Sunday, September 18, 2011

Bring health care to rural areas using ICT: solon

Senator Edgardo J. Angara, chair of the Congressional Commission on Science Technology and Engineering (Comste), has identified telehealth, which would help deliver basic medical services to remote areas through the use of information and communication technology (ICT), as a national priority.
Comste has a target of deploying 200 new telehealth clinics within the next two years. The commission is also targeting the development of new biomedical devices/subsystems–ECG, blood tests, urinalysis, disease screening in coordination with local electronics industry partners.
Department of Health secretary Enrique Ona, who is a member of the Comste health panel, noted that the role of ICT would play an important role in making the move towards achieving universal healthcare.
The National Telehealth Project, which was initiated by the University of the Philippines, Manila National Telehealth Center (UPM-NTC), is seen as an ideal partnership between healthcare and technology, which would enable doctors to remotely diagnose patients in rural and far-flung communities.
Remote consultations include the use of SMS and MMS services, video conferencing, and email referrals. The project has ten sites in four provinces, complete with workstations and training centers. In a 34 month period, there have been 1,389 telehealth referrals from remote doctors.
Angara also filed a bill in the Senate that will develop community health delivery and health team placement for rural area.
“Primary health services remain elusive or inaccessible to majority of our population, especially those living in the rural and poor areas of the country. As for our health care practitioners, particularly those in the nursing profession, a good number of them are denied employment opportunities to practice their trade and, consequently, the training to further improve their skills,” said Angara.
Angara added that, “a program that aims to improve the accessibility and delivery of primary health services will inevitably create employment for our health care practitioners and hone their skills in the process. Conversely, increasing jobs and skill level in the health sector will render primary health services more available to the public.”
Angara noted that in Region 1, the ratio of healthcare workers per person is a disproportionate 190 per 100,000 people.
If passed, the bill would establish one Local Health Unit (LHU) for cities and municipalities with a population of more than 20,000, and at least one registered nurse per 5,000 people, and no less than 2 nurses for each LHU.
The bill would also provide nurse-led operations and equipment for telemedecine for 4th and 6th class municipalities with populations of less than 5,000. These nurses would be able to remotely consult with physicians, who would also be required to conduct periodic visits to the communities.
The implementation of telehealth and telemedicine would also allow nurses in the LHUs to electronically document patients and their records.
Angara said that aside from improving basic health care services and delivery to remote areas, telemedicine will create the foundation for digital medical records. By collecting data from patients all over the country, transitioning to a digital medical record system will become easier.
The collection of digital records also creates a centralized information system that can be utilized by PhilHealth. By keeping track of its members, PhilHealth can make it easier for members to get the health care they need and at the same time sustain their membership, Angara noted.
“With the proposed Community Health Delivery and Health Team Placement Act he end goal is to elevate the availability of primary health care in the Philippines and the competence of Philippine health care practitioners to unprecedented heights,” said Angara

Monday, September 12, 2011

DOH Terminated Nurse Volunteer Programs in DOH-Retained Hospitals

The Department of Health Secretary approved and released DOH-Memorandum 0238 terminating all "nurse volunteer programs" or any of its similar forms in all DOH-retained hospitals. This is also the result of our endless meetings in the AdHoc Committee to come up with a comprehensive report about this issue. 

I would like to thank all my colleagues in AYNLA who tirelessly gathered sufficient data to file to DOH when they needed it the most. My congratulations to our small success!

DOH Termination of Nurse Volunteer Programs

Tuesday, September 06, 2011

UN to continue support to government’s RH programme

The United Nations will continue to support the Philippine government in its efforts to achieve the Millennium Development Goals (MDGs) by 2015, particularly to achieve targets to reduce maternal deaths and ensure universal access to reproductive health, including family planning. These targets remain top priorities of the government and the UN’s assistance as these are among the targets least likely to be achieved by 2015.

The United Nations continues to support the government’s commitment for a life of health and dignity of all Filipinos by ensuring that every pregnancy is wanted, every birth is safe, every young person is free of HIV and AIDS, and women and girls are treated with dignity and respect.

In keeping with President Aquino’s universal health care agenda, the UN will continue to assist government to promote, protect and fulfill every Filipino’s right to freely decide on the timing, number and spacing of their children, with the support of other development partners.

Global evidence shows that up to 30 percent of maternal deaths and as much as 20 percent of infant deaths can be averted by ensuring access to voluntary family planning, including contraceptives. The two other strategies to reduce maternal deaths are provision of skilled attendants at birth and access to life-saving services during delivery, which are also part of the UN’s development assistance in the Philippines.

In recognition of government’s renewed efforts to ensure that women and girls, especially the poor and marginalized, do not die of preventable causes during pregnancy and childbirth, the UN has increased and will sustain its support to maternal and neonatal health programmes in the Philippines.


Monday, September 05, 2011


We acknowledge the various concerns raised by certain sectors over the discrepancy of the estimated average number of maternal deaths due to pregnancy-related complications per day in the Philippines.  The reason for the variance in the data on the average number of maternal deaths per day is differences in methodology. Eleven (11) mothers dying every day is based on 4,100 maternal deaths per year divided by 365 days in a year. These are estimates derived from the 2006 Family Planning Survey conducted by the National Statistics Office which used a survey-based method following the direct sisterhood approach, where respondents are interviewed about the survival of their older sisters.
On the other hand, the lower value of almost six (6) mothers dying every day or 2,100 maternal deaths per year in 2008 is from The Maternal Mortality Estimation Inter-Agency Group, composed of the World Health Organization (WHO), United Nations Population Fund (UNFPA), United Nations Children’s Fund (UNICEF) and the World Bank, which used econometric modeling to generate estimates of maternal deaths based on secondary and vital registration data for each year between 1980 and 2008. The global estimates have been derived using standard categories and methods to enhance cross-national comparability. Given the difference in methodologies, a difference in the numbers is to be expected.
More importantly, in spite of differences in the methodology in estimating data on maternal deaths and the maternal mortality ratio, it is unacceptable for a single mother to die or mothers to continue to die from preventable causes. Regardless of the variance, the estimated number of maternal deaths and the estimated maternal mortality ratio, regardless of source, validate that by year 2015, MDG 5 targets to improve maternal health and ensure universal access to reproductive health care will not be achieved.  Women and girls will still continue to die from preventable causes and therefore ensuring universal access to reproductive health care should still be a priority of the Government of the Philippines and all Filipinos. 
In the Philippines, the vital registration system at present is weak and greatly underestimates maternal mortality. A recent formal evaluation of the vital registration system in Bukidnon conducted by the DOH National Epidemiology Center in 2008 compared maternal deaths recorded in the civil registry with those found using the Reproductive Age Mortality Studies (RAMOS) methodology. This approach involves identifying and investigating the causes of all deaths of women of reproductive age in a defined area/population by using multiple sources of data. If properly conducted, this approach provides a fairly complete estimation of maternal mortality (in the absence of reliable routine registration systems). The Bukidnon RAMOS study revealed that the local civil registry missed three-fourths of all maternal deaths.  In a setting where the vital registration system is incomplete, it is expected that the results generated using vital registration would also be lower as compared to a survey which reflects the sample population.
As to the maternal mortality ratio, we also recognize the various concerns raised by certain sectors over the discrepancy of the official country estimates on MMR vis-a-vis the recent Inter-UN Agency estimates on MMR for the Philippines. As stated by the Technical Committee on Population and Housing Statistics, one of the sectoral interagency committees created and being coordinated by the National Statistical Coordination Board (NSCB) of the Philippines, “the Inter-UN Agency estimates cannot be expected to be consistent with those of the Technical Working Group on Mortality Statistics of the Philippine National Statistical Coordination Board nor with the existing survey-based estimates for the country.” In addition we also note the position of the Department of Health that “correlating maternal mortality ratio statistical estimates with the actual situation of maternal care in the country will clearly show incongruence between the estimate and reality,” referring to indicators that were expected to improve as maternal mortality decreased such as facility based delivery and skilled birth attendance but which have not substantially increased.
The national MMR of 162 per 100,000 live births for the Philippines was generated from the 2006 Family Planning Survey of 46,000 respondents. The UN estimates are based on secondary data and civil registration reports encompassing 2,961 country-years of data from 172 countries and territories to allow for cross national comparability. As stated earlier, here in the Philippines, the vital registration system is weak and suffers from underreporting, hence it is expected that results generated would also be lower as compared to a survey which reflects the sample population.  In the Inter-agency final report, the Philippines is classified among the 85 countries “lacking good complete registration data but where registration and/or other types of data are available.” 
Given the strengths of the methodology used in the country's population-based surveys,  to this end,  the United Nations agencies in the Philippines concur with  the official national-level estimates of maternal mortality ratios for 1990 and 2000-2010 as stated in National Statistical Coordination Board Resolution No. 11, Series of 2010. The MMR estimates in NSCB Resolution No. 11 Series of 2010 are to be used “as interim estimates for planning and policy/decision-making purposes until such time that the results of population censuses and surveys and updated data from the civil registration system are made available.”
Lastly, it is also important to note that the latest round of UN estimates which reflect the change from 120 MMR in 2000, to 110 MMR in 2005, and finally 94 MMR in 2008 does not necessarily reflect any decrease in MMR as these values all remain within the 95 percent confidence intervals.            
The present discussions have once again surfaced that the civil registration system needs to be improved, strengthened and sustained.

RH advocates call for national day of the Purple Ribbon

Reproductive Health (RH) supporters all over the country are calling for a series of nationally coordinated mass actions to ask Congress to finally put the RH bill into vote. Starting September 7, the RH Consortium, together with its allies and partners in the different regions, will organize a monthly “Day of the Purple Ribbon for RH” with various activities ranging from motorcades, candle and torch parades, purple ribbon tying and stickering, rallies and cultural presentations.

Hundreds of RH supporters from grassroots organizations, local government units, arts and entertainment industry, interfaith groups, academe, business and national government agencies are expected to join the mass actions. Likewise, the organizers are calling the public to participate in these activities and to wear purple clothes, tie purple ribbons in their homes and cars and to light a candle at exactly 6PM during that day.

The major staging areas for the September 7 purple ribbon events are the cities of Baguio, Iloilo, Davao and at the Senate grounds in Pasay City.  The Baguio Day of the Purple Ribbon will feature street performances, an RH forum, a candle parade at 5PM and a concert at the UP Baguio starting at 7PM.  In Iloilo City, the whole day event will start with the early morning tying of purple ribbons in major thoroughfares, memorial march and cultural program in the afternoon at the Jaro Plaza.

In Davao City, a motorcade in the morning will launch the purple ribbon campaign, followed by a photo exhibit and a rally at the people’s park.  In Pasay City, women’s groups will hold a cultural rally at the Senate grounds to draw attention to the daily deaths of mothers. The rally will coincide with the plenary debate on the RH bill in the Senate.  A candle lighting ceremony at exactly 6PM will be the common feature for all the activities on September 7 to remember women who died needlessly due to pregnancy and childbirth complications.

The other dates and venues for the National Day of the Purple Ribbon for RH are on October 7 in Pampanga, Legaspi, Cagayan de Oro, and Zamboanga and on November 15 in Tugegarao,  Tacloban and Quezon City.

For interviews and clarifications, please contact Ms. Vigie Benosa-Llorin, PLCPD Media Advocacy Officer, Mobile No. 0918-2936786.