DOH Integrated Essential Maternal and Newborn Care

Training of Trainers on the Integrated Essential Maternal and Newborn Care (EMNC) and Lactation Management Training (LMT) for Health Care Providers in Hospitals

September 20-24, 2016

The Department of Health has a lot of programs, even for the same beneficiaries there are different programs.  For maternal and child health for example, we have the Essential Intrapartum and Newborn Care (EINC), the Kangaroo Mother Care (KMC), the Lactation Management Training (LMT) and even the Basic Emergency Obstetric and Newborn Care (BEmONC) training and Infant and Young Child Feeding (IYCF).  To make things simpler, we now have an integration of all these training programs into one broad training of trainors, much like a sampler of everything.  Hence, the Integrated Essential Maternal and Newborn Care and Lactation Management (EMNC-LM)!





As is also the norm since my three (3) years of working at the Vicente Sotto Memorial Medical Center, we are tapped by the DOH as trainers and facilitators.  Rising up to the challenge of a myriad of conflicting schedules, we managed to respond.

The first batch took place on June 13-18, 2016 at Bayview Park Hotel in Manila.  

The second batch was conducted at the Cebu Business Hotel in Cebu City. For the Cebu batch, participants include Far North Luzon General Hospital, Luis Hora Memorial Regional Hospital, Novaliches District Hospital, Batangas Medical Center, Eastern Visayas Regional Medical Center, Schistosoma Research and General Hospital, Amai Pakpak Medical Center, Mayor Hilario Ramiro Sr Regional Teaching and Training Hospital, CARAGA Regional Hospital, and Vicente Sotto Memorial Medical Center. 

Aside from introducing the laws to protect breastfeeding and the support system needed to ensure continuous successful feeding, it has to start long before labor and delivery, possibly during antenatal care. This sentiment was echoed during the last session on supportive supervision.

The programs on promoting breastfeeding should consider the hospital policies, the capabilities of the healthcare works, the health education and promotion classes, as well as support groups in the community.

This training seminar included also facilitation and communication skills, in addition to promotion of breastfeeding during pregnancy, through EINC especially during non-separation of mother and child during the entire hospital stay, practices that protect breastfeeding, as well as introducing Kangaroo Mother Care for preterm babies and low birth weight babies.

The participants visited the Vicente Sotto Memorial Medical Center to interact with the mothers and to experience for themselves how a busy overcrowded government hospital implements government programs despite the challenges of inadequate space maximizing 300-400% bed capacity, undermanned service areas and limited resources.  

It warms my heart to hear that the participants appreciated the presence of the Intensive Maternal Unit, which aims to separate pregnant patients with special concerns such as hypertension, preterm labor, infections during pregnancy and antenatal bleeding.

As a case in point, when we had to move temporarily to the Trauma Center for the duration of the construction of the Perinatal Care, we only had a labor room-delivery room complex with the neonatal intensive care unit attached to it.  We had no extra space.  We really had to request for a specific space for the Intensive Maternal Unit (IMU).  Patients with high risk pregnancies complicated by hypertension, antenatal hemorrhage, preterm labor, gestational diabetes mellitus, infections in pregnancy, and other co-morbidities are admitted at the Intensive Maternal Unit, which is under the supervision of maternal health specialists like the perinatologist and the infectious disease specialist.  With cohorting as a strategy, we noted that the conditions of these patients could not be managed while they were staying at the jampacked labor room.  Patients in labor have to take turns lying down on the bed because several of them have no choice but to share on bed.  Patients in labor understandably feel discomfort and intense pain due to childbirth.  These uncomfortable circumstances would not help control the blood pressure of a hypertensive, for example. Hopefully, all government hospitals would have an intensive maternal unit, supervised by a maternal-fetal medicine/perinatology specialist so as to reduce maternal and child morbidity and mortality.

In the end, what is important is the identification of champions for the program - whether in the community, in the hospital or in the head office of the Department of Health.  These are people who truly believe that by implementing these programs, our population of mother and children will be better fed, better nourished, better cared for and healthier.  Congratulations to the team of Dr Anthony Calibo and Ms Aya Escober!

Here is the video TV commercial by the Department of Health for the promotion of breastfeeding, All for Health towards Health for All!

Voluntary Blood Donation Drive to Save our Mothers At VSMMC

Voluntary Blood Donation Drive to Save our Mothers at VSMMC 
on September 25, 2016 (Sunday) Regional Blood Center

At Vicente Sotto Memorial Medical Center, the Department of Obstetrics and Gynecology is allotted one (1) operating room and one (1) dedicated anesthesiologist. Only one. But compared to other hospitals, we operate 24 hours a day and 7 days a week, and as public servants, we accept ALL patients who come seek our help for delivery. We do emergency cesarean section because these patients are mothers and their babies who can die if we do not intervene.

We do not turn away patients even if they do not have prenatal care. We do not turn away patients even if they don't have money. We do not turn away patients even if they do not have blood or blood donors. We do not turn away patients even if we don't have physical space or manpower. Because, if we start turning away patients, where will they go?

We need your help. We cannot do it alone. Mothers still die because of hemorrhage. They bleed to death when there is no available blood at the blood bank, when people do not care enough to donate their life-giving blood, when people start thinking about what they can get in return, when people keep thinking they don't have time to help.

You can help save our mothers and our babies. For a few minutes of your time, you can give your health to these patients. We need communities who care enough to take action to save our mothers and our babies. The Regional Blood Center along Jones Ave near Fuente Osmena is open to accomodate heroes who are willing to donate blood.  On September 25, 2016 (Sunday), the Department of Obstetrics and Gynecology is organizing a voluntary blood donation drive for the benefit of our patients.  We hope to see you there!

Promoting Child Rights Protection

The Republic Act 9344 known as the Juvenile Justice Welfare Act of 2006 celebrated 10 years of its existence.  This law recognizes the right of children to assistance, including proper care and nutrition, and special protection from all forms of neglect, abuse, cruelty and exploitation, and other conditions prejudicial to their development.  It further defines a child at risk and a child in conflict with the law. This law also points to the  minimum age of criminal liability: A child fifteen (15) years of age or under at the time of the commission of the offense shall be exempt from criminal liability.

Children are often used in drug trafficking nowadays because of this exemption.  Hence, some call for a lowering of this minimum age so that children committing heinous crimes can be put behind bars.  Child rights advocates insist that in these instances, children are victims too.

The Philippines signed the United Nations Convention on the Rights of the Child.

Since signing the UN CRC, the government is obliged to recognize the full spectrum of human rights for all children and strengthen efforts in enforcing the rights of children.  Different branches of government call for increasing programs that protect children's rights:

The Department of Interior and Local Government urges barangays to promote children's rights in the search for child-friendly barangays.

The Department of Education (Dep Ed) issued a memorandum on its child protection policy, policy and guidelines on protecting children in school from abuse, violence, exploitation, discrimination, bullying and other forms of abuse.  Dep Ed also strengthens protection for the reintegration of children at risk and children in conflict with the law.

The Department of Justice created a Committee for the Special Protection of Children.

The Department of Social Welfare and Development has rescued over 150 victims of webcam sex tourism and other forms of child abuse.

In the UN CRC, the guiding principles of the Convention include non-discrimination, adherence to the best interests of the child, the right to life, survival and development, and the right to participate.  In our own ways, we can also promote children's rights and help in the reintegration of children at risk and children in conflict with the law.




Questions that need to be answered:

1.  What are the different approaches to reintegrate children at risk and children in conflict with the law?
2.  Suggest ways on how we can keep children our of trouble and out of harm's way.
3.  What enabling environment can allow children to claim their own rights?