SONIA ZABALA

B.S. MIDWIFERY 4th year

PROGRAM MANAGEMENT

I.
NATIONAL SAFE MOTHERHOOD PROGRAM

II.
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.

III.
INTRODUCTION

Recommended content of prenatal care

World Health Organization Department of Health

Confirmation of pregnancy Tetanus Provision of essential antenatal care services
immunization, anemia prevention and control 1. Monitoring of height and weight
(iron and folic acid supplementation) 2. Taking the blood pressure
Recording and reporting 3. Screening and blood testing including CBC,
blood
typing, urinalysis, VDRL or RPR, HbsAg,
blood
 sugar screening, pregnancy test, and cervical
cancer
screening
4. Micronutrient supplementation (iron, folate,
Vitamin
A)
5. Malaria prophylaxis where appropriate
6. Deworming
7. Birth planning
Monitoring of progress of pregnancy and Measurement of fundic height against the age
assessment of maternal and fetal well-being of gestation, fetal heart beat and fetal
movement count to assess the adequacy of fetal
growth and wellbeing
Detection of problems complicating pregnancy Early detection and management of signs of
(e.g., anemia, hypertensive disorders, bleeding, complications of
malpresentations, multiple pregnancy) Birth pregnancy
planning, advice on danger signs and Prevention and management of early bleeding
emergency preparedness Syphilis testing in pregnancy
Prevention and management of other
conditions as indicated
(hypertension, anemia, diabetes, tuberculosis,
malaria,
schistosomiasis, STI/HIV/AIDS)
Laboratory screening and medical management
of STI-HIV
cases and their complications
Hepatitis B birth dose immunization
Information and counseling on self-care at Counseling on Healthy Lifestyle with focus on
home, nutrition, safer sex, breastfeeding, smoking
family planning, healthy lifestyle cessation, healthy diet and nutrition, regular
exercise, STI
control HIV prevention and oral health.
Promotion of exclusive breastfeeding, newborn
screening,
BCG and Counseling on use of modern FP
methods
especially lactation amenorrhea (LAM), with
focus on health
caring and health seeking behaviors; and
contraception
including surgical procedures where
appropriate: bilateral
tubal ligation (BTL), no-scalpel vasectomy
(NSV) and
management of complications resulting from
contraception
Respond to other reported complaints Provision of other support services
1. Antenatal registration through active
tracking by the
WHTs
2. Birth planning
3. Home visits and follow up
4. Safe blood supply
5. Transportation and communication support
services

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):

A. 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.

o Action Point and Timelines:

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

o Action Points and Timelines

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

o Action Points and Timelines

o Continuous application and renewal of PhilHealth accreditation by Birthing
Centers
o Continuous enrolment of poor families to PhilHealth Sponsored Program by
LGUs
o Establishment of Safe Blood Supply Network in collaboration with the
National Voluntary Blood Services Program is on-going
C. 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.

o Action Points and Timelines

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

IV.
FUNCTION
Midwife:

A midwife is a health care professional who provide health care services for women including
gynecological examinations, contraceptive counselling, prescriptions, and labor and delivery
care. Midwife provides expert special care during labor, delivery and after birth so that midwife
unique.

Roles and Responsibilities of A Midwives:

Various roles and responsibilities of a midwife have presented in the below:

Care giver:

Midwives provide high quality antenatal and postnatal care to maximize the women’s health
during and after pregnancy, detect problems early and manage or refer for any complications.

Coordinator:

Midwives coordinate care for all women. Coordinator ensures holistic, voluntary and social
services for pregnant women when appropriate so that every women’s birth experience
regardless of risk factor.

Leader:

The role of leader is to plan, provide and review a women’s care, with her input and agreement,
from the initial antenatal assessment through to the postnatal period. Midwife’s leading role
reduces admission to hospital and results in significantly less intervention during birth.
Communicator:

As a communicator, the midwives understand that effectiveness of communication. It helps to

develop trust relationship with pregnant women and family members. The midwife has to
communicate effectively with pregnant women and family members as well as others so that
they can share their all problems.

Manager:

Manager is a great role for midwife. Midwives manage all the circumstances where appropriate
and can recognize and refer women to obstetricians and other specialists in a timely when
necessary.

Educator:

As an educator, midwives provide high quality, culturally sensitive health education in order to
promote healthy, helpful family life and positive parenting.

Counselor:

Midwives provide information and counsel pregnant women on prenatal self care including
nutrition, hygiene, breastfeeding and danger sings in pregnancy and childbirth.

Family planner:

They also counsel people as a family planner. They provide all information about all kind of
family planning methods and help couple to take decision.

Adviser:

Midwives give advice on development of birth plan and promote the concept of birth
preparedness. They also give advice during complicated situation so that it will help them to take
decision.

Record keeper:

Record keeping is an integral part of midwifery practice. It helps making continuity of care
easier and enabling identify problem in early stage.

Supervisor:

Supervising and assisting mothers during antenatal period, monitoring the condition of the
condition of the fetus and using their knowledge to identify early sings complication