[02.07] Maternal and Child Health V2.2.pdf

Improve women’s health across the life course

What is a key principle in maternal and child health programming related to women's health?

Deploy and scale up proven interventions

What is a principle in Maternal and Child Health (MCH) programming for improving the survival and health of newborns and children?

Ending preventable neonatal deaths, stillbirths, and long-term disability

What are the outcomes that quality care during pregnancy, childbirth, and the postnatal period aims to impact?

Nutrition and Water, Sanitation, and Hygiene (WASH)

What sectors are strengthened to enable improvements in newborn and child health?

Strengthen governance and invest in well-coordinated policies and services

What action improves maternal child health programs?

Accelerate progress towards Universal Health Care (UHC) anchored on a good Primary Health Care (PHC) platform

What is a principle for maternal and child health programming related to healthcare access?

Water, Sanitation, and Hygiene

What does WHO define WASH as?

108 deaths per 100,000 live births

What is the Maternal Mortality Ratio in the Philippines, which remains a key challenge?

2,400 women and girls

How many women and girls in the Philippines die from preventable causes related to pregnancy and childbirth?

Hemorrhage and hypertension (HPN)

What are examples of preventable causes related to pregnancy and childbirth that lead to maternal deaths?

Decreased

What happened to maternal health service utilization for antenatal (ANC) and postpartum care (PP) visits when comparing pre- and during the COVID-19 pandemic periods?

27 deaths per 1000 live births

What is the Under-5 mortality rate in the Philippines?

Still a large disparity among the poorest and wealthiest households

Despite a decreasing trend in childhood mortality, what significant issue persists in the Philippines?

The Philippines

Which country is among the top 10 globally accounting for 72% of under or unvaccinated children in 2021?

Newborn mortality (deaths in the first 28 days of life)

What constitutes a major part of the under-five mortality rate?

Low birth weight and prematurity

What are immediate and underlying causes of newborn mortality that the Philippines needs to address?

30.3% (about 3.9 million)

What percentage of children under 5 years were stunted in the Philippines in 2018?

Poor nutrition, repeated infection, and inadequate psychosocial stimulation

What are the experiences from which children suffer impaired growth and development, defined as stunting?

World Health Organization (WHO)

What organization provides the standard for defining stunting (height-for-age more than 2 standard deviations below the standard)?

Poor cognition and poor educational performance, low adult wages, and loss of productivity

What are the adverse functional consequences of stunting in early life, particularly in the first 1000 days?

Increased risk of nutritional-related chronic diseases in adult life

What is a repercussion of excessive weight gain later in childhood, often following early life stunting?

Remained relatively stagnant with an annual decline of less than 1%

What was the trend for stunting from 2000 to 2018?

COVID-19 pandemic and recurrence of disasters and emergencies

What factors could result in an increase in wasting by 14.3% in children 0-5 years?

9%

What percentage of women aged 15 to 19 have begun childbearing (adolescent pregnancy)?

Road traffic injuries

What is the leading cause of injury-related deaths and disabilities for children 5-19 years old, particularly school-going children?

Family Health Cluster of DOH

What cluster includes the programs for maternal newborn child health nutrition and reproductive health?

Sustainable Development Goal 3 and National Objectives for Health

The Safe Motherhood Program is a major input to achieving which goals?

Ensure healthy lives and promote well-being for all at all ages

What is the objective of SDG 3, which the Safe Motherhood Program contributes to?

For Filipino women to have full access to health services towards making their pregnancy and childbirth safer

What is the mission of the Safe Motherhood Program?

Provide technical assistance to local government unit (LGU) partners in the implementation of rational and responsive policies

What is the goal of the Safe Motherhood Program?

FOURmula One Plus Thrust and Universal Health Care

What are the guiding policies of the Safe Motherhood Program?

Antepartum Care, Intrapartum Care, and Postpartum Care

What are the three components where appropriate strategies and activities are needed to reduce maternal and infant mortalities?

Fertility awareness, birth spacing/family planning, iron-folate supplementation, Tetanus toxoid (now Td) immunization, and healthy lifestyle practices

What interventions should a woman receive during pre-pregnancy as part of maternal care?

At least 4 prenatal visits

Ideally, how many prenatal visits should a woman have during her pregnancy?

First trimester

When should the first prenatal visit ideally occur?

Iron/folate and iodine supplementation, Td immunization, birth planning, healthy lifestyle practices, and awareness of general danger signs of pregnancy

What is given to a woman during a prenatal visit?

Skilled health professionals (doctor, nurse, or midwife)

Who should attend during intrapartum care (in labor)?

Traditional birth attendants or “hilots”

Who are NOT included as skilled health professionals for intrapartum care?

Facility-based delivery

What type of delivery is recommended, including lying-in clinics with referral services?

Use of partograph in labor watch, active management of 3rd stage of labor, and management of complications (pre/eclampsia, infection, bleeding, preterm labor)

What are key aspects of intrapartum care?

Within the first 2-3 days (72 hours) and on the 7th day

When should postpartum visits occur?

Family planning advice and services and Vitamin A supplementation

What is provided during postpartum care?

Prevent maternal and neonatal tetanus

Why are pregnant women given Tetanus-Diphtheria (Td) vaccine?

As early as possible during pregnancy

When is the 1st dose of Td given to pregnant women?

At least 4 weeks after the 1st dose

When is the 2nd dose of Td given, providing 1-3 years of protection?

At least 6 months after the 2nd dose

When is the 3rd dose of Td given, providing at least 5 years of protection?

At least 1 year from the 3rd dose, or during the next pregnancy

When is the 4th dose of Td given, providing at least 10 years of protection?

At least 1 year from the 4th dose

When is the 5th dose of Td given, protecting the mother for the entire childbearing age and possibly longer?

Minimum interval

What interval is important to look at when a woman can receive her next Td dose, rather than the maximum interval?

DPT (Diphtheria-Pertussis-Tetanus)

What vaccine was administered in the country before Penta?

Penta or 5-in-1 vaccine

What vaccine is now given, which includes Td, and potentially requires only 3 doses instead of 5 for full protection?

Attain the desired number of children and determine the spacing of pregnancies

What is the purpose of family planning?

Respect for Life, Respect for Human Rights, Informed Consent, and Responsible Parenthood

What are the guiding principles of Family Planning?

Therapeutic abortion

What type of abortion does the government allow, even though abortion is generally illegal in the Revised Penal Code?

Only medically and legally permissible methods appropriate to the health status of the client

What kind of family planning methods should be given according to the principle of Respect for Human Rights?

Full information on the different methods

What should be given to clients under the principle of Informed Consent in family planning?

Couple's right to determine their desired family size, according to their capacity to provide for their family

What does Responsible Parenthood emphasize regarding family size?

Ensure the well-being and autonomy of women, while supporting health and development of communities

Why is investing in family planning essential?

Health intervention, means to prevent high-risk/unplanned pregnancies, means to prevent abortions, means to reduce maternal and infant deaths, reproductive right of women, means towards responsible parenthood, and means to reduce poverty

What are the multiple benefits and roles of Family Planning?

Intrauterine device (IUD) and implants

What are examples of long-acting family planning methods?

Tubal ligation (for women) and vasectomy (for men)

What are examples of permanent family planning methods?

Injectables, Oral Contraceptive (OC) Pills, and male or female condoms

What are examples of short-acting family planning methods?

Temperature checking, cervical mucus consistency, and Lactational Amenorrhea Method (LAM)

What are examples of natural (fertility awareness-based) family planning methods?

Withdrawal Method (Coitus Interruptus) and Calendar of Rhythm Method (Periodic Abstinence)

What are examples of traditional family planning methods?

Intensify demand generation activities, optimize opportunities for integration, cascade/disseminate key messages, harmonize strategies with partners, and orient/capacitate Barangay Health Workers

What are the strategies to improve family planning program implementation?

FP Usapan, house-to-house visit/suyod, FP Everyday, FP Month Celebration

What are examples of demand generation activities at the community level?

FP-ANC/PP-immunization strategy, FP-HIV, FP-AHDP

What are examples of programs where Family Planning (FP) services can be integrated?

Adhere to the principles of Informed Choice and Voluntarism

What principles must be followed when providing appropriate FP services?

Facilitate referral to other facilities (e.g., hospitals, private clinics)

What action should be taken if a procedure like Long-Acting Reversible Contraception (LARC) or a permanent method is unavailable in a facility?

Ensure timely availability of FP logistics reports

What is necessary for commodity/logistics planning in health facilities?

Unang Yakap Program

What is Essential Intrapartum Newborn Care (EINC) also known as in Filipino?

A package of evidence-based practices recommended by the DOH as the standard of care in all births by skilled birth attendants

What does EINC represent?

Immediate drying, skin-to-skin contact, non-immediate clamping of the cord, and non-separation of the baby from the mother for breastfeeding initiation

What are the 4-time bound interventions of the EINC protocol?

Do not give sugar water, formula, or other prelacteals; do not give bottles or pacifiers; do not throw away colostrum

What are key reminders under the EINC protocol?

Promote good health of the newborn and prevent mortality of infants in the postpartum period

What does EINC help to achieve?

Republic Act 9288: Newborn Screening Act of 2004

What is the legal basis for the Newborn Screening Program (NBS)?

Every baby born in the Philippines

Who is offered an opportunity to undergo newborn screening?

Mental retardations and death

What heritable conditions can babies be spared from if detected and treated early through NBS?

By 2025

What is the target year for the NBS program to achieve its goal that all Filipino newborns are screened for common and life-threatening congenital endocrine and metabolic disorders?

Ensure access, establish a sustainable system, ensure health practitioners are aware, and ensure parents recognize responsibility

What are the objectives of the Newborn Screening Program?

1996

When did the NBS program start as a research project?

5 conditions, with one added in 2012

How many conditions were initially screened for when the NBS program was mandated by law?

Congenital Hypothyroidism, Congenital Adrenal Hyperplasia, Phenylketonuria, Glucose-6-Phosphate Dehydrogenase Deficiency (G6PD), Galactosemia, and Maple Syrup Urine Disease (added in 2012)

What are the 6 conditions included in the Basic Newborn Screening?

Expanded Newborn Screening

Which screening panel, introduced in 2014, covers 32 disorders?

Amino Acid Disorders, Organic Acid Disorders, Fatty Acid Oxidation Disorders, Urea Cycle Disorders, Hemoglobinopathies, Cystic Fibrosis, Biotinidase Deficiency, and the 6 basic ENBS disorders

What categories of disorders are covered by the Expanded Newborn Screening?

Advocacy, Recall & Follow-up, Capacity Building, and Data Management

What are the "ways forward" for the NBS program?

Newborn's foot is pricked

Where is the sample usually taken for newborn screening?

tinyurl.com/NBSReporting

Where can facilities link for requests to submit monthly and regular census reports for Newborn Screening?

Expanded Program Immunization (EPI)

What was the National Immunization Program (NIP) called before?

Life-course immunization

What has the NIP expanded to, beyond just children under 5 years old?

Reduce morbidity and mortality among children against vaccine-preventable diseases (VPDs)

What is the goal of the National Immunization Program?

Immunize all infants/children, sustain polio-free status, eliminate measles infection, eliminate maternal and neonatal tetanus, control diphtheria, pertussis, hepatitis B and German measles, and prevent extrapulmonary tuberculosis among children

What are the specific objectives of the NIP?

2019

When did the Philippines experience a polio outbreak before being declared polio-free again in June 2021?

Every 3-4 years

How often do measles outbreaks occur in the Philippines due to low coverage?

2017

When was the Philippines declared free of maternal and neonatal tetanus?

Polio Eradication, Maternal-Neonatal Tetanus Elimination (MNTE), Measles Elimination, and Accelerated Hepatitis B Control

What are the four international declarations on immunization to which the Philippines is a signatory?

1974

When did the World Health Organization conceive the idea for a global Expanded Program on Immunization (EPI)?

1976

When was the NIP established in the Philippines, aiming to provide immunity against 14 VPDs?

PD996

What presidential decree launched and established EPI in the Philippines?

BCG, DPT, & Tetanus diphtheria (Td) for pregnant women

What vaccines were introduced in 1979?