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Department of Health
Programs A-z, Monthly Health Events, Top 10 Causes of mortality and morbidity in the Philippines
RESPECTFULLY SUBMITTED TO: DR. AILEEN O. CAMANGEG, R.Ph. PCARE 101 INSTRUCTOR
SUBMITTED BY: JOYCE P. DELA CRUZ BS-PHARMACY I-B
2 Source:http://www.doh.gov.ph/health_programs_glossary
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Table of Contents
A
Adolescent and Youth Health Program (AYHP)
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B
Botika Ng Barangay (BnB)
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Breastfeeding TSEK
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Blood Donation Program
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C
Child Health and Development Strategic Plan Year 2001-2004
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CHD Scorecard
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Committee of Examiners for Undertakers and Embalmers
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Committee of Examiners for Massage Therapy (CEMT)
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Chronic Obstructive Pulmonary Disease Program
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Cardiovascular Disease Program
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D
Dental Health Program
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Diabetes Mellitus Prevention and Control Program
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E
Emerging and Re-emerging Infectious Disease Program
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Environmental Health
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Expanded Program on Immunization
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Essential Newborn Care
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F
Family Planning
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Food and Waterborne Diseases Prevention and Control Program
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G
Garantisadong Pambata
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H
Human Resource for Health Network
Health Development Program for Older Persons - (Bureau or Office: National Center for Disease Prevention and
Control )
Health Development Program for Older Persons - R.A. 7876 (Senior Citizens Center Act of the Philippines)
Health Development Program for Older Persons (Global Movement for Active Ageing (Global Embrace 1999))
Health Development Program for Older Persons - R.A. 7432 (An Act to Maximize the Contribution of Senior Citizens to
Nation Building, Grant Benefits and Special Privileges)
Health and Well-being of Older Persons
Healthy Lifestyle Program
I
Infant and Young Child Feeding (IYCF)
Iligtas sa Tigdas ang Pinas
Inter Local Health Zone
Integrated Management of Childhood Illness (IMCI)
K
Knock Out Tigdas 2007
L
Leprosy Control Program
LGU Scorecard
Licensure Examinations for Paraprofessionals Undertaken by the Department of Health
M
Malaria Control Program
Measles Elimination Campaign (Ligtas Tigdas)
N
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Natural Family Planning
National Filariasis Elimination Program
National Rabies Prevention and Control Program
Newborn Screening
National HIV/STI Prevention Program
National Mental Health Program
National Dengue Prevention and Control Program
National Prevention of Blindness Program
O
Occupational Health Program
P
Persons with Disabilities
Pinoy MD Program
Philippine Cancer Control Program
Province-wide Investment Plan for Health (PIPH)
Philippine Medical Tourism Program
Prevention and Control of Chronic Lifestyle Related Non Communicable Diseases
Provision of Potable Water Program (SALINTUBIG Program - Sagana at Ligtas na Tubig Para sa Lahat)
R
Rural Health Midwives Placement Program (RHMPP) / Midwifery Scholarship Program of the Philippines (MSPP)
S
Schistosomiasis Control Program
Soil Transmitted Helminth Control Program
Smoking Cessation Program
U
Urban Health System Development (UHSD) Program
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V
Violence and Injury Prevention Program
W
Women's Health and Safe Motherhood Project
Women and Children Protection Program
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Adolescent and Youth Health Program (AYHP)
A Situationer on Adolescents Health
Non-communicable diseases account for more than 40% of the deaths in young people (10-24 years old) and injuries are the causes of death in almost one third of people in this age group. Assault and transport accidents are the leading causes of mortality among young people with a mortality rate of 9.7 and 5.8 deaths per 100,000 populations, respectively (Philippine Health Statistics, 2003). Other significant causes of death among the 10-24 years old Filipinos include complications related to pregnancy, labor and puerperium; epilepsy; chronic rheumatic heart disease; intentional self harm; and accidental drowning and submersion (Philippine Health Statistics, 2003).Of the 1.67 M live births registered in 2003, 35.7% (596, 076 LB) were by women £24 years old. Teenage pregnancy accounted for 8% of all births (National Demographic Health Survey, 2003). Of the 1,798 maternal deaths registered for the same year, 22.3% were women £24 years old. The proportion of malnutrition among those 11 – 19 years of age (underweight and overweight) were noted to increase from 1993 to 2003 (FNRI Survey 1993, 1998 and 2003).About 4% of Filipinos 10 – 24 years of age have some form of disability. The most common of this are speaking and hearing disabilities.
MOST COMMON CAUSES OF DEATH AMONG 10-24 YEARS OLD PER 10,000 POPULATION. Philippine Health Statistics, 2003
Male Female Both
Rank Cause of Death No. Rate No. Rate No. Rate
1 Asssault 2,240 17.6 183 1.5 2,423 9.7
2 Transport Accidents 1,146 9.0 303 2.5 1,449 5.8 3 Event of undetermined intent 570 5.3 300 2.5 970 3.9
8 4
Symptoms, signs & abnormal clinical findings not elsewhere classified
602 4.7 352 2.9 954 3.8
5 Pneumonia 527 4.1 355 2.9 882 3.5
6 Tuberculosis of the Respiratory
System 537 4.2 340 2.8 877 3.5
7 Chronic Rheumatic Heart Disease 447 3.5 426 3.5 873 3.5 8 Accidental drowning and
submersion 596 4.7 215 1.7 811 3.2
9 Nephritis, nephrotic syndrome
and nephrosis 385 3.0 332 2.7 717 2.9
10 Other accidents & late effects of
transport/other accidents 518 4.1 113 0.9 631 2.5 Leading Threats to Adolescents Health
Accidents and other inflicted injuries
Among 10- 24 age groups, this threat caused 27% of the total deaths (2003 data). Young males always exclusively succumb to injuries and females have the increasing mortality due to complications of pregnancy, labor delivery and puerperium. These data have been on the uptrend, a challenge to community-based or DOH-led programs. The threat is caused by the adolescent‘s exposure to poorly maintained roads and poorly managed traffic systems. Adolescents‘ increased mobility to urban areas needs a corresponding physical and infrastructure support in their quest for better opportunities and education pursuits. Another is the inability of the state to provide adequate number of police personnel leading to an increasing number of assault and transport accidents among the young males.
Tuberculosis, Pneumonia, and Accidental drowning
Close to 6% of young Filipinos who died in 2003 died of various forms of tuberculosis, followed by pneumonia that caused 4% of deaths. This health issue among the young has been declining through the years due to sustained nationwide programs that began in 1987 and has somehow caused to keep deaths down, hence efforts to continue sustaining becomes the challenge.
The threat of HIV and other sexually – related diseases
Reported cases increased substantially increased over the past year. Among the 15-24 year olds, reported HIV infections nearly tripled between 2007 and 2008 from 41 cases to 110 per year, which is substantial cause for alarm. In 2009, 15-24 year olds make 29% of all new infections; in 2009, the number of new infections among 20-24 equals the number of new infections among 25-29; with 10 cases see July DOH AIDS Registry Report. The substantial increase from the past year can be traced from
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the adolescents‘ early engagement in health risk behavior, due to serious gaps of the knowledge on the dangers of drugs, as well as the cause as well as causes on the transmission of STD and HIV AIDS , dangers of indiscriminate tattooing and body- piercing and inadequate population education. Under this threat, young males are prone to engaging in health risk behavior and more young females are also doing the same without protection and are prone to aggressive or coercive behaviors of others in the community such that it often results to significant number of unwanted pregnancies,septic abortion and poor self-care practices.
In addition, there are also other less common but significant causes of disease and deaths namely;
Intentional self- harm –the 9th leading cause of death among 20-24 years old. In this age group, seven out of 10 who died of suicide were males. In age group of 10-24 years old took up 34% of all deaths from suicide in 2003
Substance Abuse - 15-19 years old group has the claim of drug use; more
males than females who are drug users and drug rehabilitation centers claim that majority of clients belong to age group of 25-29 years old. According to the SWS survey, 1996- 1.5M youth Filipinos and 1997- grew into 2.1M youth Filipinos are into substance abuse
Nutritional Deficiencies –there are no specific rates for adolescent and youth, but
there is the prevalence of anemia and vitamin A deficiency which may be also high for the adolescents and youth as those known for the younger and pregnant women.
Disability – Filipinos aged 10-24 years old has an overall disability prevalence of 4%.
The most common disability among this age group affected are speaking (35%), hearing (33%) and moving and mobility (22%)
There are also vulnerable Filipino adolescents which can be classified in their respective areas of vulnerability
VULNERABLE YOUNG FILIPINOS Sub-groups Vulnerability areas
Young among the street-dwellers
Common infections, physical abuse or assault, sexual exploitation, drug use, road accidents Out- of- school
adolescents and youth
High risk behavior; smoking, alcohol use, drug abuse, high risk sexual behavior, risky work conditions leading to injuries and diseases Urban –based male
youth
High risk behaviour; transport accidents , other inflicted injuries
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pregranancies, abortion, unsafe pregnancy and insecure motherhood
Not living with
parents or family Nutritional disorders, substance use and risky sexual behaviour, other inflcited injuries
Factors Causing Threats to Adolescents Health
The alarming patterns of health issues affecting adolescents health is caused by the following factors operating in a systemic manner reinforcing further complexities in the health issues affecting adolescents .
Socio-Cultural Factors Demographic Factors
Continuing Rapid Population Growth
The rapid population growth of the youth creates pressure to the state to expand education, health and employment forthis age group. The pressure creates an imbalance to the distribution and allocation of resources to various sectors especially the youth. The imbalance reinforces deeper the marginalization and deprivation of some sectors to basic services. A vicious cycle is created and more are having difficulties to access provision on health service delivery.
Increased population movement
The scarcity of local employment has triggered the participation of the youth in overseas work. The movement of the sector has caused displacement from families and love ones increase youth‘s vulnerability to exploitation, low paying jobs. According to a study in 2001, there were more than 6,000 workers in the teenage group overseas workers and it is most likely that they would land in overseas low paying work.
Attitudes, Lifestyles, Sense of Values, Norms and Behaviors of Adolescents Health Risk Behaviors
A significant proportion of young people engage in high-risk behaviors – 23% ever had pre- marital sex, 57% of first sex experience was unplanned and unplanned. About 70% - 80% of their most recent sexual experiences were unprotected (YAFS, 2002).
The 2002 Young Adult Fertility and Sexuality Survey showed that the proportion of 15-24 year olds who were currently smoking, drinking and using drugs were 20.9%, 41.4% and 2.4%, respectively. The proportion is higher among males compared to females. A comparative data (1994 and 2003) showed that among 15 – 24 year olds, smoking increased by 23%; drinking increased by 10%; drug use increased by 85%; and pre martial sex increased by 30% (YAFSS, 2003). The likelihood of engaging in pre-marital sex is higher among those who smoke, drink alcohol or take drugs. As a consequence of substance and alcohol abuse, some have mental and neurological
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disorders; others spend the productive years of their life behind bars with hardcore lawless adults.
Health Seeking Behavior
Adolescents are more likely to consult the health center (45%) or government physician (19%) for their health needs (Baseline Survey for the National Objectives for Health, 2000). The most common reasons for not consulting were the lack of money, lack of time, fear of diagnosis, distance and disapproval of parents. Dental examination and BP monitoring were the most common reasons for consultation (62.4% and 37.8%, respectively). Similarly, Conditions relating to pregnancy, childbirth and post partum were among the leading reasons for utilization of in-patient, emergency room and outpatient health services at DOH-Retained Tertiary General Hospitals.
Low Contraceptive Use
The overall use of contraception among sexually active adolescents is at 20%. Non- desire for pregnancy and high awareness of contraceptive methods were not enough to encourage adolescents to use contraceptives. Among the reasons cited for the low contraceptive use were:
Contraceptives were given only to married individuals of reproductive age
Even if they were made available to adolescents, the culture says that it is taboo for young unmarried individuals to avail of contraceptive services and commodities.
Condom use is perceived mainly for STIs, HIV/AIDS prevention rather than contraception
The practice Abortion and Unmet need for Contraception
In 2000, induced abortion among adolescents reached 319,000. This is due to the inadequate knowledge on preventing unwanted pregnancies. Consequences of teen-age pregnancies among young mothers include not being able to finish school and reduced employment options and opportunities. In addition, the social stigma and fear brought about by unwanted pregnancy pushes the young mother to resort to abortion. Although the disapproval rating for abortion remains to be high, there is an increasing trend among those who approve of it (from 4% to 6% in males and 3.5% to 4% in females).On contraceptive use , adolescents also don't use condoms for prevention of HIV,it's not only that they don't use them for contraception.
Risk of HIV/AIDS due to Unprotected Sex
Adolescents including children living in extreme conditions and great exposure to sexual exploitation and abuse belong to high-risk categories threatened by unprotected sex. Latest data on these shows that majority of people engaged in sex work are young and 70 % of HIV infections involve male-to-male sex. The proportion of young people reported to have STDs/HIV and AIDS is increasing. The YAFS survey
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showed that although awareness about STDs is increasing, misconceptions about AIDS appear to have the same trend. The proportion of those who think AIDS is curable more than doubled (from 12% in 1994 to 28% in 2002). Many adolescents also resort to services of unqualified traditional healers, obtain antibiotics from pharmacies or drug hawkers or resort to advices from friends (e.g. drinking detergent dissolved in water) without proper diagnosis to address problems of STDs. Improper or incomplete treatment may mask the symptoms without curing the disease increasing the risk of transmission and development of complications. The limited use of condoms to protect adolescents from risk of HIV is an issue to reflection for condom use is not only to prevent pregnancy but also preventing sexually transmitted disease. r The YAFS 2002 survey showed that Filipino males and females are at risk of STIs, HIV/AIDS. It was reported that 62 % of sexually transmitted infections affect the adolescents while 29 % of HIV positive Filipino cases are young people. In addition, it was revealed that thirty seven percent (37%) of Filipino males 25 years of age have had sex before they marry with women other than their wives. Some will have paid for sex while others will have had five or more partners.
Political and Economic Factors Marginalization and Poverty
The disturbing poverty situation of households and families where majority of the adolescents belong brings in difficulties to meet adolescents‘needs. Poverty is closely link to adolescent health issues. It reinforces to the situation of adolescents vulnerability to health risks due to the lack of access to various services and unsupportive social, political and economic environment. The following are some of the consequences of poverty faced by the youth.
Limited Access to Information -among the greatest challenges for Filipino youth
is access to correct and meaningful information on sexual and reproductive issues.
Limited access to services and commodities-The lack of access to contraceptive
services and supplies was among the most frequently articulated concerns with regard to adolescent SRH. Programs such as the AYHDP do recognize adolescents‘ need for access to contraception.
Limited awareness of pertinent policies-While the AYHP Administrative order
was issued in 2000, few key informants knew of its existence. In fact, many key informants said that no ARH policy existed at the time they were interviewed
Technological Factors
Rapid Advancement of Communication
The value of technological advancement could never be discounted. However, to the curious and adventurous adolescents various modes of communications are oftentimes abused and misused such as the use of internet and mobile phones. Adolescents then become vulnerable to exploitation, in cybersex and pornography exposing them deeper into risky behavior. In addition the digital dependence and addiction causes alienation of adolescents to personal and closer mode of communication resulting to a distorted image of the adolescents relationships to the
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social environment. This also deprives the adolescents from productive activities where they can develop themselves fully grown up and mature e economic and social being Moreover, communicationadvancement has also produced advertisements and television commercials whose image are not adolescent- friendly are paving the way for so much consumerism, distorted personal and family values
THE ADOLESCENTS HEALTH PROGRAM IN THE PHILIPPINES 8. International Policies, Passages and Laws as anchors
In International Laws
UN Convention on the Rights of Children
UN Convention the Action for the Promotion and Protection of the health of adolescents
Convention on the Elimination of all forms of discrimination againts women
1994 International Conference on Populaiton and Development ( ICPD)
1995 Fourth World Conference on Women
World Programme of Action for Youth 2000
MDG Goals :
Goal 2:Achieve Universal Primary Education
Goal 3:Promote Gender Equality
Goal 4 : Reduce Child Mortality
Goal 5: Improve Maternal Health
Goal 6:Combat HIV/AIDS, Malaria and other diseases National Laws and Policies
o National Objectives for Health o Fourmula One for Health
o Adolescent and Youth Health Policy (AYH)
o Adolescent and Youth Health and Develoment Program o National Directional Plan for reaching the Un reahced Youth Population
o Reproductive Health Program AO#1 s1998 o Local Government Code
WHO, together with countries and areas in the Region and partner agencies, are working to promote healthy development of adolescents and reduce mortality and morbidity. In the Western Pacific Region, several technical units are working to implement interventions that improve adolescent health in the Region. The Philippines belong to the Western Pacific Region and is committed to:
Recognize adolescents as ‗vulnerable and a ‗group in need‘ o Address Issues that have an evidence base o Socio- Cultural perspectives
o Develop Innovative mechanisms to reach out to adolescents. o Encourage collaboration and partnerships
o Program implementation is monitored and evaluated.
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The Adolescents Youth and Heath Development Programs were established in 2001 under the oversight of the Department of Health in partnership with other government agencies with adolescent concerns and other stakeholders. The program is targeting youth ages 10–24, and the program provides comprehensive implementation guidelines for youth-friendly comprehensive health care and services on multiple levels—national, regional, provincial/city, and municipal.
The program is solidly anchored on International and laws, passages and polices meant to address adolescent‘s health concerns. It is operating then within the facets and adolescents and youth health that includes disability, mental and environmental health, reproductive and sexuality, violence and injury prevention and among others.
It employed strategies to ensure integration of the program into the health care system in addition, broader society such as building a supportive policy environment, intensifying IEC and advocacy particularly among teachers, families, and peers, building the technical capacity of providers of care, and support for youth; improving accessibility and availability of quality health services, strengthening multi-sectoral partnerships, resource mobilization, allocation and improved data collection and management.
The program to address sexual and reproductive health issues likewise adopts gender-sensitive approaches. The primary responsibility for implementation of the AYHDP, and its mainstreaming into the health system, falls to regional and provincial/city sectors. Guidelines cover service delivery, IEC, training, research and information collection, monitoring and evaluation, and quality assurance.
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Botika Ng Barangay (BnB)
I. What is Botika ng Barangay?
Botika ng Barangay (BnB) - refers to a drug outlet managed by a legitimate community organization (CO) / non-government organization (NGO) and/or the Local Government Unit (LGU), with a trained operator and a supervising pharmacist specifically established in accordance with this Order. The BnB outlet should be initially identified, evaluated and selected by the concerned Center for Health Development (CHD), approved by the PHARMA 50 Project Management Unit (PMU) and specially licensed by the Bureau of Food and Drugs (BFAD) to sell, distribute, offer for sale and/or make available low-priced generic home remedies, over-the-counter (OTC) Drugs and two (2) selected, publicly-known prescription antibiotics drugs (i.e. Amoxicillin and Cotrimoxazole).
The establishment of the Botika ng Barangay (BnB) in the communities, including the insurgent areas, ensures accessibility of low-priced generic over-the-counter drugs and eight (8) prescription drugs as recommended by the National Drug Formulary Committee. Under Memorandum # 31 and its amendment, as much as 40 essential medicines that address common diseases can be made available in BnBs depending on the morbidity and mortality profiles of the community. And the policies surrounding the BnB (AO 144) ensure that such can be sustained in the medium term.
II. Objectives
The objectives of this Order are as follows:
1. To promote equity in health by ensuring the availability and accessibility of affordable, safe and effective, quality essential drugs to all, with priority for marginalized, underserved, critical and hard to reach areas.
2. To integrate all related issuances of the DOH that provides rules and regulations in the establishment and operations of BnBs; and
3. To define the roles and responsibilities of the different units of the DOH and other partners from the different sectors in facilitating and regulating the establishment of BnBs.
III. Status of the Program
Variants of the BnBs include Botika Binhi (funded by the members of the Peso for Health with counterpart from the local government unit), Health Plus (funded by the GTZ), Botika sa Parokya (funded by DOH and Office of the President) and the Botika ng Bayan (BNB) express under PITC/ PITC Pharma Inc. At present, about 16,350 BnB outlets have been established in the country.
The initial target was to establish 1 BnB to serve 3 adjacent Barangays. However, due to the immensity of Barangays, and the need for more than 1 BnB in some poor adjacent barangays to better provide for the service, the target were changed to 1:1. Since absorptive capacity for the DOH-CHDs to establish BnBs is also limited due to resource and time constraints, the initial phasing of the target to achieve 1:1 is being done. Thus, for the next two (2) years, the target would be initially 1:2 except for
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select areas that have high poverty incidence, conflict or Geographically isolated areas, and the like where the target would be 1:1.
Sourcing of medicines for the initial seed capital of these medicines is done through PITC Pharma Inc.
Issuances about Botika ng Barangay
Issuances Date Title
Department Memorandum No. 2011-0022
January 26, 2011
Moratorium on the Establishment of Botika ng Barangay (BnB) Nationwide Department Memorandum
No. 2010-0033
February 12, 2010
Submission of Reports for the Impact Assessment of Maximum Drug Retail Price (MDRP) / Government
Department Memorandum No. 2008-0038
February 21, 2008
Amendment to Memorandum No. 31 s. 2003 dated 17 February 2003 re: Drugs to be sold in Botika ng Barangays
(BnBs) Department Memorandum
No. 2005-0046
April 5, 2005
Utilization of Slow-Moving Pharma 50 Botika ng Barangay (BnB) Drugs and Medicines
Administrative Order No. 2005-0011
April 4, 2005
Supplemental Guidelines to Administrative Order No. 144 series 2004, entitled: "Guidelines for the Establishment and Operations of Botika ng Barangays (BnB) and Pharmaceutical Distribution Network (PDNs)" relative to the inclusion of other drugs which are classified as Prescription Drugs and other related matters
Department Memorandum No. 118 s. 2004
November 22, 2004
Botika ng Barangay Performance Monitoring Reports and Routine Schedule of Submissions
Administrative Order No. 144 s. 2004
April 14, 2004
Guidelines for the Establishment and Operations of Botika ng Barangays (BnB) and Pharmaceutical Distribution Network (PDNs)
Memorandum No. 31 s. 2003
February 17, 2003
Drugs to be sold in Botika ng Barangays (BnBs)
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Breastfeeding TSEK
On February 23, 2011, the Department of Health (DOH) launched the exclusive breastfeeding campaign dubbed ―Breastfeeding TSEK: (Tama, Sapat, Eksklusibo)‖. The primary target of this campaign is the new and expectant mothers in urban areas.
This campaign encourages mothers to exclusively breastfeed their babies from birth up to 6 months. Exclusive breastfeeding means that for the first six months from birth, nothing except breast milk will be given to babies.
Moreover, the campaign aims to establish a supportive community, as well as to promote public consciousness on the health benefits of breastfeeding. Among the many health benefits of breastfeeding are lower risk of diarrhea, pneumonia, and chronic illnesses.
Blood Donation Program
Republic Act No. 7719, also known as the National Blood Services Act of 1994, promotes voluntary blood donation to provide sufficient supply of safe blood and to regulate blood banks. This act aims to inculcate public awareness that blood
donation is a humanitarian act.
The National Voluntary Blood Services Program (NVBSP) of the Department of Health is targeting the youth as volunteers in its blood donation program this year. In accordance with RA No. 7719, it aims to create public consciousness on the
importance of blood donation in saving the lives of millions of Filipinos.
Based from the data from the National Voluntary Blood Services Program, a total of 654,763 blood units were collected in 2009. Fifty-eight percent of which was from voluntary blood donation and the remaining from replacement donation. This year, particular provinces have already achieved 100% voluntary blood donation. The DOH is hoping that many individuals will become regular voluntary unpaid donors to guarantee sufficient supply of safe blood and to meet national blood necessities.
Mission:
Blood Safety
Blood Adequacy
Rational Blood Use
Efficiency of Blood Services
Goals:
The National Voluntary Blood Services Program (NVBSP) aims to achieve the following:
1. Development of a fully voluntary blood donation system;
2. Strengthening of a nationally coordinated network of BSF to increase efficiency by centralized testing and processing of blood;
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3. Implementation of a quality management system including of Good Manufacturing Practice GMP and Management Information System (MIS); 4. Attainment of maximum utilization of blood through rational use of blood products and component therapy; and
5. Development of a sound, viable sustainable management and funding for the nationally coordinated blood network.
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Child Health and Development Strategic Plan Year 2001-2004
Introduction
The Philippine National Strategic Framework for land Development for Children or CHILD 21 is a strategic framework for planning programs and interventions that promote and safeguard the rights of Filipino children. Covering the period 2000-2005, it paints in broad strokes a vision for the quality of life of Filipino children in 2025 and a roadmap to achieve the vision.
Children's Health 2025, a subdocument of CHILD 21, realizes that health is a critical and fundamental element in children's welfare. However, health programs cannot be implemented in isolation from the other component that determines the safety and well being of children in society. Children's Health 2025, therefore, should be able to integrate the strategies and interventions into the overall plan for children's development.
Children's Health 2025 contains both mid-term strategies, which is targeted towards the year 2004, while long-term strategies are targeted by the year 2025. It utilizes a life cycle approach and weaves in the rights of children. The life cycle approach ensures that the issues, needs and gaps are addressed at the different stages of the child's growth and development.
The period year 2002 to 2004 will put emphasis on timely diagnosis and management of common diseases of childhood as well as disease prevention and health promotion, particularly in the fields of immunization, nutrition and the acquisition of health lifestyles. Also critical for effective planning and implementation would be addressing the components of the health infrastructure such as human resource development, quality assurance, monitoring and disease surveillance, and health information and education.
The successful implementation of these strategies will require collaborative efforts with the other stakeholders and also implies integration with the other
developmental plan of action for children.
Vision
A healthy Filipino child is:
Wanted, planned and conceived by healthy parents carried to term by healthy mother born into a loving, caring, stable family capable of providing for his or her basic needs, delivered safely by a trained attendant
Screened for congenital defects shortly after birth; if defects are found,
interventions to correct these defects are implemented at the appropriate time
Exclusively breastfed for at least six months of age, and continued breastfeeding up to two years, introduced to complementary foods at about six months of age, and gradually to a balanced, nutritious diet, protected from the consequences of protein-calorie and micronutrient deficiencies through good nutrition and access to fortified foods and iodized salt
Provided with safe, clean and hygienic surroundings and protected from accident, properly cared for at home when sick and brought timely to a health facility for appropriate management when needed. Offered equal access to good quality
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curative, preventive and promotive health care services and health education as members of the Filipino society
Regularly monitored for proper growth and development, and provided with adequate psychosocial and mental stimulation, screened for disabilities and developmental delays in early childhood; if disabilities are found, interventions are implemented to enabled the child to enjoy a life of dignity at the highest level of function attainable
Protected from discrimination, exploitation and abuse
Empowered and enabled to make decisions regarding healthy lifestyle and
behaviors and included in the formulation health policies and programs, afforded the opportunity to reach his or her full potential as adult
Current Situation
Deaths among children have significantly decreased from previous years. In the 1998 NDHS, the infant mortality rate was 35 per 1000 live births, while neonatal death rate was 18 deaths per 1000 live births. Among regions IMR is highest in Eastern Visayas and lowest in Metro Manila and Central Visayas. Death is much higher among infants whose mothers had no antenatal care or medical assistance at the time of delivery. Top causes of illness among infants are infectious diseases (pneumonia, measles, diarrhea, meningitis, and septicemia), nutritional deficiencies and birth-related complications.
The probability of dying between birth and five years of age is 48 deaths per 1000 live births. The top five leading causes of deaths (which make up about 70%) of deaths in this age group) are pneumonia, diarrhea, measles, meningitis and malnutrition. About 6% die of accidents i.e. submersion, foreign bodies, and vehicular accidents.
The decline in mortality rates may be attributed partly to the Expanded Program of Immunization (EPI), aimed to reduce infant and child mortality due to seven immunizable diseases (tuberculosis, diptheria, tetanus, pertusis, poliomyelitis, Hepatitis B and measles).
The Philippines has been declared as polio-free during the Kyoto Meeting on Poliomyelitis Eradication in the Western Pacific Region last October 2000. This however, is not a reason to be complacent. The risk of importing the poliovirus from neighboring countries remains high until global certification of polio eradication. There is an urgent need for sustained vigilance, which includes strengthening the surveillance system, the capacity for rapid response to importation of wild poliovirus, adequate laboratory containment of wild poliovirus materials, and maintaining high routine immunization until global certification has been achieved.
Malnutrition is common among children. The 1998 FNRI survey show that three to four out of ten children 0-10 years old are underweight and stunted. The prevalence of low vitamin A serum levels and vitamin A deficiency even increased in 1998 compared to 1996 levels as reported by FNRI. Vitamin A supplementation coverage reached to more than 90%, however, a downward trend was evident in the succeeding years from as high as 97% in 1993 to 78% in 1997.
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Breastfeeding rate is 88% (NSO 2000 MCH Survey), with percentage higher in rural areas (92%) than in urban areas (84%). Exclusive breastfeeding increased from 13.2% to 20% among children 4-5 mos. of age (NDHS).
Several strategies were utilized to improve child health. The Integrated Management of Childhood Illness aims at reducing morbidity and deaths due to common childhood illness. The IMCI strategy has been adopted nationwide and the process of integration into the medical, nursing, and midwifery curriculum is now underway.
The Enhanced Child Growth strategy is a community-based intervention that aims to improve the health and nutritional status of children through improved
caring and seeking behaviors. It operates through health and nutrition posts established throughout the country.
Gaps and Challenges
Many Local Health Units were not adequately informed about the Framework for Children's Health as well as the policies. There is a need to disseminate the two
documents, CHILD 21 and Children's Health 2025 to serve as the template for local planning for children‘s health. There is also the need to update and reiterate the policies on children's health particularly on immunization, micronutrient
supplementation and IMCI.
LGUs experienced problems in the availability of vaccines and essential drugs and micronutrients due to weakness in the procurement, allocation and distribution. Pockets of low immunization coverage are attributed largely to the irregular supply of vaccines due to inadequate funds. Moreover, there is a need to revitalize the promotion of immunization.
Goal
The ultimate goal of Children's Health 2025 is to achieve good health for all Filipino children by the year 2025.
Medium-term Objectives for year 2001-2004 Health Status Objectives
1. Reduce infant mortality rate to 17 deaths per 1,000 live births
2. Reduce mortality rate among children 1-4 years old to 33.6% per 1000 live births
3. Reduce the mortality rate among adolescents and youths by 50%
Risk Reduction Objectives
1. Increase the percentage of fully immunized children to 90%
2. Increase the percentage of infants exclusively breastfed up to six months to 30%
3. Increase the percentage of infants given timely and proper complementary feeding at six months to 70%
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home management of childhood illness to 80%
5. Reduce the prevalence of protein-energy malnutrition among school-age children
6. Increase the health care-seeking behavior of adolescents to 50%
Services and Protection Objectives
1. Ensure 90% of infants and children are provided with essential health care package
2. Increase the percentage of health facilities with available stocks of vaccines and essential drugs and micronutrients to 80%
3. Increase the percentage of schools implementing school-based health and nutrition programs to 80%
4. Increase the percentage of health facilities providing basic health services including counseling for adolescents and youth to 70%
Strategies and Activities
Enhance capacity and capability of health facilities in the early recognition, management and prevention of common childhood illness
This will entail improvements in the flow of services in the implementing facilities to ensure that every child receive the essential services for survival, growth and development in an organized and efficient manner. Facilities should be equipped with the essential instruments, equipment and supplies to provide the services. Health providers shall have the knowledge and skills to be able to provide quality services for children. Existing child health policies, guidelines and standards shall be reviewed and updated, and new ones formulated and disseminated to guide health providers in the standard of care.
Strengthening community-based support systems and interventions for children's health
Notable community-based projects and interventions, such as the health and nutrition posts, mother support groups, community financing schemes shall be replicated for nationwide implementation. Model building and dissemination of best practices from pilot sites has proven effective in generating support and adoption in other sites. More of these shall be initiated particularly for
developing interventions to increase care-seeking and prevention of malnutrition in children.
Fostering linkages with advocacy groups and professional organizations and to promote children's health
Collaboration with the nongovernment sector and professional groups shall: Conduct national campaigns on children's health
Conduct and support national campaigns for children
Initiate and support legislations and researches on children's health and welfare
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Development of comprehensive monitoring and evaluation system for child health programs and projects
CHD Scorecard
CHD Scorecard shall reflect performance of the CHD as extension producers of the DOH in its mandate and function of steering and leading the national health system. Performance indicators shall include extent and quality of goods and services desired by the local health systems in the regional coverage area, and prescribed by DOH management, along the 4 main strategies of F1. Performance indicators shall also include satisfaction of clients with CHD services and products.
Committee of Examiners for Undertakers and Embalmers
RationaleEmbalming is the funeral custom of cleaning and disinfecting bodies after death. It has been part of the funeral parlors so with our lives. For the past decades, embalming has been undergoing profound transformational events, not only in the Philippines but worldwide. Today, embalming is also considered an art. It is done to preserve the dead body from natural decomposition and for restoration for a more pleasing appearance. Likewise, the procedure is significant for restoration of evidences such as in medico-legal cases.
These changes were made possible by the multitudes of forces converging in the national as well as the local levels, which is impacting on the quality of embalming practice in the country. Embalmers today should therefore, be looked up to, because of the significant manifold tasks they are rendering including the counseling assistance they are providing the bereaved parties.
Objective:
The Department of Health (DOH) created the CEUE to regulate embalming practice
in the country. The creation was made possible by Presidential Decree (PD) No. 856
"Code of Sanitation of the Philippines" Chapter XXI "Disposal of Dead Persons" and Executive Order No. 102 s. 1999 "Rationalization and Streamlining Plan of the DOH".
Strategies:
To ensure that only qualified individuals enter the regulated profession and that the care and services which the embalmers provide are within the standards of practice, the DOH-CEUE created:
1. CEUE Resolution No. 2011-001 - Three Year Transition Period for Compliance of Administrative Order No. 2010-0033.
2. Memorandum dated August 10, 2010 - to the Centers for Health Development (CHDs) Human Resource Development Units (HRDUs) regarding Updates on the Committee of Examiners for Undertakers and Embalmers (CEUE) Program.
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3. Administrative Order No. 2010-0033 - Revised Implementing Rules and Regulations of PD 856 Chapter XXI Governing Disposal of Dead Persons
4. CEUE Resolution No. 2010-001 - Adoption of the Code of Ethics for Embalmers in the Philippines
5. CEUE Resolution No. 2009-001 - Creation of the Committee for Continuing Embalmers Education Council (CEEC)
6. CEUE Resolution No. 2008-001 - Conduct of Licensure Examination for Embalmers in Centers for Health Development (CHDs) to conduct a simultaneous licensure examination in the Central Office and the CHDs with a minimum of 50 examinees for cost effectiveness.
7. Department Memorandum No. 2008-0009 - Designation of DOH Human Resource Development Units (DOH-HRDUs) as Coordinators for Embalmers Program" to facilitate immediate response to queries and complaints regarding the embalming practice.
8. CEUE Resolution No. 2008-001 - Accredited Training Institutions and Training Providers for Embalmers for CY 2008-2011 to regulate existing and potential training providers and training institutions for embalmers for the enhancement and maintenance of its professional standards.
9. CEUE Resolution No. 2008-002 - Extension of Moratorium as per CEUE Resolution No. 2007-001.
10. CEUE Resolution No. 2007-001 - Moratorium on the Non-renewal of Licenses of Embalmers for the past five (5) years and over with the aim of providing chance to licensed embalmers who were unable tio renew their licenses for the past five years and over.
11. Administrative Order No. 2007-0020 - Policies and Guidelines for the Accreditation of Training Institutions, Training Programs and Training Providers for Embalmers in the Philippines with the aim of institutionalizing the continuing education program for embalmers in the country. Hence, to ensure the maintenance of efficient, ethical and technical, moral and professional standards in its practice, taking into account the quality of care to be rendered to respective clientele. At the same time, the regulation ensures the global competitiveness of the Filipino embalmers.
12. Department Circular No. 2007-0139 - Reiteration on the observance of precautionary measures in the disposal of dead persons.
Chapter XXI "Disposal of Dead Persons" mandate the CEUE to monitor and enforce quality standards of embalming practice in the Philippines and exercise the powers necessary to ensure the maintenance of efficient, ethical and technical, moral and professional standards in its practice, taking into account the quality of care to be rendered to respective clientele. At the same time, the regulations ensure the global competitiveness of the Filipino embalmers.
Program Status
Nationwide information dissemination of the following:
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Curriculum for licensure examinations
Manuals for Licensure Examinations
Code of Ethics
1. March 25, 2011 - National Capital Region 2. May 3, 2011 - Visayas Region (Iloilo City)
3. May 13, 2011 - Mindanao Regions (Cagayan de Oro City) 4. June 30, 2011 - Butuan City (upon request)
5. August 25, 2011 - Aklan (upon request)
Committee of Examiners for Massage Therapy (CEMT)
RationaleTraditional medicine throughout the world recognizes the significance of therapeutic massage in managing stress, illness or chronic ailments. Massage therapy is considered the oldest method of healing that applies various techniques like fixed or movable pressure, holding, vibration, rocking, friction, kneading and compression using primarily the hands and other areas of the body such as the forearms, elbows or feet to the mascular structure and soft tissues of the body.
Massage therapy can lead to significant biochemical, physical, behavioral and clinical changes in massage as well as the person giving the massage. It contributes to a higher sense of general well-being. Recognizing this, many healthcare professionals have begun to incorporate massage therapy as a complement to their routine clinical care. Efficacy of massage therapy in patient ranges from pretern neonates to senior citizens. Although the country has the training standards and regulations through the Technical Education and Skills Development Authority (TESDA), it lacks control / regulations over the training institutions, thus, anyone who calls himself/herself a massage therapist is one, regardless of training or experience.
Objective:
The Department of Health created the Committee of Examiners for Massage Therapy (CEMT) to regulate the practice of massage therapy in accordance to the provisions of the Sanitation Code of the Philippines (PD 856) and Executive Order No. 102 s. 1999, Reorganization and Streamlining of the Department of Health. It provides the CEMT the function to ensure that only qualified individuals enter the regulated profession and that the care and services which the massage therapists provide are within the standards of practice.
Strategies:
To ensure that only qualified individuals enter the regulated profession and that the care and services which the massage therapists provide are within the standards of practice, the DOH-CEMT created:
1. CEMT Resolution No. 2011-001 - Three-Year Transition Period for Compliance to Administrative Order No. 2010-0034.
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2. Memorandum dated August 10, 2010 - to the Centers of Health Development (CHDs) Human Resource Development Units (HRDUs) regarding Updates on the Committee of Examiners for Massage Therapy (CEMT) Program
3. Administrative Order No. 2010-0034 - Revised Implementing Rules and Regulations of PD 856 Chapter XIII Governing Massage Clinics and Sauna Establishments
4. CEMT Resolution No. 2010-001 - Adoption of the Code of Ethics for Massage Therapists in the Philippines.
5. CEMT Resolution No. 2009-001 - Creation of Committee for Continuing Massage Therapy Education Council (CMTEC)
6. CEMT Resolution No. 2008-001 - Conduct of Licensure Examination for Massage Therapists in Centers for Health Development (CHDs) to conduct a simultaneous licensure examination in the Central Office and the CHDs with a minimum of 50 examinees for cost effectiveness.
7. Department Memorandum No. 2008-0009 - Designation of DOH Human Resource Development Units (DOH-HRDUs) as Coordinators for Massage Therapy Program to facilitate immediate response to queries and complaints regarding the massage therapy practice.
8. CEMT Resolution No. 2008-001 - Accredited training institutions and training providers for massage therapists for CY 2008-2011 to regulate existing and potential training providers and training institutions for massage therapists for the enhancement and maintenance of its professional standards.
9. CEMT Resolution No. 2008-002 - Extension of Moratorium as per CEMT Resolution No. 2008-001
10. CEMT Resolution No. 2008-001 - Moratorium on the Non-Renewal of Licenses for Embalmers for the past five (5) years and over with the aim of providing chance to licensed embalmers who were unable to renew their licenses for the past five years and over
11. Administrative Order No. 2008-0031 - Policies and Guidelines for the Accreditation of Training Institutions, Training Programs and Trainining Providers for Massage Therapists in the Philippines with the aim of institutionalizing the continuing education program for massage therapists in the country. Hence, to ensure the maintenance of efficient, ethical and technical, moral and professional standards in its practice, taking into account the quality of care to be rendered to respective clientele. At the same time, the regulation ensures the global competitiveness of the massage therapists.
Chapter XIII "Massage Clinics and Sauna Establishments mandate the CEMT to monitor and enforce quality standards of massage therapy practice in the Philippines and exercise the powers necessary to ensure the maintenance of efficient, ethical and technical, moral and professional standards in its practice, taking into account the quality of care to be rendered to respective clientele. At the same time, the regulations ensure the global competitiveness of the Filipino massage therapists.
Program Status
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Administrative Order No. 2010-0034 (Massage Clinics and Sauna Establishments)
Curriculum for Licensure Examinations
Manuals for Licensure Examinations
Code of Ethics
1. March 25, 2011 - National Capital Region 2. May 3, 2011 - Visayas Regions (Iloilo City)
3. May 13, 2011 - Mindanao Region (Cagayan de Oro City) 4. June 30, 2011 - Butuan City(upon request)
5. August 25, 2011 - Aklan (upon request)
Chronic Obstructive Pulmonary Disease Program
I. Rationale:
Respiratory conditions impose an enormous burden on society. According to the WHO World Health Report 2000, the top five respiratory diseases account for 17.4% of all deaths and 13.3% of all Disability Adjusted Life Years (DALYs). Lower respiratory tract infections, chronic obstructive pulmonary disease (COPD), tuberculosis and lung cancer are among the leading 10 causes of death worldwide. Based partly on demographic changes in the developing world, but also on the changes in health care systems, schooling, income and tobacco use, the burden of communicable diseases is likely to lessen while the burden of chronic respiratory diseases (CRDs) including asthma, COPD, and Lung Cancer will worsen because of tobacco use and population ageing.
COPD (CRD) is a major public health problem in the Philippines today. It occupies 7th among the latest list of top 10 causes of mortality. Significantly, the mortality trend in the last 3 decades shows a shift from acute infectious illness to chronic degenerative diseases. This is also true in the etiology of COPD.
No large local study has been done to determine the prevalence of COPD in the Philippines. So far, estimates have been based primarily on morality statistics. These provide misleading figures because COPD is underdiagnosed and often not listed either as primary or contributory cause of death. A spirometry based study in 1997 in a rural community found irreversible airway obstruction in 3.7% of the population. Proceeding from an Asia-Pacific regional workshop in 2000 cited the prevalence of COPD in the Philippines as 6.3%.
In 1998, International Study of Asthma and allergies in Childhood (ISAAC) survey reported the prevalence of asthma among 13-14 years old in the Philippines at 11.6% this level increased in the recently concluded WHO-funded National Asthma Epidemiology Survey (NAES) where the prevalence of definite asthma was placed at 4.3% in adults and 28.1% and 12.9% in children aged 13-14 and 6-7 years respectively. In all, among the respondents found to have asthma by the expert panel, about 33% of the children aged 6-7 years, 72% of school children and 28% of adults did not report prior knowledge of Doctor-diagnosed asthma to explain their
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symptoms. Prevalence and occurrence of Chronic respiratory diseases is likely to increase and the extent of mortalities and financial cost necessitates a decisive plan of action-both preventive and therapeutic. A national program supported by the government, the scientific community, non-government organizations and people‘s organization is probably the optimal strategic approach to achieve a control of the rising prevalence of CRDs.
A. Policy Statement:
The prevention and control of chronic lifestyle related non communicable diseases shall be guided by the following policy statements.
1. The country shall adopt an integrated, comprehensive and community based response for the prevention and control of chronic, lifestyle related NCDs.
2. Health promotion strategies shall be intensified to effect changes that would lead to a significant reduction in mortality and morbidity due to chronic lifestyle related NCDs.
3. Complementary accountabilities of all stakeholders must be ensured and actively pursued in the implementation of an integrated, comprehensive and community based response to chronic, lifestyle- related NCDs.
B. Objectives:
1. Decrease of morbidity and Mortality
2. Decrease in the economic burden of CVDs to the individual, family and community.
Vision: Improved quality of life for all Filipinos.
Mission: To ensure that quality prevention and control and LRD services are accessible to all, especially to the vulnerable and at-risk population.
II. Scenario
A. Global Situation
The leading causes of NCD deaths in 2008 were: cardiovascular diseases (17 million deaths, or 48% of NCD deaths); cancers (7.6 million, or 21% of NCD deaths); and respiratory diseases, including asthma and chronic obstructive pulmonary disease (COPD), (4.2 million). Diabetes caused an additional 1.3 million deaths. Over 80% of cardiovascular and diabetes deaths, and almost 90% of deaths from COPD, occurred in low- and middle-income countries. Behavioral risk factors, including tobacco use, physical inactivity, and unhealthy diet, are responsible for about 80% of coronary heart disease and cerebrovascular disease. These important
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behavioral risk factors of heart disease and stroke are discussed in detail later in this chapter.
Referenced from: WHO-Global Status Report on Non-Communicable Diseases 2010
B. Local Situation:
Seven (7) out of 10 leading causes of mortality (death) are to Non-Communicable Diseases.
1st: Diseases of the Heart (CAD)
2nd: Diseases of the Vascular System (Stroke) 3rd: Malignant Neoplasm (Cancer)
4th: Injuries (Accidents)
7th: Chronic Obstructive Pulmonary Disease (COPD) 10th: Nephritis, Nephrotic Syndrom
Referenced from: NEC, Department of Health
III. Strategies implemented by DOH
Adopted in the context of health promotion in order to decrease the chances of the targeted population to adopt high risk behaviors and habits that may lead to the development of COPD.
Will be implemented by setting: Community-Based
School-Based Industry-Based Hospital-Based
Training, Research, Environmental support system are important components of the progress.
IV. Status of Implementation/Accomplishment
Program is well in place and its implementation is continuous from the community level (IEC) and screening Hospital (Definitive Diagnosis and treatment and rehabilitation.
Development of Administrative Order on the National Policy on the Integrated Chronic Non-Communicable Disease Registry System (Cancer, Stroke, DM, and COPD).
1st Public Hearing on the Administrative Order on the National Policy on the Integrated Chronic Non-Communicable Disease Registry System (Cancer,
Stroke, DM, and COPD) with CHD-NCR, Government and Private Hospitals and Non-Government Agencies.
Trained Hospitals for the Registry System entitled ―Users‘ training for the Unified Registry System‖.
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Trained CHDs for the Registry System entitled ―Users‘ training for the Unified Registry System‖ (Non-Communicable Diseases).
Establishment of Philippine Coalition on the Prevention and Control of NCD. A Training Manual for Health Workers on Promoting Healthy Lifestyle.
(Non-Communicable Diseases).
Twenty Years of Non-communicable Diseases (NCD) Prevention and Control in the Philippines (1968-2006).
Healthy Lifestyle Advocacy Campaign.
Manual of Operations on the Prevention and Control Lifestyle-Related Non-Communicable Diseases in the Philippines.
Training Manual for Health Workers: WHO/DOH Smoking Cessation Clinic: Helping Smokers Quit.
V. Future Plan/Action:
Implement the program through the institutionalized integrated program of NCD-Lifestyle related diseases control program.
Development of Service Package for Chronic Obstructive Pulmonary Disease (COPD)
Development of Clinical Practice Guideline for COPD.
Development of Strategic Framework and a five Year Strategic Plan for COPD (2012-2016).
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Cardiovascular Disease Program
I. Rationale:
Cardiovascular diseases (CVD),cancers, chronic respiratory diseases and diabetes (DM) are among the top killers in the Philippines, causing more than half of all deaths annually. Hypertension and diseases of the heart are among the ten leading causes of illnesses each year. These diseases are collectively known as Lifestyle Related Non-Communicable Diseases (NCDs), as defined in the National Objectives for Health 2005-2010, particularly because these diseases have common risk factors which are to a large extent related to unhealthy lifestyle.
The risk factors involved are tobacco use, unhealthy diet, physical inactivity and alcohol use. The Food and Nutrition Research Institute (FNRD National Nutrition and Health Surveys in 1998 to 2008 (Acuin and Duante, 2010) showed that there is increasing prevalence in the associated risk factors between 1998 to 2008: hypertension from 2l%o to 25.3 %; diabetes from 3.9%o to 4.8%; among adults who are overweight, there has been a significant increase from 24.2% to 26.60/o; and those with high blood cholesterol levels had increased from 4Yo to 10.2%. Furthermore, the study found out that the following groups are at risk for NCDs: age group from the 40's onwards and those with Body Mass Index (BMI) > 23, dyslipidemia, high waist circumference and waist hip ratios. Moreover, dietary intake trends show increasing consumption of energy dense foods high in fats and sugars, while almost the entire adult population has low levels of physical activity in all domains: occupation, non-occupation, leisure, transportation.
Children and adolescents are also exposed to the above-mentioned risks. Latest data from the Global Adult Tobacco Survey in 2009 shows prevalence of tobacco use (current smokers) among population 15 years old and above tobe28.3%o (17.3 million Filipinos); 47.7% of these are men (14.6 million) and 9%o are women (2.8 million). On the other hand, the prevalence of overweight among adolescents 9-11 years old has increased two folds from 2.4oh in 1993 to 4.8%;oin2005. Similarly, the prevalence rate of overweight for children 6-10 years old doubled from 0.8% in 2001 to 1.6%o in 2005. (Source: Philippine Nutrition Facts and Figures 2005). About 30Yo of teenage students are physically inactive, spending three or more hours per day sitting and watching television, playing computer games, talking with friends, or doing other sitting activities. (Source: Philippines Global School-based Student Health Survey, 2007). And, data shows that in 2008 hazardous alcohol intake stands at26.90/o (FNRI-NNHeS 2008).
The Philippine Renal Disease Registry (PRDR) illustrates that for 2009, diabetic nephropathy, a complication of diabetes remained the most common etiology of end stage renal disease while clinical hypertensive nephrosclerosis, a complication of hypertension ranked as the second most common etiology of end stage renal disease. Unless something is done to control these non-communicable diseases, renal complications will escalate to a degree that will compromise the current capacity to care for these types of patients.
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The cost of care of lifestyle-related non-communicable diseases may cause people to fall into poverty and create a downward spiral of worsening poverty and illness. They also undermine the country's economic development. In response to the increasing prevalence of lifestyle related diseases in the country, vertical programs on the prevention and control of cardiovascular diseases, cancers and diabetes were put in place in the mid 1990's. The individual programs however, were focused on treatment and management of those who were already sick and thus were competing with each other for resources and for attention upon field implementation.
A. Policy Statement:
The prevention and control of chronic lifestyle related non communicable diseases shall be guided by the following policy statements.
1. The country shall adopt an integrated, comprehensive and community based response for the prevention and control of chronic, lifestyle related NCDs.
2. Health promotion strategies shall be intensified to effect changes that would lead to a significant reduction in mortality and morbidity due to chronic lifestyle related NCDs.
3. Complementary accountabilities of all stakeholders must be ensured and actively pursued in the implementation of an integrated, comprehensive and community based response to chronic,lifestyle related NCDs.
B. Objectives:
1. Decrease of morbidity and Mortality
2. Decrease in the economic burden of CVDs to the individual, family and community.
Mission: To ensure that quality prevention and control and LRD services are accessible to all, especially to the vulnerable and at-risk population.
Vision: A nation of Filipinos with Healthy Lifestyle and habits, living and working in clean and safe environment and with access to adequate medical care for CVD.
33 II. Scenario
A. Global Situation
The leading causes of NCD deaths in 2008 were: cardiovascular diseases (17 million deaths, or 48% of NCD deaths); cancers (7.6 million, or 21% of NCD deaths); and respiratory diseases, including asthma and chronic obstructive pulmonary disease (COPD), (4.2 million). Diabetes caused an additional 1.3 million deaths.
Over 80% of cardiovascular and diabetes deaths, and almost 90% of deaths from COPD, occurred in low- and middle-income countries. Behavioral risk factors, including tobacco use, physical inactivity, and unhealthy diet, are responsible for about 80% of coronary heart disease and cerebrovascular disease. These important behavioral risk factors of heart disease and stroke are discussed in detail later in this chapter.
Population growth and improved longevity are leading to increasing numbers and proportions of older people, with population ageing emerging as a significant trend in many parts of the world. As populations age, annual NCD deaths are projected to rise substantially, to 52 million in 2030. Whereas annual infectious disease deaths are projected to decline by around 7 million over the next 20 years, annual cardiovascular disease mortality is projected to increase by 6 million and annual cancer deaths by 4 million. In low and middle-income countries, NCDs will be responsible for three times as many disability adjusted life years (DALYs) and nearly five times as many deaths as communicable diseases, maternal, perinatal and nutritional conditions combined, by 2030.
B. Local Situation:
Seven (7) out of 10 leading causes of mortality (death) are to Non-Communicable Diseases.
1st : Diseases of the Heart (CAD)
2nd: Diseases of the Vascular System (Stroke) 3rd: Malignant Neoplasm (Cancer)
4th: Injuries (Accidents)
7th: Chronic Obstructive Pulmonary Disease (COPD) 10th: Nephritis, Nephrotic Syndrome
