AN ORDINANCE ESTABLISHING THE RHU

BAMBANG BIRTHING FACILITY, DEFINING ITS

FUNCTIONS, OPERATION AND
ADMINISTRATION
 
(with inclusion of Dr. Cortez recommendations & LHB Reso. #1, 2020
POST Feb. 19, 2020 Committee Hearing)
 
Author: ARNEL GAMPONIA MAGDIRILA, MD, MPH
 EXPLANATORY NOTE
 
 
Pursuant to Section 16 of R.A. 7160 which mandates that every local
government unit shall exercise the powers expressly granted, those necessarily
implied therefrom, and those which are essential to the promotion of the general
welfare. Section 17 part A and B 2.III of R.A. 7160 also mandates that every local
government unit likewise exercise such other powers and discharge such other
function and responsibilities as are necessary, appropriate or incidental to
efficient and effective provision of the basic services and facilities to health
services which include the implementation or programs and projects on primary
health care, maternal and child care and so forth,
 World Health Organization (WHO) data as of February 16, 2018
revealed that; Every day, approximately 830 women die from preventable
causes related to pregnancy and childbirth. Ninety-nine (99%) of all
maternal deaths occur in developing countries. Maternal mortality is
higher in women living in rural areas and among poorer communities.
Young adolescents face a higher risk of complications and death as a
result of pregnancy than other women. Skilled care before, during and
after childbirth can save the lives of women and newborn babies.
Between 1990 and 2015, maternal mortality worldwide dropped by
about 44%. And, as part of the Sustainable Development Goals, the target
between 2016 and 2030 is to reduce the global maternal mortality ratio
to less than 70 per 100 000 live births.
 Philippines maternal mortality ratio is still high at level of
121 deaths/100,000 live births in 2017 making it crucial to
follow a woman from prenatal to postnatal stage. The MMR in
2016 was 124 deaths per 100,000 live birth.
 
Causes of Maternal Deaths include; Complications related to
pregnancy occurring in the course of labor, delivery and
puerperium; Hypertension complicating pregnancy, childbirth
and puerperium; Postpartum hemorrhage; Pregnancy with
abortive outcome; and Hemorrhage in early pregnancy
 In an attempt to curb MMR, the DOH - under President Gloria
Macapagal-Arroyo -passed Administrative Order 2008-0029
titled, “Implementing Health Reforms towards Rapid Reduction
in Maternal and Neonatal Mortality,” or the “No Home Birthing
Policy.” Advocating facility-based deliveries where women can
get timely and correct diagnosis, early intervention, and access
to emergency obstetric care under the supervision of a licensed
SBA or doctor is considered to be a crucial factor in lowering
MMR.
 The vision of the Safe Motherhood Program of the
Philippines is “for Filipino women to have full access to health
services towards making their pregnancy and delivery safer”
and one of its components is “Local Delivery of the Maternal–
Newborn Service Package”
 
Steadfast on its duties and commitment to uphold and
protect the lives of its constituents, the Municipality of
Bambang, Nueva Vizcaya deems it necessary and appropriate
to adopt and establish measures to reduce and finally eliminate
maternal deaths in the municipality.
 
 Section 2. TITLE. – This Ordinance shall be known as “An
Ordinance Establishing the RHU Bambang Birthing Facility
(RBBF), Defining its Functions, Operation and Management.”
Section 3. OFFICIAL NAME AND ADDRESS OF THE
BIRTHING FACILITY
The birthing facility shall officially named as RHU
BAMBANG BIRTHING FACILITY with official address at
Bambang Municipal Compound, Buag, Bambang,
Nueva Vizcaya.
 Section 4. FUNCTION. – To provide assured quality family
planning, prenatal, and birthing services, thus ensuring
safety of the life of both mother and child.
Section 5. DEFINITION OF TERMS
BEMONC - Basic Emergency Obstetrics and Neonatal Care
Birthing - A health facility staffed by BEMONC trained
Facility nurses, midwives, and doctors, for mother in
labor.
DOH - Department of Health
Gravida - the total number of confirmed pregnancies that a
woman has had, regardless of the outcome.
Job Order - Shall mean the job order worker assigned at the
Worker Municipal Health Office.
MCP - Maternity Care Package Is a PhilHealth benefit that covers
the complete essential health care services for women
about to give birth throughout their pregnancy and
normal delivery (during antenatal, intrapartum, and
immediate postpartum periods) regardless of the type of
health care institution where the services are rendered.
The services shall include antenatal care, intrapartum
monitoring, assist in normal delivery and postpartum
care within 72 hours and 7 days after delivery.
MHO - Municipal Health Officer
Midwife - A licensed midwife employed on a regular or
permanent appointment.
MMR - Maternal mortality ratio the ratio between the
number of women who died (for reasons of
pregnancy, childbirth and puerperium) to the
number of reported livebirths in a given year,
expressed as the number of maternal deaths per
100,000 live births
Nurse - A licensed one employed on a regular or
permanent appointment.
NDPs - Nurses under the Nurse Deployment Program of
the DOH
Patient - A pregnant woman who avails the birthing
services
PhilHealth / - Philippine Health Insurance Corporation
PHIC
PhilHealth - (PCF) is the fund paid by PHILHEALTH Corporation to
Capitation the Rural Health Unit for Specific services it provides on
Fund a particular period, which is arrived at based on a
predetermined criteria under the condition that any
savings from the agreed amount accrues to the benefit of
the RHU and that in case of insufficiency thereof, the
particular services due to the covered beneficiaries shall
be delivered at the cost of the RHU.
RBBF - RHU Bambang Birthing Facility with Basic Emergency
Obstetric and Newborn Care (BEMONC) Services
Section 6. COVERAGE.
The RHU Bambang Birthing Facility shall cater non-
complicated pregnancies with mothers from multi Gravida 2 to
Gravida 4 only. However, the facility shall provide initial
services to all pregnant women and refer further to a higher
facility for evaluation especially to complicated cases.
Section 7. LICENSE TO OPERATE – the RBBF shall have a DOH
issued License to Operate as a birthing facility before its
operation.
Section 8. PHILHEALTH ACCREDITATION – to maximize
Philhealth benefit delivery, the facility shall be accredited
annually to the Maternity Care Package (MCP) and Newborn
Screening Package of the PHIC.
Section 9. DELIVERY OF QUALITY CARE
8.1. The facility shall follow the policy-based DOH Manual
of Operation for Basic Emergency and Neonatal Care
(BEmONC)

8.2 The RBBF will provide safe and aseptically clean

environment during labor, delivery and recovery of the
mother by a trained and skilled health personnel. The
delivery quality care to the mothers and babies shall be
provided.
Section 10. SUPERVISION AND CONTROL OF THE RBBF. – The
operation of the RBBF shall be under the supervision and
control of the Municipal Health Officer.
Section 11. TIME AND DAY OF OPERATION. – The Municipal
Health Officer shall see to it that the RBBF shall operate
twenty-four (24) hours a day, Monday to Sunday.
Section 12. STAFFING AND MANAGEMENT. –
12.1. The RBBF shall be administered and operated by the
Municipal Health Office personnel, namely:
a. Municipal Health Officer – as Officer-In-Charge of the RBBF
b.Midwives – as regular personnel to attend to the patient
c. Nurse – as Senior Staff or Team Leader of the regular
personnel who’ll attend to the patient
a. Casual or Job Order Midwife/Nurse or Volunteer
Midwife/Nurse - who’ll assist the regular personnel of RBBF
b.Utility Worker – person responsible for the cleanliness of the
RBBF and such other minor tasks to be assigned from time to
time by his/her immediate superiors
a. Ambulance Driver- who shall transport the patient from and to
their home.
b.Birthing Clinic Manager – nurse that runs the day to day
operations of the Birthing Clinic
 12.2. The MHO shall see to it that:
a. The midwives/ nurses assigned in the different barangays
shall rotate in rendering duty to the RBBF as they attend to
their respective pregnant clients.
b.The day-to-day delivery of other health services at the
Bambang Rural Health Unit shall not be interrupted.
c. Designation and shifting of personnel are in order to ensure
efficient and effective operation of the RBBF
d. Duty hours of health personnel shall be 40 hours a week.
Section 13. DUTIES AND RESPONSIBILITIES OF THE RBBF
STAFF;
13.1. To provide quality health care delivery services during
the antenatal care.
13.2. To allocate funds for medicines needed to provide
quality services
13.3. To strictly implement and support the RBBF Activities
on safe motherhood and responsible parenting activities.
13.4. To conduct massive Information Dissemination
Campaign on safe motherhood during antenatal care.
13.5. To distribute leaflets about the RBBF and its services
13.6. To conduct Information Education Campaign in all
Barangays in the municipality.
13.7. Early detection referral and management of
complicated cases to prevent unnecessary maternal and child
mortality
13.8. Conduct advocacy meeting with local officials, private
sector and NGOs
Section 14. SERVICE FEE. – Fee for services rendered by RBBF
shall be in accordance to PhilHealth guidelines.
 
Section 15. FUNDING
15.1. Income derived from PhilHealth payments
15.2. From MLGU augmentation – additional operation
expenditures may be needed and shall be included in the
regular budget of the RHU…… REFER TO LFC
Section 16. CREATION TRUST FUND FROM MCP & NBS
PACKAGES – for LFC COMMENT
16.1. For efficient administration of funds from PhilHealth,
separate trust fund shall be created for each PhilHealth
packages where all fees collected shall be deposited.
16.2. Open the trust fund at Landbank of the Philippines with
Two (2) accounts for;
16.2.a. Administrative or Professional Fee Component
16.2.b. Facility Component
Section 17. DISPOSITION OF THE FUNDS FROM MCP & NBS PACKAGES
shall be in accordance to Philhealth guidelines….. (PHIC Circular
No. 022-2014)

17.1. Forty Percent (40%) of the package rate is for professional fee.
17.1.1. 10% - MHO
17.1.2. 10 % - Personnel on Duty:
a) RBBF Manager - 2.5%
b) Midwife ---------- 2.5%
c) Ambulance Driver – 2.5%
d) Utility -------------- 2.5%
17.1.3. 20% - In charge personnel
a) Sector Nurse /Midwife – 15 %
b) Sector BHW -------------- 10 %
c) Medical Technologist – 3 %
d) Dentist --------------------- 2 %
 17.2. Sixty Percent (60%) of the package rate is for the facility
fee.
17.2.1. Procurement of drugs, medicines and supplies
necessary for the operation of the RBBF;
17. 2.2. Purchase of equipment for the improvement of
RBBF s services;
17. 2.3. Fuel, oil and maintenance cost of the ambulance
and generator assigned to the RBBF; and
17. 2.4. Repairs and maintenance of the RBBF facilities and
equipment
Section 18. CONTINUING EDUCATION AND ADVOCACY
PROGRAM. – The MHO shall include in their annual plans and
programs the continuing education and advocacy program
regarding the benefits of RBBF to ensure safety of the life of
both mother and child.
Section 19. PROHIBITED ACTS- The following are hereby prohibited;
1)Conduct of surgical procedures such as dilatation and curettage (D&C)
and Bilateral Tubal Ligation (BTL)
2)Soliciting non-prescribed fees from clients
3)Encouraging home deliveries
4)Non-compliance to the Manual of Operation for Basic Emergency and
Neonatal Care (BEmONC)
5)Non-compliance to protocols set forth by the RBBF management
6)Utilization of RBBF funds not in accordance to prescribed disposition
funds
Section 20. PENALTY. – RHU personnel who shall violate this
Ordinance shall be penalized as follows:
20.1. Job Orders & Casuals
First Offense - P1,500.00
Second Offense - P 2,000.00
Third Offense - P 2,500.00, and dismissal from the
service
20.2. Permanent employees & NDPs
First Offense - P1,500.00
Second Offense - P 2,000.00
Third Offense - P 2,500.00, and Administrative sanctions
which shall be in accordance with the Civil Service
guidelines and the Supreme Court Memorandum Circular
on the Guidelines in the Application of Penalties in
Administrative Cases.
Section 21. COMPLIANCE OF MINIMUM REQUIREMENT. – The
Local Chief Executive (LCE) shall see to it, through the
SUPERVISION of the MHO, that the RBBF complies with the
minimum requirement set by the DOH regarding the operations
of birthing facility.
Section 22. APPROPRIATION- To effectively implement this
ordinance, an initial amount of P500,000 shall be allocated,
then annual funding shall be determined by the Local
Health Board. ----- to be REFERRED TO LFC
Section 23. REPEALING CLAUSE. – All Ordinances, rules and
regulations, or part thereof, whose provisions are in conflict
with or contrary to the provisions of this Ordinance are hereby
deemed repealed, amended or modified accordingly.
Section 24. SEPARABLITY CLAUSE. – If any provision of this
Ordinance or part thereof is declared unconstitutional or
invalid by a court of competent jurisdiction, the other
provisions or part thereof not affected shall continue to be in
full force and effect.
Section 25. EFFECTIVITY. This Ordinance shall take effect
fifteen (15) days after a copy hereof is posted in a bulletin
board at the entrance of the municipal hall and in at least two
(2) other conspicuous places and after publication in a locally
circulated newspaper.
THANK YOU!!!