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Republic of the Philippines

Department of Health
OFFICE OF THE SECRETARY

National Implementation Team for the RPRH Law


61st Regular Meeting
February 8, 2018
Disease Prevention and Control Bureau Conference Room B, 2nd Floor
Department of Health Building 14, San Lazaro Compound
Tayuman, Sta. Cruz, Manila

Present: Please see attached the list of attendees.

Preliminaries: The meeting was called to order at around 10:00 AM by the Chairperson of the
National Implementation Team (NIT) for the RPRH Law, Dr. Esperanza I. Cabral. The provisional
agenda was presented and approved, with no additional items for discussion. The review of the minutes
of the 60th Regular NIT Meeting then followed.

Highlights: The following discussions and agreements were made during the meeting.

Meeting/Agenda Items Discussions Agreements


1. Highlights of the The review of the minutes of the previous
60th Regular NIT meeting was led by the Vice-Chairperson and
Meeting Head of Secretariat of the NIT for the RPRH
Law, Dr. Juan Antonio A. Perez III. The
following points were raised and discussed:

1. On the DOH Funds for CSOs – The CSO


Engagement Meeting among Dr. Cabral,
DOH-NCRO, POPCOM, PCPD, and
Likhaan was held on January 24, 2018, and
it was followed by another meeting with
other concerned CSOs on February 5, 2018.
POPCOM-NCR RD Lydio M. Español, Jr.
noted that they were still awaiting the release
of the ₱6,000,000.00 funds from DOH. The
CSOs would nominate among themselves
four lead CSOs for the four priority LGUs in
NCR chosen in consideration of their CPR
standing. These LGUs were Taguig,
Caloocan, Manila, and Las Piñas and would
include, as a fifth priority LGU,
Mandaluyong since the POPCOM Wellness
Clinic was part of the service delivery
network for FP information and services.
FriendlyCare would lead the provision of
services in Mandaluyong as they had already
entered into a memorandum of agreement
(MOA) with POPCOM.
Republic of the Philippines
Department of Health
OFFICE OF THE SECRETARY

Meeting/Agenda Items Discussions Agreements


The four lead CSOs should decide whether
the funds would be released through
reimbursement or by tranches. The relative
advantage of release by tranches was that the
funds would be available from the start of the
project. Release through reimbursement
would be based on the output and
performance of each CSO. Dr. Junice L.
Demeterio-Melgar of Likhaan Center for
Women’s Health recalled that the consensus
during the second meeting was on
reimbursement, but CSOs were concerned
that the funds might not be readily available.
Dr. Perez recommended that the funds be
given directly to CSOs for them to be able to
provide the services at the earliest time
possible.

To ensure the availability of both clients and


service providers, POPCOM and LGUs
would conduct demand generation activities
while the CSOs provided the necessary
services. CSOs would provide services on
implants and IUD, and LGUs would provide
all other services. No LGU would have a
budget higher than ₱1,000,000.00; such
amount would cover the cost of service
provision, especially on ancillary supplies
and the related expenses to deliver the
required number of acceptors. Dr. Jonathan
David A. Flavier of the Philippine Center for
Population and Development expressed
concern on the non-availability of ligation
and vasectomy services in LGUs. Dr. Cabral
said that since CSOs did not always offer the
same services, LGUs were responsible for
referring clients to proper facilities.

Dr. Junice added that DOH-NCRO


mentioned that no fee for service should be
charged for the reimbursement of implants.
The amount of ₱300.00 would be applied
since implant insertion required the same
supplies used to perform the procedure for
permanent methods. RD Español noted that

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Republic of the Philippines
Department of Health
OFFICE OF THE SECRETARY

Meeting/Agenda Items Discussions Agreements


POPCOM allowed for a 20% management
fee to be charged.

2. On the RPRH Communication Plan – Ms. RPRH Health


Edna V. Nito of the Health Promotion and Promotion and
Communication Service – DOH presented Communication TWG
the activities lined up for the promotion of to convene to develop
RPRH and other health programs. These a communication plan
activities included, among others, the
inclusion of RPRH advertisements in
available media platforms, the provision of
LED TV to health centers and regional
hospitals, and the distribution of tablets to
health workers. Ms. Elizabeth Angsioco of
the Democratic Socialist Women of the
Philippines (DSWP) commended the
proposed activities and requested that a
communication plan be developed to
synchronize the objectives of these activities.
Ms. Nito noted that the RPRH Health
Promotion and Communication TWG would
convene on February 22, 2018, 10:00 AM to
2:00 PM to develop a comprehensive plan,
incorporating all proposed activities.

3. On the PhilHealth Accreditation of PhilHealth to


Nurses as MCP Providers – Dr. Mary document instances of
Antonette Y. Remonte of PhilHealth updated CSOs requesting for
that she sent an e-mail to PhilHealth regional payment of implants
offices, asking them to document instances
in which CSOs collected from midwives
₱500.00 as payment for implants so that
involved CSOs could be blacklisted from the
implants program.

Ms. Patricia M. Gomez of the Integrated RPRH PhilHealth and


Midwives’ Association of the Philippines, Financing TWG to
Inc. asked during the 60th Regular NIT give updates on the
Meeting about the readiness of the e-claims issues raised on the
to address the issues encountered by the 60th Regular NIT
previous system used by PhilHealth. E- Meeting
claims could have a limited number of
claims that it could receive within a period
of time. Mr. Arnel Rostom C. Deiparine of
the Population Services Pilipinas,

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Republic of the Philippines
Department of Health
OFFICE OF THE SECRETARY

Meeting/Agenda Items Discussions Agreements


Incorporated (PSPI) added that claims filed
manually experienced delays due to the
system. It follows, then, that the PhilHealth
system was at fault for any delay in the
processing of claims. Dr. Perez
recommended that Dr. Remonte meet with
the RPRH PhilHealth and Financing TWG to
address all issues on the processing of
claims. During the 61st Regular NIT
Meeting, Dr. Remonte updated that the
RPRH PhilHealth and Financing TWG
would convene on March 1, 2018.

Dr. Remonte presented PhilHealth Circular


No. 2017-0023 on the “Accreditation of
Nurses for Maternal and Child Health
Services,” which was issued on December
29, 2017. The following were the highlights
of such presentation:

• The rationale was to save mothers and


newborns by providing financial access
to essential health services. The Revised
Implementing Rules and Regulations of
the RPRH Law allowed PhilHealth to
accredit nurses, among other health care
professionals. The Circular then
provided guidelines for the accreditation
of nurses as providers of MCP, NSD,
NCP, IUD insertion, and PSI in birthing
homes.
• All nurses applying for accreditation
should be a licensed practitioner and an
active member of PhilHealth, adhere to
the standards of nursing practice and
Code of Ethics, comply to provisions in
the Performance Commitment and other
PhilHealth requirements, have
completed the training on BEmONC,
and have work experience for at least
two years in the labor and delivery room
in at least a Level 1 hospital.
• The general requirements for
accreditation included an updated PRC
license, Provider Data Record,

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Meeting/Agenda Items Discussions Agreements


Performance Commitment, and two
pieces of 1x1 photo with the applicant’s
name at the back. Those who would
apply for initial accreditation should also
submit the certificate of BEmONC
Training and a certification of work
experience in labor and delivery. All
nurses were also required to present a
proof of payment of premium
contributions.
• All nurses who would provide FP
services should also submit certificates
of training from a DOH-recognized
training institution on IUD as first case
(interval), IUD as second case rate or as
first case rate (PPIUD and interval), and
Subdermal Contraceptive Implant
Package.

Dr. Cabral thanked Dr. Remonte for


informing the NIT on the PhilHealth policy
and encouraged the RPRH PhilHealth and
Financing TWG to convene earlier so that
issues on the delayed processing of claims
could be promptly addressed.

4. On the Youth Hubs – Asec. Rhea B. NYC and POPCOM


Peñaflor of the National Youth Commission to discuss youth hubs
(NYC) informed the body during the 60th during the RPRH
Regular NIT Meeting that since NYC was Adolescent Sexuality
using its area offices as youth hubs, the and Reproductive
challenge was that they could not give Health TWG Meeting
service deliveries for youths going to these
offices. The goal, then, was to develop a
more programmatic approach to enhance the
positive impact of youth hubs. NYC had
already constituted a National AHDP TWG
tasked to come up with a program or policy
on the NYC teen connection that was
patterned after that of New York City.
During the 61st Regular NIT Meeting, Dr.
Perez informed the body that a meeting had
yet to be set up.

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Republic of the Philippines
Department of Health
OFFICE OF THE SECRETARY

Meeting/Agenda Items Discussions Agreements


5. On the FP Logistics Update – Dr. Perez POPCOM to present
noted during the 60th Regular NIT Meeting the regional PSI
that the PSI utilization reports POPCOM utilization report in
received had been forwarded to FHO. the next meeting
During the 61st Regular NIT Meeting, Dr.
Perez committed to presenting the utilization
report of PSIs at the regional level in the next
meeting.

Dr. Cabral presented the data on implants


before they were given from the supply of the
DOH Central Office. The following DOH
Regional Offices received the following
number of implants:
• CAR – 31,918 implants;
• Region I – 29,808 implants;
• Region II – 34,448 implants;
• Region V – 15,000 implants;
• Region VII – 1,078 implants;
• Region VIII – 4,500 implants;
• Region IX – 21,000 implants;
• Region X – 16,784 implants;
• Region XI – 21,000 implants; and
• CARAGA – 28,186 implants.
All other regions did not receive implants
until December 2017 when they were given
supplies from the central warehouse. In
which case, the following DOH Regional
Offices received the following number of
implants:
• NCR – 10,000 implants;
• Region III – 10,000 implants;
• Region IV-A – 10,000 implants;
• Region IV-B – 20,000 implants;
• Region VI – 8,750 implants;
• Region XII – 10,000 implants; and
• ARMM – 16,000 implants.
It followed, then, that all regions had a
combined supply of 323,452 implants.
Adding the 138,000 implants distributed to
the CSOs, a total of 461,464 implants was
available by the end of 2017. Dr. Cabral
noted that these should all be implanted
before the end of 2018.

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Republic of the Philippines
Department of Health
OFFICE OF THE SECRETARY

Meeting/Agenda Items Discussions Agreements


Ms. Maria Arlene T. Rivera of FHO
informed the body that the procurement of
ancillary supplies was not incorporated in
their Work and Financial Plan (WFP) for
2018. Dr. Cabral responded that FHO should
immediately supply the needs of CSOs so
that the latter could effectively provide FP
services.

Dr. Esmeraldo T. Ilem of the Philippine RPRH Training TWG


Society for Responsible Parenthood, Inc. to convene to come
(PSRP) committed during the 60th Regular up with a national
NIT Meeting to issuing a training calendar so plan and schedule for
that CSOs could refer those interested in presentation to the
being trained. Ms. Gomez said that the next meeting
problem, however, was that CSOs might
have the capacity for training (i.e., training
room, materials), but there was no sufficient
funding. Dr. Perez suggested that PSRP and
FHO or Fabella, representing all DOH
hospitals, come up with a national plan and
schedule on training with which CSOs and
LGUs could refer to. The matter was
deferred to the next meeting because PSRP
was not present during the 61st Regular NIT
Meeting.

Ms. Ana Lyne L. Joven of the POPCOM – DOH and POPCOM


FP Logistics Hotline said during the 60th to develop the joint
Regular NIT Meeting that some RHUs did memorandum during
not comply to their request for inventory and the RPRH Logistics
order report of FP commodities because the TWG Meeting
only memorandum available to the FP
Logistics Hotline was not signed by DOH.
During the 61st Regular NIT Meeting, Dr.
Perez updated that the joint memorandum
between DOH and POPCOM was not yet
prepared.

6. On the Proposed Issues and Actions for Secretariat to provide


Accelerating FP from the National assistance in
Workshop of Key FP Stakeholders on convening the RPRH
January 16-17, 2018 – Mr. Erickson TWGs
Bernardo of Likhaan requested during the
60th Regular NIT Meeting for assistance

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Republic of the Philippines
Department of Health
OFFICE OF THE SECRETARY

Meeting/Agenda Items Discussions Agreements


from the NIT, particularly the Secretariat, in
convening the RPRH TWGs and its members
so that they could discuss the specific
recommendations of the workshop
participants of the National Brainstorming
and Workshop on Strategic Actions for Key
FP Players.

2. Family Health Mr. Hermenegildo M. Caronan, Jr. of the Health


Associates Terms Human Resources Development Bureau – DOH
of Reference presented the DOH-Human Resources for
Health (HRH) Deployment Program. The
following were the highlights of such
presentation:

• The DOH-HRH Deployment Program


was a strategy of the national
government to redistribute healthcare
workers to increase access to quality
healthcare services, to address the
inequitable distribution of healthcare
professionals, and to improve local
health systems. The Family Health
Associates Deployment Project was
among these programs. Family Health
Associates (FHAs) would have a
monthly salary of ₱26,494.00, would be
enrolled in PhilHealth and GSIS Group
Personal Accident, and would work
under the direct supervision of the DOH
Provincial Health Team Leader (DMO
IV)/DOH Representative (DMO III) in
coordination with the Municipal Health
Officer or the Designated Officer-in-
Charge.
• FHAs should be licensed nurses. They
would be employed under Contract of
Service for one year, subject to
performance evaluation every semester
during contract period. They would
automatically be terminated if their
performance rating was below very
satisfactory. Their job functions were
also detailed in the presentation.

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• The partial submission of FHAs hired
per region showed a total of 1,211 FHAs
for the Philippines. Regions V, VI, VIII,
and ARMM had FHAs that reached
beyond 100. On the other hand, Regions
III and VII had yet to submit their FHA
inventory report.

During and after such presentation, the


following comments and discussions ensued:

• Mr. Caronan mentioned that the


Provincial DOH Office or the Integrated
Provincial Health Office should lobby to
LGUs the provision of meal allowances
and travelling expenses to HRH during
their tour of duty. Dr. Cabral suggested
for the DOH to enter into a MOA with
LGUs, putting into writing that the latter
would provide these incentives. She
added that LGUs should commit to
allocating funds for the provision of
additional support before FHAs were
deployed to their areas of assignment.
• Dr. Yolanda E. Oliveros of the United
States Agency for International
Development commented that the huge
discrepancy between the salaries of local
nurses and FHAs was a connected issue.
In addition, there had been instances in
which the outputs of local profiling were
submitted to the regions instead of the
LGUs. She said that HHRDB should
address these issues to ensure the success
of the deployment program.
• Dr. Perez informed the body that the HHRDB to meet with
Local Investment Planning for Health BLHSD to discuss the
(LIPH) provided that any assistance addition of FHA
given by DOH should be part of an incentives and
investment plan for health. LGUs should support in the LIPH
be apprised before any assistance was
committed so that they could allocate the
necessary funds. He recommended that
HHRDB meet with the Bureau of Local
Health Systems Development (BLHSD)

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– DOH to discuss the inclusion of these
incentives of FHAs in the LIPH.

3. Framework for a Ms. Cynthia A. Arce of the Philippine


Study on RPRH Legislators’ Committee on Population and
Law with Focus on Development (PLCPD) presented an
Adolescent independent assessment of R.A. 10354: The
Reproductive Responsible Parenthood and Reproductive
Health Health Act. The following were the highlights of
such presentation:

• The rationale was to determine the lags,


challenges, and gaps in the
implementation of the RPRH Law that
might provide critical information as
basis for the development of remedial
legislation and administrative measures.
The aim of the project was to conduct an
independent assessment of the RPRH
Law which would help inform
parliamentarians on mandatory review
and policy amendments and the
Executive through National Government
Agencies and LGUs on strategic action
and programmatic intervention. The
project would operate under a
development context that acknowledged
the wide disparities between the rich and
the poor, especially the vulnerable and
marginalized.
• The project would focus on the key
priority area of Adolescent Sexual and
Reproductive Health (ASRH) and would
be cross-analyzed across the other four
key priority areas. The proposal was to
cover young adolescents to young adults
from age 10 to 24 to reflect the age range
prescribed by the Civil Registry and the
Young Adult Fertility and Sexuality
Study. A three-part methodology would
be employed to cover all bases from the
desk review of available secondary data
from the NIT to the iteration of results
through participatory evaluation and the

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development of policy
recommendations.
• Key research questions were identified
for each of the three parts in the
methodology, and sample evaluation
questions were presented for
consideration of the possible members of
the Evaluation Reference Group (ERG).
The ERG would primarily be involved in
the conduct of online interview through
the Delphi method. The proposed
schedule and milestone dates included
the finalization of the ERG composition
on February 13, 2018 to the conduct of a
synthesis and validation session on
March 16, 2018.

During and after such presentation, the


following comments and discussions ensued:

• Dr. Melgar commented that any


assessment focused on ASRH might
come across limited data since it was a
relatively new and controversial key
priority area. Regional offices were
conflicted on what to assess or focus on
when it came to ASRH. She added that
she was doing a study with the World
Health Organization on adolescent
conception on human rights and
committed to sharing with PLCPD their
study literature and references.
• Dr. Flavier expressed concern on the
multiplicity of proposed outcomes and
advised that PLCPD focus on the
objective to contribute to the Teenage
Pregnancy Bill. He opined that the
RPRH Law was restrictive, specifically
on the provisions of parental consent and
conscientious objection, thus limiting
the access of adolescents to FP services.
The project would be more helpful if the
results could suggest ways to go around
these two main impediments that

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restricted adolescents from accessing
preventive and protective services.
• Ms. Arce requested for the body to FHO, POPCOM,
nominate members of the ERG and PCPD, Likhaan,
emphasized that the nominees need not DSWP, NYC, and RH
be regular members of the NIT. The Agenda to be part of
request was for about 8 to 10 members to the ERG
ensure manageability of the group that
would finalize the evaluation questions,
respond to online interviews, and
participate in the validation session.
FHO, POPCOM, PCPD, Likhaan,
DSWP, NYC, and RH Agenda
volunteered to be part of the ERG.

4. Other Matters On the Proposed E.O. to Strengthen the


National Family Planning Program

Dr. Perez gave a presentation on the early


economic gains by fully implementing the
RPRH Law. The same was presented by the
Secretary of the National Economic and
Development Authority, Dr. Ernesto M. Pernia
to the Cabinet Meeting on February 5, 2018. The
following were the highlights of such
presentation:

• As of 2016, the Philippines had a


population of 103.32 million, a
population growth rate of 1.56%, and a
gross national income per capita of
$3,580.00. The high fertility rate in the
Philippines was complemented with an
equally high poverty incidence. Among
the 17 regions, NCR and ARMM had the
lowest and the highest fertility rate and
poverty incidence, respectively.
• Poor women were found to have two
children more than they wanted.
Philippines was one of the only two
ASEAN countries with rising births
among adolescents. Births among
adolescent mothers aged 10 to 19
increased from 203,653 births in 2011 to
1,040,211 in 2015.

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• The full implementation of the FP
program could accelerate the
achievement of wanted fertility and
could sharply reduce by itself the
number of poor Filipinos. If the FP
program could be fully implemented, the
number of poor Filipinos could be
reduced by up to two million. Full FP
implementation from 2018 to 2045 could
1
even generate gains of up to 13 of the
2017 gross domestic product.
• The operational considerations were
presented to include, among others, the
creation of the Presidential Arm for
Family Planning (PAFP). The PAFP
would include NEDA as the chairperson,
DOH as the co-chairperson, OP, DBM,
DILG, DSWD, DepEd, and ULAP as
members, and POPCOM as an ex officio
member. The inclusion of the OP, DBM,
and ULAP was intended to strengthen
the POPCOM Board of Commissioners.

During and after such presentation, the


following comments and discussions ensued:

• Dr. Melgar expressed concern that the


creation of the PAFP might shift the
focus of the FP program to population
control and suggested that all efforts be
made to ensure that health and
reproductive rights remained at the
center of family planning.
• Ms. Joy Salgado of Likhaan asked about
the difference between E.O. No. 12 and
the E.O. being proposed. Dr. Perez
responded that the proposed E.O.
focused on FP implementation alone. In
contrast, E.O. No. 12 provided the
technical definition of “unmet need for
modern family planning,” detailed the
roles and functions of each agency
involved in RPRH Law implementation,
and specified the reporting mechanism
to trace the progress of the Law.

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• Dr. Cabral commented that a more
effective implementation of the RPRH
Law should feature better mobilization
of resources, strengthened partnership
with LGUs, and localization of FP
information and services to reach the
level of LGUs. She suggested that the
benefits of creating a PAFP could be
maximized by spelling out an order to
DBM to put the budget into the National
Expenditure Program. Dr. Perez said that
these comments would be considered
during the review of the proposed E.O.

Adjournment:

Having no further matters to discuss, the meeting was adjourned at around 1:35 PM.

Prepared by:

MARC LAURENZ B. BALMEO


For the POPCOM Secretariat

Noted by:

JUAN ANTONIO A. PEREZ III, MD, MPH


Vice-Chairperson and Head of Secretariat, NIT for the RPRH Law

Approved by:

ESPERANZA I. CABRAL, MD
Chairperson, NIT for the RPRH Law

61st Regular NIT Meeting | February 8, 2018 Page 14 of 14

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