National Safe Motherhood Program

Vision

For Filipino women to have full access to health services towards

making their pregnancy and delivery safer

Mission

Guided by the Department of Health FOURmula One Plus thrust and the
Universal Health Care Frame, the National Safe Motherhood Program is
committed to provide rational and responsive policy direction to its
local government partners in the delivery of quality maternal and
newborn health services with integrity and accountability using proven
and innovative approaches

Objectives

The Program contributes to the national goal of improving women’s

health and well-being by:

1. Collaborating with Local Government Units in establishing

sustainable, cost-effective approach of delivering health services
that ensure access of disadvantaged women to acceptable and
high quality maternal and newborn health services and enable
them to safely give birth in health facilities near their homes
2. Establishing core knowledge base and support systems that
facilitate the delivery of quality maternal and newborn health
services in the country.

Program Components

Component A: Local Delivery of the Maternal–Newborn Service

Package

This component supports LGUs in establishing and mobilizing the

service delivery network of public and private providers to enable
them to deliver the integrated maternal-newborn service package. In
each province and city, the following shall continue to be undertaken:

1. Establishment of critical capacities to provide quality maternal-

newborn services through the organization and operation of a
network of Service Delivery Teams consisting of:
 1. Barangay Health Workers
2. BEmONC Teams composed of Doctors, Nurses and
Midwives
2. In collaboration with the Centers for health Development and
relevant national offices: Establishment of Reliable Sustainable
Support Systems for Maternal-Newborn Service Delivery through
such initiatives as:
1. Establishment of Safe Blood Supply Network with support
from the National Voluntary Blood Program
2. Behavior Change Interventions in collaboration with the
Health Promotion and Communication Service
3. Sustainable financing of maternal – newborn services and
commodities through locally initiated revenue generation
and retention activities including PhilHealth accreditation
and enrolment.

Component B: National Capacity to Sustain Maternal-Newborn

Services

1. Operational and Regulatory Guidelines

1. Identification and profiling of current FP users and
identification of potential FP clients and those with unmet
need for FP (permanent or temporary methods)
2. Mainstreaming FP in the regions with high unmet need for
FP
3. Development and dissemination of Information, Education
Communication materials
4. Advocacy and social mobilization for FP
2. Network of Training Providers
1. 31 Training Centers that provide BEmONC Skills Training
3. Monitoring, Evaluation, Research, and Dissemination with
support from the Epidemiology Bureau and Health Policy
Development and Planning Bureau
1. Monitoring and Supervision of Private Midwife Clinics in
cooperation with PRC Board of Midwifery and Professional
Midwifery Organizations
2. Maternal Death Reporting and Review System in
collaboration with Provincial and City Review Teams
3. Annual Program Implementation Reviews with Provincial
Health Officers and Regional Coordinators

Partner Institutions
  Local Government Units
 Development Partners

Policies and Laws

Republic Act No. 10354: Responsible Parenthood and Reproductive

Health Law (RPRH Act of 2012)

1. Administrative Order 2008-0029: Implementing Health Reforms to

Rapidly Reduce Maternal and Neonatal Mortality
2. Department Order 2009-0084: Guidelines Governing the Payment
of Training Fees relative to the Attendance of Health Workers to
Basic Emergency Obstetric and Newborn Care Skills Training
Course at Duly Designated Training Centers
3. Administrative Order 2011-0011: Establishment of Basic
Emergency Obstetric and Newborn Care Training Centers in
Regional Hospitals and Medical Centers
4. Administrative Order 2015-0020: Guidelines in the Administration
of Life Saving Drugs During Maternal Care Emergencies by
Nurses and Midwives in Birthing Centers
5. Administrative Order 2016-0035: Guidelines on the Provision of
Quality Antenatal Care in All Birthing Centers and Health
Facilities Providing Maternity Care Services
6. Administrative Order 2018-0003: National Policy on the
Prevention of Illegal and Unsafe Abortion and Management of
Post-Abortion Complications

Program Accomplishments/Status

The Department of Health through the National Safe Motherhood

Program shall continue to update its strategies to address critical
reproductive health concerns including control of sexually transmitted
infections and mother to child transmission of HIV while confronting
both demand and supply side obstacles to access for disadvantaged
women including indigenous women of reproductive age. Among the
changes, the following have been systematically mainstreamed into
the safe motherhood service delivery network (BEmONC-CEmONC
network):

1. Strategic Change in the Design of Safe Motherhood Services

These changes involve (1) a shift in emphasis from the risk

approach that identifies high-risk pregnancies during the prenatal
period to an approach that prepares all pregnant for the complications
at childbirth – this change brought about the establishment the
BEmONC – CEmONC network within the bigger Service Delivery
Network (SDN), (2) improved quality of FP counseling and expanded
service availability of post-partum family planning in hospitals and
primary birthing centers and (3) the integration of cervical cancer,
syphilis, hepatitis B and HIV screening among others into the
antenatal care protocols.

 Action Point and Timelines:

 Continuous advocacy on:
 Importance of ANC and Facility Delivery is on-going at
LGU level;
 National and regional advocacy every 2nd week of
May, the safe Motherhood week with support from the
Health Promotion and Communication Service
 Continuous implementation of policies passed at LGU
Health Systems
 Implementation of AO 2016-0035 on the Provision of Quality
Antenatal Care
 On-going
 Distribution of ANC Tarpaulin within the last quarter of
2018
 Distribution of ANC Policy Implementation Manual by
2019
2. An Integrated Package of Women’s Health and Safe Motherhood
Services

The above changes in service delivery also involved a shift from

centrally controlled national programs operating separately and
governed independently at various levels of the health system to an
LGU governed system that delivers an integrated women’s health and
safe motherhood service package. This service delivery strategy is
focused on maximizing synergies among key services that influence
maternal and newborn health and on ensuring a continuum of care
across levels of the referral system. At the ground level, this implies
that a woman, whatever her age and specially if she is disadvantaged,
who seeks care from a public health provider for reproductive health
concerns, could expect to be given a comprehensive array of services
that addresses her most critical reproductive health needs.

 Action Points and Timelines

  Culture and gender sensitive service delivery provision by
LGU Health Systems is on-going
 Updated AO 2008-0029 (MNCHN Policy) draft by last quarter
of 2018
 The update involves the expansion of MNCHN to
RMNCAHN (Reproductive Maternal Newborn Child
Adolescent Health and Nutrition)
3. Reliable Sustainable Support Systems

Support systems for Maternal-Newborn service delivery is anchored

on Philhealth accreditation of birthing centers and individual
membership or enrolment into the Sponsored Program. This
mechanism ensures sustainable financing of quality maternal-newborn
services efficiently eliminating out-of-pocket expenditures for
antenatal, facility delivery and postnatal care. The system likewise
includes systems for safe blood supply and stakeholder behavior
change, through a combination of advocacy and interpersonal
communication during clinic visits.

 Action Points and Timelines

 Continuous application and renewal of PhilHealth
accreditation by Birthing Centers
 Continuous enrolment of poor families to PhilHealth
Sponsored Program by LGUs
 Establishment of Safe Blood Supply Network in
collaboration with the National Voluntary Blood Services
Program is on-going
3. Stronger Stewardship and Guidance from the DOH Program
Manager and Regional Coordinators

DOH provides stewardship and guidance through (1) evidence-based

guidelines and protocols on maternal – newborn services; (2) a system
for recognizing providers of emergency obstetrics and newborn care
(BEmONC) training program; and (3) monitoring, evaluation and
research on the new maternal-newborn strategies.

 Action Points and Timelines

 Conduct of Maternal Death Surveillance and Response is
on-going at Provincial and City Health Systems is on-going
 Conduct of National MDSR Forum every 2 years. The
second national forum shall be conducted in 2019 (the
first was conducted in 2017)
  Conduct of 4 Regional Maternal Death Surveillance
and Response (MDSR) Fora every 2 years (2018, 2020,
etc)
 Drafting and passage of relevant policies with MDSR
results as basis:
 National Policy on the Provision of Birthing
Assistance of Primigravid and Multigravid
Women is targeted to commence implementation
by 2019.
 Establishment of Safe Motherhood Program Monitoring and
Evaluation System in collaboration with Epidemiology Bureau and
Health Policy Development and Planning Bureau by 2019

Program Accomplishments/Status

The Program shall continue to monitor the implementation of its

policies and evaluate effectiveness in improving maternal outcomes
and consequently translate these to maternal and newborn mortality
reductions. LGUs shall be continuously encouraged to address local
health system’s gaps identified during maternal death reviews.

Relevant policies that responds to maternal needs have been passed

that include among others for 2018, the policy of prevention of illegal
and unsafe abortions and management of post – abortion complication.
Implementation of this policy is expected to reduce maternal death by
at least 21%. The Program shall continue to pass policies based on
death review results.

To date, 95% of Birthing Centers have teams trained on basic

emergency obstetric and newborn care.

Calendar of Activities

 Conduct of BEmONC Training by Training Centers – on-going

 Conduct of Maternal Death Surveillance and Response – on-going
 Safe Motherhood Week Celebration at Regional level every
2nd week of May
 Enhancement of Positive Birthing Experience Protocol: First
Quarter of 2019
 MHO Forum: BEmONC Updates tentatively May 2019
 Maternal Sepsis Elimination Campaign: May 2019
 Program Implementation Reviews: third quarter and 4th quarter of
2019