Expanding Essential Care for Newborn and their Mothers – Philippines

Photo Credit: Lynsey Addario/ Save the Children

This blog was co-authored by Dr. Anthony Calibo, Dr. Socorro de Leon-Mendoza and Dr. Amado Parawan. 

Every hour of each day in the Philippines, a mother gives birth to a child who does not live to see the next day.

In 2011, more than 10,000 Filipino babies died on the day they were born, according to Save the Children’s State of the World’s Mothers report, Surviving the First Day. The high number of first day deaths illustrates the need to make newborn care a top health priority.

Accordingly, the Philippine government is committed to helping save newborn lives, and has undertaken a series of activities and interventions to prioritize and address newborn health in the country.

Consider the management of premature and low birth weight newborns, which alone accounts for 40% of newborn deaths in the Philippines. The country is one of the pioneers in the region in piloting and building local evidence on Kangaroo Mother Care (KMC), a cost-effective, simple and effective practice that involves mothers, fathers and other family members to keep their babies warm through skin-to-skin contact, promotes a sustained breastfeeding practice thereby enhancing growth, and due to early discharge from the hospital, decreases the incidence of health-care related sepsis and decreases over-all cost of care for the family.

Since the introduction of KMC began at the Dr. Jose Fabella Memorial Hospital in Manila nearly 15 years ago, such care has now been documented to be a valuable life-saving measure for all premature and low birth weight babies in the Philippines. After only two years, the Fabella Hospital experience which showed a significant impact on the hospital’s neonatal mortality, training for implementation was expanded to seven (7) key hospital facilities in Metro Manila. Skills training was subsequently cascaded to all the Lying-in clinics of the Manila City health department by 2004. In 2008 the Bless-Tetada Kangaroo Mother Care Foundation Philippines was established to develop, monitor, and accredit KMC centers across the country. As of September 2013, three KMC centers of excellence have been accredited and four other centers are in the implementation stage, in various regions across the country.

With over 2.3 million births per year and a population of more than 98 million, the Philippines is one of the most populated countries in Southeast Asia and the world. In 2011, a Filipino mother gave birth to the world’s 7th billionth person, Danica May Camacho. She was one of the nearly 350,000 babies who is born preterm every year in the Philippines; yet thanks to skilled health workers who knew that preterm babies need extra care, Danica became a symbol of progress in accessible health services.
The troubling reality however, is that not all our newborns receive the same care from skilled professionals at health facilities in the Philippines. The government however is committed to changing that situation.

The “Unang Yakap” program, meaning First Embrace, is a campaign of the Philippines’ Department of Health (DOH), in cooperation with the World Health Organization (WHO), to adopt the Essential Intrapartum and Newborn Care (EINC) guidelines for the safe and quality care of mothers and their newborns. It stresses the importance of delayed bathing and thorough drying of a newborn, early skin-to-skin contact with the mother, early and exclusive breastfeeding, and properly timed cord clamping. With over 60% of births in the Philippines now being attended by a skilled health worker, implementing the EINC protocol ensures that quality and timely care is provided by all skilled birth attendants, so that all mothers and newborns receive the best possible care during pregnancy and childbirth.

To achieve that end, the Philippines is in the process of developing clinical guidelines and standards for addressing the leading causes of neonatal mortality, and will work with health professionals (midwives, nurses, social workers, physicians) other key stakeholders and partners including community-based health and nutrition workers and local government units (LGUs) to ensure all the relevant cadres of health service providers in the country are equipped with the right knowledge, attitudes and skills to save more newborn lives.

And there is more good news. In August of 2013, the DOH hosted experts from local and international groups including UNICEF and WHO to focus on ways to improve newborn and maternal health by identifying the remaining barriers standing in the way of our goals. The national consultation was part of a global effort to develop Every Newborn, an action plan to save newborn lives.

The consultation offered everyone the opportunity to share experiences, lessons learned and renew our commitment to parents and caregivers across the Philippines.

In November 2013, the strongest typhoon and storm surge devastated the Eastern Visayas region of the country with many lives lost and infrastructure destroyed. Health services suffered a big blow and the regional hospital in Tacloban City (Eastern Visayas Regional Medical Center) was not spared. Incidentally, this is the regional center for training and excellence in KMC. Although the process of rebuilding and healing is in full swing, thanks to the huge outpouring of aid and assistance from all over the world, one cannot but pray and remain hopeful that there is always a way through which all of our efforts for the mother and her newborn will help sustain the nations’ future generation.
We consider the day a child is born to be a crucial day of critical and significant importance. It is our mandate to make sure that every hour of every day is a time of joy for mothers, their newborns and their families, no matter what.

Find more information on newborn health in emergencies on the Newborn Health in Emergencies Resource Page and the blogs below:

 


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