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Malaria is a parasite-caused disease that is usually acquired through the bite of a female
Anopheles mosquito. It can be transmitted in the following ways:
(1) blood transfusion from an infected individual;
(2) sharing of IV needles; and
(3) transplacenta (transfer of malaria parasites from an infected mother to its unborn
child).
This parasite-caused disease is the 9 leading cause of morbidity in the country. As of this
year, there are 58 out of 81 provinces that are malaria endemic and 14 million people
are at risk. In response to this health problem, the Department of Health (DOH)
coordinated with its partner organizations and agencies to employ key interventions with
regard to malaria control.
Vision: Malaria-free Philippines
Mission: To empower health workers, the population at risk and all others concerned to
eliminate malaria in the country.
Goal: To significantly reduce malaria burden so that it will no longer affect the socioeconomic development of individuals and families in endemic areas.
Objectives:
Based on the 2011-2016 Malaria Program Medium Term Plan, it aims to:
1. Ensure universal access to reliable diagnosis, highly effective, and appropriate
treatment and preventive measures;
2. Capacitate local government units (LGUs) to own, manage, and sustain the Malaria
Program in their respective localities;
3. Sustain financing of anti-malaria efforts at all levels of operation; and
4. Ensure a functioning quality assurance system for malaria operations.
th
Beneficiaries:
The Malaria Control Program targets the meager-resourced municipalities in endemic
provinces, rural poor residing near breeding areas, farmers relying on forest products,
indigenous people with limited access to quality health care services, communities
affected by armed conflicts, as well as pregnant women and children aged five years old
and below.
Program Strategies:
The DOH, in coordination with its key partners and the LGUs, implements the following
interventions:
1.Early diagnosis and prompt treatment
Diagnostic Centers were established and strengthened to achieve this strategy.
The utilization of these diagnostic centers is promoted to sustain its functionality.
2. Vector control
The use of insecticide-treated mosquito nets, complemented with indoor residual
spraying, prevents malaria transmission.
3. Enhancement of local capacity
LGUs are capacitated to manage and implement community-based malaria
control through social mobilization.
Program Accomplishments:
For the development of health policies, the Malaria Medium Term Plan (2011-2016) is
already in its final draft while the Malaria Monitoring and Evaluation Framework and Plan
is being drafted. The Malaria Program is being monitored in six provinces as the
Philippine Malaria Information System is being reviewed and enhanced.
In strengthening the capabilities of the LGUs, trainings are conducted. These include:
series of Basic and Advance Malaria Microscopy Training; Malaria Program Management
Orientation and Training for the rural health unit (RHU) staff; and Data Utilization
Training. Also, there are the Clinical Management for Uncomplicated and Severe Malaria
and the Malaria Epidemic Management.
Lastly, health services are leveraged through the provision of anti-malaria commodities.
Partner Organization/Agencies:
The following organizations/agencies take part in achieving the goals of Malaria Control
Program:
Pilipinas Shell Foundation, Inc, (PSFI)
Roll Back Malaria (RBM); World Health Organization (WHO)
Act Malaria Foundation, Inc
Field Epidemiology Training Program Alumni Foundation, Inc. (FETPAFI)
Research Institute of Tropical Medicine (RITM)
University of the Philippines-College of Public Health (UP-CPH)
Philippine Malaria Network
Australian Agency for International Development (AusAID)
Asia Pacific Malaria Elimination Network (APMEN)
Malaria Elimination Group (MEG)
Local Government Units (LGUs)
Program Manager:
Dr. Mario S. Baquilod
Department of Health-National Center for Disease Prevention and Control (DOH-NCDPC)
Contact Number: 651-78-00 local 2353
Email: marbaquilod@yahoo.com
Identify children with visual disability in the community for timely intervention;
2.
Improve capability of 90% of health worker to identify and treat visual
disability in children by 2010; and
3.
Establish a completely equipped primary eye care facility in municipalities by
2008.
Burden of Blindness and Visual Impairment :
Global Facts
The Philippines is a signatory in the Global Elimination of Avoidable Blindness:
Vision 2020 The Right to Sight. The Vision 2020 was initiated by the International
Agency for Prevention of Blindness (IAPB), World Health Organization (WHO), and the
Christian Blind Mission (CBM), Vision 2020 aims to develop sustainable comprehensive
health care system to ensure the nest possible vision for all people and thereby improve
the quality of life.
According to WHO estimates :
Approximately 314 million people worldwide live with low vision and blindness
Of these, 45 million people are blind and 269 million have low vision
145 million people's low vision is due to uncorrected refractive errors (nearsightedness, far-sightedness or astigmatism). In most cases, normal vision
could be restored with eyeglasses
Yet 80% of blindness is avoidable - i.e. readily treatable and/or preventable
90% of blind people live in low-income countries
Restorations of sight, and blindness prevention strategies are among the most
cost-effective interventions in health care
Infectious causes of blindness are decreasing as a result of public health
interventions and socio-economic development. Blinding trachoma now affects
fewer than 80 million people, compared to 360 million in 1985
Aging populations and lifestyle changes mean that chronic blinding conditions
such as diabetic retinopathy are projected to rise exponentially
Women face a significantly greater risk of vision loss than men
Without effective, major intervention, the number of blind people worldwide
has been projected to increase to 76 million by 2020
Burden of Blindness and Visual Impairment :
Local Facts
0.16
0.19
0.2
Central Mindanao
0.4
Ilocos Region
0.5
Western Visayas
0.51
Eastern Visayas
0.53
Southern Luzon
0.56
National Figure
0.58
Northern Mindanao
0.61
Central Visayas
0.62
Bicol Region
0.71
Western Mindanao
0.74
Central Luzon
0.79
0.8
Cagayan Valley
0.87
Southern Mindanao
1.08
0.6
0.81
0.87
Central Luzon
1.21
Central Mindanao
1.53
Western Mindanao
1.59
Southern Mindanao
1.71
Central Visayas
1.76
Western Visayas
1.91
National Figure
1.98
Northern Mindanao
2.17
Ilocos Region
2.43
2.43
Bicol Region
2.52
Eastern Visayas
2.56
Southern Luzon
3.71
Cagayan Valley
4.07
0.76
1.07
Central Mindanao
1.93
Central Luzon
Western Mindanao
2.33
Central Visayas
2.38
Western Visayas
2.42
National Figure
2.56
Northern Mindanao
2.78
2.79
2.93
3.18
3.23
Bicol Region
3.23
4.27
Cagayan Valley
4.94
This includes patient information and education, public information and education and
intersectoral collaboration on eye health promotion and the nature and extent of visual
impairments particularly its risk factors and complications and the need/urgency of early
diagnosis and management.
2.
Capability Building
This component shall focus on ensuring the capability of national and local
government health facilities in delivering the appropriate eye health care services
especially to the indigent sector of the population. Program shall provide training for
coordinators at regional and provincial levels; will ensure the availability of and access to
training programs by program implementers. It shall include strengthening
treatment/management capabilities of existing personnel and operating capabilities of
facilities conducting cataract operations etc., taking into outmost consideration basic
quality assurance and standardization of procedures and techniques appropriate to each
facility/locality.
3.
Information Management
The program shall encourage the conduct of researches for purposes of developing
local competence in eye health care and for other purposes that may be necessary. The
development and dissemination of clinical practice guidelines for eye health shall form
part of the research agenda of the program.
The program shall support researches/studies in the clinical behavior (KAP) and
epidemiological (trends) areas. It also aims to acquire information that is utilized for
continuing public health information and education, policy formulation, planning and
implementation.
7.
Service Delivery
Service delivery for the prevention of Blindness Program shall be covered by the
principle of best practice. In collaboration with the local government units and
stakeholders, the program shall develop systems and procedures for the integration and
provision of services at the community level. This means primary eye prevention
concentrating on health education, advocacy and primary eye interventions; Secondary
prevention; screening/early detection/basic management/ counseling, referral and/or
definitive care and tertiary prevention: management of complications, continuing care
and follow up including rehabilitation. The following areas will be the priority areas for
services to be provided by the National Prevention of Blindness Program:
a.
Cataract Surgeries
b.
Errors of Refraction
c.
Childhood Blindness
Activities for the Vitamin A Deficiency Disorder, for practical purposes, shall be led by the
Family Health Office also of the NCDPC.
A Referral System shall form part of services delivered by the program. This is to ensure
that all patients receive quality eye health care at appropriate levels of health care
delivery system. All rural health units should be linked to an eye care referral center.
Cataract
Cataract, the opacification of the normally clear lens of the eye, is the most common
cause of blindness worldwide. It is the cause in 62% of all blindness in the Philippines
and is found mostly in the older age groups. The only cure for cataract blindness is
surgery. This is available in almost all provinces of the country; however there are
barriers in accessing such services. Interventions will therefore consist of increasing
awareness about cataract and cataract surgery; as well as improving the delivery of
cataract services. The parameter used worldwide to monitor cataract service delivery is
the Cataract Surgical Rate.
Errors of Refraction
Errors of refraction is the most common cause of visual impairment in the country
(prevalence is 2.06% in the population). Errors of refraction are corrected either with
spectacle glasses, contact lenses or surgery. The services to address the problem of EOR
are provided mainly by optometrists. However, the provision of the eyeglasses or lenses
(who should provide, how is it provided, etc.) has to be addressed.
Childhood Blindness
The prevalence of blindness among children (up to age 19) is 0.06% while the
prevalence of visual impairment in the same age group is 0.43%. The problem of
childhood blindness is the highly specialized services that are needed to diagnose and
treat it. However, screening of children for any sign of visual impairment can be done by
pediatricians, school clinics and health workers.
Future Plan/Action:
Status of Implementation/Accomplishment:
Financial Resources
o DOH provides funds largely for technical assistance for training, capacity building
activities, and augmentation of funds for local program implementation.
o Philippine Health Insurance Corporation covering personal eye care services (hospital
based)
Partner Organizations:
Aside from the collaborating divisions in the DOH, the following institutions
partake in the program:
Rotary International
UP - Institute of Ophthalmology
MICRONUTRIENT PROGRAM
Contact Person:
Liberty Importa
Telephone Nos.:
651-7800 loc. 1726-1730
Micronutrient deficiencies can cause inter-generational consequences. The level of health care and
nutrition that women receive before and during pregnancy, at childbirth and immediately post-partum has
significant bearing on the survival, growth and development of their fetus and newborn. Undernourished
babies tend to grow into undernourished adolescents. When undernourished adolescents become
pregnant, they in turn, may give birth to low-birth weight infants with greater risk of multiple micronutrient
deficiencies.
Micronutrient deficiencies have considerable impact on economic productivity, growth and national
development. Widespread iron deficiency is estimated to decrease the gross domestic product (GDP) by as
much as 2% per year in the worst affected countries. Conservatively, this translates into a loss of about
Php 172 per capita or 0.9% of GDP. Productivity losses for anemic manual laborers have been documented
to be as high as 9% for severely stunted workers and 5% and 17% for workers engaged in moderate and
heavy physical labor respectively (Micronutrient Supplementation Manual of Operations)
Mandate: AO 36, s. 2010
Aquino Health Agenda (AHA): Achieving Universal Health Care for All Filipinos Kalusugan Pangkalahatan
Goal of Micronutrient:
Achievement of better health outcomes, sustained health financing and responsive health system by
ensuring that all Filipinos especially the disadvantaged group (lowest 2 income quantiles)have equitable
access to affordable health care.
Objectives:
1.
Contribute to the reduction of disparities related to nutrition through a focus on population groups
and areas highly affected or at risk to malnutrition
2.
To provide vitamin A capsules, iron and iodine supplements to treat or prevent specific micronutrient
deficiencies
3.
Go to scale with key interventions on micronutrient supplementation, food fortification, salt
iodization and nutrient education.
4.
Revive, identify, document and adopt good practices and models for nutrition improvement.
5.
Build Nutrition human resource in relevant departments/ agencies.
Scenario:
1.
Child Under nutrition
The 2008 National Nutrition survey, FNRI-DOST showed a significant decline in the prevalence of
underweight-for-age under five children since 1990. However, the overall decline was not fast enough. In
2008 a 20.6% prevalence rate was recorded which is equivalent to an average annual percentage point
decrease of 0.37%, however, it is lower than the targeted 0.55 annual percentage point reduction from
2000 to achieve one of the targets of Millennium Development Goal I. In addition, stunting (32.2%) among
under fives (an indication of prolonged deprivation of food and frequent bouts of infections) and wasting
indicative of a lack of food or infection or both on the hand, remained at bout the 6% from 2003 to 2008.
1.
Maternal Under nutrition
For the past 10 years, the nutritionally-at-risk pregnant women gradually decreased since 1998, with an
average change of 0.44% per year. (FNRI National Nutrition surveys 2008)
2.
Micronutrient Deficiencies
The 2008 National Nutrition Survey reported significant gains as levels of Vitamin A deficiency among 6months infants to 5 years old children, pregnant and lactating women but still is a public health problem
based on WHO cut off 15%. Furthermore, the prevalence rate of Iron deficiency anemia among children
decreased significantly. However, percentage levels of IDA among infants 6 years old (55.7%) and
pregnant women (42.5%) remain at levels that are considered high as per WHO classification of <40%
public health problem.
Iodine Deficiency is a public health problem among pregnant and lactating women. In 2008, the median
UIE among 6-12 year old children was 132/ug/L, indicating adequate iodine status and only <20% of the
children had UIE less than 50 ug/L. The elimination of iodine deficiency has been sustaines from 20032008.
Among pregnant women, the median UIE was 105 ug/L represents insufficient iodine intake. Iodine
deficiency in this group persists. While lactating women the median UIE was 81 ug/L represents mild iodine
insufficiency.
INTERVENTIONS/ STRATEGIES EMPLOYED OR IMPLEMENTED
1.
Micronutrient Supplementation- is the provision of pharmaceutically prepared vitamins & minerals
for treatment or prevention of specific micronutrient deficiency.
2.
Food Fortification- the addition of essential micronutrients to widely consumed food product at levels
above its normal state.
3.
Improving diet/ dietary diversification- the adoption of proper food and nutrition practices thru
nutrition education food production & consumption.
4.
Growth monitoring and promotion- is an educational strategy for promoting child health, human
development and quality of life through sequential measurement of physical growth and development of
individuals in the community.
STATUS OF IMPLEMENTATION/ ACCOMPLISHMENT
The following policies were formulated and implemented:
AO No. 2010-0010: revised Policy on Micronutrient Supplementation to support achievement of
2015 MDG Targets to reduce under-five and maternal deaths and micronutrient needs of other
population groups
AO No. 2007-0045: Zinc Supplementation and reformulated Oral rehydration salt in the
Management of diarrhea among children
ASIN Law- R.A. 8172, An act promoting salt iodization nationwide and for other purposes,
signed into law on Dec. 20, 1995
Food fortification law, R.A. 8976, An act establishing the Philippine Food Fortification Program
and for other purposes mandating fortification of flour, oil and sugar with Vit A and flour and
rice with iron by November 7, 2004 and promoting voluntary fortification through the SPSP,
signed into law on November 7, 2000
Department Memorandum No. 2011-0303 Micronutrient powder supplementation for children
6-23 months
Micronutrient supplementation manual of operations was developed to guide local, regional
and national managers and implementers in providing good quality micronutrient
supplementation services to targeted populations nationwide
Accomplishment
Oversee the development of mental health measures for sub-programs and components.
Integrate the various programs, project and activities from the various program development and
management groups for each sub-program.
Manage the various sub-programs and components of the national mental health program.
Oversee the implementation of prevention and control measures for mental health issues and
concerns
Recommend to the Secretary of Health a master plan for mental health aligned with the mandates
and thrusts of various government agencies.
2.
Program Development and Management Teams (PDMT)- under NPMC, PDMT shall be established
corresponding to the four sub-programs of the National Mental Health Program.
FUNCTIONS:
Formulate and recommend policies, standards, guidelines approaches on each specifics sub-program
on mental health.
Develop a plan of action for each specific sub-program in consultation with mental health advocates
and stakeholders.
Develop operating guidelines, procedures, protocols for the mental health sub-program.
Provide technical assistance to other mental health teams according to sub-program funds.
3.
Other Partners and Stakeholders
Ensuring the availability of competent, efficient, culturally and gender-sensitive health care
professionals who will provide mental health services.
Identifying mental health needs of the population and refer findings to the appropriate mental care
provider
Promoting and advocating for the implementation of the program within their respective areas of
responsibility.
INTERVENTIONS / STRATEGIES EMPLOYED/IMPLEMENTED BY DOH
1.
Enrichment of advocacy and multimedia information, education and community (IEC) strategies targeting
the general public, mental health patients and their families.
2.
Service Provision
Enhancement of service delivery at the national and local levels will enable the early recognition and
treatment of mental health problems.
3.
Policy and legislation
The formulation and institutionalization of national legislations, policies, program standards and guidelines
shall emphasize the development of efficient and effective structures, systems and mechanisms that will
ensure equitable accessible, affordable and appropriate health services for the mentally ill patients, victims
of disaster and other vulnerable groups.
4.
Encouraging the development of a research culture and capacity
The program shall support researches and studies relevant to mental health, with focus on the clinical
behaviour, epidemiology, public health treatment options and knowledge management.
5.
Capacity building
Training shall be conducted on psychosocial care, the detection and management of specific psychiatric
morbidity and the establishment of mental health facilities.
6.
Public-Private Partnership
Inter-sectoral approaches and networking with other government agencies, non-government organizations,
academe and private service providers shall be pursued to develop partnership and expand the
involvement of stakeholders.
7.
Establishment of database and information system
This is needed to determine the magnitude of the problem to serve as basis for shifting the program for
being institutional and treatment focused on being preventive, family focused and community oriented.
8.
Development of model programs
Best practices for prevention of substance abuse and risk reduction for mental illness can be replicated in
different LGUs in coordination with other agencies involved in mental health and substance abuse
prevention programs.
9.
Monitoring and evaluation. Results of program monitoring and evaluation shall be used in
formulating and modifying policies, program objectives and action plans to sustain the
mental health initiatives and ensure continuing improvement in the delivery of mental
health care.
Program Direction
Celebration
Date
February 14 to 19
FUTURE PLAN/ACTION
Partner Organizations/Agencies:
The following organizations/agencies partake in achieving the vision of the program:
2. Any health practitioner who delivers or assists in the delivery of a newborn in the Philippines shall
3.
4.
5.
6.
prior to delivery, inform parents or legal guardians of the newborns the availability, nature and
benefits of NBS;
Health facilities shall integrate NBS in its delivery of health services;
Creation of the Newborn Screening Reference Center at the National Institutes of Health and
establishment and accreditation of NSCs equipped with a NBS laboratory and recall/follow up
program;
Provision of NBS services as a requirement for licensing and accreditation, the DOH and the
Philippine Health Insurance Corporation (PHIC)
Inclusion of cost of NBS in insurance benefits
Currently, there are four Newborn Screening Centers (NSCs) in the country: NSC-National Institutes of Health in Manila; NSCVisayas in Iloilo City; NSC-Mindanao in Davao City; and NSC-Central Luzon in Angeles City. The four NSCs provide laboratory and
follow up services for more than 3000+ health facilities.
DOH, its partners and major stakeholders remain aggressive in identifying strategies to intensify awareness in the communities and
increase coverage among home deliveries. Among the recent efforts to increase the newborn screening coverage are appointment of
full-time Regional NBS Coordinators; opening more G6PD Confirmatory Laboratories; partnership with midwives organizations; and
production of information materials targeting different groups of health workers and professionals.
Key Players in the Implementation
Email: info@newbornscreening.ph
www.newbornscreening.ph
Newborn Screening Centers
For Regions I, II, III & CAR
Unit Head: Dr. Florencio Dizon
Newborn Screening Center Central Luzon
Angeles City University Foundation Medical Center
MacArthur Highway, Barangay Salapungan, Angeles City
Telephone: (045) 6246502-03; Email: nsc@aufmc.org
For Regions IV, V & NCR
Newborn Screening Center National Institutes of Health
Unit Head: Ms. Ma. Elouisa Reyes
Building H, UP Ayala Land Technohub
Complex,Commonwealth Avenue, Brgy. UP Campus
Diliman, Quezon City
Email: nbsadmin.ihg@gmail.com
For Visayas
Newborn Screening Center Visayas
Unit Head: Dr. J Winston Edgar Posecion
West Visayas State University Medical Center
E. Lopez St., Jaro, Iloilo City
Telefax: (033) 329-3744; Email: wvsumc_nsc@info.com.ph
For Mindanao
Newborn Screening Center Mindanao
Unit Head: Dr. Conchita Abarquez
Southern Philippines Medical Center
J.P. Laurel Avenue, Davao City
Telephone: (082) 226-4595 / 224-0337
Telefax (082) 227-4152; Email:nscmindanao@gmail.com
Centers for Health Development
CHD
Mailing Address
Business Phone
NBS Regional
Coordinator
CHD 1 - Ilocos
Clarita B. Lewis, RN
CHD 2 - Cagayan
Tuguegarao City
Valley
CHD 3 - Central
San Fernando, Pampanga
Luzon
CHD 4-A
Calabarzon
(02) 4403372
CHD 4-B
Mimaropa
CHD 5- Bicol
(052) 4830840
loc 517/516
CHD 6 - Western
Q. Abeto St., Mandurriao, Iloilo City (033)3210364
Visayas
Renilyn P. Reyes, MD
CHD 7 - Central
Osmea Blvd., Cebu City
Visayas
Nayda P.
Bautista,MD, MPH
(032) 4187633
Maria Luisa M.
Malana, RN
CHD 8- Eastern
Visayas
(053)3235025
Lilibeth Andrade, MD
CHD 9 Zamboanga
Peninsula
(062)9830314-15
Nerissa B. Gutierrez,
RN
CHD 10 Northern
Mindanao
Ellenietta HMV N.
Gamolo, MD, MPH
CHD 11 - Davao
J.P. Laurel Avenue, Davao City
Region
Ma. Clarose M.
Mascardo, RN, MPH
Lucy Decio, RN
CHD CARAGA
(085) 3411452
Glynna B. Andoy,
MD, MPH
CHD CAR
CHD NCR
CHD ARMM
(064) 4217703
Dayan Sangcopan,
MD
Reunion of Saved Babies, October 10, 2010 at the UP Bahay ng Alumni, Quezon City
October 3, 2011
Traders Hotel
The main oral health problems are dental caries (tooth decay) and peridontal disease (gum
disease). These two oral diseases are so widespread that 87% of our people are suffering from
tooth decay and 48% have gum disease. (2011 NMEDS Survey)
The combined ill effects of these two major diseases (except oral cancer) weaken bodily
defense and serve as portal of entry to other more serious, potentially dangerous and
opportunistic infections overlapping other diseases present. Such will incapacitate a young
victim as in crippling heart conditions arising from oral infection that may end in death.
The individual so affected with such handicap also has disturbed speech, becomes withdrawn
and avoids socializing with people and so lessen his opportunities for advancement. More
critical however is the effect of poor or defective teeth to overall nutrition to maintain good
general health, that begins with the first bite and chewing the food efficiently.
a.
Develop an outpatient benefit package for oral health under NHIP of the government.
b.
Develop financing schemes for oral health applicable to other levels of care (fee for service,
cooperatives,
network with HMOS)
c.
Restoration of oral health budget line item in the GAA of DOH CO.
3. Provide relevant, timely and accurate information management system for oral health
a. Improve existing information system/ data collection (reporting and recording dental services
and accomplishments)
- Setting essential indicators
- Development of IT system on recording and reporting oral health services accomplishments
and indices- Integrate oral health
in every family health information tools, recording
books/manuals
b. Conduct regular epidemiological dental surveys- every 5 years
4. Ensure access and delivery of quality oral health care services
a. Upgrading of facilities, equipment, instruments, supplies
b. Develop packages of essential care/services for different groups (children, mothers and
marginalized groups)
- Revival of the sealant program for school children
- Tooth brushing program for pre-school children
- Outreach programs for marginalized groups
c. Design and implement grant assistance mechanism for high performing LGUs
- Awards and incentives
- Funding grants for priority programs/activities
d. Regular conduct of consultation meetings, technical updates and program implementation
reviews with stakeholders
5. Build up highly motivated health professionals and trained auxiliaries to manage and provide
quality oral health care
a. Provision of adequate dental personnel
b. Capacity enhancement programs for dental personnel and non-dental personnel
5. Status of Implementation / Accomplishments
Outpatient Dental Health Care Finance Package Being advocated for inclusion under PhilHealth
outpatient packages. The best scheme is through Capitation wherein a certain amount will be provided for
these dental services for indigent patients to certain health facilities including RHUs.
Capacity Enhancement Program (CEP) for Public Health Dentists- This training program was
designed with the public health dentists (PHDs) as the main recipients of the Basic Course on the
Management of Oral Health Program. The training is expected to provide an in-depth understanding of the
different roles and functions of the PHDs in the management and delivery of Public Health Services. For the
last two years (2010-2011) 10.2 Million pesos were sub-allotted to all CHDs for this purpose. To date almost
87% of all PHDs are trained. NCDPC is proposing to develop Skills Training (Oral and Maxillo-facial surgery)
for Hospital dentist as continuation to the CEP.
Oral Health Survey The Department of Health (DOH) has been conducting nationwide surveys
every five years (1977, 1982, 1987, 1992 and 1998) to determine the prevalence of oral diseases in the
Philippines. In 2011, the NCDPC with a 5 Million pesos budget conducted the National Monitoring and
Evaluation Dental Survey (NMEDS) through the UP-National Institute of Health (UP-NIH).
Orally Fit Child (OFC) Campaign- In 2009 the DOH launched the OFC campaign for 2-6 years old
children (pre-school children) in day care centers. Orally Fit child is a child who meets the following
conditions upon oral examination and /or completion of treatment a.) caries-free or all carious tooth/teeth
must be restored either temporary or permanent filling materials
b.) have healthy gums
c.) has no oral debris
d.) no dento-facial anomaly that limits oral cavitys normal function.
NCDPC have allotted 8.5 million pesos each year to implement the programin day care centers. Activities
include both tooth brushing activities, training of day care workers, awards, IEC materials among others.
The DOH is hoping to attain 12% OFC in 2016 and 20% in 2020. To date more or less 3.20% pre-schoolers
are OFC.
AO 101 s. 2003 dated October 14, 2013- National Policy on Oral Health
AO 2007-0007 dated January 3, 2013 - Guidelines in the Implementation of Oral Heaalth
Program for Public Health Services in the Philippines
AO 4 s. 1998 - Revised Rules and Regulations and Standard Requirements for Private School
Dental services in the Philippines.
AO 11-D s. 1998 - Revised Standard Requirements for hospital Dental services in the
Philippines.
AO 3 s. 1998 - Revised Rules and Regulations and Standard Requirements for Occupational
Dental Services in the philippines
AO 4-A s. 1998 - Infection Control Measures for Dental Health Services
IV. Objectives/Goals
By 2022, reduce the number of occupational diseases and injuries by 30% from the 2015 baseline as identified
in the Occupational Health and Safety Profile of the Philippines.
V. Program Components
1. Policies / Guidelines / Standards Development
2. Capacity Building
3. Technical Assistance
4. Research
5. Communication and Promotion
6. Advocacy and Lobbying
7. Monitoring and Evaluation
8. Human Resource Development
9. Information Management
VI. Target Population/Client
Informal Sector Workers (ISW) consisting of Agricultural Workers, Small-scale
Miners, and Transport Group
Public Health Workers (PHW)
VII. Area of Coverage
Nationwide
VIII. Partner Institutions
Inter-Agency Committee on Environmental Health (IACEH)
- Occupational Health Sector
- Toxic and Hazardous Substances Sector
Department of Labor and Employment (DOLE)
- Occupational Safety and Health Center (OSHC)
- Bureau of Working Conditions (BWC)
Department of Environment and Natural Resources (DENR)
- Environmental Management Bureau (EMB)
- Mines and Geoscience Bureau (MGB)
Department of Transportation and Communications (DOTC)
Department of Energy (DOE)
- Energy Utilization Management Bureau (EUMB)
Civil Service Commission (CSC)
UP College of Public Health
UP-PGH National Poison Management Control Center
Philippine College of Occupational Medicine
Occupational Health Nurses Association of the Phils.
IX. Policies and Laws
1961, Administrative Order No. 63 Industrial Hygiene Code
Specific:
Conduct 74,000 good outcome cataract surgeries by 2010;
Ensure that all health centers are actively linked to a cataract referral center by
2008;
Advocate for the full coverage of cataract surgeries by Philhealth;
Establish provincial sight preservation committees in at least 80% of provinces
by 2010;
Mobilize and train at least one primary eye care worker per barangay by 2010;
Mobilize and train at least one mid-level eye care health personnel per
municipality by 2010;
Improve capabilities of at least 500 ophthalmologists in appropriate techniques
and technology for cataract
surgery;
Develop quality assurance system for all ophthalmology service facilities by
2008; and
Ensure that 76 provincial,16 regional and 56 DOH retained hospitals are
equipped for appropriate technology for cataract surgery.
5.
6.
and
Identify children with visual disability in the community for timely intervention;
Improve capability of 90% of health worker to identify and treat visual
in children by 2010; and
Establish a completely equipped primary eye care facility in municipalities by
Global Facts
Local Facts
0.16
0.19
0.2
Central Mindanao
0.4
Ilocos Region
0.5
Western Visayas
0.51
Eastern Visayas
0.53
Southern Luzon
0.56
National Figure
0.58
Northern Mindanao
0.61
Central Visayas
0.62
Bicol Region
0.71
Western Mindanao
0.74
Central Luzon
0.79
0.8
Cagayan Valley
0.87
Southern Mindanao
1.08
0.6
0.81
0.87
Central Luzon
1.21
Central Mindanao
1.53
Western Mindanao
1.59
Southern Mindanao
1.71
Central Visayas
1.76
Western Visayas
1.91
National Figure
1.98
Northern Mindanao
2.17
Ilocos Region
2.43
2.43
Bicol Region
2.52
Eastern Visayas
2.56
Southern Luzon
3.71
Cagayan Valley
4.07
0.76
1.07
Central Mindanao
1.93
Central Luzon
Western Mindanao
2.33
Central Visayas
2.38
Western Visayas
2.42
National Figure
2.56
Northern Mindanao
2.78
2.79
2.93
3.18
3.23
Bicol Region
3.23
4.27
Cagayan Valley
4.94
This includes patient information and education, public information and education and
intersectoral collaboration on eye health promotion and the nature and extent of visual
impairments particularly its risk factors and complications and the need/urgency of early
diagnosis and management.
2.
Capability Building
This component shall focus on ensuring the capability of national and local
government health facilities in delivering the appropriate eye health care services
especially to the indigent sector of the population. Program shall provide training for
coordinators at regional and provincial levels; will ensure the availability of and access to
training programs by program implementers. It shall include strengthening
treatment/management capabilities of existing personnel and operating capabilities of
facilities conducting cataract operations etc., taking into outmost consideration basic
quality assurance and standardization of procedures and techniques appropriate to each
facility/locality.
3.
Information Management
Financial Resources
o DOH provides funds largely for technical assistance for training, capacity building
activities, and augmentation of funds for local program implementation.
o Philippine Health Insurance Corporation covering personal eye care services (hospital
based)
Partner Organizations:
Aside from the collaborating divisions in the DOH, the following institutions
partake in the program:
Sources:
then necessary for persons with disabilities (PWDs) as it entails actions beyond the
context of health, but more on helping them to overcome difficulties by removing
environmental and social barriers (WHO, 2013).
Globally, over 1 billion people, or approximately 15% of the worlds population, have
some form of disability. About 110 to 190 million people 15 years and older have
significant difficulties in functioning. Moreover, the rapid spread of chronic diseases and
population ageing contribute to the increasing rates of disability. About 80% of the
worlds PWDs live in low-income countries, wherein majority are poor and cannot access
basic services. With their conditions, PWDs need greater attention and considerations in
terms of health needs, without discrimination. However, reports show that PWDs have
less access to health services and therefore have greater unmet needs (WHO, 2012.)
In the Philippines, the results of the 2010 Census of Population and Housing (CPH, 2010)
show that of the household population of 92.1 million, 1.443 million Filipinos or 1.57%,
have a disability. Region IV-A, with 193 thousand PWDs, was recorded to have the highest
number of PWD among the 17 regions, while the Cordillera Administrative Region (CAR)
had the lowest number with 26 thousand PWDs. There were more males, who accounted
for 50.9% of the total PWD in 2010, compared to females, with 49.1% with disability. For
every five (5) PWD, one (18.9%) was aged 0 to 14 years, three (59.0%) were in the
working age group (15-64 years old), and one (22.1%) was aged 65 years and above
(NSO, 2013).
The mandate of the DOH to come up with a national health program for PWD was based
on Republic Act No. 7277, An Act Providing for the Rehabilitation and Self-Reliance of
Disabled Persons and Their Integration into the Mainstream of Society and for Other
Purposes or otherwise known as The Magna Carta for Disabled Persons andthe
Implementing Rules and Regulations (IRR) of RA 7277. This document stipulated that the
DOH is required to: (1) institute a national health program for PWDs, (2) establish
medical rehabilitation centers in provincial hospitals, and (3) adopt an integrated and
comprehensive program to the Health Development of PWD, which shall make essential
health services available to them at affordable cost. In response to this, the DOH issued
Administrative Order No. 2006-0003, which specifically provides the strategic framework
and operational guidelines for the implementation of Health Programs for PWDs.
In 2013, a MediumTerm Strategic Plan (2013-2017) was developed to strengthen the
existing health program for PWDs. However, in the review done for the purpose, it was
noted that in the implementation of the program in the past years, there were
operational issues and gaps identified that need to be addressed. These include among
others, the need to strengthen multi-sectoral action to harmonize efforts of stakeholders;
clarify delineation of roles and responsibilities of concerned government agencies
working for PWDs; strengthen national capacity, both facilities and manpower, to provide
rehabilitation services for PWDs from primary to tertiary level of care; provide access to
health facilities and services for PWDs; and, strengthen registration database for PWDs.
Recently, the World Health Organization released the Global Disability Action Plan 20142021. This document intends to help countries direct their efforts towards specific
actions in order to address health concerns of persons with disabilities. The Action Plan
identified three major objectives: to remove barriers and improve access to health
services and programmes; (2) to strengthen and extend rehabilitation, habilitation,
assistive technology, assistance and support services, and community-based
A. Vision:A country where all persons with disability, including children and their
families, have full access to inclusive health and rehabilitation services.
B.
Mission:A program designed to promote the highest attainable standards of health
and wellness for PWDs by fostering a multi-sectoral approach towards a disability
inclusive health agenda.
C.
Objectives:
D. Action Framework for the Health and Wellness Program of Persons with
Disabilities
The Action Framework for the Health and Wellness Program of Persons with Disabilities is
adapted from the three major objectives of the WHO Global Disability Action Plan 20142021. As applied in the country, program actions or interventions shall focus on the
following areas: 1) removal of barriers and improve access to health services and
programs; (2) strengthening and expansion of rehabilitation, habilitation, assistive
technology, and community-based rehabilitation; (3) strengthen collection of relevant
and internationally comparable data on disability and support research on disability and
related services.
Figure 1 depicts the Action Areas that the Health and Wellness Program for Persons with
Disabilities shall focus its interventions along the thrusts and goals of Kalusugang
Pangkalahatan or Universal Health Care.
Action Area 1:Removal of barriers and improve access to health services and
programs. People with disabilities, including children, encounter a range of attitudinal,
physical and systemic barriers when they attempt to access health care such as physical
barriers related to the architectural design of health facilities or health providers lack of
adequate knowledge and skills in providing services for persons with disabilities, among
many others.
Therefore, actions or interventions should be under taken to ensure that persons with
disabilities have access, on an equal basis with others, to health facilities and services. It
is important to identify all of these barriers and institute collective actions to remove
these barriers and improve access of persons with disabilities to health services and
programs.
Action Area 2: Strengthening and expansion of rehabilitation, habilitation,
assistive technology, and community based rehabilitation. Habilitation and
rehabilitation are sets of measures that assist individuals, who experience or are likely
to experience disability, to achieve and maintain optimal functioning, in interaction with
their environments. Encompassing medical care, therapy and assistive technologies,
they should begin as early as possible and be made available as close as possible to
where people with disabilities live.
Increasing government investments in habilitation, rehabilitation and provision of
assistive technologies are expected actions or interventions that must be put in place.
This is going to be beneficial in the long run because they build human capacity and can
be instrumental in enabling people with limitations in functioning to remain in or return
to their home or community, live independently, and participate in all aspects of life.
They can reduce the need for formal support services as well as reduce the time and
physical burden for caregivers.
Action Area 3: Strengthening collection of relevant and internationally
comparable disability data and support disability researches. Data is needed to
strengthen health care systems, as it informs policy and interventions. These can be
collected through dedicated disability surveys, or disaggregating data from other data
collection efforts by disability status, and research.
Interventions along this action area should ensure that data collected would be
internationally comparable and results of researches and studies done are used for
informing policy and resource allocation. The use of the Philippine Registry for Persons
with Disability is an intervention that should be strengthened and made fully operational.
Figure1: Action Framework for the Health and Wellness Program for Persons with
Disabilities
Ms. Frances Prescilla Cuevas, RN, MAN
Chief Health Program Officer
Degenerative Disease Office
National Center for Disease Prevention and Control, Department of Health, San Lazaro
First Public Health Convention on the Health and Wellness of PWDs November 6-7, 2014
PowerPoint Presentation of Speakers
Day 1
- Current Developments in the Philippine Rehabilitation Services
- Current Innovative Approaches to Increasing Access to Rehabilitation Services
- First Survey on Disabilities as part of NNHeS
- Access to SRH Services
- Opening: DOH Disability and Health Summit
- Community Based Inclussive Health; A Vision
- Perspective on Health and Wellness for Persons with Disabilities
- National Perspectives: Philippine Framework for Action on the Health and Wellness
Program for PWDs
- Personal Perspectives on Health and Wellness for PWDs
Day 2
- Issues on Screening for Developmental Disabilities: Health Promotion Issues and
Challenges
- Issues on Sexual and Reproductive Health of Persons with Disabilities
- Health Promotion Issues on Increasing Access to Health and Wellness of PWDS
- Promoting Physical Activity Among PWDS
- Mental Health and Psychosocial Support for PWDs
- 1st Public Health Convention on the Health and Wellness of Persons with Disabilities
- Expanding the ZMORPH Benefit Package - The Product Team for Special Benefits
Vision:
"The global leader in providing quality health care for all through universal health care"
Mission:
To ensure that the Philippines is globally competitive through implementation of quality
standards in both public and private sector.
Goal:
1. The local Global Health Care industry will contribute a noticeable and quantifiable
amount to the Philippine economy and improvement in the quality of life.
2. Increase the number of institutions offering advanced medical services suitable for
Global HealthCare, the generation of jobs in the Medical Services industry and other
related industries, thereby increasing the productivity of the workforce and enabling it to
expand and upgrade.
3. Attract increased numbers of visitors from other countries availing of medical services
and at the same time ensure that quality of those currently offering services suitable for
Global Health Care is on the same level as with globally-recognized standards, and
making these services equitably available for both Medical Travellers and local patients.
Objectives:
1. To increase competitiveness by compliance to recognized bodies that implement
national and international healthcare organization accreditation
2. Institutionalize policies and enact legislation for high level quality healthcare and
patient safety standards in all health facilities
3. Continue collaboration with national government agencies, LGUs, private sector
organizations and academe involved in quality healthcare and patient safety,
international medical travel and wellness services, retirement, trade and tourism
4. Continue advocacy in all regions of the country on quality healthcare and patient
safety, international medical travel and wellness services, retirement, trade and tourism
through quad media approach, capacity building activities and collaborative participation
in international forum and conferences
Stakeholders/Beneficiaries:
Private clinics/centers, Public and Private Hospitals, National Government Agencies,
Private Specialty Clinics/Centers providing Dermatology, plastic surgery, ophthalmology
and dental medicine, Geriatric and Treatment and Rehabilitation Centers for substance
abuse
Partner Organizations/Agencies:
TUV Rheinland
Private Sector
Health and Wellness Alliance of the Philippines (HEAL Philippines)
Health Core and HIM Communications
Retirement and Healthcare Coalition (RHC)
Spas and Wellness Association of the Philippines (SAPI)
Philippine Dental Association (PDA)
Program Manager:
Emmanuel A. Tiongson, MD
Provision of safe water supply is one of the basic social services that improve health and
well-being by preventing transmission of waterborne diseases. However, about 455
municipalities nationwide have been identified by NAPC as waterless areas that are
having households with access to safe water of less 50% only. As a result, diarrhea and
other waterborne diseases still rank among the leading causes of morbidity and mortality
in the Philippines. The incidence rate for these diseases is high as 1,997 per 100,000
population while mortality rate is 6.7 per 100,000 populations. The Sagana at Ligtas na
Tubig sa Lahat Program (SALINTUBIG) is one of the governments main actions in
addressing the plight of Filipino households in such areas.
The program aims to contribute to the attainment of the goal of providing potable water
to the entire country and the targets defined in the Philippine Development Plan 20112016 Millennium Development Goals (MDG), and the Philippine Water Supply Sector
Roadmap and the Philippine Sustainable Sanitation Roadmap. To attain this
objective, One Billion and Five Hundred Million Pesos (Php 1,500,000,000) is
appropriated to the DOH through Item B.I.a of the 2011 General Appropriations Act
(GAA). The appropriation is a grant facility for LGU to develop infrastructure for the
provision of potable water supply.
A.
B.
OBJECTIVES
1. To increase water service for the waterless population
2. To reduce incidence of water-borne and sanitation related diseases
3. To improved access of the poor to sanitation services
TARGETS
1. Increased water service for the waterless population by 50%
2. Reduced incidence of water-borne and sanitation related diseases by 20%
3. Improved access of the poor to sanitation services by at least 10%
January 2012
February 2012
March 2012
April 2012
May 2012
June 2012
July 2012
August 2012
September 2012
October 2012
November 2012
December 2012
2013
January 2013
February 2013
March 2013
April 2013
May 2013
June 2013
July 2013
August 2013
September 2013
October 2013
November 2013
December 2013
October 2011
January 2012
February 2012
March 2012
April 2012
May 2012
June 2012
July 2012
August 2012
September 2012
October 2012
November 2012
December 2012
2013
January 2013
February 2013
March 2013
April 2013
May 2013
June 2013
July 2013
August 2013
September 2013
October 2013
November 2013
December 2013
Administrative Issuances
V.
A.
PROGRAM MANAGER(S)
FULL NAME(S) OF PROGRAM MANAGERS
1. ENGR. JOSELITO M. RIEGO DE DIOS
2. ENGR. MA. SONABEL S. ANARNA
3. ENGR. LUIS F. CRUZ
4. ENGR. GERARDO S. MOGOL
5. ENGR. ROLANDO I. SANTIAGO
6. ENGR. CATHERINE J. OLAVIDES
B.
3.
DEPARTMENT OF HEALTH
Environmental and Occupational Health Office Division
International Support
In 2011, the UNFPA had donated three (3) units of cryotherapy machines for use in the treatment of precancerous lesion in the cervix. This partner also provided funds in the development of the Training Module
on Cervical Cancer Prevention and Control together with the support of Womens Health and Safe
Motherhood Project II.
INTERVENTIONS/ STRATEGIES EMPLOYED OR IMPLEMENTED BY DOH
Packages of Services
Free cervical cancer screening provided every year in 58 DOH Hospitals done during the month of
May to screen women ages
30-45 years of age.
Free adjuvant chemotherapy for women diagnosed stage 1 to 3A breast cancer in 4 pilot hospitals
(Jose Reyes Memorial Medical Hospital, East Avenue Medical Center, Rizal Medical Center, UP-PGH) funded
by NCPAM
Free chemotherapy for acute lymphatic leukemia (ALL) among children with cancer funded by NCPAM
Strategies
Improve rehabilitation and palliative care
IX. Updates
Hiring of additional 928 PHAs for deployment on July to December 2016. (Refer to Department Memorandum
No. 2015-0383-A)
X. Program Coordinator Contact Information
Ms. Janette S. Cruz
HRMO III, HHRDB-DOH
Program Strategies:
To attain its goal, the program employs the following strategies:
1. Provision of Post Exposure Prophylaxis (PEP) to all Animal Bite Treatment Centers (ABTCs)
2. Provision of Pre-Exposure Prophylaxis (PrEP) to high risk individuals and school children in high
incidence zones
3. Health Education
Public awareness will be strengthened through the Information, Education, and Communication
(IEC) campaign. The rabies program shall be integrated into the elementary curriculum and the
Responsible Pet Ownership (RPO) shall be promoted. In coordination with the Department of Agriculture,
the DOH shall intensify the promotion of dog vaccination, dog population control, as well as the control of
stray animals.
In accordance with RA 9482 or The Rabies Act of 2007, rabies control ordinances shall be strictly
implemented. In the same manner, the public shall be informed on the proper management of animal bites
and/or rabies exposures.
4. Advocacy
The rabies awareness and advocacy campaign is a year-round activity highlighted on two
occasions March as the Rabies Awareness Month and September 28 as the World Rabies Day.
5. Training/Capability Building
Medical doctors and Registered Nurses are to be trained on the guidelines on managing a victim.
6. Establishment of ABTCs by Inter-Local Health Zone
7. DOH-DA joint evaluation and declaration of Rabies-free islands
Program Achievements:
The DOH, together with the partner organizations/agencies, has already developed the guidelines for
managing rabies exposures. With the implementation of the program strategies, five islands were already
declared to be rabies-free.
In 2010, 257 rabies cases and 266,200 animal bites or rabies exposures were reported. A total of 365
ABTCs were established and strategically located all over the country. Post Exposure Prophylaxis against
rabies was provided in all the 365 ABTCs.
Partner Organizations/Agencies:
The following organizations/agencies take part in attaining the goal of the National Rabies Prevention and
Control Program:
Department of Agriculture (DA)
Program Manager:
Dr. Raffy A. Deray
Department of Health-National Center for Disease Prevention and Control (DOH-NCDPC)
In order to ensure a constant supply of competent midwives and to deliver their services
to the people in dire need, the DOH created the MSPP that aims to produce competent
midwives from qualified residents of priority areas.
Program Description:
The World Health Organization (WHO) affirms that approximately 15% of all pregnant
women develop a potentially life-threatening complication that calls for either skilled
care or major obstetrical interventions to survive. Readily accessible Emergency
Obstetric Care may thus reduce maternal and perinatal morbidity and mortality.
The DOH is restating its commitment towards a health nation through more aggressive
safe motherhood initiatives, hence, the upgrading of obstetric deliveries to strategic
facility-based Basic Emergency Obstetric Care (BEmONC), where these facilities are
manned by a team composed of a licensed physician, public health nurse, and a rural
health midwife at the primary level.
Since the rural health midwives are considered as the frontline health workers in the
rural areas and have progressed to become multi-task personnel in the delivery of
healthcare services, amidst migration of other healthcare professionals, the DOH created
the Rural Health Midwife Placement Program (RHMPP) to address the inequitable
distribution of midwives and equip them for facility-based BEmONC practice. In support
to the RHMPP, thus, ensure constant supply of competent midwives, the DOH created the
Midwifery Scholarship Program of the Philippines (MSPP).
Career Track/ Return Service Obligation
Upon completion of the MSPP and obtaining the midwifes Certificate of Registration and
license, the scholars shall render two (2) years of service to the DOH for every year of
scholarship granted as form of return service.
Expected Output:
The MSPP aims to produce and ensure constant supply of competent midwives who are
ready to serve the DOH identified priority areas of the country.
The RHMPP addresses the inequitable distribution of midwives and equip them for
facility-based BEmONC practice. Likewise, it provides competent midwives to areas that
have not performed well in terms of facility-based deliveries, fully immunized child and
contraceptive prevalence rates, hence, improve facility-based health services. The DOH
ultimately aims in the attainment of the Millennium Development Goals (MDGs).
Program Status:
For the MSPP, a hundred scholars are currently pursuing the Midwifery Course. On April
of this year, 11 scholars graduated and passed the Board Examination by the
Professional Regulation Commission (PRC). These scholars were deployed to DOH
identified priority areas starting July 2011. This coming November, 37 other scholars will
take the Board Examination.
For the RHMPP, 23 Registered Midwives were already deployed for the first batch (20082010). In addition to that, 175 Registered Midwives (batch 2, 2010-2012) and 11 scholars
(batch 3, 2011-2013) are currently being deployed in the DOH (BEmONC/CCT) identified
priority areas.
Partner Schools:
Currently, the MSPP has four partner schools:
Area
Partner School
Total # of Scholars
Batch 1: 16 scholars (2008-2010)
Batch 2: 11 scholars (June 2009May 2011)
National Capital
Region
Luzon
Visayas
Mindanao
The RHMPP has deployed midwives in the different DOH identified priority areas of the country:
Batch/ Year
Batch 1
23 RHMs
2008-2010
Batch 2
175 RHMs
2010-2012
Batch 3
11 RHMs
2011-2013
11 scholars graduated on April 2011 and passed the Board Examination by the
Professional Regulation Commission will be deployed starting July 2011 to DOH
identified priority areas.
37 scholars will take the November 2011 Board Examination by the
Professional Regulation Commission
100 scholars pursuing the Midwifery Course
B. RHMPP
175 Registered Midwives are currently deployed in the DOH (BEmONC/CCT)
identified priority areas
Deployment of 11 scholars
Program Manager:
Dr. Josephine H. Hipolito / Ms. Winselle Joy C. Manalo
Program Coordinators
Department of Health-Health Human Resource Development Bureau (DOH-HHRDB)