Children, The Family and Health: What it Takes to Give Children Long Life
The Singapore Workshop: Philippines - Health Problems In The Philippines
Children in the Philippines have several health problems varying on the economic, social and cultural standing of their parents. It also depends on the kind of weather and location of the tile residence of their families.
One example of a health problem is the weight. According to survey most children who are either overweight or underweight are found in ages one to four. Recent studies show that overweight children are studying in the private schools, showing that most belong to parents with higher level of income. Most underweight children are studying in the public or government schools showing that they belong to the middle or lower level income group of parents.
Instead of exploring more on the health problems, we are sharing with you a very nice program called the Under Five Clinic Program”. We hope this program will help those countries which are not yet implementing it.
The Under Five Clinic Programs
The thrust of the Under Five Clinic programs is to introduce a comprehensive health package for 0-4 years old children and to provide preventive, promotive, and curative health care through a series of consultations with the children and their parents. The main concern of the programs is to reduce mortality, morbidity, malnutrition and to ensure healthy Filipino children.
In the delivery of health care for the 0-4 years old children, innovative approaches were designed and employed to attain its objectives. The home based growth charts are aimed to monitor growth and development of a child, detection of anemia, prevention and correction of dehydration through oral rehydration, provide immunizations. such as BCG, DPT, OPV and Measles among 0-4 years old children, advise proper nutrition which includes breastfeeding, food supplements and micronutrients and treat acute and chronic illnesses. Maternal services are also being given such as immunization of tetanus toxoid, proper nutrition and family planning advice on responsible parenthood.
The Under Five Clinic of Baguio General Hospital & Medical Center started as a nutrition project in July 1975. It was initiated by Dr. Natividad Relucio-Clavano, who was then the Head of Pediatric Department. The hospital pioneered the establishment of such clinics in the Philippines because of its wide acceptance.
It was subsequently adopted as a regional program for Region I in 1977. Dr. Ignacio de Guzman, the then Regional Health Director, Region I issued a Regional Circular No.77 s.1977 for the regionwide expansion of the Under Five Clinic Program. A special budget was appropriated, based on Baguio’s pioneering program, for the regional thrust. Over 300 participants consisting of regional technical staff members, chiefs of hospitals, pediatricians and nurses were trained to implement the Under Five Clinic concept.
The Project Management Staff (PMS) adopted on February 1978, the Under Five Clinic Programs for implementation in the re-structured Rural Health Clinic Program. To jibe with the Philippine target age group of 0-5 years old, the program’s name changed to Under Six Clinic.
In 1979, the Under Six Clinic program was launched as a National Undertaking. This same year was declared as the “International Year of the Child” and Under Six Clinic of Baguio General Hospital & Medical Center was a decade Marker Awardee. Through the whole hearted support of Dr. Trinidad T. Gomez, the Director of the Nutrition Service and Minister of Health, Clemente Gatmaitan, who issued Ministry Circular No.43, s. 1979, all chiefs of hospitals were directed to start operations of Under Six Clinics so that these could later serve as training laboratories for rural health units and barangay health stations.
The Under Six Clinic of Baguio General Hospital & Medical Center became the National Training for the Under Six Clinic Program. Dr. Natividad Relucio-Clavano was designated as the National Program Consultant of the Under Six Clinic Program under Ministry Circular No. 77-C.s. 1979.
Modules were designed to be used as guides for duplication and implementation of the Under Six Clinic Programs in all Regions. The concept and implementation of the Under Six Clinic was integrated ‘in the primary health care.
The program was included in the UNICEF Country Program for 1980-83 and subsequent years, with the full support of Dr. Wong, a UNICEF Representative to the Philippines.
On March 7, 1980, Health Minister Enrique M. Garcia issued Memorandum Circular No. 3, directing all chiefs of hospitals and maternity clinics to enforce rooming-in and breastfeeding. Likewise, Minister Jesus Azurin issued Ministry Circular No. 9-A on January 1983, requiring the adoption of breastfeeding and rooming-in. Baguio’s Under Six Clinic was designated to train trainers on breastfeeding and rooming-in for the health ministry and non-government organizations.
Breastfeeding was further supported and strengthened through the promulgation of Executive Order No. 51 a national code of marketing of breastmilk substitutes, breastmilk supplements and related products, penalizing violations thereof, and for other purposes. President Cory Aquino signed this executive order on October 20, 1986, aiming to contribute to the provision of safe and adequate nutrition for infants by the protection and promotion of breastfeeding and by ensuring the proper use of breastmilk substitutes and breastmilk supplements when these are necessary.
Moreover, breastfeeding and rooming-in bill was enacted into law on June 2, 1992 under Republic Act No. 7600, approved and signed by President Corazon Aquino. One of the bases of this law were the Breastfeeding and Rooming-in practices in Baguio General Hospital & Medical Center. This was the realization of the uniting efforts, dedication, and commitment of Dr. Natividad Relucio-Clavano. The Under Six Clinic became the working arm of the Department of Health in the promotion and establishment of breastfeeding and rooming-in practices.
Previously, the practice of most hospitals especially in the private ones, separate the baby from the mother as soon as she is born and brought to the nursery. It is only during nursing time that she is brought to her mother. But with the breastfeeding being encouraged, so is “rooming-in”, wherein the baby is brought to stay with the mother in her bed as soon as she is able while they are still in the hospital.
The state adopts rooming-in as a national policy to encourage, protect and support the practice of breastfeeding, not only in the government hospitals but also the private sectors of health institutions. It shall create an environment where basic physical, emotional and psychological needs of mothers and infants are fulfilled through the practice of rooming-in and breastfeeding. When the mother and child will be discharged from the hospital, the continuation of the promotion of breastfeeding does not stop there but it will be given and provided every monthly visit of the mother. and child. The problems of the mother with regards to breastfeeding are referred and discussed with the health worker of the Under Six Clinic who is well trained on this matter. Proper advice and motivations are extended to the mother for possible solutions of her problems on breastfeeding.
The name of the Under Six Clinic was again changed to Under Five Clinic by the Department of Health and the transition took effect on July 1, 1991. The target age group to serve are those 0-4 years old children in contrast to the previous of 0-5 years old.
To date, there are more than 2,000 Under Five Clinics throughout the country serving more than two (2) million under five registrants.
Some medical universities, midwifery and nursing schools have incorporated the methodology and implementation of the Under Five Clinic in their curricula.
It is also a model, not only locally but internationally, as well, with regards to primary comprehensive health care. Health workers and some paramedicals often come to observe and to be trained. These people represent developed and developing countries.
The Under Five Clinic Programs have achieved a significant level of preventive, promotive, and curative health care for the 0-4 years old children in the Philippines.
A Country Report
1. Why is breastfeeding the most vital contribution to child survival?
Breastfeeding is the most vital contribution to child survival. because it is a form of intimate communication between the mother and her baby which contributes to the creation of love bond between them.
Breastfeeding cuts down hospital expenditures, since there is no need to purchase feeding bottle sets, milk formulae, electricity, water, detergents and cleaning brushes. Maintenance of formulae rooms and nurseries are no longer indispensable. This means savings to the hospital which will allow them to procure additional drugs and medicines and other supplies.
Breastmilk is the best food for a baby in any society. A baby who is being breastfed by her mother is most likely to avoid the risk of malnutrition, infection and an early grave.
The most dramatic research was conducted in the Philippines, sponsored by UNICEF. It was a study of over 10,000 new born babies in Baguio General Hospital which was done in a four (4) year period. During the halfway of the study, there was an evident precipitous fall in the incidence of infection, diarrhea and death.
UNICEF believes that one million infant lives a year could be saved within a decade from now as research proved the immunological qualities of breastmilk, especially the Colostrum.
2. What are the effects of the Under Five Clinic programs to the promotion of health education?
Reduction in the rate of mortality, morbidity and malnutrition are the effects of the Under Five Clinic Programs to the promotion of health education.
3. Do we consider the following factors contributory to the success of the Under Five Clinic Programs?
a) Effective Management;
b) Commitment and Dedication of the personnel to service;
c) Intensified campaign of the programs.
The factors enumerated are considered contributory or solid ground as basis to the success of the Under Five Clinic Programs because of the right attitude, motivation and knowledge of the personnel to implement the programs.
4. What is the importance of the Expanded Program on Immunization (EPI) to 0-4 years old children?
The importance of the Expanded Program on Immunization (EPI) to 0-4 years old children is to stop them from getting measles, poliomyletis (polio), tuberculosis, diptheria, whooping cough (pertussis) and tetanus. The perfect immunization schedule consist of a single vaccine given at birth which would offer life long protection against U PI diseases.
5. Why is the Under Five Clinic Programs contributory to the mission of the Department of Health’s Center of Wellness Program?
The Program is contributory to the mission because of its comprehensive health care package to 0-4 years old children which are undeniably preventive, promotive, and curative.
6. Is the implementation of the Under Five Clinic Programs a response to low cost health care programs? Why?
It is a response to low cost health care programs because of its preventive, promotive and curative aspects. The ultimate beneficiaries who are the clients as well as government hospitals are assured of savings since the cut down on expenditures intended for drugs, medicines, medical and laboratory supplies will now be spent on other needs.
1997 Annual Mortality Report Chlldren Ages> 1 To 14 Cordiliera Administrative Region
| <1 M | <1F | 14 M | 1-4F | 5-14M | 5-14F | TOTAL | |
|---|---|---|---|---|---|---|---|
| Pneumonias | 79 | 59 | 32 | 34 | 20 | 14 | 238 |
| Accidents, all kinds | 2 | 1 | 12 | 6 | 31 | 17 | 68 |
| Prematurity | 37 | 30 | 0 | 0 | 0 | 0 | 67 |
| Sepsis/Septicemia | 20 | 16 | 2 | 3 | 0 | 3 | 44 |
| Heart Diseases | 6 | 3 | 0 | 1 | 22 | 1 | 33 |
| Asphyxia | 13 | 11 | 1 | 2 | 2 | 29 | |
| Diarrheal Diseases | 7 | 4 | 3 | 5 | 2 | 3 | 24 |
| Congenital Anomalies | 14 | 7 | 0 | 0 | 0 | 1 | 22 |
| Malaria | 5 | 2 | 3 | 2 | 3 | 1 | 16 |
| Measles | 6 | 2 | 5 | 3 | 0 | 0 | 16 |
| Dehydration | 1 | 2 | 3 | 6 | 0 | 2 | 14 |
| Meningitis | 2 | 3 | 3 | 0 | 1 | 3 | 12 |
| Broncho-pneumonia | 2 | 2 | 1 | 3 | 2 | 0 | 10 |
| Cancer, all forms | 0 | 0 | 0 | 1 | 3 | 5 | 9 |
| Resp. Distress Syndrome | 6 | 2 | 0 | 0 | 0 | 0 | 8 |
| Malnutrition | 2 | 2 | 1 | 2 | 0 | 0 | 7 |
| Anemia | 1 | 1 | 0 | 0 | 4 | 0 | 6 |
| Sudden Infant Death | 4 | 1 | 0 | 0 | 0 | 0 | 5 |
| Aspiration | 2 | 1 | 0 | 1 | 0 | 0 | 4 |
Last Modified: November 29, 2002