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DOH PROGRAMS AND PLANS

 Filariasis Elimination Program


• Filariasis is a major parasitic infection, which continues to be a public health problem in the
Philippines. It was first discovered in the Philippines in 1907 by foreign workers. Consolidated
field reports showed a prevalence rate of 9.7% per 1000 population in 1998. It is the second
leading cause of permanent and long-term disability. The disease affects mostly the poorest
municipalities in the country about 71% of the case live in the 4th-6th class type of
municipalities.
• The World Health Assembly in 1997 declared “Filariasis Elimination as a priority” and followed
by WHO’s call for global elimination. A sign of the DOH’s commitment to eliminate the disease,
the program’s official shift from control to elimination strategies was evident in an
Administrative Order #25-A,s 1998 disseminated to endemic regions. A major strategy of the
Elimination Plan was the Mass Annual Treatment using the combination drug,
Diethylcarbamazine Citrate and Albendazole for a minimum of 2 years & above living in
established endemic areas after the issuance from WHO of the safety data on the use of the
drugs. The Philippine Plan was approved by WHO which gave the government free supply of the
Albendazole (donated by GSK thru WHO) for filariasis elimination. In support to the program, an
Administrative Order declaring “November as Filariasis Mass Treatment Month was signed by
the Secretary of Health last July 2004 and was disseminated to all endemic regions.
Vision: Healthy and productive individuals and families for Filariasis-free Philippines
Mission: Elimination of Filariasis as a public health problem thru a comprehensive approach and
universal access to quality health services
Goal: To eliminate Lymphatic Filariasis as a public health problem in the Philippines by year 2017
General Objectives: To decrease Prevalence Rate of filariasis in endemic municipalities to <1/1000
population.
Specific Objectives:
The National Filariasis Elimination Program specifically aims to:
1. Reduce the Prevalence Rate to elimination level of <1%;
2. Perform Mass treatment in all established endemic areas;
3. Develop a Filariasis disability prevention program in established endemic areas; and
4. Continue surveillance of established endemic areas 5 years after mass treatment.
• Program Strategies
STRATEGY 1. Endemic Mapping
STRATEGY 2. Capability Building
STRATEGY 3. Mass Treatment (integrated with other existing parasitic programs)
STRATEGY 4. Support Control
STRATEGY 5. Monitoring and Supervision
STRATEGY 6. Evaluation
STRATEGY 7. National Certification
STRATEGY 8. International Certification
• Management Being Used
1. Selective Treatment – treating individuals found to be positive for microfilariae in nocturnal blood
examination.
Drug: Diethylcarbamazine Citrate
Dosage: 6 mg/kg body weight in 3 divided doses for 12 consecutive days (usually given after meals)
2. Mass Treatment – giving the drugs to all population from aged 2 years and above in all established
endemic areas.
Drug: Diethlcarbamazine Citrate (single dose based on 6 mg/kg body wt) plus Albendazole 400mg given
single dose given once annually to people 2 yrs & above living in established endemic areas
3. Disability Prevention thru home-based or community-based care for lymphedema & elephantiasis
cases. Surgical management for hydrocele patients.
 Rabies Prevention and Control Program
• Rabies is a human infection that occurs after a transdermal bite or scratch by an infected
animal, like dogs and cats. It can be transmitted when infectious material, usually saliva, comes
into direct contact with a victim’s fresh skin lesions. Rabies may also occur, though in very rare
cases, through inhalation of virus-containing spray or through organ transplants.
• Rabies is considered to be a neglected disease, which is 100% fatal though 100% preventable. It
is not among the leading causes of mortality and morbidity in the country but it is regarded as a
significant public health problem because:
(1) it is one of the most acutely fatal infection and
(2) it is responsible for the death of 200-300 Filipinos annually.
• Vision: To Declare Philippines Rabies-Free by year 2020
• Goal: To eliminate human rabies by the year 2020
• 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
Rabies Facilities (NARIS website)
Private Animal Bite Centers
Public Animal Bite Centers
Regional Diagnostic Centers
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 2015, 217 rabies cases and 783,879 animal bites or rabies exposures were reported. A total
of 486 ABTCs were established and strategically located all over the country. Post Exposure
Prophylaxis against rabies was provided in all the 486 ABTCs.
 Newborn Screening Program
• Newborn screening (NBS) is an essential public health strategy that enables the early
detection and management of several congenital metabolic disorders, which if left untreated,
may lead to mental retardation and/or death. Early diagnosis and initiation of treatment, along
with appropriate long-term care help ensure normal growth and development of the affected
individual. It has been an integral part of routine newborn care in most developed countries for
five decades, either as a health directive or mandated by law. In the Philippines, it is a service
available since 1996.
VISION
The National Comprehensive Newborn Screening System envision all Filipino child will be born
healthy and well, with an inherent right to life, endowed with human dignity; and Reaching her/his
full potential with the right opportunities and accessible resources.
MISSION
To ensure that all Filipino children will have access to and avail of total quality care for the
optimal growth and development of their full potential.
GOAL
By year 2025, all Filipino newborns are screened for the more common and life-threatening
congenital metabolic disorders
• Policies and Laws
• RA 9288 or the Newborn Screening Act of 2004 and DOH AO No. 2014-0045 or the Guidelines on
the Implementation of the Expanded Newborn Screening Program
• STRATEGIES ACTION POINTS AND HIGHLIGHTS
1. Operations/ Systems/ Network
• Expanded Newborn Screening (eNBS) has been made available since December of 2014. This
panel now covers more disorders to be tested (endocrinology, hemoglobinopathies, metabolic).
Recognizing that eNBS is more beneficial for newborns, the program looks forward to the full
transition from the NBS 6-test to eNBS by 2018. This will ensure the continuity and
sustainability of quality testing and follow-up service to newborns in the country.
• Development of a reference laboratory for confirmation of metabolic disorders.
• Establishment of a treatment/referral network and other components necessary for the
efficient implementation of the program.
• Increase in the number of G6PD confirmatory centers, ideally one center per province. Today, a
total 25 G6PD laboratory are established.
• Establishment of additional Newborn Screening Centers (NSCs) in strategic areas in the country
(Region 7, Bicol Region, Southern Mindanao) in the next 4 years. The timing of the opening of
the NSCs is dependent on the volume of samples from the catchment area of the proposed sites.
NSC in Northern Luzon was opened on May 2017.
• Upgrading of Newborn Screening National Laboratory Information Systems
2. Treatment and Management
• Identification of regional NBS follow-up clinics to handle the long term follow up of confirmed
patients. Today, there are 14 Continuity Clinics nationwide.
• Undertake collaborations with medical subspecialty organizations (e.g. pediatric hematology,
neonatology and pediatric endocrinology) critical in the proper and standardized referral and
management of positive cases, in line with the expansion of screening.
• Conduct of Monthly Case Audits among NSCs to ensure that babies with positive screens are
provided with prompt and appropriate management essential for preventing debilitating
consequences of the disorders being screened. The Case Audits are attended by the NSC Follow-
up Teams and the adviser of the Newborn Screening National Follow-up Committee (NNSFC)
chair, and presided by the National Follow-up Coordinator.
• Facilitate provision of scholarships to new MS Genetics Counseling students. These prospective
graduates are expected to respond to the counseling need of the patients and their families who
will be identified positive by the program.
• Support fellows-in-training in the fields of Pediatric Endocrinology and Clinical Genetics at the
Philippine General Hospital
3. Financing
• Currently, PHIC is funding the basic screening of six disorders for P550 for its members. The
expanded newborn screening costs P1500 and remains as an option to parents, wherein PhP
550 is covered by PHIC and the remaining PhP 950 as an out of pocket expense of the family.
Discussions with PHIC for possible full coverage of expanded newborn screening is ongoing. The
successful transition from the NBS 6-test to eNBS is dependent on the financing capacity of the
program to implement eNBS in full.
4. Advocacy/ Promotion/ Linkages
• Inclusion of NBS in the assessment criteria of performance-based grants (e.g. those in
scorecards) to serve as leverage for the LGUs to make sure all their MCP accredited facilities are
performing NBS package.
• Incorporation of NBS in pre-natal education
• Inclusion of NBS in curricula for public health, medical, nursing, midwifery, and law schools
• Development of expanded newborn screening IECs for various audiences
5. Program Monitoring and Evaluation
• DOH and DILG to continue program monitoring of strict implementation of the Law and the IRR
and strengthen the capacity of the NSRC, ROs and LGUs in regulatory and monitoring aspects.
• The DOH and program implementers to remain aggressive in identifying strategies to intensify
awareness in the communities and increase coverage among home deliveries
6. Capability Building
• The Regional Offices will continuously provide capability building activities to increase the
knowledge of the health professionals included in the Women’s Health Teams or Barangay
Health Teams on the importance of NBS and help empower parents to plan and prepare for the
cost of having their baby undergo newborn screening.
 HIV/STI Prevention Program
• HIV is a virus that attacks the immune system, which is our body’s natural defence against illness.
The virus destroys a type of white blood cell in the immune system called a T-helper cell, and
makes copies of itself inside these cells. T-helper cells are also referred to as CD4 cells.
• Program Activities
With regard to the prevention and fight against stigma and discrimination, the following are the
strategies and interventions:
1. Availability of free voluntary HIV Counseling and Testing Service;
2. 100% Condom Use Program (CUP) especially for entertainment establishments;
3. Peer education and outreach;
4. Multi-sectoral coordination through Philippine National AIDS Council (PNAC);
5. Empowerment of communities;
6. Community assemblies and for a to reduce stigma;
7. Augmentation of resources of social Hygiene Clinics; and
8. Procured male condoms distributed as education materials during outreach.
 Mental Health Program
• Mental health is a level of psychological well-being, or an absence of mental illness. It is the
"psychological state of someone who is functioning at a satisfactory level of emotional and
behavioral adjustment“.
• INTERVENTIONS / STRATEGIES EMPLOYED/IMPLEMENTED BY DOH
1. Health Promotion and Advocacy
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.
• FUTURE PLAN/ACTION
• 2 Batches of training on promotion mental health in the communities
• 1 Batch of training on psychosocial intervention
• Series of lecture on suicide prevention in different schools and colleges.
• Mental Health summit in celebration of World Mental Health Day.
 Dengue Prevention and Control Program
• Dengue fever is a mosquito-borne tropical disease caused by the dengue virus. Symptoms
typically begin three to fourteen days after infection. This may include a high fever, headache,
vomiting, muscle and joint pains, and a characteristic skin rash.
• The National Dengue Prevention and Control Program was first initiated by the Department of
Health (DOH) in 1993. Region VII and the National Capital Region served as the pilot sites. It was
not until 1998 when the program was implemented nationwide. The target populations of the
program are the general population, the local government units, and the local health workers.
Vision: Dengue Risk-Free Philippines
Mission: To improve the quality of health of Filipinos by adopting an integrated dengue control
approach in the prevention and control of dengue infection.
Goal: Reduce morbidity and mortality from dengue infection by preventing the transmission of the
virus from the mosquito vector human.
Objectives: The objectives of the program are categorized into three: health status objectives; risk
reduction objectives; and services & protection objectives.
Health Status Objectives:
• Reduce incidence from 32 cases/100,000 population to 20 cases/100,000 population;
• Reduce case fatality rate by <1%; and
• Detect and contain all epidemics.
Risk Reduction Objectives:
• Reduce the risk of human exposure to aedes bite by House index of <5 and Breteau index of 20;
• Increase % of HH practicing removal of mosquito breeding places to 80%; and
• Increase awareness on DF/DHF to 100%.
Services & Protection Objectives:
• Establish a Dengue Reference Laboratory capable of performing IgM capture ELISA for Dengue
Surveillance;
• Increase the % of 1° and 2° government hospitals with laboratory capable of platelet count and
hematocrit; and
• Ensure surveillance and investigation of all epidemics.