12. Program Administration

A Midwifery school shall be administered by a full-time Dean/Principal with the

following qualifications:

- Filipino citizen of good moral character

- Duly Registered Midwife (preferably BS in Midwifery) in the

Philippines, with valid and updated PRC ID, a Master’s Degree
in Allied health-related courses.
- Must have a minimum of five (5) years clinical, teaching,
administrative, managerial, or supervisory experience in
Midwifery;

- Must be a member of good standing of PRC accredited

professional organization of Midwifery and the Association of
Philippine Schools of Midwifery (APSOM).

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 - The general functions and responsibilities of the Dean/ Principal
as stated, in the Manual of Regulations for private schools shall
apply.

Section 13. SCHOOL/ COLLEGE OF MIDWIFERY

To be recognized as a legally constituted institution for midwifery

education, a school/college of Midwifery must have a permit or
recognition from the Commission on Higher Education (CHED) to
operate a Midwifery program. The school/college must own or be
affiliated through a Memorandum of Agreement (MOA) with a twenty
(20) bed maternity hospital, with an 80% occupancy rate; or DOH
accredited birthing center/s with Maternal and Child Health services.
A self managed Birthing Center shall be required in the offering
of the BS Midwifery Program.

Section 14. FACULTY

Each faculty member must possess the following qualifications and

academic preparation appropriate to his/her teaching assignments:

To teach Midwifery professional subjects, he/she must:

- Have a BS degree in Midwifery or Allied Health Profession

preferably with Masters degree in field of specialization.

- Be a duly Registered Midwife in the Philippines, with valid and

updated PRC ID

- Member of good standing of accredited professional organization

- With at least two (2) years clinical experience in her/his field of

specialization and with teaching potentials.

- Preferably a holder of master’s degree in her/his major/specialty

field.

• Load
A faculty should be assigned not more than 24 units with a
maximum of three (3) preparations within a semester.

• Employment Status

At least 50% of the faculty of every college / university offering

Midwifery program shall be on a full time status. The institution
must be guided by Educational Laws promulgated by duly
constituted authority.

Other provisions on faculty stated in the Manual of Regulations

for Private Schools shall apply.

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 • Faculty Development Program.

There should be a faculty development program to allow professional

development and for an effective operation of the institution. This program
may be carried out through:

Scholarship grants to full-time faculty members

Educational loans or tuition fee discounts to faculty members enrolled

in the graduate school

Subsidized attendance in continuing education programs, conferences,

professional and scientific meetings, etc.

Programs/activities that encourage Midwifery research among the

faculty members

Each college/university should have a faculty manual containing

policies and procedures of all matters pertaining to the faculty.

Clerical assistance should be provided to handle correspondence,

secretarial and other administrative functions.

Section 15. LIBRARY

• Librarian

 A well-equipped Midwifery library whether established separately or as

a section in a general library shall clearly be defined as a Midwifery
collection and shall be managed by a professional librarian with a
library assistant as necessary.

 The library should have adequate space and resources, adequate in

quantity and quality including the currency of its collection. Basic and
reference materials relevant to liberal arts, midwifery and professional
subjects specified by the curriculum. These resources shall serve the
needs of the students and should allow for expansion.

 Midwifery students should have access to science libraries. The total

basic collection of relevant books and audio-visual reference materials,
(e.g. CD-ROM, slides, tapes, etc.) must be proportional to the numbers
of students: total 1-300 students, 1000 volumes ; 301-500 students,
3,000 volumes; over 500 students, 5000 volumes. There should be at
least three (3) copies for textbooks and one (1) copy for reference books
per title. Recency of edition should be at least 5 years or the latest
edition available locally.

 The institution offering the Midwifery program must assure availability

of the textbooks used by the students at the library.

 The library should subscribe to an adequate number of scientific

journals and periodicals. It should also assure the subscription to at

18
 least one (1) scientific journal of international circulation in Midwifery
and one (1) general scientific journal to update the students and faculty
staff in the latest development in the fields, and internet access.

Section 15. FACILITIES AND EQUIPMENT

• Classroom requirements
 The school, institution, college or university offering a Midwifery
program should provide for an adequate number of lecture rooms and
laboratories equipped with blackboards and desks for adequate
instruction. In addition, the use of audio-visual aids should be
encouraged.

 It should have its own fully equipped laboratory, distinct from the
clinical facilities of the hospital, for the purpose of providing instruction
and practice to students in the proper use of modalities.

• Laboratory requirements

 Each laboratory room must be well-lighted and ventilated and shall

have an adequate supply of water, gas and/or electricity, as needed.
 Safety devices/first aid facilities shall be readily accessible.

Health Sciences and Midwifery Skills Laboratory

• The rooms should have adequate space for demonstration and practice. It
should not only contain instruments and equipment found in a maternity
hospital setting but should also depict a simulated setting of a community,
the home, health centers, lyingin clinic or birthing home/center. It should
have at least two (2) doors which will serve as entrance and exit and there
should be a fire extinguisher installed near the door.
• A demonstration room where there is one (1) bed to eight (8) students at
one given time.

Section 16. CLINICAL FACILITIES AND RESOURCES FOR CLINICAL PRACTICUM

 It should include maternity hospitals, lying-in / birthing homes / clinics,

primary health care clinics (privately owned or government-managed),
midwifery clinics, community agency where collaboration is undertaken in
the practice of midwifery, and out-patient clinics.

a. Hospitals utilized by the midwifery students for clinical practicum

should be accredited by the National Center for Health Facility
Development of the DOH. The hospital may be owned and operated
by the School of Midwifery, or an attached institution to the School
of Midwifery operating under a Memorandum of Agreement. The
minimum capacity of 20 maternity beds and 80% bed occupancy
rate are required of every hospital used for the clinical experiences
of midwifery students.

b. Midwifery Clinics, Birthing Homes/Clinics, Community Health

Agencies and other health facilities utilized for purposes of

19
 providing the clinical practicum of midwifery students should
likewise be DOH-accredited.

c. Parties entering into the contract for affiliation should provide and
maintain an environment conducive to the attainment of the
teaching-learning objectives.

d. The hospital/affiliating center should have a training coordinator

and the required staffing composed of qualified professional and
non-professional personnel.

e. Health facilities utilized for clinical practicum should have

adequate physical facilities, supplies and equipment for effective
maternal and newborn/infant care, to complement the students’
learning experience such as:

i. conference room
ii. library
iii. comfort room
iv. dressing room
v. lounge vi. locker

List of Laboratory Facilities: see Annex

Section 17. ADMISSION AND RETENTION

 The institution shall establish its own admission criteria.

 A basic criteria for admission shall however include the following:

• The applicant must have graduated from a general secondary course

recognized by the government. Graduates of foreign school must have
clearance from CHED or Department of Education;
• The applicant must be of good moral character;
• The applicant must have passed all required examinations to determine
his/her suitability for the profession.

 The requirements in the promotion and retention of students shall be

determined according to the criteria established by the institution offering
the course. These shall be accessible to the students in the form of a
student manual.

 In general, however, no student shall be permitted to take a subject until

he/she satisfactorily passed the prerequisite subjects.

 Psychological and guidance counseling shall be available to the students.

 The Technical Committee for Midwifery Education (TCME) may recommend

admission quota to the Commission.

Article VIII
RESIDENCY AND UNIT REQUIREMENTS
20
Section 18. As a general rule, a candidate for graduation must have taken the last
curriculum year in the school which is to confer the title. The student
should be evaluated according to the criteria or system of evaluation
set by the school to determine proficiency in all major courses.

Section 19. No student should be permitted to take a subject until he/she has
satisfactorily passed the pre-requisite subject/s.

Section 20. A student should be allowed to carry only the regular semestral load.
However, related issuances or orders must guide graduating students.
Units in excess of these requirements shall need a special permit from
the CHED.

Article IX
SANCTION

The CHED, upon the recommendation of its Technical Committee on Midwifery

Education (TCME), shall take appropriate action regarding the operation of any
School of Midwifery for violation or non-compliance to the provisions of this CMO.
Further, if the school registers zero (0) passing percentage rate for three (3)
consecutive board examinations, the Technical Committee may recommend to the
CHED phasing out order subject to the observance of CHED procedural
requirements.

Article X
REPEALING CLAUSE

Section 21. This order supersedes all previous issuances for Midwifery education
program which maybe inconsistent or contradictory with any of the provisions
thereof.
Article XI
EFFECTIVITY

Section 22. This set of Policies and Standards for Diploma in Midwifery and B.S.
Midwifery Education shall take effect beginning school year 2007-2008.

Pasig City, Philippines.

May ___, 2007
(SGD)CARLITO S. PUNO, DPA
Chairman

21
 Republic of the Philippines
Professional Regulation Commission
(CPE/CPD)

A. Continuing Professional Education/Development Defined

Continuing Professional Education/ Continuing Professional Development (CPE/CPD)

refers to the inculcation, assimilation and acquisition of knowledge, skills, proficiency,
and ethical and moral values, after the initial registration of a professional, that raise
and enhance the professional’s technical skills and competence.

B. Objectives of the CPE/CPD Programs

The following are the objectives of the CPE/CPD Programs:
1. To provide and ensure the continuous education of a registered professional with
the latest trends in the profession brought about by modernization, scientific and
technological advancement;
2. To raise and maintain the professional’s capability of delivering professional
services;
3. To attain and maintain the highest standards and quality in the practice of
his/her profession;
4. To comply with the professional’s continuing ethical standard requirements;
5. To promote the general welfare of the public.

C. Nature of CPE/CPD Programs

The CPE/CPD Programs consists of properly planned and structured activities, the
implementation of which requires the participation of a determined group of
professionals to meet the requirements of maintaining and improving the occupational
standards and ethics of the profession.

D. Rationale
Compliance with the CPE/CPD Programs is deemed a moral obligation of each
professional and within the context of the concerned profession code of ethics and is
considered a necessary, effective and credible means of ensuring competence, integrity
and global competitiveness.

E. Legal Base of CPE/CPD

1. Section 14, Article XII of the 1987 Philippine Constitution provide that the
sustained development of a reservoir of national talents consisting of Filipino
scientists, entrepreneurs, professionals, managers, high level technical
manpower, and skilled workers, and craftsmen in all fields shall be promoted by
the State. The State shall encourage appropriate technology and regulate its
transfer for the national benefit.

2. Section 7(a), (n), and (y) of the Republic Act No. 8981 known as the “PRC
Modernization Act of 2000”, grant the Commission these specific powers: (a) to
administer, implement and enforce regulatory policies of the national government
with respect to the regulation and licensing of the various professions and
occupations under its jurisdiction including the enhancement and maintenance
of professional and occupational standards and ethics and the enforcement of
the rules and regulations relative thereto; (b) to adopt and promulgate such rules
and regulations as may be necessary to effectively implement policies with

22
 respect to the regulation and practice of the professions; (c) to perform such
other functions and duties as may be necessary to carry out the provisions of
this Act, the various professional laws, decrees, executives, orders, and other
administrative issuances.

3. Section 9 (b) of R. A. NO.8981 provides that one of the Powers, Functions and
Responsibilities of the Various Professional Regulatory Boards (PRBs) is to
monitor the conditions affecting the practice of the profession or occupation
under their respective jurisdictions and whenever necessary, adopt such
measures as may be deemed proper for the enhancement of the profession or
occupation and/or the maintenance of high professional, ethical, and technical
standards.

4. Executive Order No. 220 issued by the President of the Republic of the
Philippines on 23 June 2003 directed the Adoption of the Code of Good
Governance for the Professions in the Philippines. The said Coe adopted by the
PRC and the PRBs embodying the principles of professional conduct, specifically,
integrity, and objectivity, professional competence and global competitiveness.

5. The Republic of the Philippines, as one of the sovereign member state of the
World Trade Organization (WTO), has to deal and prepare itself for the
implementation of the 4th protocol, under the General Agreement for Services in
the Trades (GATS), a general agreement that will govern trade among the
member nations in the 12 Classifications of Services. In the 4 th Protocol under
the GATS, the Philippines is mandated to make sure that it can offer
competitively to other WTO members professional services in Health and
Education, Marketing and Distribution, Telecommunications, Business Process
Outsourcing (BPO) services, Information Technology; Engineering, Architectural
and other Construction services, Tourism and other Allied services;
Transportation and Logistics services, among others, and therefore made
attendance by our registered professionals to accredited CPE/CPD mandatory,
as a result of the WTO and the GATS initiatives.

6. The Republic of the Philippines as a member state of the Association of the

Southeast Asian Nations (ASEAN), has to ensure that the Filipino professional is
compliant with established requirements in the various Mutual Recognition
Arrangement/Agreements (MRA) entered into under the ASEAN Framework
Agreement on Services (AFAS), APEC Registries for Architecture and Engineers,
MRAs on Nursing , Engineering, Surveying, and Architecture services prescribe
line requirements prior to recognition of competencies/qualifications for the
practice of these professions within the territories of the other member states.
One of the requirements and common to all of the aforementioned MRAs is the
compliance with the satisfactory continuing professional development.

7. The specific provisions of the Professional Regulatory Laws of the concerned

profession shall govern the implementation of the Continuing Professional
Education/Continuing Professional Development programs.

II. The Continuing Professional Education/Continuing Professional Development

(CPE/CPD) Council

A. CPE/CPD Council
23
PRC Resolution No. 466, series of 2008 provides that each of the concerned Professional
Regulatory Board (PRB), upon approval of the PRC, shall create a continuing professional
education/continuing professional development council within thirty days from the
effectivity of the resolution. The CPE/CPD Council shall assist its corresponding PRB in
implementing its CPE/CPD programs.

B. CPE/ CPD Council Composition

Each CPE Council shall be composed of a chairman and two (2) members.
 The chairman of each CPE/CPD Council shall be chosen from among the
members of the PRB by the members themselves.
 The first member shall be the president or, in his absence or incapacity, any
officer chosen by the Board of Directors of the Accredited Professional
Organization (APO).
 The second member shall be the president, or in his absence or incapacity, any
officer of the organization of deans or department heads of schools, colleges or
universities offering the course requiring licensure examination.
 In the absence of such organization, the second member shall be chosen and
appointed by the PRC from at least three (3) recommendees of the PRB concerned.
Said recommendees shall be academicians.
 All members of the CPE/CPD Council shall be appointed by the Commission and
shall take their oath of office before any or all member/s of the Commission.

C. Powers and Functions of CPE/CPD Council

Each CPE/CPD Council shall, upon a majority vote if its members, exercise powers and
functions which shall include, but not be limited, to the following:

1. Accept, evaluate, and approve applications for accreditation of CPE/CPD

providers;
2. Accept, evaluate, and approve applications for accreditation of CPE/CPD
programs, activities or sources as to their relevance to the profession and determine
the number of CPE/CPD credit units to be earned on the basis of the contents of the
program, activity or source as submitted by the CPE/CPD provider;
3. Accept, evaluate, and approve applications for exemptions from CPE/CPD
requirements;
4. Monitor periodically the implementation of programs, activities or sources;
5. Assess periodically and upgrade the criteria for accreditation of CPE/CPD
providers and CPE/CPD programs, activities or sources; and
6. Perform such other related functions that may be incidental to the implementation
of the CPE/CPD programs or policies.

D. Functions of the CPE/CPD Chairman

Each Council Chairman shall have the following functions:

1. To preside over the meetings of the Council.

2. To direct or supervise the activities of the Council.
3. To submit minutes of regular and special meetings within thirty 30) days from
date of said meetings.

24
 4. To submit Council annual reports before the end of February of the succeeding
year.
5. To issue the certificate of accreditation (the “CoA”) to CPE/CPD providers found by
the Council to be qualified in accordance with these Guidelines as well as the
certificate of accreditation of program/s (the “CoAP”), activities and sources.

E. Terms of Office of the Chairman and Members of the CPE/CPD Council

The term of office of the chairman of each CPE/CPD Council shall be co-terminus with
his/her incumbency in the PRC or determined by his/her capacity to fully discharge such
functions.

 Should a change be required by the PRB before the end of the Council Chairman’s
incumbency, the necessary replacement shall be nominated/named by the simple
majority of the PRB and thereafter appointed by the Commission in accordance
with due process.
 The first member shall have a term of office co-terminus with his/her incumbency
as officer of the APO; the second member shall have a term of office co-terminus
with his/her incumbency as officer of the organization of deans or heads of
departments. In the case of the academician chosen and appointed by the
Commission, his/her term of office shall be for two (2) years in one reappointment.
Except in the case of the academician-member, upon the expiration of their
respective terms of office in the PRB, APO or organization of deans or heads of
departments, the chairman, the first member and the second member shall
continue to function as such in the Council until the appointment or election of
their respective successors in the PRB, APO or organization.

F. CPE/CPD Council Meetings

The CPE/CPD Councils shall hold regular meetings once a month on dates fixed by said
Councils. Special meetings may be called by the Chairman or upon written request of at
least a member of the CPE/CPD Council.

G. CPE/CPD Council Secretariat The Chairman of the Commission shall designate or

appoint an official of the Commission with the rank not lower than Division Chief who
shall act as the Secretary of all CPE Councils. The designated official may participate in
the deliberations of the CPE Councils but shall not vote.

H. CPE/CPD Council Secretariat Functions

The duties and functions of the CPE Secretariat are as follows:

1. To see to it that the sessions, meetings or proceedings of all the CPE Councils
are recorded;
2. To prepare the minutes of all the meetings and proceedings of the CPE
Councils;
3. To receive applications for accreditation of CPE providers, programs, activities
or sources;
4. To submit to the Councils applications for accreditation of aspiring CPE/CPD
providers and CPE/CPD programs, activities and sources;
5. To release Certificates of Accreditation to CPE/CPD providers and programs,
activities or sources;

25
 6. To assist the Councils by providing relevant statistical data on the renewal of
professional licenses and other related matters.

The Secretary shall exercise general supervision and control over each of the
Council Secretaries, the staff of which shall be selected by the Chairman of the
Commission from among the existing personnel of the Commission. Each of the
Council Secretaries shall have, among others, the following functions:

1. To release CPE Certifications of credit units (the “CUs”) earned to the registered
and licensed professionals concerned;
2. To keep all records, papers and other documents relative to the evaluation,
approval and accreditation of CPE programs, activities or sources.
3. To maintain records of accredited CPE providers, ongoing, continuing or
completed CPE programs, activities or sources, the list of participants and other
relevant data.

I. Involvement of the Accredited Professional Organization (APO)

The CPE/CPD Council, if the need arises, and upon approval of the Commission, may
delegate to the APO the processing of the application, keeping of all records of CPE/CPD
providers and their respective programs and credit units (CUs) earned by each registered
and licensed professional who avail of the CPE programs and related functions. For this
purpose, the APO may create a counterpart CPE Council known as APO CPE/CPD
Council (“the APO-CPE/CPD Council”) and may ask for reimbursement of reasonable
processing and recordkeeping fees directly from the applicants apart from the
accreditation fee that such applicants pay directly to the Commission. The APO-
CPE/CPD Council shall keep separate books of accounts of its expenses and amounts
collected from applicants and make a monthly report thereof to the Commission through
the PRB. Any excess collection shall be used exclusively as working capital of the APO for
the CPE/CPD activities.

J. Specific Responsibilities of PRB/APO in CPE/CPD

1. Promotion of Lifelong Learning. The PRB/APO should promote the importance of

maintaining the continuous improvement and competence and a commitment to lifelong
learning for all.

2. Access to CPE/CPD. The PRB/APO should facilitate access to CPE opportunities and
resources to assist the professionals in meeting the responsibility for continuous
learning.

3. Mandatory CPE/CPD for all Professionals. The PRB/APO should require their
respective disciplines to develop and maintain competence relevant and appropriate to
their work and professional responsibilities. The responsibility for developing and
maintaining competence rests primarily among the professional.

4. Relevance. CPE/CPD contributes the competence of the professional and therefore

acceptable CPE/CPD activities are expected to develop professional knowledge,
professional skills and professional values, ethics and attitudes of the professional
relevant to their current work and professional responsibilities.

PRBs/APOs choose to develop requirements or other guidelines regarding which types of

the CPE/CPD activities are considered professionally relevant. Others may choose to rely
26
 on the professional judgment of individuals to make may choose to set requirements in
certain areas and allow the individual professional the flexibility to choose relevant
learning activities in other areas.

PRBs/APOs may prescribe specific or additional CPE/CPD for professionals working in

special areas or areas of high risk to the public. Professionals are encouraged to consult
with employers, colleagues, professional organizations to help them identify competency
or learning gaps and then specific learning opportunities to meet these needs.

5. Measurement. Professionals are required to measure learning activities or outcomes to

meet the member body’s CPE requirements. Learning activity may be measured in terms
of effort or time spent or through a valid assessment method which measures
competence achieved or developed.

6. Verification. Professionals are responsible to retain appropriate records and

documents related to their CPE and upon request by the PRB/APO, provide sufficient
evidence to demonstrate their compliance with the requirements of the PRB/APO.

Women’s Health and Safe Motherhood Program

Introduction
The Women’s Health and Safe Motherhood Project (WHSMP) is a 5-year project of the
DOH and the Local Government Units (LGUs) at the provincial, municipal, and the
barangay levels. The DOH will provide all technical and managerial directions, while
LGUs will would be responsible for the actual delivery of the project services.

The Women’s Health and Safe Motherhood Project was developed:

 To reduce the maternal mortality and morbidity;
 To support efforts of the local level to provide women’s health and services to
targeted groups of women.
 At the national level to strengthen DOH capability to support LGUs in carrying out
these services/activities.

Project Objective

The project’s overall objective is to improve the health status of women, with particular
focus on women of reproductive age, and thereby support the Government’s long term
goal of reducing female morbidity and maternal mortality.

Specific Objectives

This objective can be best reached by:

 Improving the quality and range of women’s health and safe motherhood services
 Strengthening the capacity of LGUs to manage the provision of these services, and
of the DOH to provide policy, technical, financial and logistical support
 Enhancing the effectiveness an sustainability of health interventions through the
participation of local communities and non-government organizations in the
project
 Expanding the knowledge base upon which to draw policy and technical guidance
for women’s health programs

Emergency Obstetric and Newborn Care (EMONC)

27
Are the elements of obstetric & newborn care needed for the management of normal and
complicated pregnancy, delivery, postpartum periods and the newborn. It includes:
 Early detection and treatment of problem pregnancies to prevent progression to an
emergency
 Management of emergency complications

Basic Emergency Obstetric and Newborn Care (BEmONC)

Refers to functions provided by a team of experiences and trained skilled attendants at the
primary level providing basic emergency care to mothers and babies to prevent maternal and
newborn mortality.

Functions of the BEmONC

1. Administration of parenteral antibiotics (initial loading dose)
2. Administration of parenteral oxytoxic drugs (for active mgt of the 3rd stage of labor
only)
3. Administration of parenteral anticonvulsant for preeclampsia/eclampsia (initial
loading dose)
4. Performance of manual removal of placenta
5. Performance of removal of retained products
6. Performance of IMMINENT breech delivery
Requirements for CEmONC Facility
1. It must be close to the client’s home
2. It must have available transport
3. It should be within 2 hours away from a CEmONC facility\
4. It can be a district hospital, RHU, Birthing Home or Lying in

Component of BEmONC Team

1. Doctor
 Acts as the team leader and supervises the nurse and the midwife in performing their
duty
 Performs the 6 CEmONC functions
 Performs networking activities and referral of mothers to CEmONC facilities
2. Nurse
 Acts as the assistant leader and performs the administrative function
 Performs the first 3 function of CEmONC
 Conducts health education to mothers
 Performs networking activities and referral of mothers to CEmONC facilities
3. Midwife
 Performs the first 3 functions
 Assists in the 4th-6th functions
 Conducts pre-natal and post-natal care
 Conducts health education to mothers
 Performs networking activities and referral of mothers to CEmONC facilities

Comprehensive Emergency Obstetric and Newborn Care (CEmONC)

28
Refers to a hospital facility that can perform all BEmONC functions plus the capability to
perform blood transfusion and cesarean section to patients referred from BEmONC facility.

Essential Newborn Care

The DOH embarked on Essential Newborn Care, a new program to addressed neonatal
deaths in the country. Under the umbrella of the Unang Yakap Campaign, Essenial Newborn
Care is an evidence based strategic intervention amed at improving newborn care and
helping cub neonatal mortality.

Essential Newborn Care (ENC) is a set of preventive measures including hygienic cor care,
thermal control (including drying and wrapping, skin to skin, and delayed bathing), and early
and exclusive breastfeeding. These measures are needed to ensure the survival of all
newborns and assist babies to breathe when needed. Early recognition or detection of sick
newborn is also a component of ENC.

The Essential Newborn Care package is a four-step newborn care intervention undertaken to
lessen newborn death.
1. Immediate and thorough drying to stimulate breathing after delivery of the baby.
2. Provision of appropriate thermal care through mother and newborn skin-to-skin
contact maintaining a delivery room temperature of 25-28 degrees centigrade and
wrapping the newborn with clean, dry cloth.
3. Properly timed clamping and cutting of the umbilical cord, (1-3 minutes or until cord
pulsation stops)
4. Immediate latching on and initiation of breastfeeding within first hour after birth.

Post-natal care required within 24 hours after birth also includes:

 Cord care
 Breastfeeding
 Vitamin K injection]
 Eye prophylaxis
 Delayed bathing until 6 hours of life
 BCG and first dose of Hepatitis B immunization
 Newborn Screening

Newborn Screening

What is Newborn Screening?

Newborn Screening (NBS) is a simple procedure to find out if your baby has a congenital
metabolic disorder that may lead to mental retardation and even death if left untreated.

Why is it important to have Newborn Screening?

Most babies with metabolic disorders look normal at birth. One will never know that the
baby has the disorder until the onset of signs and symptoms and more often ill effects are
already irreversible.

When is Newborn Screening done?

Newborn screening is ideally done on the 48th hour or at least 24 hours from birth. Some
disorders are not detected if the test is done earlier than 24 hours. The baby must be
screened again after 2 weeks for more accurate results.

How is Newborn Screening done?

29
Newborn screening is a simple procedure. Using a heel prick method, a few drops are taken
from the baby’s heel and blotted on a special absorbent filter card. The blood is dried for 4
hours and sent to the Newborn Screening Laboratory (NBS LAb).
Who will collect the sample for Newborn Screening?
A physician, a nurse, a midwife or medical technologist can do the newborn screening.

Basic Information about Newborn Screening

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 the 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
abnormality 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 produce galactose, the sugar
present in milk. Accumulation of excessive galactose in the body can cause many
problem including liver damage, brain damage and cataracts.

4. Phenyketonuria (PKU)
PKU is a metabolic disorder in which the body cannot properly use one of the building
blocks of protein called phenylalanine. Excessive accumulation of phenylalanine in
the body causes brain damage.

5. Glucose-6- Phosphate Dehydrogenase Deficiency (G6PD Def)

G6PD Deficiency is a condition where the body lacks the enzyme called G6PD. Babies
with this deficiency may have hemolytic anemia resulting from exposure to certain
drugs, foods and chemicals.

Where is Newborn Screening Available?

Newborn Screening is available in a practicing health institutions (hospitals, lying-ins, rural

health units and health centers). If babies are delivered at home, babies may be brought to
the nearest institution offering newborn screening.

When are the Newborn results Available?

Newborn Screening results are available within three weeks after the NBS lab receives and
tests the samples sent by the institutions. Results are released by the NBS lab to the
institutions and are released to your attending birth attendants or physicians, Parents may
seek the results from the institutions where samples are collected.

A negative screen means that the result of the test is normal and the baby is not suffering
from any of the disorders being screened.

In case of a positive screen, the NBS coordinator will immediately inform the institution
where the sample was collected to recall the patients for confirmatory testing.
30
What should be done when a baby has a positive newborn screen result?

Babies with positive results should be referred at once to the nearest hospital or specialist for
confirmatory test and further management. Should there be no specialist in the area; the
NBS secretariat office will assist its attending physician.

Infant and Young Child Feeding

In 2002, WHO and UNICEF jointly endorsed the “Global Strategy for Infant and Young Child
Feeding” to focus world attention on the impact that feeding practices have on the nutritional
status, growth and development, health, and thus the very survival of infants and young
children. This strategy renews the Baby-friendly Hospital Initiative (BFHI), and the
International Code of Marketing of Breast-Milk Substitutes, the scope of the Global Strategy,
countries are urged to formulate, implement, monitor and evaluate a comprehensive national
policy on infant and young children feeding. This includes ensuring sufficient maternity leave
to promote exclusive breastfeeding.

Appropriate Infant and Young Child Feeding practices include:

 Exclusive breastfeeding for 6 months;
 Timely initiation of nutritionally adequate and safe complementary foods while
continuing breastfeeding up to 2 years or beyond; and
 Appropriate feeding of infants and young children living in especially difficult
circumstances (low-birth-weight infants, infants of HIV-positive mothers, infants in
emergency situations, malnourished infants, etc.)

There is evidence that appropriate infant and young child feeding is among the most effective
preventive actions for reducing under-five mortality. Promotion of breastfeeding ranked first,
and improved complementary feeding, administration of zinc and vitamin A were also
described as important ways to prevent deaths. Infants are particularly vulnerable during the
transition period when complementary feeding begins. Ensuring that their nutritional needs
are meth thus requires that complementary foods be timely, adequate, safe, and properly fed.
Appropriate complementary feeding depends on accurate information and skilled support
from the family, community and health care system.

Integrated Management of Childhood Illness

What is IMCI?
Integrated Management of Childhood Illness (IMCI) is a strategy for reducing the mortality
and morbidity associated with the major causes of childhood illness.

IMCI is an integrated approach to child health that focuses on the well-being of the whole
child.

IMCI aims:
 To reduce death, illness, and disability, and
 To promote improved growth and development among children under five years of age

IMCI Strategy
 Promotes the accurate identification of childhood illnesses;

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  Ensures appropriate integrated treatment of all major illnesses;
 Strengthens the counselling of caregivers;
 Identifies the need of and speeds up the referral of severely ill children.

In the Home Setting:

 Promotes appropriate care-seeking behaviors;
 Improved nutrition and preventive care;
 Promotes the correct implementation of prescribed care.

Components of IMCI Strategy

 Improving case management skills of health-care providers;

 Improving overall health systems;
 Improving family and community health practices.

Rationale for an Integrated Approach

 Every year almost 10 million children die before they reach their fifth birthday. A
majority of these deaths caused by just five preventable and treatable conditions:
Pneumonia; diarrhea, malaria, measles, and malnutrition
 Often, those deaths are caused by a combination of the above conditions. Many of
childhood deaths could be avoided if those children received appropriate and timely
care. In addition, three out of four episodes of childhood illness are caused by these
five conditions.

Principle of IMCI

 The children and the infants are then assessed for main symptoms. For older children
the main symptoms include cough and difficulty breathing, diarrhea, fever, and ear
infection. For young infants, the main symptoms include local bacterial infection,
diarrhea, and jaundice. In addition, all sick children are routinely assessed for
nutritional and immunization status, and other potential problems.
 Only a limited number of clinical signs are used, selected on the basis of their
sensitivity and specificity to detect disease.
 IMCI management procedures use a limited number of essential drugs and encourage
active participation of caregivers in the treatment of children.
 An essential component of ICMI is the counselling the caregivers regarding home care,
appropriate feeding and fluids, and when to return to the clinic- immediately or for
follow-up.

The IMCI Case Management Process

 Assess a child by checking first for danger signs or very severe disease in young
infant, asking about questions about common conditions, examining the child, and
checking nutrition and immunization status. Assessment also includes checking
the child for other health problems.
 Classify a child’s illness using a color-coded triage system. Each of the child’s
major symptoms corresponds to the severity of the disease. Classify means to
make a decision about the severity of the illness. For each of the child’s main
symptoms, select a “classification” that corresponds to the severity of the disease.
Classifications are not exact disease diagnoses. Instead, they are categories that
are used to determine appropriate action or treatment. Children may have more
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 than one condition and each of illness is classified according to presenting signs
according to whether it requires:
-urgent pre-referral treatment and referral (pink), or
-specific medical treatment and advice (yellow), or
-simple advice on home management (green)
 After classifying all conditions, identify specific treatments for the child. If a child
requires urgent referral, give essential treatment before the patient is transferred.
If a child needs treatment at home, develop an integrated treatment plan for the
child and give the first dose of drugs in the clinic. If a child should be immunized,
give immunizations.
 Treat the child is the treatment given in the health center, instructions, including
teaching the caretaker how to give oral drugs, how to feed and give fluids during
illness, and how to treat local infections at home. Ask the caretaker to return
immediately to the healthy facility.
 Counsel the mother includes assessing feeding, including assessment of
breastfeeding practices, and counsel to solve any feeding problems found. Then
counsel the mother about her own health.
 Follow up care is given when a child is brought back to the clinic as requested and
reassesses the child for new problems

National Healthy Lifestyle Campaign

Rationale:
The DOH, cognizant of the increasing prevalence of lifestyle related diseases, has taken one
of its priorities for the year 2003, the Promotion of Healthy Lifestyles. The promotion of
healthy lifestyles emphasizes the anti-smoking campaign, regular physical activity, and
weight control. It also includes healthy diet and nutrition, stress management and regular
health check-up.

The National Healthy Lifestyle Campaign

The National Healthy Lifestyle Campaign is being undertaken in collaboration with the
Philippine Heart Association and a Coalition of Stakeholders composed of various medical
societies, professional organizations, academe, and other government agencies.

As a year round advocacy and IEC campaign it aims to:

 Raise the awareness of the Filipinos on the need to practice healthier lifestyle.
 Raise the consciousness of policy makers on the need to provide the Filipinos with an
environment supportive of healthy lifestyle.
Healthy lifestyle in this context is defined as a way of life which promotes and protects one’s
health and well-being. The campaign promotes the following messages:
 Don’t smoke
 Regular exercise
 Eat healthy diet everyday
 Watch your weight/Weight control
 Manage stress
 Regular health check up

Target Audiences:

Primary Audience:
1. All family members-grandparents, parents, sons and daughters, belonging to the C-D-
E economic class in the urban areas

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 2. Each of the healthy messages will specifically prioritize the following target audiences:
 Adults to elderly for exercise
 Schoolchildren for healthy diet
 Mothers and daughters for watch your weight
 Teenagers for not smoking
 Working adults for manage your stress
3. For purpose of this campaign, the profile of the family members are as follows:
 Grandparents: 60 years old and above
 Father: 40-45 years old
 Mother: 30-35 years old
 Teenage son: 13-15 years old
 Preteen daughter: 9-12 years old

Secondary Audience
1. Executive and employees of local government units
2. Legislators/politicians
3. Media

REVISED IMPLEMENTING RULES AND REGULATIONS ON THE MAGNA

CARTA OF PUBLIC HEALTH WORKERS OR R.A. 7305

RULE I Coverage

SECTION 1. These Rules and Regulations shall cover all persons engaged in health and health-
related work, employed in all hospitals, sanitaria, health centers, rural health units, barangay
health stations, clinics and other health-related establishments owned and related
establishments owned and operated by the government or its political subdivisions, regardless
of their employment status. Also covered are medical and allied professionals and support
services personnel.

RULE II Interpretation

SECTION 1. These Rules and Regulations shall be interpreted in the light of the Declaration
of Policy and Objective under Section 2 of the Act as follows:
“The State shall instill health consciousness among our people to effectively carry out the
health programs and projects of the government essential to the growth and health of the
nation”. Towards this end; this Act aims:

a To promote and improve the social and economic well-being of the health workers, their
living and working conditions and terms of employment;

b. To develop their skills and capabilities in order that they will be more responsive
and better equipped to deliver health projects and. programs; and

c. To encourage those with proper qualifications and excellent abilities to join and
remain in government service.”

RULE III Definition of Terms

As used in these Revised Rules and Regulations, the terms below are defined as follows:
1. Public Health Workers (PWH) — Persons engaged in health and health-related
works. These cover employees in any of the following:

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 a Any government entity whose primary function according to its legal mandate
is the delivery of health services and the operation of hospitals, sanitaria,
health infirmaries, health centers, rural health units, barangay health
stations, clinics or other institutional forms which similarly perform health
delivery functions, like clinical laboratories, treatment and rehabilitation
centers, x-ray facilities and other similar activities involving the rendering of
health services to the public; and

b Offices attached to agencies whose primary function according to their legal

mandates involves provision, financing or regulation of health services.

Also covered are medical and allied health professionals, as well as

administrative and support personnel, regardless of their employment
status.

2. Health-Related Establishment — health service facility or unit which

performs health service delivery functions within an agency whose legal mandate
is not primarily the delivery of health services. This applies to, among others,
clinics or medical departments of government corporations, medical corps and
hospitals of the AFP, and specific health service section, division, bureau or any
type of organizational subdivision of a government agency. In no case shall the
law apply to the whole agency when the primary function of the agency is not the
delivery of health services.

3. Act — Republic Act 7305 otherwise known as the Magna Carta of Public Health
Workers. (See Annex A)

4. Agency — any department, bureau, service, office, college, university,

commission, board of institute with original charter or any other branch of
national government as well as local government employing public health workers,
except as hereinafter otherwise provided.

5. Benchmark — a reference point upon which the salary grade of classes or

positions are based.

6. Client — a person or group seeking or needing the services of a public

health worker.

7. Clinic — unit providing direct health service wherever it is located as

defined in the law.

8. Demotion — a movement from one position to another involving the issuance of

an appointment with diminution in duties, responsibilities, status or rank which
may or may not involve reduction in salary.
9. Depressed Area — an area where majority of its population do not meet the
minimum basic needs and/or the income of the majority of households in the area
is below the poverty line as defined by NEDA.
10. Difficult Area — a place where an increased amount of risk to life is
encountered while traveling to such places, i.e. rough seas, dangerous and steep
trails.
11. Distressed Area — an area under a state of calamity and/or emergency.

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 12. Due Process — a fair investigation and hearing by a neutral body wherein
parties concerned or a person is given an opportunity to be heard.
13. Disciplining Authority — the appropriate appointing authority.
14. Emergency — a sudden occurrence demanding immediate action that
may be due to epidemics; to natural or technological catastrophes; to strife; or to
other man-made and/or natural causes.
15. Employed — a state of being appointed to a position in government
whether permanent, temporary, contractual/casual, full-time or part-time status.

16. Exigency of the Service — a situation where service is urgently needed and where
any delay in its execution and delivery will adversely affect the outcome of the
service as well as pose a threat to the life of a person and/or condition of a facility
or property.

17. Geographical Reassignment — a movement of a public health worker from one

geographical location to another in the same department or agency which does
not involve a reduction in rank, status or salary.
18. Hazard — the risks to the health and safety of public health workers.

19. Holiday — the regular holidays and special days as mandated by law (Book 1,
Chapter 7, Administrative Code of 1987).

20. Job Rotation — a temporary assignment to a similar position in another

geographic area or unit as a means to enrich professional experience as well as to
avoid service interruption.

21. Legal Tender — any form of money which by laws must be accepted when offered
as payment.

22. Married Couple — a pair of male and female individuals of legal age joined in
wedlock by a person authorized by law to perform marriage ceremony.

23. Medico-Legal Case Completed — the case is completed upon submission of the
medico-legal report to the proper authority.

24. Municipal Health Officer (MHO) — a mandatory position under the Local
Government Code of 1991 which serves as the department head in-charge of a
municipality tasked with the formulating and implementing the health and
medical programs for the whole municipality.

25. Night Shift — a duly authorized work rendered between 10:00 p.m. and 6:00 a.m.

26. On-Call Service — the period during which the worker satisfies the agency’s
requirement for him or her to remain on stand-by within the premises of specified
place in order to be readily available to perform work on demand or to be deployed
in work areas.

27. Overloading — a situation where a public health worker is given more than the
accepted standard workload he/she can efficiently handle.

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28. Overtime — a duly authorized work rendered beyond the regularly scheduled
normal hours of work, such as work during the day beyond the 8 hours of work
required from daily paid workers or work during the week beyond the 40 hours of
work required from monthly paid workers.

29. Rest Day — any day within the week when the employee is scheduled not to report
to work provided the employee shall have rendered forty (40) hours work within
the week.

30. Post Graduate Degree Course — the graduate degree course completed after
finishing baccalaureate degree relevant to his/her job.

31. Satisfactory Service — the performance of an employee who has been

rated at least satisfactory for the past two (2) consecutive performance rating
periods.

32. Preliminary Investigation — a fact-finding proceeding seeking to determine the

existence of a prima facie evidence or sufficient grounds sufficient enough to file
formal administrative charges.

33. Prescribed Uniform — the uniform authorized by the head of agency to be worn
by the personnel which delivers direct health services.

34. Qualification Standard — a statement of the minimum qualifications for a position

which shall include education, experience, training, civil service eligibility and
physical characteristics and personality traits required by the job.

35. Rural Health Physician (RHP) — One who is in-charge of a rural health unit (RHU)
that renders preventive and curative medical services in a specific area of
assignment within the municipality.

36. Rural Physician — common term used to include the municipal health officer
(MHO), rural health physician (RHP), medical officer (MO), chief of the district
hospital (CDH), and resident physicians who are designated to perform medico-
legal services in a rural setting.

37. Social Security — the protection against economic and social distress that
is caused by the stoppage or substantial reduction of earnings resulting from
sickness, maternity, employment injury, incapacitation and old age.

38. Subsistence — meal allowance.

39. Transfer — a movement from one position to another which is of equivalent rank,
level or salary without break in service.

40. Understaffing — a situation where the staffing or personnel complement of a

health or health-related establishment is inadequate, failing to meet the
acceptable standard ratio of manpower to patient / population.

41. Unit — a subdivision of any government agency.

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 42. Work During Rest Day — a duly authorized work rendered during periods
designated as regular rest day of the worker.

43. R.A. 6758 — An Act Prescribing a Revised Compensation and Position

Classification in the Government and for other purposes.

44. Part-time public health worker — those who are rendering services for four (4)
hours per day or twenty (20) hours per week.

45. Standard Ratio of Manpower to Population:

Rural Health Physician = 1:20,000

Public Health Nurse = 1:20,000
Rural Health Midwife = 1:5,000
Rural Sanitary Inspector = 1:20,000
Rural Health Dentist = 1:50,000

46. Networking — an organized system of government and private hospitals helping

each other in rendering/providing services not available at their respective
hospital. This includes sharing of equipment, manpower and other resources
which follow certain referral procedure. The agency concerned shall shoulder the
expenses incurred thereof.

47. Professional Services — services rendered or extended by public health workers

but not limited to medical, dental and nursing professionals.

RULE IV Standards Applicable to Agencies Claiming Parts of its Organization as

Covered by Virtue of a Health-Related Function

SECTION 1. The agency should show that its health service function is specifically included
in the legal mandate of the agency as shown by the legislation or executive order creating or
establishing the agency or unit of the agency. The basis will be an examination of the relevant
legal document.

SECTION 2. In addition, the agency should then show the official approved staffing pattern
corresponding to the unit or subdivision covered by the legal mandate which include the
health service function. The basis will be an examination of the relevant administrative
documents.

SECTION 3. Based on satisfying the above two (2) requirements, i.e. legal mandate and staffing
pattern, the inclusion under the law’s coverage will apply only to those personnel occupying
the identified positions in the unit determined to be “health related” under these procedures.

RULE V Recruitment and Qualification

SECTION 1. Appointment of a public health worker in the service shall be made on the basis
of the qualification standards established for the position. The qualification standards shall
be used as basis for civil service examinations as guides in appointment and other personnel
actions, in the adjudication of protested appointments, in determining training needs, and as
aids in the evaluation of the personnel work program of an agency. Qualification standards
for a position provided by the agency concerned in addition to the minimum qualification
standards, as cited in page 20, Qualification Standards Revised 1997, of the Civil Service

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Commission (CSC) for that particular position shall be binding as cited in Rule IV, Section 2
of Book V.

SECTION 2. The recruitment, selection, appointment and qualification standards of public

health workers developed and implemented by the appropriate government agency shall be in
accordance with existing and pertinent civil service law, rules and regulation as cited in Rule
II to V, Book V.

SECTION 3. A Selection / Promotion Board (Rule VI, Section 9 to 11 of Book V) shall be

established in each Department or agency in accordance with civil service law and rules. The
Board shall pass upon all applicants for original / promotional appointments. Furthermore,
it shall set criteria or guidelines in the deliberation of the applicant’s qualifications, which
should be made public.

SECTION 4. Each agency shall develop its own process, in addition to those provided by the
Civil Service Law and Rules.

SECTION 5. Permanent appointment shall be issued to a health worker who meets all the
requirements for the position to which he/she is being appointed / promoted, including the
approximate eligibility prescribed, in accordance with the provisions of the law, rules and
standards promulgated in pursuance thereof.

SECTION 6. A temporary appointment shall be issued to a public health worker who meets
all the requirements for the position to which he/she is being appointed except the appropriate
eligibility, in the absence of appropriate eligibles in the area, willing and able to assume the
position as certified by the Civil Service Regional Director concerned and it deems necessary
in the interest of public service a vacancy. Such appointment shall not exceed twelve months
nor be less than three (3) months renewable thereafter, but that the appointee maybe replaced
sooner if (a) a qualified civil service eligible becomes available, or (b) the appointee is found
wanting performance or conduct befitting a government employee.

SECTION 7. The special cases of appointments in the career service such as in the field of
medicine where the requirements for permanency is based not only on eligibility but shall also
be governed by existing laws and pertinent civil service rules and regulations.

RULE VI Performance Evaluation and Merit Promotion

SECTION 1. The Secretary of Health, upon consultation with the proper government agency
concerned and the Management-Health Workers’ Consultative Councils, as established under
Section 33 of this Act, shall prepare a uniform career and personnel development plan
applicable to all public health personnel. Such career and personnel development plan shall
include provisions on merit promotion, performance evaluation, in-service training grants, job
rotation, suggestions and incentive award system.

SECTION 2. The performance evaluation plan shall consider foremost the improvement of
individual employee efficiency and organizational effectiveness; provided, that each employee
shall be informed regularly by his/her supervisor or his/her performance evaluation.

SECTION 3. The merit promotion plan shall be in consonance

with the rules of the Civil Service Commission.

RULE VII Transfer or Geographical Re-Assignment

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SECTION 1. A public health worker shall not be transferred and/or re-assigned, except when
made in the interest of public service, in which case, the employee concerned shall be informed
of the reasons therefore in writing. If the public health worker believes that there is no
justification for the transfer and/or re-assignment, he/she may appeal his/her case to the
Civil Service Commission, which shall cause his/her transfer and/or reassignment to be held
in abeyance.

SECTION 2. No transfer nor reassignment shall be made three

months before any local or national elections.

SECTION 3. In case of temporary reassignment, all expenses incidental to the reassignment

of the public health worker shall be reimbursed by the government.

SECTION 4. In case of permanent reassignment requiring the relocation of the family, all
necessary expenses shall be paid for by the government.

RULE VIII Married Public Health Workers

SECTION 1. In case spouses are both public health workers, they can be assigned, as much
as possible in the same locality but not in the same office or unit.

SECTION 2. Couples wanting to be in the same locality of assignment shall signify their
intention by writing to the head of the
agency. Such request shall be approved only if a vacancy exists.

SECTION 3. Request shall be approved on a “first-come, first served” basis.

RULE IX Security of Tenure

SECTION 1. Public health workers who are regularly employed under permanent status shall
have security of tenure and shall not be terminated or dismissed except for cause provided by
law and after due process.

SECTION 2. In case a public health worker is found by the Civil Service Commission to be
unjustly dismissed from the service, he/she shall be entitled to reinstatement without loss of
seniority rights and payment of backwages/salaries and other benefits with twelve percent
(12%) interest computed from the time such salaries and other benefits were withheld up to
the time of reinstatement.

SECTION 3. Public health worker’s right to security of tenure

shall always be respected / guaranteed as provided by law.

RULE X Staffing and Workload

SECTION 1. Each agency shall conduct periodic reviews of the personnel complement of its
health and health-related establishments to determine the adequacy of staffing pattern and
work load of each public health worker.

SECTION 2. The Department of Health, in consultation with Department of Budget and

Management and other agencies concerned shall set standard staffing pattern for health and
health related establishments.

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SECTION 3. The standard staffing pattern shall not be determined based on health workers
to population ratio alone but must consider the terrain, road network, population
concentration and others that affect operations.
SECTION 4. Positions that are vital and necessary shall be filled to prevent overloading of
public health workers and under staffing of the agency as determined by the head of
agency/unit.

SECTION 5. The Head of the Local Government Unit concerned shall designate a Medico-Legal
Officer for their
Province/Municipality. The Rural Health Physician or any Resident Physician in a non-
training hospital could be designated as the Medico-Legal Officer provided that the individual
had undergone an appropriate training for such services.

SECTION 6. In line with the above policy, substitute officers or employees shall be provided
in place of officers or employees who are on leave for over three (3) months. Likewise, the
Secretary of Health or the proper government official shall assign a medico-legal officer in
every province.

SECTION 7. In places where there is no such medico-legal officer, rural physicians who are
required to render medico-legal services shall be entitled to additional honorarium and
allowances.

RULE XI Administrative Discipline

SECTION 1. No administrative charges shall be filed against a public health worker unless an
existing prima facie evidence established in the preliminary investigation/hearing.
Administrative charges shall be made known to him/her and heard by the committee created
for the purpose.

SECTION 2. The preliminary and formal investigation/hearing of administrative charges shall

be in accordance with the Omnibus Rules Implementing Book V of Executive Order No. 292
and other Pertinent Civil Service Laws, Rules and Regulations and other Implementing rules
and regulations.

SECTION 3. Local health workers’ organizations duly recognized by the Local Government
Unit shall be represented in the investigating committee.

SECTION 4. Investigation findings and recommendations shall be submitted to the Head of

Agency or to the Local Government Unit
within thirty (30) days upon completion of the Investigation.

SECTION 5. Administrative charges against a public health worker shall be heard by a

committee composed of the provincial health officer of the province where the public health
worker belongs, as chairperson, a representative of any existing national or provincial health
worker’s organization or in its absence its local counterpart and a supervisor of the office
mentioned above. The committee shall submit its recommendation to the Secretary of Health
or the appropriate disciplining authority within thirty (30) days from the termination of the
investigation/hearings. Where the provincial health officer is an interested party in the case,
all the members of the committee shall be appointed by the Secretary of Health or the
appropriate disciplining authority.

SECTION 6. The national public health workers under the jurisdiction of the Secretary of
Health and/or its delegated officer or officers shall be governed by the rules embodied under
Executive Order 292, its Implementing Rules and Regulations, other pertinent
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Civil Service Laws, Rules and Regulations and Orders.

RULE XII Safeguards in Disciplinary Procedure Shall Be Undertaken to Uphold the

Following

a. The right to be informed in writing of the charges;

b. The right to full access to the evidence of the case;

c. The right to defend himself/herself and to be defended by a representative of his/her choice

and/or by his/her organization, adequate time being given to the public health worker for
the preparation of his/her defense;

d. The right to confront witness/es presented against him/her and summon witness/es in
his/her behalf;

e. The right to appeal to designated authorities;

f. The right to reimbursement of reasonable expenses incurred in his/her defense in case of

exoneration or dismissal of the charges; and

g. Such other right that will ensure fairness and impartiality during proceedings.

RULE XIII Duties and Obligations

SECTION 1. In addition to the duties of public officials and employees contained in the
Implementing Rules of the Code of Conduct and Ethical Standards under RA 6713
promulgated herein, pursuant to Section 14 of RA 7305, the public health worker is bound
to:

a. Discharge his/her duty humanely, with conscience and dignity;

b. Perform his/her duty with utmost respect for life; and

c. Exercise his/her duty without consideration of client’s race, gender, religion,

nationality, party politics, social standing or capacity to pay.

RULE XIV Code of Conduct

SECTION 1. As provided for by Section 14 of the Act, the Code of Conduct for Public Health
Worker shall be disseminated at all levels of the health system.
RULE XV Compensation, Benefits and Privileges

SECTION 1. Normal Hours of Work. — Public health workers, similar to other government
employees, shall be required to render eight (8) hours of work per day or forty (40) hours a
week.

1.1. Hours worked shall include: a) all the time during which a public health worker is required
to be on active duty or to be at a prescribed workplace; and b) all the time during which a
public health worker is required or permitted to work; provided, that during times that a

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public health worker is “ON CALL” status as defined in these Rules, he shall be entitled to ON
CALL pay equivalent to fifty per cent (50%) of his regular wage.

1.2. Scheduling of Normal Work Hours

a) Heads of agencies and managers or supervisors of component organizational

units shall have the authority to schedule the normal work hours of public
health workers according to the demands of public service. Administrative
regulations governing the application of flexible work hours shall apply as
appropriate.

b) In scheduling the 8 hours of work normally rendered by daily rated

workers, consideration should be given to utilizing the daily work hours in
only one shift or in no more than two 4-hour segments within the day.

c) In scheduling the 40 hours per week normally rendered by monthly or

annually rated workers, any regular day’s work required should not exceed
12 hours nor be less than 4 hours, unless the public health worker gives a
written consent to serve otherwise.

d) Public health workers required to render 24-hour service shall be granted an

extra day off immediately after each 24-hours tour of duty.

e) In scheduling normal work hours, attention should be given to

distributing the burden of shifts outside the normal office hours (8am to 5pm)
and usual operating days (Monday to Friday) of government agencies. Normal
work hours rendered at night, on weekends and during holidays should be
shared equitably with all members of the workforce.

f) Work schedules of all workers should be duly posted in the premises of the
agency or unit so that public health workers can determine for themselves
the fairness of distribution of normal work hours among all members of the
organization.

g) Any arrangement requiring less than normal full-time services (e.i. less than
8 hours for daily rated or less than 40 hours for monthly or annually rated
workers) shall be regarded as part-time employment and subject to
proportional adjustment in salary to be computed as a percentage of actual
time served divided by the fulltime service required.

h) Any arrangement requiring public health workers to render more than 8

hours a day or 40 hours for a week shall be subjected to overtime pay and/or
night shift differential pay for the periods in excess of the fulltime service.

i) During normal hours of work, the public health worker is expected to perform
his or her duties and functions in a specific post or assignment subject to a
regular schedule of work and rest periods, including sufficient allowance for
meal breaks and short interruptions for the purpose of meeting personal
necessities as these arise.

SECTION 2. Additional Compensation for Additional Work. —

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 2.1. Types of Additional Work Eligible for Additional Compensation

The following types of service rendered, in addition to the normal work hours covered by the
basic salary, shall be entitled to additional compensation:

(a) “On Call” service

(b) “Overtime” service

(c) “Work During Rest Day”

(d) “Night Shift” service

2.2. Conditions Governing the Grant of Additional

Compensation for these Types of Additional Work.

2.2.1. The following general conditions apply to the grant of additional compensation for the
above types of additional work:

(a) Heads of agencies/local chief executives shall issue specific

authorizations whenever workers are required to render any of these
four types of additional work. Such authorizations shall include all
the details necessary to verify to what extent the required was actual
rendered. The authorization shall include a certification that funds
necessary for payment of the corresponding additional compensation
have been or will be set aside by the office to ensure prompt payment
of this benefit;

(b) Public health workers are required to render any of these four types
of additional work that are duly authorized by the head of agency or
manager of the organizational unit. They cease to be obligated to do
so;
However, whenever their previously rendered and properly validated
additional service remains unpaid three months after such service,
it is thus the legal right of a public health worker to refuse to render
additional work beyond normal work hours when prior additional
work has remained unpaid three months after rendering service.
Such refusal to render additional work under this condition shall not
be a ground for any administrative action made or basis for an
unfavorable performance rating;

(c) All additional compensation earned by rendering duly

authorized and properly validated additional work should be paid
within three months after such work was rendered. Payments for
additional compensation may be made together with or separately
from usual payments of regular salaries;

(d) No amount of additional compensation earned for rendering these

four types of additional work shall be incorporated into the basic
salary of the worker; and

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 (e) Funding for the payment of additional compensation for
these four types of additional work may be sourced from the agency’s
personal services, savings, as well as from other trust funds whose
purposes cover the activities included in the additional work.

2.3. “On Call Service”

2.3.1. Heads of agencies or local chief executives may require certain public
health workers to remain on standby in a specified location in anticipation of a
possible need for their services. This constitutes the act of placing workers “On
Call”.

2.3.2. A written authority should be issued to place workers “on-call”. ‘This

authority should state the eventuality being anticipated by the office which
might require the workers to be in service, duration of the “on call” status,
location where workers will stay during the period, and the condition or situation
that will release the workers from being “on call” or will instruct the workers to
begin rendering actual service. The actual service rendered maybe considered.
as part of normal hours of work; or overtime work or work during rest day
depending on the worker’s schedule.

2.3.3. Appropriate documentation should be provided (e.g. log-books, time

records, signed time slips) to establish the actual period when the worker
actually made himself or herself available on a stand-by basis on the specific
location designated for those “On Call.”

2.3.4. Time spent while on “on call” status shall be compensated at the rate of
50% of the worker’s hourly rate.

2.3.5. Actual service rendered emanating from authorized and validated “on call”
duty and which is not considered as part of normal duty hours of work shall be
compensated in accordance with Budget Circular No. 15 s. 1996 regarding Over-
time Pay and subsequent Circular that will be issued.

2.4. Service Beyond Normal Hours of Work

2.4.1. Heads of agencies or managers of organizational units may require public

health workers to render service in excess of the normal hours of work. This may
include required service rendered during the same day but beyond the duration
of the regularly scheduled normal hours of work (overtime service) up to Division
Chief level or its equivalent only or during days when normal work has both been
scheduled (service during rest days or holidays).

2.4.2. A written authority should be issued to require workers to serve beyond

normal hours of work. This authority should state the tasks and activities which
require the workers service, duration of the work required beyond normal hours
and the procedures governing the supervision and validation of the service being
rendered.

2.4.3. Rates for authorized service rendered beyond normal hours of work.

45
 (a) Work rendered in excess of the day’s scheduled normal work period:
125% of base rate.

(b) Work rendered during a rest day: 150% of base rate.

(c) Work rendered during a holiday: 150% of base rate.

2.5. Rates for Night Shift Differential

2.5.1. Public Health Workers required to render service for any number of hours between
10pm and 6am shall be granted additional compensation as follows:

(a) A night shift differential pay of ten percent (10%) of his/her regular
wage plus for each hour of work performed during the night shifts
customarily adopted by hospitals/health institutions.

(b) An entitlement to his/her regular wage schedule on the

period covered after his/her regular schedule plus the regular over
time rate and additional amount of ten percent (10%) of such
overtime rate for each hour of work performed between ten (10)
o’clock in the evening to six (6) o’clock in the morning.

SECTION 3. Salary and Salary Scale. — Republic Act 6758 shall apply in determining the
salary scale of public health workers, except that the benchmark for Rural Health Physicians
shall be upgraded from Grade 20 to Grade 24 and that they shall now be entitled to
Representation and Transportation Allowance (RATA).

a. The salary scale of public health workers shall provide for progression, provided
that the progression from the minimum to the maximum of the salary scale shall
not extend over a period of ten (10) years and provided further that the efficiency
rating of the public health worker concerned is at least satisfactory.

Each agency shall formulate salary scales progression plan for public health workers, taking
into consideration the upgraded salary of the Rural Health Physician. The salary increases
shall be determined by the agency in coordination with Department of Budget and
Management. This shall be included in the annual budget proposal.

b. For appointees occupying regular item positions, their respective salary rates shall
be those established for the position in accordance with implementation guidelines
of DBM pursuant to the various Salary Standardization Laws. y

c. For appointees occupying position items outside the regular plantilla, the respective
salary rates shall be those established by the appropriate authority creating or
establishing the position in accordance with various government regulations.

d. Salary rates shall be expressed as annual, monthly or daily rates. The specific salary
rates in the appointment or position item shall be the basic salary of the employee.
This salary rate shall be the basis of all computation defined as a percentage of
salary or wage.

e. Salaries of public health workers shall be paid in legal tender of the Philippines or
the equivalent in checks or treasury warrants.

46
SECTION 4. Equality in Salary Scale. —

The salaries of public health workers as appropriated by a city, municipality, or provincial

government shall not be less than those provided for public health workers of the national
government. The amount necessary to pay the difference between the salaries received by the
nationally paid and the locally paid public health workers of equivalent positions shall be
charged against the Internal Revenue Allotment (IRA) of the concerned Local Government Unit
(LGU) as
authorized in the Annual General Appropriations Act (GAA).

a. No deduction shall be allowed from the payroll of public health workers, except
those allowed by law.

b. The Secretary of Health, in collaboration with other government agencies, shall

conduct a periodic review of the salary structure of public health workers to update
and recommend appropriate action to proper authorities.

c. The head of the agency shall be responsible for the timely preparation and release
of the salaries of the public health worker.

d. All appointments shall indicate the appropriate mandated salary rate for each
position.

e. In case the action of the appointing authority is subsequently reversed by a

competent authority with the effect of reducing the appropriate mandated salary
rate of an appointee, the public health worker shall refund such overpayment. In
case the decision of a competent authority results in increasing the mandated salary
rate of an appointee, the appointing authority shall cause the payment of any salary
differential due the public health worker.

SECTION 5. Basic Salary for Normal Hours of Work. —

a. In accordance with RA 6758 prescribing a revised compensation and position

classification system in the government, all salaries shall “represent full
compensation for full-time employment, regardless of where the work is performed.
Salaries for services rendered on a part-time basis shall be adjusted
proportionately.”

b. For purposes of determining the scope of the full-time employment standards,

the basic salary rate attached to any position occupied by a public health worker
shall be in consideration of his or her rendering the normal hours of work, defined
as 8 hours of work per day for daily rated workers (excluding 1 hour for meals) or
40 hours per week for monthly or annually rated workers.

c. Legally mandated increases in basic salaries shall be implemented without altering

the required normal hours of work. All increases in basic salaries in relation to RA
6758 shall be implemented only in accordance with policies and procedures issued
by DBM. y

SECTION 6. Salary Increases. —

47
6.1. Highest Basic Salary Upon Compulsory Retirement. — Three (3) months before
compulsory retirement, the public health worker shall be granted an automatic one salary
grade increase in his basic salary and his retirement benefit thereafter shall be computed on
the basis of his highest salary received and paid; provided that the public health worker has
reached retirement age and fulfilled the service requirements under the existing law.

6.1.1.The head of agency/office or his/her duly authorized representative shall

submit an annual list of compulsory retirees who are eligible to claim the
abovementioned benefit for the succeeding year to the concerned Department
Secretary/Local Chief Executives.

6.1.2. The agency concerned shall prepare the Notice of Salary Adjustment to be
signed by the Head of Agency/Local Chief Executive, and shall serve as basis for
the computation of the retiree’s retirement benefits.

6.2. Salary Increase after Post-Graduate Studies for a Degree Course.

Public Health Workers who have earned post-graduate degrees after July 1, 1992, shall be
entitled to a raise in pay equivalent to two percent (2%) of their basic salary.

6.2.1. To prove completion of the post-graduate degree study in order to qualify for the
increase in salary or upgrading in position, the public health worker shall submit to the
Personnel Division/Unit through their respective Head of Agency the authenticated-copies of
the following:

a. Diploma;

b. Transcript of Records from the school where the degree is obtained;

c. Certificate of Service of at least two (2) continuous years;

d. Latest appointment of permanent status; and

e. A satisfactory performance rating during his/her employment.

6.2.3. The head of offices/agencies/units concerned shall submit the names of all the eligible
health workers to the Personnel Division for screening, evaluation and approval. Once request
is approved, notice of salary adjustment signed by the Secretary of Health or Local Chief
Executive or head of the office or agency concerned shall be issued to the qualified personnel.
The Personnel division of the concerned agencies at all levels shall maintain an updated list
of eligible Public Health Workers and shall submit to the Provincial/Regional/National
Management Health Workers Consultative Council (NMHWCC) the names of Public Health
Workers granted with benefits.

6.3. Longevity Pay. — A monthly longevity pay equivalent to five percent (5%) of the present
monthly basic pay shall be paid to public health workers for every five (5) years of continuous,
efficient and meritorious services rendered as certified by the Head of Agency/Local Chief
Executives commencing after the approval of the Act. (April 17, 1992)

6.3.1. Criteria for Efficient and Meritorious Service

A Public Worker shall have:

48
 a. At least a satisfactory performance rating within the rating period.

b. Not been found guilty of any administrative or criminal case within the
rating period.

6.3.2. Mechanism for Evaluation

1). The personnel unit of the office/agency concerned shall evaluate the qualification of the
employee based on the criteria as supported by the following documents:

a. Performance Appraisal Report of the last 5 years (10

performance ratings);

b. Certification from the Legal Office concerned affirming that the

public health worker has not been found guilty of any
administrative or criminal case within the rating period.

c. The result of the evaluation shall be submitted to the head of

office concerned for approval of the grant of longevity pay.

SECTION 7. Other additional compensation:

7.1. Hazard Pay

7.1.1. Eligibility to Receive Hazard Pay. — All public health workers covered
under RA 7305 are eligible to receive hazard pay when the nature of their work
exposes them to high risk/low risk hazards for at least fifty percent (50%) of
their working hours as determined and approved by the Secretary of Health or
his authorized representatives.

7.1.2. Basis for Granting Hazard Pay. — The following hazards are recognized
under RA 7305: difficult locations; strife-torn or embattled areas; distressed and
isolated stations; prison camps; mental hospitals; radiation exposed clinics;
laboratories and disease-infested areas; areas declared under a state of calamity
or emergency for the duration when there is exposure to danger, contagious
disease, radiation, volcanic activity or eruption, occupational risks and perils to
life as determined by the Secretary of Health or the Head of the Unit with the
approval of the Secretary of Health.

7.1.3. Based on the standards provided by law, the following categories of

hazard are hereby recognized:

a. High risk exposure shall refer to the direct, unavoidable and frequent
exposure to radiation,
communicable/contagious/infectious/biological hazards. It includes
those who from time to time are authorized to travel and be assigned
to hazardous workplaces where the above conditions exist.

b. High risk hazardous areas shall include the following:

• Work areas in hospitals, sanitaria, rural health units, health

centers, clinics, barangay health stations, municipal health
49
 offices and infirmaries which shall include public health
workers but not limited to medical and allied health personnel
directly involved in the delivery of services to patients with
highly contagious and communicable diseases including those
handling hospital paraphernalia used by patients such as
linen, utensils, bed pan, etc. Under this category, all field health
workers giving direct service delivery are already classified as
high risk.

• Radiation exposed areas/clinics such as laboratories and

service workshops which involves operation of radiation
emitting equipment and handling of radioactive and toxic
substances but not limited to the services of x-ray technicians
and physiotherapists.

• Institutions for mental health where exposure to bodily

harm, and risks from psychiatric patients actually exists.

• Drug-abuse drop-in-centers or rehabilitation centers where

exposure to bodily harm and risks from drug-crazed patient
exists.

• Work areas where rescue operations/evacuation have to be

carried out due to natural calamities, where the health
workers/rescuers are directly and actually exposed to harm
danger or occupational risks or perils to life in the course of
performing their duties.

• Chemical and medical laboratories where health workers

receive and directly handle infectious specimens or materials
including but not limited to services rendered by pathologists,
laboratory technicians and medical technicians.

• Highly disease-infected and vector-infested areas including

but not limited to services rendered by malariologists,
entomologists, and zoologists.

• Work areas involving handling of and spraying of

insecticides, molluscides and hazardous chemicals, flammable,
noxious and explosive substances including but not limited to
services rendered by malaria spraymen, schistosomiasis spray-
men, sanitary inspector and chemists.

• Work areas involving direct handling of laboratory animals

for purposes of experimentation, research, observation and the
like.

c. Low risk exposure refers to infrequent and minimum degree of

exposure in a hazardous workplace wherein personnel are not directly
involved in the delivery of services but nevertheless are in contact from
time to time with the former including the intended clientele and
patients. Low-risk hazardous areas shall include the following:

50
 • Work areas in hospitals, sanitaria and infirmaries which
entail minimal risks or danger to health and safety due to
indirect and infrequent exposure to patients in the said areas
which shall include technical and administrative personnel
whose duties/functions require visitation, networking,
coordinating, monitoring, evaluating, referrals, etc.

• Work areas adjacent to near hospitals dealing with

infectious diseases.

7.1.4. Entitlement and Determination of Personnel Exposed to

Hazards:

a. Each agency shall prepare a list of positions in its plantilla with the
corresponding job description that describes the basis for justifying
such positions that are exposed to high risk or low risk hazard This
list shall be reviewed by a DOH technical committee created for the
purpose at the national and regional levels, according to the standards
provided above. Occupants of these positions shall then be granted
hazard pay during their periods of work.

b. Each head of agency shall establish a procedure for identifying

personnel who shall be exposed to high risk or low risk hazard
including the duration of such exposure. This procedure shall be
similar to the provisions authorizing overtime pay.

c. The Head of Agency/Local Chief Executive is authorized to allow

the grant of hazard pay to all public health workers in accordance with
the rules and regulations in this IRR without the need for approval by
the Department of Budget and Management (DBM) and shall ensure
that funds for this purpose are set aside and made readily available.

d. The period of entitlement to Hazard Pay shall be co-terminus with

the duration of the actual assignment of the official or employee in the
work areas enumerated under item 7.1.3 above.

e. Part-time officials and employees shall receive half of the amount

received by the full-time official or employee in the same situation.

f. Hazard Pay of officials and employees who are on full-time or part-

time detail with another agency shall be paid by their mother agency.

g. Officials and employees, who would appear to be entitled to more

than one type of Hazard Pay due to the peculiar nature of their work,
shall only be allowed to enjoy one type of Hazard Pay that is more
advantageous to them.

7.1.5. Rates of Hazard Pay

a. Public health workers shall be compensated hazard allowances

equivalent to at least twentyfive (25%) of the monthly basic salary of

51
 health workers, receiving salary grade 19 and below, and five percent
(5%) for health workers with salary grade 20 and above. This may be
granted on a monthly, quarterly or annual basis.

b. The implementation of Hazard Pay shall be made on staggered

basis provided that at the fifth year, the 25% and 5% differentiation
shall have been fully complied with or fully satisfied.

1999 - 1st year - 5%

2000 - 2nd year - 10% 2001 - 3rd
year - 15%
2002 - 4th year - 20%
2003 - 5th year - 25%

c. The public health workers exposed to high risk hazard may receive a hazard pay not
exceeding 5% higher than those prescribed above.

7.1.6. Limitations

Officials and employees who are under the following instance of more than one (1) full calendar
month shall not be entitled to Hazard Duty Pay:

a. Those on vacation, sick, and study leave with or without pay;

b. Those on maternity/paternity and terminal leave; and

c. Those on full time attendance in training grant/scholarship

grant/seminar or any other similar activity, except when the place of
activity is certified to be risky or hazardous area as specified under
7.1.2. and 7.1.3.

7.2. Subsistence Allowance

7.2.1. Eligibility for Subsistence Allowance

a. All public health workers covered under RA 7305 are eligible to receive
full subsistence allowance as long as they render actual duty.

b. Public Health Workers shall be entitled to full Subsistence Allowance

of three (3) meals which may be computed in accordance with
prevailing circumstances as determined by the Secretary of Health in
consultation with the ManagementHealth Workers Consultative
Council, as established under Section 33 of the Act.

c. Those public health workers who are out of station shall be entitled
to per diems in place of Subsistence Allowance. Subsistence Allowance
may also be commuted.

7.2.2. Basis for Granting Subsistence Allowance

52
Public health workers shall be granted subsistence allowance based on the number of
meals/days included in the duration when they rendered actual work including their regular
duties, overtime work or on-call duty as defined in this revised IRR.

Public health workers who are on the following official situations are not entitled to
collect/receive this benefit:

a. Those on vacation/sick leave and special privilege leave with or

without pay;

b. Those on terminal leave and commutation;

c.Those on official travel and are receiving per diem regardless of the
amount; and

d. Those on maternity/paternity leave.

7.2.3. Rates of Subsistence Allowance

a. Subsistence allowance shall be implemented at not less than

PhP50.00 per day or PhP1,500.00 per month as certified by head of
agency.

b. Non-health agency workers detailed in health and health-related

institutions/establishments are entitled to subsistence allowance and
shall be funded by the agency where service is rendered.

c. Subsistence allowance of public health workers on full-time and part-

time detail in other agency shall be paid by the agency where service
is rendered.

d. Part-time public health workers/consultants are entitled to one-half

(1/2) of the prescribed rates received by full-time public health
workers.

7.3. Laundry Allowance

7.3.1. Eligibility for Laundry Allowance. All public health workers

covered under RA 7305 are eligible to receive laundry allowance if they
are required to wear uniforms regularly.

7.3.2. Rate of Laundry Allowance. The laundry allowance shall be

P150.00 per month. This shall be paid on a monthly basis regardless of
the actual work rendered by a public health worker.

7.4. Representation and Transportation Allowance (RATA) — Municipal Health Officers (MHO)
and Rural Health Physicians (RHP) shall be entitled to collect RATA, provided that said MHO
or RHP is actually performing the duties and responsibilities of the said position. The following
guidelines shall be observed in the payment of RATA:

a. RATA shall be enjoyed by an RHP wherein a government vehicle is not

assigned for his/her use in the discharge of his/her duties. In case a vehicle
53
 is assigned to the MHO or RHP, he/she shall only be entitled to
representation allowance (RA);

b. Pursuant to National Compensation Circular (NCC) No. 67, issued by

DBM dated 01 January 1992, an MHO or RHP who is authorized to attend a
training course, scholarship, seminar or any other similar activity, which is
tantamount to the performance of his regular duties and responsibilities as
determined by the Local Chief Executive (LCE) concerned shall be authorized
to continue to collect RATA on a reimbursement basis;

c.Any government physician officially designated by the Head of Agency/

LCEs as MHO or RHP shall be entitled to RATA;

d. An MHO or RHP who is on vacation, such as maternity leave of absence

with or without pay for one full calendar month shall not be entitled to RATA
for that period;

e. An MHO or RHP who is on full time detail with another organizational

unit and performs as such, shall be entitled to RATA. But if he/she does not
discharge the responsibilities of the position he/she shall not be entitled to
RATA; and

f. A government physician who shall take over the position of RHP or MHO
and performing the equivalent function shall be entitled to RATA for the
duration of the detail.

7.5. Medico-Legal Allowance. — In places where there is no Medico-Legal Officer, rural

physicians who are required to render medico-legal services and had undergone an
appropriate training for such services shall be entitled to additional allowance subject to the
following rates and guidelines.

7.5.1. Rates of Payments per assigned work are as follows:

a. P200.00 - slight physical injury

b. P300.00 - less serious physical injury

c. P500.00 - serious physical injury P1,000.00 - necropsy

d. P1,000.00 - autopsy

e. P600.00 - per appearance in court

7.5.2. Funding source:

a. Local Health Workers - local funds

b. National Health Workers - national funds

7.5.3. Those who shall be provided with additional travelling allowances are as follows:

54
 a. Those without RATA

b. Those with RATA who travels outside his/her municipalities

7.5.4. Traveling expenses at rates authorized under existing rules and regulations shall be
paid for the following official travels:

a. Performing medico-legal examination

b. Appearance in court hearings

c. Submission of report-case completed

7.5.5. Request for payment shall be made after report of the case has been submitted to the
proper authority.

7.6. Remote Assignment Allowance

7.6.1. Eligibility for Remote Assignment Allowance. All public

health workers are eligible to claim a remote assignment allowance if
they assumed a post certified as a remote assignment as defined herein.

7.6.2. Basis for granting Remote Assignment Allowance. Remote Assignment

Allowance Doctors, dentists, nurses and midwives, who accept
assignments in remote areas or isolated stations, which for reasons of
far distance or hard accessibility (such positions have remained vacant
for at least two (2) years) shall be entitled to an incentive bonus in the
form of remote assignment allowance.

In addition to the above, the public health worker assigned in remote

area shall be given priority in terms of promotion or assignment to better
areas except when he voluntarily accepts or prefers to remain in such
remote assignment.

7.6.3. Rate of Remote Assignment Allowance. Public health

workers assuming a post certified as a remote assignment shall be
granted the following in addition to the normal compensation attached
to the position:

a) A one-time relocation allowance of P20,000.00 shall be provided for

the estimated costs of relocating to the area of assignment.

b) A remote assignment allowance equivalent to 50% of basic pay for

the first 24 months of the assignment.

c) A reduced remote assignment allowance equivalent to 25% of basic

pay for the next 24 months of the assignment after the first 24 months.

7.6.4. The remote assignment package of compensation shall be granted only to persons
appointed to positions vacant for at least 2 continuous years prior to the appointment. When
a remote assignment has been continuously occupied after 4 years the remote assignment
allowance for the position shall be phased out. Different occupants of a remote assignment
55
shall each be entitled to one-time relocation bonus but shall receive the remote assignment
allowance that is applicable for the remainder of the 4-year period since the post was first
occupied after the 2 year vacancy.

7.7. Other Benefits

7.7.1 Housing. — All public health workers who are on tour of duty and those who, because
of unavoidable circumstances are forced to stay in the hospital, sanitaria or health infirmary
premises shall be entitled to free living quarters within the hospitals sanitarium or health
infirmary.

a. For those required to live in the premises of the facility, physical

arrangements shall be made to provide them with adequate quarters
or housing for free. This decision shall be made by the head of the
health unit in accordance with the demands of service and is not based
on the preference of the health worker. Health workers who prefer not
to stay in the premises but whose duties require them to stay shall be
provided with quarters. Health workers who prefer to stay in the
premises but whose duties do not really require them to stay shall not
be entitled to this benefit.

b. Only workers who are required to stay in the premises but could
not be accommodated in available government provided quarters or
housing shall be granted a housing allowance. This allowance shall be
discontinued the moment free quarters or housing are available.

c. The Department of Health is authorized to develop housing projects in

its own lands not otherwise devoted for other uses for public health
workers in coordination with appropriate government agencies.

d. Rate of Housing Allowance. In order to pay the housing allowance

to any worker the head of agency should first certify that (a) the nature
of the health workers duty requires that he or she should stay in the
premises of the health facility; and (b) the available quarters and
housing is not sufficient to accommodate the health worker. Under
these conditions the health worker shall then be granted a housing
allowance at the prevailing rental rate in the locality until such time
when adequate quarters are available or when the worker is no longer
required to reside in the premises of the health facility.

e. The Secretary of Health shall henceforth require all health facilities,

especially in remote areas, to provide a component space to serve as
quarters for public health workers during their tour of duty or visits.
A Provident Fund shall be established by each agency for the
availment of this housing benefit package.

7.7.2 Medical Examination for Public Health Workers.

During the tenure of their employment all public health workers including selected applicants
shall be given a compulsory and free medical examination once a year and immunization as
the case may warrant in a hospital designated by the Department of Health. The medical exam
includes:

56
 a. Complete physical examination;

b. Routine laboratory chest x-ray and Electro-cardiogram;

c. Psychometric exam;

d. Dental exam; and

e. Other indicated examination.

In case the designated hospital is not accessible or the facilities required for the examination
are not sufficient, the public health worker shall avail of the networking and referral system
established in the Department of Health.

a. The term “free” shall mean free of charge where capability and
facility for such services are available.

b. Complete physical examination would mean a thorough physical

check-up by a designated physician/s for this purpose.

c. Routine laboratory would include complete blood examination,

urinalysis, fecalysis and chest x-ray. For those above forty (40) years
old, additional examinations such as EKG, Fasting Blood Sugar, Uric
Acid, Blood Urea Nitrogen, Creatinine, Cholesterol and Tryglycerides;
and PAP-Smear, Transvaginal Ultrasound and Mammography for
women; and Prostrate Scientific Antigen (PSA) for men would be added
if available.

d.Dental services include preventive dentistry and dental

emergencies.

e. Other indicated examinations would include medical and surgical

procedures within the competence and capability of designated
hospitals/units as required by the examining physician.

f. Immunization would refer to giving of vaccines recommended by

the Secretary of Health as part of policy covering DOH.
7.7.3. In-Patient Services. — For those already in government service, in case of
hospitalization or inpatient treatment is necessary the cost of hospitalization and treatment
shall be answered for by the agency. In agencies with in-patient facilities, the public health
worker shall be entitled to FREE room and board, treatment and professional service. Where
in-patient facilities are not available the public health worker shall be referred to other
hospitals designated by the Department of Health.

Free medical examination, hospitalization and treatment shall be implemented upon the
effectivity of this Act.

a. Free room and board, treatment and professional services would

mean hospital admissions to National Health Insurance Program
(NHIP) and employees ward after availing of the Philippine Health
Insurance Corporation (PHIC) benefits.

57
 b. Hospitals designated by the DOH would be all regional hospitals
and medical centers and to include specialty hospitals. The four
specialty hospitals shall only accept cases properly referred to and is
particular for their respective specialization.

c. Provisions of all the above mentioned series shall be subject to

availability of appropriate facilities and trained manpower expertise of
the receiving establishments.

7.8. Procedures in Availment of Benefits

7.8.1. Compulsory Annual Medical Examination

7.8.1.1. The Physical Examination unit of the Department of Health

and the Medical Centers/Regional Hospitals shall prepare an annual
schedule of examinations for the Public Health Workers assigned within
their area of Jurisdiction and disseminate such schedule to all concerned.

7.8.1.2. The Regional, Provincial and District Hospitals shall be in

charge of the medical examination of Public Health Worker assigned in
their catchment areas.

7.8.1.3. Public Health Workers shall have the option to choose any
government health facility for his/her place of work or residence for
medical examination except the four specialty hospitals which are
government corporations.

7.8.1.4. The Public Health Workers shall be responsible in

submitting themselves for medical examination on their scheduled date
and if for some important reasons he/she was not available on the
designated date, he/she shall inform the concerned unit and reset
another schedule for such examination.

7.8.1.5. Results of the annual compulsory medical examination shall

be submitted to the administrative/personnel unit of the agency where
the public health worker is assigned and shall be part of the personnel
records of the public health worker concerned.

7.8.2. Free Treatment and Hospitalization

7.8.2.1. When the medical examination reveals that medical

treatment and/or hospitalization is necessary, referral slip shall be issued
to the public health workers concerned to any government hospital or
private hospital to provide such services to public health workers.

7.8.2.2. Upon admission in the hospital the public health worker

shall be required to fill up the Magna Carta Hospitalization Benefit Form
A (See Annex B).

7.8.2.3. Each hospital unit concerned shall exert all efforts to

provide for an infirmary or special bed/room especially designated for the
use and confinement of public health workers.
58
 7.9. Availment of Benefits

a. All public health workers shall avail of their benefits after proper
identification with their respective ID System.

b. All outpatient services shall be availed only from their hospitals. Public
Health Workers with no hospitals e.g. central office and regional field
personnel can use their employees clinic or make arrangements with the
nearest hospital.

c. in case of “emergency” any Public Health Worker shall avail of emergency

services in any DOH retained hospital after proper identification has been
done. In the event that he forgot his ID he/she is allowed to submit
supporting documents (ID or authorization letter) within 24 hours.

d. A proper endorsement to the receiving hospital shall be made in case there

is a need for referral to a higher level of hospital care. Subsequently, after
assessing the patient, feedback shall be given for purposes of proper follow-
up.

e. Outpatient medicines are not covered unless available in any DOH program
such as TB etc.; however inpatient medicines shall be covered.

f. Financial obligations shall be shouldered by the mother agency.

g. It is mandatory that all Public Health Personnel shall file their PhilHealth
Insurance papers Employment Compensation papers or any other insurance
papers for this purpose before discharge.

h. Drug addiction, self-inflicting illnesses, induced abortion

are not covered under this benefit.

RULE XVI Self-Organization of Public Health Workers

SECTION 1. Public health workers shall have the right to freely form, join or assist
organization or unions for purposes not contrary to law, in order to defend and protect their
mutual interests and to obtain redress of their grievances through peaceful concerted
activities.

SECTION 2. While the State recognizes the right of public health workers to organize or join
any such organization, public health workers on-duty cannot declare state or join any strike
or cessation of their service to patients in the interest of public health safety or survival of
patients.
SECTION 3. Health workers organizations or unions shall serve the following purposes:

a. To serve as a mechanism to promote harmonious relationships between rank-

and-file employees and management;

b. To assert the observance of democratic processes relating to the merit system in

public health service;

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 c. To serve as partners of management in policy making as well as in policy
implementation and monitoring;

d. To help minimize graft and corruption;

e. To serve as agents of change in bringing about a more efficient and effective

delivery of health services; and

f. To serve as agents for improved terms and conditions of work, particularly those
not fixed by law.

SECTION 4. Health worker’s organizations shall enter into collective negotiations/bargaining

agreements and attend regular consultations with management for health workers. A
Collective Negotiation Agreement Bonus shall be paid to each public health worker after the
successful signing thereof, subject to existing rules and regulations or, as approved by the
Agency Governing Board.

SECTION 5. The public health worker whose functions or duties shall not in any way directly
endanger clients survival and safety, may join peaceful concerted activities for legitimate
causes or issues relevant to public health workers. Participation in such acts shall be done
only after the health worker has filed for leave or when he is
OFF-DUTY.

RULE XVII Freedom From Interference and Coercion

SECTION 1. It shall be unlawful for any person to commit any of the following acts:

a. It shall be unlawful for any person not to recognize organizations or unions of

public health workers who shall be represented in all decision-making of the
government health system;

b. To require a condition of employment that a public health worker shall not join
a health workers’ organization or union;

c. To discriminate in regard to hiring or tenure of employment or any item or

condition of employment in order to encourage or discourage membership in any
health workers organization or union;

d. To prevent health worker from carrying out duties laid upon him/her by his/her
position in the organization or union or to penalize him/her for the action
undertaken in such capacity;

e. To harass or interfere with the discharge of the functions of the health worker
when these are calculated to intimidate or to prevent the performance of his/her
duties and responsibilities; and

f. To otherwise interfere in the establishment, functioning, or administration of

health workers’ organization or unions through acts designated to place such
organization or union under the control of government authority.

RULE XVIII Consultation with Health Workers’ Organization

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SECTION 1. The formulation of national policies governing the social security of public health
workers, professional and health workers organizations or unions as well as other appropriate
government agencies concerned, shall be consulted by the Secretary of Health. For this
purpose, Management Health Workers’ Consultative Councils for national, regional and other
appropriate levels shall be established and operationalized.

SECTION 2. A Management-Health Workers Consultative Council shall be established and

put into operation at the national regional; provincial/city and municipal/district levels for
the purpose. The Council shall be composed of representatives from management
accredited/recognized union, organized professional and public health workers
associations/organizations, the number of which shall be determined by the Secretary of
Health. It serves as fora for continuing dialogue with health workers concerning
issues/concerns arising from the implementation of the Magna Carta for Public Health
Workers. At the local government level it shall serve as the grievance committee for the Local
Health Board.

SECTION 3. The membership of the Council at the national and appropriate levels shall be
reconstituted by the Secretary of Health and by the Regional Health Director respectively,
when necessary.

SECTION 4. The Council at any level shall be supported by a Secretariat, the members of
which shall be designated by its chairman.

SECTION 5. The Council shall meet regularly at schedule decided upon among its members.

SECTION 6. Specifically, the Council shall have the following function:

a. Formulate, review, recommend policies/strategies for social security and welfare

of public health workers to the Secretary of Health;

b. Establish and maintain coordinative linkages with other concerned government

and non-government agencies and other entities at all levels;

c. Provide technical assistance in the implementation of the provisions of the law;

d. Promote Magna Carta issues and concerns through advocacy activities;

e. Participate in the resolution of issues, concerns and grievances of public health

workers, specifically those that affect their social and economic well-being, their
living and working conditions and terms of employment; and

f.
Monitor and evaluate the implementation of the provisions of the law or RA 7305
and its implementing Rules and Regulations.
RULE XIX Conduct of Health Human Resource Development and Management

SECTION 1. Every public health worker is an asset or resource to be valued, developed and
utilized in the delivery of basic services to the public. Hence, the development and retention
of a highly competent and professional workforce in the public service shall be the main
concern of every department or agency.

Every department or agency shall therefore establish a continuing program for career and
personnel development for all agency personnel at all levels, and shall create an environment

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or work climate conducive to the development of personnel skills, talents and values for better
public service.

Each department or agency therefore shall formulate a Human Resource Development Plan
to insure that the staffing needs of health and health-related establishments are met with
qualified, committed and competent public health workers. In the development of the said
plan, representatives of the rank and file must be consulted, preferably from the registered
employee’s organization in the agency.

SECTION 2. The Human Resource Development Plan shall be reviewed every five (5) years and
this shall include, but not limited to the following:

a. The establishment and maintenance of an updated data bank of all public health
workers and their training needs;

b. The establishment of an organizational structure and maintenance of an

affective staffing patterns and qualification standards;

c. The establishment, provision, upgrading and maintenance of adequate and

appropriate facilities, equipment and supplies for training;

d. The establishment of career paths/plans for every category of public health

workers, to serve as one of the bases for upgrading positions, reclassification and
standardizing salary scales, such that positions requiring longer study to be
upgraded and given corresponding pay scale; and

e. The establishment of alternative strategies or approaches for improving job

performance such as coaching, counseling, job rotation, on-the-job training and
others.

There is hereby created a Congressional Commission on Health (HEALTHCOM) to review and

assess health human resource development particularly on continuing professional education
and training and other areas described above. The Commission shall be composed of five (5)
members of the House of Representatives and five (5) members of the Senate. It shall be co-
chaired by the chairpersons of the Committee on Health of both houses. It shall render a
report and recommendation to Congress which shall be the basis for policy legislation in the
field of health particularly on continuing professional education and training assessment of
the national policy on exportation of skilled health human resources to focus on how these
resources could instead be utilized productively for the country’s needs. Such a congressional
review shall be
undertaken once every five (5) years.

SECTION 3. In coordination with the Department of Health, the Civil Service Commission and
other appropriate agencies, each agency shall implement training programs and set
mechanisms to operationalize the Human Resource Development/Management Plan for
public health workers.

SECTION 4. The Department of Health in collaboration with the Professional Regulation

Commission (PRC) and other professional societies and associations, shall accredit training
courses for continuing professional education relevant to public health workers.

SECTION 5. Each agency shall provide for all opportunities to up-grade the skills and
competencies of both technical and support personnel. These include:

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 a. Basic job orientation course which shall be compulsory for all newly appointed
public health workers to enable them to perform the job they were hired for. Each
agency, through the training unit shall be responsible for giving said orientation
course as needed;

b. Values orientation course shall be compulsory to all health workers and shall be
conducted on a regular basis;

c. Local academic studies shall be made available to those who have been at the
service for at least one (1) year and whose jobs require additional knowledge and
skills;

d. Refresher course and other skills improvement training courses must be given
to those already in service to improve
individual capabilities as required by their jobs;

e. Off-shore fellowship/study grants covering periods of one (1) month to one (1)
academic year shall be made available to those who have rendered one (1) year of
continuous satisfactory service to further develop and expand their capabilities to
perform their jobs better; and

f. Pre-retirement orientation and training shall be made available to those who are
about to retire to help them become productive even after retirement.

SECTION 6. Personnel Development Committee shall be established to provide support

function to management on matters pertaining to selection of agency nominees to training
development and scholarship programs in accordance with existing civil service policies and
standard.

SECTION 7. Each agency shall continuously dialogue with the academe, the accredited
professional organizations, medical and allied societies and health workers, through the
Management Health Workers Consultative Council, to keep abreast with the educational
and technical training needs of public health workers.

SECTION 8. A public health worker who has been granted fellowship or training whether local
or abroad shall execute a contract consistent with the Civil Service Commission
Administrative Order No. 367 s. 1992 to render payback service to the Department or agency
for a minimum of two (2) years of service if the duration of training is seven (7) months to one
(1) year or comply with other
directives which may hereinafter be promulgated.

SECTION 9. In case the grantee fails to render payback service he/she shall refund in full or
proportionately the remunerations he/she received during the training as well as the cost of
the fellowship and shall not be issued clearance unless he/she complies with Section 9 of this
rule.

SECTION 10. To protect the interest of the government any clearance sought by a public
health worker in case of separation, resignation, transfer or any other reason shall contain a
provision of obtaining grants availed of.
RULE XX Prohibited Acts

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SECTION 1. A public health worker shall not be discriminated against with regards to gender,
civil status, health workers organizations or unions.
SECTION 2. Regardless of status, religion, political affiliation and ethnic grouping, a public
health worker shall not be discriminated against in the exercise of his/her duties,
responsibilities and in the availment of his benefits.

SECTION 3. Other rules and regulations issued pursuant to Section 9 of RA 7305 shall take
effect thirty (30) days after publication in a newspaper of general circulation.

SECTION 4. Prohibition Against Double Recovery of Benefits. — Whenever other laws provide
for the same benefits covered by this Act, public health workers shall have the option to choose
which benefit shall be paid to him. In case the benefit chosen is less than that provided by
the Act, the workers shall be paid only the difference.

The employer shall be responsible for arranging with the concerned agency the benefits for
which the public health workers is entitled.

SECTION 5. Prohibition Against Elimination and/or Diminution. — Nothing in the law shall
be interpreted as eliminating or in any way diminishing the benefits to be enjoyed by the
public health workers at the time of effectivity of this revised IRR.

SECTION 6. All doubts in the interpretation of any of the provisions of the Implementing Rules
and Regulations shall be liberally interpreted in favor of the public health worker in the context
of the Act.
RULE XXI Responsibility of the Head of Agency

1. The head of agency shall be responsible and held administratively liable for any
payment not in accordance with the provisions of this revised IRR.

2. Unless otherwise provided in various provisions in this revised IRR, the cost of
pay/allowances and other benefits under RA 7305 are subject to periodic review by the
Secretary of Health through the National Management-Health Workers consultative
Council.

RULE XXII Financial Requirements

SECTION 1. The Department of Health, in collaboration with other government agencies

concerned, shall conduct studies on the benefits to be granted to public health workers as
well as on the sourcing of funds.

SECTION 2. As mandated in Section 38 of the Act, the Secretary of Health and other
Department Secretaries/Head of Government Owned and Controlled Corporations
(GOCC)/Local Government Units (LGUs) employing public health workers shall determine the
budgetary requirements to comply with the provisions of the Implementing Rules and
Regulations (IRR) to be incorporated in their respective annual budget.
2.1. For National Government Agencies (NGAs), the Magna Carta benefits shall be included in
their annual budgetary proposals.

2.2. For Government Owned and Controlled Corporation (GOCC), the benefits shall be funded
out of their respective corporate funds to be integrated into their respective corporate
operating budget.

2.3. For Local Government Units (LGUs), the said benefits shall be funded out of local funds
to be incorporated in their respective local budget.
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SECTION 3. Consistent with the Declared Policy and Objective of the Magna Carta of Public
Health Workers in promoting and improving the social and economic well-being of health
workers nationwide, the budget for various benefits granted shall be governed by the
principles of equity, justice, fairness and availability of funds.

The following conditions are prescribed in the phasing, determination and allocation of budget
needed to implement these benefits within a span of five (5) years:

a. The benefits are to be enjoyed by a greater number of health workers;

b. The need to implement the benefits is urgent;

c. The benefits are to serve as incentives for adequate and better health services in the
rural areas, particularly in the far-flung islands or provinces, remote/depressed
areas, prison camps, and other such places;

d. The benefits are to minimize the disruption of health services

nationwide; and

e. The benefits are to expand the area coverage of health

services.

SECTION 4. In case of deficiency in the funds needed to implement the Magna Carta of Public
Health Workers pursuant to R.A. No. 7305, the requirements shall be charged against savings
in the appropriation authorized for each department, bureaus, office, or agency concerned.

SECTION 5. No deduction shall be allowed from the payroll of public health workers except
those allowed by law and existing government rules and regulations such as CSC, DBM, COA
and others or as may be formally authorized by the health workers concerned. y

RULE XXIII Resolution of Issues

Cases not covered by these guidelines shall be submitted to the National Management Health
Workers Consultative Council
(NMHWCC).

RULE XXIV Penal Provision

SECTION 1. Any person who shall willfully interfere with, restrain or coerce any public health
worker in the exercise of his rights or shall commit any act violating any of the provisions in
the Implementing Rules and Regulations of the Magna Carta of Public Health Workers shall
be punished, upon conviction, with a fine of not less than Twenty Thousand Pesos
(P20,000.00) but not more than Forty Thousand Pesos (P40,000.00) or Imprisonment of not
more than one (1)year or both at the discretion of the court.

If the offender is a public official, the court may impose the penalty of disqualification from
office, in addition to the penalties provided in the preceding paragraph.
SECTION 2. Measures to Promote Enforcement of the Law. — In order to promote the
enforcement of the law in accordance with these revised IRR, the DOH shall set aside a portion
of its regular budget in order to undertake the following activities in accordance with Section
39:

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 a. The systematic identification of persons who appear to “willfully interfere
with, restrain or coerce any public health worker in the exercise of his/her
rights” or who are reported to “commit any act in violation of any of the
provisions of the law;”

b. The active investigation of such instances identified in (a) and if

appropriate the collection of evidence and thorough documentation of the
same in order to refer to the proper authorities for whatever administrative or
criminal
proceedings are supported by the findings; and

c. The regular proper and full reporting of actions taken on complaints

received related to (a) and concrete actions
initiated in relation to the enforcement of the law.

The DOH shall identify the budgeted amount and the location of such amount in the
Department’s approved annual budget. These facts shall be reported each year to
Management-Health Workers’ Consultative Councils established under the law.

SEPARABILITY CLAUSE

If any provision of the Implementing Rules and Regulations of the Magna Carta of Public
Health Workers is declared invalid, the remainder of the Rules thereby shall remain in force
and in effect.

REPEALING CLAUSE

All laws, presidential decrees, executive orders, and implementing rules and regulations
inconsistent with the Implementing Rules and Regulations for the Magna Carta of Public
Health Workers are hereby repealed, amended or modified accordingly.

EFFECTIVITY

These implementing Rules and Regulations shall take effect fifteen (15) days after its
publication in two national newspapers of general circulation.

Approved.

(SGD.)
ALBERTO G. ROMUALDEZ Jr. M.D.
Secretary of Health

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