NATIONAL LEPROSY CONTROL PROGRAM

DESCRIPTION

The National Leprosy Control Program (NLCP) is a multi-agency effort to control Leprosy in
the country with private and public partnership in achieving its goals to lessen the burden
of the disease and its mission to have a leprosy-free country.

VISION

Leprosy-free Philippines by the year 2022

MISSION

To ensure the provision of comprehensive, integrated quality leprosy services at all levels
of healthcare

OBJECTIVES

 To further reduce the disease burden and sustain provision of high-quality

leprosy services for all affected communities ensuring that the principle of equity
and social justice are followed
 To decrease by 50% the identified hyper endemic cities and municipalities

PROGRAM COMPONENTS

 Early diagnosis and treatment

 Integration of leprosy services
 Referral system
 Case detection and diagnosis
 Advocacy and IEC focusing on stigma discrimination and reduction
 Prevention of Deformity, self-care and rehabilitation
 Recording and reporting
 Monitoring, supervision and evaluation

PARTNER INSTITUTIONS

 World Health Organization

 Novartis Foundation
 Sasakawa Memorial Health Foundation
 Culion Foundation, Inc.
 Philippine Leprosy Mission
 Cebu Leprosy and TB Research Foundation Inc.
  Philippine Dermatological Society
 Coalition of Leprosy Advocates and Patients in the Philippines
 International Leprosy Association

POLICIES AND LAWS

 Administrative Order No. 167, s. 1965: Rules and Regulations of Leprosy Control
in the Philippines
 Republic Act No. 4073: An Act further liberalizing the treatment of leprosy by
amending and repealing certain sections of the revised Administrative Code
 Presidential Decree No. 384 January 30, 1974: Amending Republic Act No. 4073
entitled An Act further liberalizing the treatment of leprosy by amending and
repealing certain sections of the revised Administrative Code
 Proclamation No. 467: Declaring the Last Week of February of every year as
Leprosy Week
 Administrative Order No. 26 – A, s. 1997: Guidelines on Elimination of Leprosy as
Public Health Problem
 Administrative Order No. 5, s. 2000: Guidelines on the integration of leprosy
services in hospitals
 Department memorandum No. 79, s. 2004: Recommendations to pursue Leprosy
Elimination Activities in all areas in the country
 Department Circular 366-B, s. 2003: First Leprosy Forum of the Philippine
Dermatological Society on November 12, 2003
 Department Circular 254, s. 2004: Second Leprosy Forum of the Philippine
Dermatological Society on November 9, 2004

STRATEGIES, ACTION POINTS AND TIMELINE

Strengthen local government ownership, coordination and partnership

 Ensuring political commitment and adequate resources for leprosy

programs at all levels
 Contributing to UHC with a special focus on children, women and
underserved populations including migrants and displaced people.
 Promoting partnerships with state and non-state actors and promote inter-
sectoral collaboration and partnerships at the international, national and
sub-national level
 Facilitating and conducting basic and operational research in all aspects of
leprosy and maximize the evidence base to inform policies, strategies and
activities.
 Strengthening surveillance and health information systems for program
monitoring and evaluation (including geographical information systems)

Stop leprosy and its complications

  Strengthening patient education and community awareness on leprosy.
 Promoting early case detection through active case-finding (e.g.
campaigns) in areas of higher endemicity and contact management.
 Ensuring prompt start and adherence to treatment, including working
towards improved treatment regimens
 Improving and management of disabilities.
 Strengthening surveillance for antimicrobial resistance including
laboratory network.
 Promoting innovative approaches for training, referrals and sustaining
expertise in leprosy such e-Health (LEARNS)
 Promoting interventions for the prevention of infection and disease. -
Chemoprophylaxis

Stop discrimination and promote inclusion

 Promoting societal inclusion through addressing all forms of

discrimination and stigma
 Empowering persons affected by leprosy and strengthen their capacity to
participate actively in leprosy services. -CLAP
 Involving communities in actions for improvement of leprosy services.
 Promoting coalition-building among persons affected by leprosy and
encourage the integration of these coalitions and or their members with
other CBOs.
 Promoting access to social and financial support services, e.g. to facilitate
income generation, for persons affected by leprosy and their families.
 Supporting community-based rehabilitation for people with leprosy
related disabilities

PROGRAM ACCOMPLISHMENTS/STATUS

Indicators
2017

Prevalence rate of <1 per 10,000

0.4
population

MB/PB (new cases)

1660/249
 Children below 15 years old &
proportion
6.7%

The National Leprosy Control Program in coordination with the Research Institute for
Tropical Medicine (RITM) has started the National Leprosy Baseline Survey this year (2018)
and expected to be completed in 2019. This will help the program in prioritizing
augmentation in areas with high prevalence rate. This will also give a real picture of the
country’s status in maintaining the elimination level of leprosy cases.

Continuous support has been given to all new MB and PB cases through provision of
supportive drugs from the NLCP and Multidrug Therapy (MDT) from World Health
Organization (WHO).

CALENDAR OF ACTIVITIES

 World Leprosy Day (Every last Sunday of January)

 Leprosy Control Week (Every 4th week of February)
 National Skin Disease Detection and Prevention Week (Every 2nd week of
November)

DENGUE PREVENTION AND CONTROL PROGRAM

BACKGROUND

Dengue is the fastest spreading vector-borne disease in the world endemic in

100 countries·

 Dengue virus has four serotypes (DENV1, DENV2, DENV3 and DENV4)

 First infection with one of the four serotypes usually is non-severe or

asymptomatic, while second infection with one of other serotypes may
cause severe dengue.

 Dengue has no treatment but the disease can be early managed.

  The five year average cases of dengue is 185,008; five year average
deaths is 732; and five year average Case Fatality Rate is 0.39 (2012-
2016 data).

TRANSMISSION

Dengue virus is transmitted by day biting Aedes aegypti and Aedes albopictus
mosquitoes.

DENGUE CASE CLASSIFICATION AND LEVEL OF SEVERITY

 Dengue illness is categorized according to level of severity as dengue

without warning signs, dengue with warning signs and severe dengue.

 Dengue without warning warnings can be further classified according to

signs and symptoms and laboratory tests as suspect dengue, probable
dengue and confirmed dengue.

a. dengue without warning signs

a.1 suspect dengue

- a previously well individual with acute febrile illness of 1-7 days duration
plus two of the following: headache, body malaise, retro-orbital pain, myalgia,
arthralgia, anorexia, nausea, vomiting, diarrhea, flushed skin, rash (petechial,
Hermann’s sign)

a.2 probable dengue

- a suspect dengue case plus laboratory test: Dengue NS1 antigen test and
atleast CBC (leukopenia with or without thrombocytopenia) or dengue IgM
antibody test (optional)

a.3 confirmed dengue

- a suspect or probable dengue case with positive result of viral

culture and/or Polymerase Chain Reaction (PCR) and/or Nucleic Acid
Amplification Test- Loop Mediated Amplification Assay (NAAT-LAMP) and/
or Plaque Reduction Neutralization Test (PRNT)

b. dengue with warning signs

• a previously well person with acute febrile illness of 1-7 days plus any of the
following: abdominial pain or tenderness, persistent vomiting, clinical signs of
fluid accumulation (ascites), mucosal bleeding, lethargy or restlessness, liver
enlargement, increase in haematocrit and/or decreasing platelet count

c. severe dengue

severe plasma leakage leading to

 shock (DSS)

 fluid accumulation with respiratory distress

severe bleeding

 as evaluated by clinician

severe organ impairment

 Liver: AST or ALT ≥ 1000

 CNS: e.g. seizures, impaired consciousness
 Heart:and other organs (i.e. myocarditis, renal failure)

PHASES OF DENGUE INFECTION

a. Febrile Phase
 Usually last 2-7 days
 Mild haemorrhagic manifestations like petechiae and mucosal
membrane bleeding (e.g nose and gums) may be seen.
 Monitoring of warning signs is crucial to recognize its progression
to critical phase.
b. Critical Phase
 Phase when patient can either improve or deteriorate.
  Defervescence occurs between 3 to 7 days of
illness. Defervescence is known as the period in which the body
temperature (fever) drops to almost normal (between 37.5 to 38°C).
 Those who will improve after defervescence will be categorized
as Dengue without Warning Signs, while those who will deteriorate
will manifest warning signs and will be categorized as Dengue with
Warning Signs or some may progress to Severe Dengue.
 When warning signs occurs, severe dengue may follow near the
time of defervescence which usually happens between 24 to 48
hours.
c. Recovery Phase
 Happens in the next 48 to 72 hours in which the body fluids go back to
normal.
 Patients’ general well-being improves.
 Some patients may have classical rash of “isles of white in the sea of red”.
 The White Blood Cell (WBC) usually starts to rise soon after defervescence
but the normalization of platelet counts typically happens later than that of
WBC.

MANAGEMENT (based on patient type)

1. Group A- patients who may be sent home

These are patients who are able to:

 Tolerate adequate volumes of oral fluids

 Pass urine every 6 hours
 Do not have any of the warning signs particularly when the fever subsides
 Have stable haematocrit
2. Group B- patient who should be referred for in-hospital management

Patients shall be referred immediately to in-hospital management if they have the following
conditions:

 Warning signs\
 Without warning signs but with co-existing conditions that may make dengue
or its management more complicated ( such as pregnancy, infancy, old age,
obesity, diabetes mellitus, hypertension, heart failure, renal failure, chronic
haemolytic diseases such as sickle- cell disease and autoimmune diseases,
etc.)
 Social circumstances such as living alone or living far from health facility or
without a reliable means of transportation.
  The referring facility has no capability to manage dengue with warning signs
and/or severe dengue.
3. Group C- patient with severe dengue.requiring emergency treatment and
urgent referral

These are patients with severe dengue who require emergency treatment and urgent
referral because they are in the critical phase of the disease and have the following:

 Severe plasma leakage leading to dengue shock and/or fluid accumulation

with respiratory distress;
 Severe haemorrhages;
 Severe organ impairment (hepatic damage, renal impairment,
cardiomyopathy, encephalopathy or encephalitis)

Patients in Group C shall be immediately referred and admitted in the hospital within 24
hours.

LABORATORY TESTS

Test
 Requested between 1
1. Dengue NS1 RDT  Use to detect dengue
 Test is for free in all h
 Requested beyond fiv
 Use to detect dengue
previous infection (I
2. Dengue IgM/IgG
 May give false positiv
 May cross react with
 DOH augmentation is
 One of the gold stand
3. Polymerase Chain Reaction (PCR)  Molecular based test
 Available only in den
 A novel molecular-ba
4. Nucleic Acid Amplification Test- Loop Mediated Isothermal  Work just like PCR bu
Amplification Assay (NAAT-LAMP)  In the pipeline to be i
district and provinci
 Gold standard to char
5. Plaque Reduction Neutralization Test (PRNT)
 Available only at the d
6. Other tests:
 Routinely used in hos
-Total While Blood Cell (WBC) count  Look for trend of decr
-Platelet

-Hematocrit

NATIONAL DENGUE PREVENTION AND CONTROL PROGRAM

Vision A dengue free Philippines

Mission Ensure healthy lives and promote well-being for all at all ages

Goal To reduce the burden of dengue disease

Objectives/ 1.) To reduce dengue morbidity by atleast 25% by 2022

Indicators Morbidity rate = No. of suspect, probable & confirmed cases x100,000

total population

(baseline: 198.1 per 100,000 population)

(2015 data: 200,145/100,981,437 x 100,000)

2.) To reduce dengue mortality by atleaset 50% by 2022

Mortality rate = No of dengue (probable & confirmed) deaths x 100,000

total population

(baseline: 0.59 per 100,000 population)

(2015 data: 598/100,981.437 x 100,100)

3.) To maintain Case Fatality Rate (CFR) to < 1% every year.

CFR = no. of dengue (probable & confirmed) deaths x 100

no. of probable & confirmed cases

PROGRAM COMPONENTS

1. Surveillance
 Case Surveillance through Philippine Integrated Disease Surveillance
and Response (PIDSR)
 Laboratory-based surveillance/ virus surveillance through Research
Institute for Tropical Medicine (RITM) Department of Virology, as
national reference laboratory, and sub-national reference laboratories.
 Vector Surveillance through DOH Regional Offices and RITM
Department of Entomology

2. Case Management and Diagnosis

 Dengue Clinical Management Guidelines training for hospitals.

 Dengue NS1 RDT as forefont diagnosis at the h ealth center/ RHU level.
 PCR as dengue confirmatory test available at the sub-national and
national reference laboratories.
 NAAT-LAMP as one of confirmatory tests will be available at district
hospitals, provincial hospitals and DOH retained hospitals.

3. Integrated Vector Management (IVM)

 Training on Vector Management, Training on Basic Entomology for

Sanitary Inspector, Training on Integrated Vector Management (IVM)
for health workers.
 Insecticide Treated Screens (ITS) as dengue control strategy in
schools.

4. Outbreak Response

 Continuous DOH augmentation of insectides such as adulticides and

larvicides to LGUs for outbreak response.

5. Health Promotion and Advocacy

 Celebration of ASEAN Dengue Day every June 15

 Quad media advertisement
 IEC materials

6. Research

STRATEGIES

 Enhanced 4S Strategy
S - earch and Destroy

S - eek Early Consultation

S - elf Protection Measures

S - ay yes to fogging only during outbreaks

LINKS TO PROGRAM POLICIES AND GUIDELINES

AO 2016- Guidelines for the nationwide Implementation of Dengu

0043 Diagnostic Test

AO 2012-006 Revised Dengue Clinical Management Guidelines

Guidelines on the Application of Larvicides on the Breed

AO 2001-0045
Dengue Vector Mosquitoes in Domestic Water

Implementation Guidelines for Initial Implementation of

DM 2017-0353 Acid Amplification Assay - Loop Mediated Isothermal As
as One of Dengue Confirmatory Tests to Support Dengu

Reactivation of Dengue Fast Lanes and Continuing Impro

DM 2015-0309
Systems for Dengue Case Management and Services

Technical Guidelines, Standards and other Instructions f

DM 2014-0112 Reference in the Implementation of Sentinel-based Acti
Surveillance

EXPANDED PROGRAM ON IMMUNIZATION

I. Rationale

The Expanded Program on Immunization (EPI) was established in 1976 to ensure that
infants/children and mothers have access to routinely recommended infant/childhood
vaccines. Six vaccine-preventable diseases were initially included in the EPI: tuberculosis,
poliomyelitis, diphtheria, tetanus, pertussis and measles. In 1986, 21.3% “fully immunized”
children less than fourteen months of age based on the EPI Comprehensive Program review.
II. Scenario

Global Situation

The burden

In 2002, WHO estimated that 1.4 million of deaths among children under 5 years due to
diseases that could have been prevented by routine vaccination. This represents 14% of
global total mortality in children under 5 years of age.

Source: Weekly Epidemiological Record, WHO: No.46,2011,86.509-520)

Burden of Diseases

The immunization coverage of all individual vaccines has improved as shown in Figure 1:
(Demographic Health Survey 2003 and 2008). Fully Immunized Child (FIC) coverage
improved by 10% and the Child Protected at Birth (CPAB) against Tetanus improved by
13% compared to any prior period. Thus, the Philippines has now historically the highest
coverage for these two major indicators.

Figure 1: Comparison of the 2003 and 2008 EPI indicators, Source: NDHS

III. Interventions/ Strategies

Program Objectives/Goals:

Over-all Goal:

To reduce the morbidity and mortality among children against the most common vaccine-
preventable diseases.
Specific Goals:

1. To immunize all infants/children against the most common vaccine-preventable

diseases.

2. To sustain the polio-free status of the Philippines.

3. To eliminate measles infection.

4. To eliminate maternal and neonatal tetanus

5. To control diphtheria, pertussis, hepatitis b and German measles.

6. To prevent extra pulmonary tuberculosis among children.

Mandates:

Republic Act No. 10152“MandatoryInfants and Children Health Immunization Act of

2011Signed by President Benigno Aquino III in July 26, 2010. The mandatory includes
basic immunization for children under 5 including other types that will be determined
by the Secretary of Health.

Strategies:

 Conduct of Routine Immunization for Infants/Children/Women through

the Reaching Every Barangay (REB) strategy

REB strategy, an adaptation of the WHO-UNICEF Reaching Every District (RED), was
introduced in 2004 aimed to improve the access to routine immunization and reduce drop-
outs. There are 5 components of the strategy, namely: data analysis for action, re-establish
outreach services, , strengthen links between the community and service, supportive
supervision and maximizing resources.

 Supplemental Immunization Activity (SIA)

Supplementary immunization activities are used to reach children who have not been
vaccinated or have not developed sufficient immunity after previous vaccinations. It can be
conducted either national or sub-national –in selected areas.

 Strengthening Vaccine-Preventable Diseases Surveillance

This is critical for the eradication/elimination efforts, especially in identifying true cases of
measles and indigenous wild polio virus

 Procurement of adequate and potent vaccines and needles and syringes to all
health facilities nationwide

IV. Status of implementation/ Accomplishment

 All health facilities (health centers and barangay health stations) have at least one
(1) health staff trained on REB.

Polio Eradication:

 The Philippines has sustained its polio-free status since October 2000.
 Declining Oral Polio Vaccine (OPV) third dose coverage since 2008 from 91% to
83%. A least 95% OPV3 coverage need to be achieved to produce the required herd
immunity for protection.

Figure 2 OPV1 and OPV3 Coverage, Philippines, 2005-2010

 There is an on-going polio mass immunization to all children ages 6 weeks up to 59

months old in the 10 highest risk areas for neonatal tetanus. These areas are the
following: Abra, Banguet, Isabela City and Basilan, Lanao Norte, Cotabato City,
Maguindanao, Lanao Sur, Marawi City and Sulu.

 Acute Flaccid Paralysis (AFP) reporting rate has decreased from 1.44 in 2010 to
1.38 in 2011. Only regions III, V and VIII have achieved the AFP rate of 2/100,000
children below 15 years old. (Source: NEC, DOH). A decreasing AFP rate means we
may not be able to find true cases of polio and may experience resurgence of polio
cases
Measles Elimination

 Conducted 4 rounds of mass measles campaign: 1998, 2004, 2007 and 2011.
 Implemented the 2-dose measles-containing vaccine (MCV) in 2009

MCV1 (monovalent measles) at 9-11 months old

MCV2 (MMR) at 12-15 months old.

 Implemented and strengthened the laboratory surveillance for confirmation of

measles. Blood samples are withdrawn from all measles suspect to confirm the case
as measles infection.
 A supplemental immunization campaign for measles and rubella (German measles)
was done in 2011. This was dubbed as “Iligtas sa Tigdas ang Pinas” 15.6 million
(84%) out of the 18.5 million children ages 9 months to 8 years old were given 1
dose of the measles-rubella (MR) vaccine between April and June 2011.
 Rapid coverage assessment (RCA) were conducted in selected areas to validate
immunization coverage, assess high quality and that there are NO missed child
in every barangay. Overall RCA results showed that 70,594 (97.6%) out of
72,353 9 months to 8 years old living in the randomly selected barangays were
vaccinated. There are 3,494 barangays with a population of 1000 and above that
were randomly selected. 97.6% of all eligible children were given the MR vaccine
during the immunization campaign.
 The Government of the Philippines spent PhP 635.7M for the successful conduct of
the MR campaign.ss high quality and that there are NO missed child in every
barangay. Overall RCA results showed that 70,594 (97.6%) out of 72,353 9 months
to 8 years old living in the randomly selected barangays were vaccinated. There
are 3,494 barangays with a population of 1000 and above that were randomly
selected. 97.6% of all eligible children were given the MR vaccine during the
immunization campaign.
 As of Morbidity Week 8 of 2012, there were 92 confirmed cases: 60 cases were
laboratory confirmed, 5 cases were epidemiologically-linked and 27 clinically
confirmed. This means we have at least 60 “true” measles at present. Measles is said
to be eliminated if we have 1 case per million or below 100 cases in a year

Maternal and Neonatal Tetanus Elimination

 10 areas were classified as highest risk for neonatal tetanus (NT). Figure 3 shows
the areas categorized as low risk, at risk and highest risk based on the NT
surveillance, skilled birth attendants and facility based delivery and the tetanus
toxoid 2+ (TT 2+) vaccination.
Figure 3: Level of Risk for NT, Philippines

 Three (3) rounds of TT vaccination are currently on-going in the 10 highest risk
areas. An estimated 1,010,751 women age 15 - 40 year old women regardless of
their TT immunization will receive the vaccine during these rounds. This is funded
by the Kiwanis International through UNICEF and World Health Organization.

Control of other common vaccine-preventable diseases (Diphtheria,

Pertussis, Hepatitis B and Meningitis/Encephalitis secondary to H. influenzae type
B)

Continuous vaccination for infants and children with the DPT or the combination DPT-HepB-
HiB Type B. Annex1 EPI Annual Accomplishment Report. DOH procures all the vaccines and
needles and syringes for the immunization activities targeted to infants/children/mothers.

Hepatitis B Control

 Republic Act No. 10152 has been signed. It is otherwise known as the “Mandatory
Infants and Children Health Immunization Act of 2011, which requires that all
children under five years old be given basic immunization against vaccine-
preventable diseases. Specifically, this bill provides for all infants to be given the
birth dose of the Hepatitis-B vaccine within 24 hours of birth.
 One strategy to strengthen Hepatitis B coverage is to integrate birth dose in the
Essential Intrapartum and Newborn Care Package (EINC). In 2011, 11 tertiary
hospitals are already EINC compliant.
 The goal of Hepatitis B control is to reduce the chronic hepatitis B infection rate as
measured by HBsAg prevalence to less than 1% in five-year-olds born after routine
vaccination started 100% Hepatitis B at birth vaccination.

Figure 4 Hepatitis B Coverage. Philippines, 2001-2011

Timing of administration/dose 2009 2010* 2011*

<24 hours 34% 38% 14%

>24 hours 62% 55% 24%

Hep B 3rd dose 86% 81% 30%

*both 2010 and 2011 data are as of October 2011

Vaccines and cold chain management

 Upgraded the cold chain equipment in the 80 provinces, 38 cities and 16 regions
since 2003.
 An effective vaccine management assessment was conducted last December 2011
and revealed cold chain capacity gaps from the national up to the implementers
level.
 A total of PhP 267 million is required to address the gaps identified during the
assessment.

Introduction to New Vaccines

 For 2012, Rotavirus and Pneumococcal vaccines will be introduced in the national
immunization program. Immunization will be prioritized among the infants of
families listed in the National Housing and Targeting System (NHTS) for Poverty
Reduction nationwide.
 The Government of the Philippines has allocated PhP 1.6 billion for the
procurement of these 2 vaccines.

V. Future Plan/ Action

 Strengthening the Cold Chain to support the Immunization Program

 Capacity Building for Health Workers for the Introduction of New Vaccines
 Advocacy for the financial sustainability for the newly introduced vaccines for
expansion.
 Development of the comprehensive multi-year plan for immunization program.

VI. Other Significant information worth mentioning

 One significant milestone is that the budget allocation for the immunization
program has continued to increase year by year
 The Government of the Philippines allocated budget for the immunization of all
infants/children/women/older persons nationwide. For 2012, the budget for EPI
is PhP1.8 billion and another P1.5 Billion for the immunization for senior citizen
and children for the NHTS families. This is great leap towards universal access to
 quality vaccines for the prevention of the most common vaccine-preventable
diseases.

HIV/STI PREVENTION PROGRAM

Objective:

Reduce the transmission of HIV and STI among the Most At Risk Population and General
Population and mitigate its impact at the individual, family, and community level.

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.

Program Accomplishments:

As of the first quarter of 2011, the program has attained particular targets for the three
major final outputs: health policy and program development; capability building of local
government units (LGUs) and other stakeholders; and leveraging services for priority
health programs.
For the health policy and program development, the Manual of Procedures/ Standards/
Guidelines is already finalized and disseminated. The ARV Resistance surveillance among
People Living with HIV (PLHIV) on Treatment is being implemented through the Research
Institute for Tropical Medicine (RITM). Moreover, both the Strategic Plan 2012-2016 for
Prevention of Mother to Child Transmission and the Strategic Plan 2012-2016 for Most at
Risk Young People and HIV Prevention and Treatment are being drafted.

With regard to capability building, the Training Curriculum for HIV Counseling and Testing
is already revised. Twenty five priority LGUs provided support in strengthening Local AIDS
councils. as of March 2011, there were already 17 Treatment Hubs nationwide.

Lastly, for the leveraging services, baseline laboratory testing is being provided while male
condoms are being distributed through social Hygiene Clinics. A total of 1,250 PLHIV were
provided with treatment and 4,000 STI were treated.

Partner Organizations/Agencies:

The following organizations/agencies take part in achieving the goal of the National
HIV/STI Prevention Program:

 Department of Interior and Local Government (DILG)

 Philippine National AIDS Council (PNAC)
 Research Institute for Tropical Medicine (RITM)
 STI/AIDS Cooperative Central Laboratory (SCCL)
 World Health Organization (WHO)
 United States Agency for International Development (USAID)
 Pinoy Plus Association
 AIDS Society of the Philippines (ASP)
 Positive Action Foundation Philippines, Inc. (PAFPI)
 Action for Health Initiatives (ACHIEVES)
 Affiliation Against AIDS in Mindanao (ALAGAD-Mindanao)
 AIDS Watch Council (AWAC)
 Family Planning Organization of the Philippines (FPOP)
 Free Rehabilitation, Economic, Education, and Legal Assistance
Volunteers Association, Inc. (FREELAVA)
 Philippine NGO council on Population, Health, and Welfare, Inc.
(PNGOC)
 Leyte Family Development Organization (LEFADO)
 Remedios AIDS Foundation (RAF)
 Social Development Research Institute (SDRI)
 TLF share Collectives, Inc.
 Trade Union Congress of the Philippines (TUCP) Katipunang
Manggagawang Pilipino
 Health Action Information Network (HAIN)
  Hope Volunteers Foundation, Inc.
 KANLUNGAN Center Foundation, Inc. (KCFI)
 Kabataang Gabay sa Positibong Pamumuhay, Inc. (KGPP)

RABIES PREVENTION AND CONTROL PROGRAM

DESCRIPTION

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 2022

MISSION

To eliminate human rabies by the year 2020

OBJECTIVES

To eliminate rabies as a public health problem with absences of indigenous cases for
human and animal

PROGRAM COMPONENTS

 Post Exposure Prophylaxis

 Pre- Exposure Prophylaxis (PrEP)
 Health Education and advocacy campaign
 Training/Capability Building
 Training on National Rabies Information System (NaRIS)
 Establishment of ABTCs by Inter-Local Health Zone
 DOH-DA joint evaluation and declaration of Rabies-free areas/provinces

PARTNER INSTITUTIONS
The following organizations/agencies take part in attaining the goal of the National Rabies
Prevention and Control Program:

 Department of Agriculture (DA)

 Department of Education (DepEd)
 Department of Interior and Local Government (DILG)
 Department of Environment and Natural Resources (DENR)
 World Health Organization (WHO)
 Animal Welfare Coalition (AWC)

POLICIES AND LAWS

1. Anti-Rabies Act of 2007 (Republic Act 9482) : An Act Providing for the
Control and Elimination of Human and Animal Rabies, Prescribing penalties for
Violation Thereof and Appropriating Funds Thereof.
2. Batas Pambansa Bilang 97: An Act Providing for the Compulsory
Immunization of Livestock, Poultry and other Animals against Dangerous
Communicable Diseases. The Act required the Secretary of Agriculture to make
compulsory the vaccination of susceptible animals and poultry should there be
a threat or existence of a highly communicable animal or avian disease in a
certain locality.
3. Executive Order No. 84: Declaring March as the Rabies Awareness Month,
Rationalizing the Control Measures for the Prevention and Eradication of
Rabies and Appropriating Funds.
4. Memorandum of Agreement on Interagency Implementation of the
NRPCP: Signed in May 1991 by the Secretaries of Agriculture (DA), Health
(DOH), Local Government (DILG) and Education, Culture and Sports, now,
Department of Education
5. Joint DA, DOH, DepEd, DILG Administrative Order No. 01 Series of
2008: Implementing Rules and Regulations Implementing Republic Act 9482
An Act Providing for the Control and Elimination of Human and Animal Rabies,
Prescribing Penalties for Violation Thereof and Appropriating Funds Therefor
6. Administrative Order No. 2014-0012 entitled New Guidelines on the
Management of Rabies Exposures: To provide new policy guidelines and
procedure to ensure an effective and efficient management for eventual
reduction if not elimination of human rabies.
7. Administrative Order No. 2018-0013 entitled Revised Guidelines on the
Management of Rabies Exposures: Ensure availability of anti-rabies vaccines to
allow the use of Non-WHO Prequalified Rabies Vaccine but registered and
approved by FDA only when there is shortage of vaccines.
8. Joint Department Administrative Order No. 01 entitled Guidelines for
Declaring Areas as Rabies-Free Zones: To provide the guidelines for declaring
zones/areas as Rabies-Free by which the DA, DOH and other concerned
 institutions and agencies that will administer programs and activities on the
control, prevention and elimination of Rabies

STRATEGIES, ACTION POINTS, AND TIMELINE

1. Provision of Post Exposure Prophylaxis to all rabies exposures/ animal bite

victims (provided by RA 9482).
2. ABTC/ABC certification as quality PEP providers-PhilHealth Package
3. Provision of Pre- Exposure Prophylaxis (PrEP) to high risk individuals and
school children in high incidence area- Provided by RA 1984.
4. Strengthened IEC campaign on:
o Responsible Pet Ownership (RPO)
o RA 9482 known as the “The Anti Rabies Act of 2007” and
enactment of and strict implementation of local rabies control
ordinances.
o Early and proper management of animal bites.
o In coordination with DA-BAI: promotion of dog vaccination, dog
population control and control of stray animals.
5. Advocacy Campaign:

Rabies awareness and advocacy campaign is a year round activity highlighted on 2

occasions: March – the Rabies awareness month and September 28 – World Rabies Day.
The campaign focuses on three target audiences; pet owners – to have their dog/s
registered and vaccinated; animal bite victims- to practice immediate washing of bites with
soap and water for at least 10 minutes and receive appropriate Post-Exposure Prophylaxis
(PEP)if need from trained health workers and not from traditional healers; and lastly
Legislators, Local Chief Executives (LCEs), NGO’s Pos and other stakeholders to implement
(LCEs) and support a comprehensive rabies prevention and control program.

6. Training of Medical Doctors and Registered Nurses of ABTCs on the

guidelines on the management of animal bite victims- A requirement for ABTC
certification as providers of quality PEP services and PHIC accreditation:
o Training course offered only to government and privately
owned bite centers.
o MHOS. CHOs, PHNs and residents physicians not functioning as
ABTC are not invited to attend the training
7. Disease free zone – Joint DOH-DA evaluation and declaration of Rabies-free
islands (as provided for in the DOH disease free zone initiative and the Joint
DOH-DA AO).
8. Integration of rabies program in elementary curriculum- almost 50% of
animal bite victims are <15 years old
9. Post-mortem review – death review will be performed jointly by both human
health workers from the provinces/cities and hospitals with cases of human
rabies by. This aims to review the diagnostic history, clinical aspect, and
outcome of the patient, status of biting animal and location of biting incidence
 of human death cases due to rabies to be able to call for an action on how to
have a zero incidence of rabies.
10. Support to Department of Agriculture on Dog Vaccination

PROGRAM ACCOMPLISHMENTS/STATUS

Performance
2010 2011 2012 2013 2014 2015 2016 2017
Indicator
Number of
Rabies-free
areas/ 3 8 12 18 28 38 41 49

provinces
Incidence of
human-rabies 257 219 213 205 236 218 184 219
cases
96.61%
91.7% 100%
52.8% 100% 80% 100%
(8 full
(4 dose (6 dose 94%(8
(2 dose) (2 dose) (2 dose) (4 dose) dose
TCV) TCV) full dose
% of Post- 216,569 328,733 410,811 522,420 TCV)
683,302 544,992 TCV)
exposure 128,110
1,130,873
prophylaxis Erig: Erig: Erig: Erig:
Erig: Erig:
against rabies Erig:
Erig: 52%
27.3% 33.9% 25.84% 33.9%
25.23% 44.4% (142,816)
40%
(27,351) (40,098) (51,778) (40,098)
(54,395) (99,186)
(51,244)

CALENDAR OF ACTIVITIES

1. March as the Rabies Awareness Month

2. September 28 as the World Rabies Day
DENTAL HEALTH PROGRAM

Oral disease continues to be a serious public health problem in the Philippines. The
prevalence of dental caries on permanent teeth has generally remained above 90%
throughout the years. About 92.4% of Filipinos have tooth decay (dental caries) and
78% have gum diseases (periodontal diseases) (DOH, NMEDS 1998). Although
preventable, these diseases affect almost every Filipino at one point or another in his or
her lifetime.

Table 1: Prevalence of the Two Most Common Oral Diseases by Year,

Philippines

Prevalence
YEAR
Dental Caries Peridontal Disease
 1987 93.9% 65.5%

1992 96.3% 48.1%

1998 92.4% 78.3%

The oral health status of Filipino children is alarming. The 2006 National Oral
Health Survey (Monse B. et al, NOHS 2006) investigated the oral health status of
Philippine public elementary school students. It revealed that 97.1% of six-year-old
children suffer from tooth decay. More than four out of every five children of this
subgroup manifested symptoms of dentinogenic infection. In addition, 78.4% of twelve-
year-old children suffer from dental caries and 49.7% of the same age group manifested
symptoms of dentinogenic infections. The severity of dental caries, expressed as the
average number of decayed teeth indicated for filling/extraction or filled permanent teeth
(DMFT) or temporary teeth (dmft), was 8.4 dmft for the six-year-old age group and 2.9
DMFT for the twelve-year-old age group (NOHS 2006).

Table 2 - Dental caries Experience (Mean DMFT/dmft), per age groups,

Philippines

Age in NMEDS NMEDS NMEDS NMEDS NMEDS

Years 1982 1987 1992 1998 2006

6 8.4 dmft

12 6.39 5.52 5.43 4.58 2.9

15-19 8.51 8.25 6.3

35-44 14.18 14.82 14.42 15.04

Filipinos bear the burden of gum diseases early in their childhood. According
to NOHS, 74% of twelve-year-old children suffer from gingivitis. If not treated early,
these children become susceptible to irreversible periodontal disease as they enter
adolescence and approach adulthood.

In general, tooth decay and gum diseases do not directly cause disability or
death. However, these conditions can weaken bodily defenses and serve as portals of
entry to other more serious and potentially dangerous systemic diseases and infections.
Serious conditions include arthritis, heart disease, endocarditis, gastro-intestinal
diseases, and ocular-skin-renal diseases. Aside from physical deformity, these two oral
diseases may also cause disturbance of speechsignificant enough to affect work
performance, nutrition, social interactions, income, and self-esteem. Poor oral
health poses detrimental effects on school performance and mars success in later life.
In fact, children who suffer from poor oral health are 12 times more likely to have
restricted-activity days (USGAO 2000). In the Philippines, toothache is a common
ailment among schoolchildren, and is the primary cause of absenteeism from school
(Araojo 2003, 103-110). Indeed, dental and oral diseases create a silent epidemic,
placing a heavy burden on Filipino schoolchildren.

VISION: Empowered and responsible Filipino citizens taking care of their

own personal oral health for an
enhanced quality of life

MISSION: The state shall ensure quality, affordable, accessible and

available oral health care delivery.

GOAL: Attainment of improved quality of life through promotion of oral

health and quality oral health care.

OBJECTIVES AND TARGETS:

1. The prevalence of dental caries is reduce

Annual Target : 5% reduction of the prevalence rate every year

2. The prevalence of periodontal disease is reduced

Annual Targets : 5% reduction of the prevalence rate every year

3. Dental caries experience is reduced

Annual Target : 5% reduction of the mean dmft/DMFT for 5/6 years old and 12 years old
children every year

4. The proportion of Orally Fit Children (OFC) 12-71 months old is

increased

Annual Targets : Increased by 20% yearly

The national government is primarily tasked to develop policies and guideline for
local government units. In 2007, the Department of Health formulated the Guidelines in
the Implementation of Oral Health Program for Public Health Services (AO 2007-0007).
The program aims to reduce the prevalence rate of dental caries to 85% and
periodontal disease by to 60% by the end of 2016. The program seeks to achieve these
objectives by providing preventive, curative, and promotive dental health care to
Filipinos through a lifecycle approach. This approach provides a continuum of quality
care by establishing a package of essential basic oral health care (BOHC) for every
lifecycle stage, starting from infancy to old age.

The following are the basic package of essential oral health services/care for
every lifecycle group to be provided either in health facilities, schools or at home.

TYPES OF SERVICE
LIFECYCLE
(Basic Oral Health Care Package)
 Oral Examination
 Oral Prophylaxis (scaling)
Mother(Pregnant
 Permanent fillings
Women) **
 Gum treatment
 Health instruction
 Dental check-up as soon as the first
Neonatal and Infants tooth erupts
under 1 year old**  Health instructions on infant oral health
care and advise on exclusive
breastfeeding
 Dental check-up as soon as the first
tooth appears and every 6 months
thereafter
 Supervised tooth brushing drills
 Oral Urgent Treatment (OUT)

- removal of unsavable teeth

Children 12-71
months old ** - referral of complicated cases

- treatment of post extraction

complications

- drainage of localized oral abscess

 Application of Atraumatic Restorative

Treatment (ART)
 Oral Examination
 Supervising tooth brushing drills
School Children (6-  Topical fluoride theraphy
12 years old)  Pits and Fissure Sealant Application
 Oral Prophylaxis
 Permanent Fillings
  Oral Examination
Adolescent and  Health promotion and education on oral
Youth (10-24 years hygiene, and adverse effect on
old)** consumption of sweets and sugary
beverages, tobacco and alcohol
 Oral Examination
Other Adults (25-59  Emergency dental treatment
years old)  Health instruction and advice
 Referrals
 Oral Examination
Older Person (60  Extraction of unsavable tooth
years old and  Gum treatment
above)**  Relief of Pain
 Health instruction and advice

STRATEGIES AND ACTION POINTS:

1. Formulate policy and regulations to ensure the full implementation of OHP

a. Establishment of effective networking system (Deped, DSWD, LGU, PDA, Fit for
School, Academe and others)

b. Development of policies, standards, guidelines and clinical protocols

- Fluoride Use

- Toothbrushing

- Other Preventive Measures

2. Ensure financial access to essential public and personal oral health services

a. Develop an outpatient benefit package for oral health under the 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 Central Office

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 of essential indicators

- development of IT system on recording and reporting oral health service

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 servicesa.

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

- toothbrushing program for pre-school children

- outreach programs for marginalized groups

c. Design and implement grant assistance mechanism for high performing LGUs

- Awards and incentives

- Sub-allotment of funds 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 auxilliaries 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

Current FHSIS Indicators/parameters:

a) Orally Fit Child (OFC)– Proportion of children 12-71 months old and are
orally fit during a given point of time. Is defined as a child who meets the following
conditions upon oral examination and/or completion of treatment a) caries- free or
carious tooth/teeth filled either with temporary or permanent filling materials, b) have
healthy gums, c) has no oral debris, and d) No handicapping dento-facial anomaly or no
dento-facial anomaly that limits normal function of the oral cavity

b) Children 12-71 months old provided with Basic Oral Health Care (BOHC)

c) Adolescent and Youth (10-24 years old) provided with Basic Oral Health
care (BOHC)

d) Pregnant Women provided with Basic oral Health Care (BOHC)

e) Older Persons 60 years old and above provided with Basic Oral Health
Care (BOHC)

Policy/Standards/Guidelines formulated/developed:

a. AO. 101 s. 2003 dated Oct. 14, 2003 – National Policy on Oral Health

b. AO 2007-0007 – Dated January 3, 2007 Guidelines In The

Implementation Of Oral Health Program For Public Health Services In The Philippines

c. AO 4-s.1998 – Revised Rules and Regulations and Standard

Requirements for Private School Dental services in the Philippines

d. AO 11-D s. 1998 – Revised Standard Requirements for Hospital Dental

services in the Philippines

e. AO 3 s. 1998 - Revised Rules and Regulations and Standard

Requirements for Occupational Dental services in the Philippines

f. AO 4-A s. 1998 – Infection Control Measures for Dental Health Services

Trainings/Capacity Enhancement Program:

a. Basic Orientation Course on Management of Public Health Dentist

The 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. A
training module was developed for the basic course.
Researches:

a. National Monitoring Evaluation Dental Survey (NMEDS).

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. Data gathered provide continuous information that enables planners
to update data used in planning, implementation and evaluation of existing oral health
programs. The latest NMEDS was conducted in 2011. Results will be available on the
1st quarter of 2012.

Existing Working Group for Oral Health:

National Technical Working Group (TWG) on Oral Health (DPO 2005-1197)

Member Agencies: Department of Health (NCDPC, HHRDB, NCHP)

DOH- Center for Health Development for NCR, Central Luzon

and Calabarzon

Philippine Dental Association

Department of Education

Up- College of Public Health

Department of Interior and Local Government

Department of Social Welfare and Development

Local Government Units ( Makati, Quezon City)

NATIONAL FAMILY PLANNING PROGRAM

Vision

For Filipino women and men achieve their desired family size and fulfill the reproductive
health and rights for all through universal access to quality family planning information and
services.

Mission

In line with the Department of Health FOURmula One Plus strategy and Universal Health
Care framework, the National Family Planning Program is committed to provide responsive
policy direction and ensure access of Filipinos to medically safe, legal, non-abortifacient,
effective, and culturally acceptable modern family planning (FP) methods.

Objectives

1. To increase modern Contraceptive Prevalence Rate (mCPR) among all women

from 24.9% in 2017 to 30% by 2022
2. To reduce the unmet need for modern family planning from 10.8% in 2017 to
8% by 2022

Program Components

Component A: Provision of free FP Commodities that are medically safe, legal, non-
abortifacient, effective and culturally acceptable to all in need of the FP service:

o Forecasting of FP commodity requirements for the country

o Procurement of FP commodities and its ancillary supplies
o Strengthening of the supply chain management in FP and ensuring of
adequate FP supply at the service delivery points
Component B: Demand Generation through Community-based Management Information
System:

o Identification and profiling of current FP users and identification of

potential FP clients and those with unmet need for FP (permanent or
temporary methods)
o Mainstreaming FP in the regions with high unmet need for FP
o Development and dissemination of Information, Education Communication
materials
o Advocacy and social mobilization for FP

Component C: Family Planning in Hospitals and other Health Facilities

o Establishment of FP service package in hospitals

o Organization of FP Itinerant team for outreach missions
o Delivery of FP services by hospitals to the poor communities especially
Geographically Isolated and Disadvantaged Areas (GIDAs):
o Provision of budget support to operations by the itinerant teams including
logistics and medical supplies needed for voluntary surgical sterilization
services
o FP services as part of medical and surgical missions of the hospital
o Partnership with LGU hospitals for the FP outreach missions

Component D: Financial Security in FP

o Strengthening PhilHealth benefit packages for F

o Expansion of PhilHealth coverage to include health centers providing No
Scalpel Vasectomy and FP Itinerant Teams
o Expansion of Philhealth benefit package to include pills, injectables and
IUD
o Social Marketing of contraceptives and FP services by the partner NGOs
o National Funding/Subsidy

Partner Institutions

o Local Government Units

o Civil Society Organizations
o Non-Government Organizations
o Private Sector
o Faith-based Organizations
o Development Partners

Policies and Laws

1. Republic Act No. 10354: Responsible Parenthood and Reproductive Health Act of
2012 (RPRH Law)
 2. Executive Order No. 12, s. 2017: Attaining and Sustaining “Zero Unmet Need for
Modern Family Planning” Through the Strict Implementation of the Responsible
Parenthood and Reproductive Health Act, Providing Funds Therefor, and for other
Purposes
3. Administrative Order 2017-0005: Guidelines in Achieving Desired Family Size
through Accelerated and Sustained Reduction in Unmet Need for Modern Family
Planning Methods
4. Administrative Order 2016-0005: National Policy on the Minimum Initial Service
Package (MISP) for Sexual and Reproductive Health (SRH) in Emergencies and
Disasters
5. Administrative Order 2017-0002: Guidelines on the Certification of Free Standing
Family Planning Clinics
6. Department Order 2017-0345: Guidelines on the Forecasting, Procurement,
Allocation and Distribution of Modern Family Planning Commodities
7. Administrative Order 2015-0006: Inclusion of Progestin Subdermal Implant as One
of the Modern Methods Recognized by the National Family Planning Program.
8. Administrative Order 2014-0042: Guidelines on the Implementation of Mobile
Outreach Services for Family Planning
9. Department Memorandum 2015-0384: Establishment of the Family Planning
Logistics Hotline

Strategies, Action Points and Timeline

Apart from the routine means of FP service delivery, the National Family Planning Program
also employs the following main strategies to ensure universal access to FP:

1. FP Outreach Mission – this maximizes opportunities where clients are and FP

services are delivered down to the community level.
2. FP in hospitals – this address missed opportunities where women especially
those who recently gave birth are offered with appropriate FP services.
3. Intensive Demand generation through house-to-house visits by the community
health volunteers, Family Development Sessions, Usapan sessions, among
others

Program Accomplishments/Status

The passage of the RPRH Law in 2012 is considered as a landmark legislation in the country’s
law-making history, and has laid down the legislative foundation in achieving reproductive
health and rights of all Filipinos towards better health outcomes and socioeconomic growth.
The 0-10 Point Socioeconomic Agenda of the current administration, President Rodrigo
Duterte, acknowledged the full implementation of the RPRH Law as an essential policy
measure in achieving the targets set by the Philippines in the Sustainable Development Goals
(SDG) 2030 and Ambisyon Natin (Our Ambition) 2040.

As a result, President Duterte issued an Executive Order (EO) No. 12, entitled Attaining and
sustaining “Zero Unmet Need for Modern Family Planning” through the strict implementation
of the Responsible Parenthood and Reproductive Health Act, providing funds therefor, and for
other purposes in January of 2017. The Order intensifies and accelerates the implementation
of critical actions necessary to address the unmet need of Filipinos for modern family
planning (mFP). The Order also directs all executive agencies to allocate resources and
solicits support in this initiative. The Department of Health (DOH), as the lead agency, issued
an operational guideline for the said Order. The guideline provides direction and strategies
to accelerate and sustain reduction in unmet need for mFP, and eventually attain the
Filipinos’ desired family size especially among the poor and marginalized.

In the first six months of the EO No. 12 implementation, a total of 610,998 women were
reached and identified to have unmet need for mFP, of which 356,460 accepted the FP
service. The succeeding report of the EO No. 12 was incorporated in the annual Responsible
Parenthood and Reproductive Health (RPRH) Accomplishment Report that was submitted
in April 2018.

In 2017, the Philippine Development Plan (PDP) 2017-2022 was formally introduced. The
PDP is the country’s medium-term plan geared towards achieving SDG and Ambisyon Natin.
The Family Planning was identified as a pivotal intervention in realizing the country’s
demographic dividend.

One of the major highlights in 2017 is the lifting of the Supreme Court’s Temporary
Restraining Order (TRO) to the DOH and Food and Drug Administration (FDA), particularly
the DOH from utilizing its progestin subdermal implant supplies - Implanon and Implanon
NXT, and the FDA from issuing certificates of product registration of contraceptives. The TRO
was lifted on Nov. 10, 2017 when the DOH promulgated the revised Implementing Rules and
Regulations of the RPRH Law, and the FDA re-certified all 51 contraceptive products to be
non-abortifacient, including the subdermal implants - Implanonand Implanon NXT.
  To achieve catastrophic cost of TB-affected households
 To responsively deliver TB service

III. Program Components

 Health Promotion
 Financing and Policy
 Human Resource
 Information System
 Regulation
 Service Delivery
 Governance

IV. Target Population / Client

Presumptive TB and TB affected households

V. Area of Coverage

Nationwide
VI. Partner Institutions

 Department of Health : Food and Drug Administration, Bureau of Quarantine

 Other Government: DepEd, DSWD, DILG (BJMP), DOJ (BuCor)
 Non Government Organizations: PhilCAT, PBSP
 International Organizations: WHO, USAID, GFATM, ICRC, HIVOS-KNCV

VII. Policies and Laws

RA 10767 : Comprehensive TB Elimination Plan Act of 2016

VIII. Strategies, Action Points and Timeline

2017-2022 Philippine Strategic TB Elimination Plan

 Activate communities and patient groups to promptly access quality TB

services
 Collaborate with other government agencies to reduce out-of-pocket
expenses and expand social protection programs
 Harmonize local and national efforts mobilize adequate and competent human
resources
 Innovate TB information generation and utilization for decision making
 Enforce standards on TB care and prevention and use of quality products
 Value clients and patients through integrated patient-centered TB services
 Engage national, regional and local government units/ agencies on multi-
sectoral implementation of TB elimination plan

IX. Program Accomplishments and Status

 2017 WHO Global TB Report

 Estimate TB Burden : Mortality 21/100,000 Incidence 554/100,000
 Total Notified Cases: 345,144
 Treatment Coverage: 58%
 Treatment Success Rate, All Forms (2015) : 91%
 Treatment Success Rate, MDR/RRTB (2014) 46%

X. Calendar of Activities

 March 24 - World TB Day Commemoration

 August - Lung Month Celebration
DIARRHEA

Mode of Transmission
• Ingestion of contaminated food and water.
Signs and Symptoms
• Passage of watery stools at least 3x a day.
• Excessive thirst.
• Sunken eyeballs and fontanel.
Immediate Treatment:
• Give Oral Rehydration Solution (ORESOL), rice soup (am) to
replace lost body fluid.
• Continue feeding.
Prevention and Control:
• Drink water only from safe sources. If unsure, boil water for 3
minutes or do water chlorination.
• Eat only foods that are well cooked and properly prepared. Avoid
eating “street vended food”.
• Keep the food away from insects and rats by covering them using
food cover.
• Wash fruits and vegetables with clean water before eating or
cooking.
• Use toilet when defecating.
• Wash your hands before eating and after using the toilet.
If diarrhea does not stop, consult the nearest health center
10 Herbal Medicines Approved by DOH
These is the list of the ten (10) medicinal plants that the PhilippineDepartment of Health
(DOH) through its “Traditional Health Program” haveendorsed. All ten (10) herbs have
been thoroughly tested and have beenclinically proven to have medicinal value in the rel
ief and treatment of various aliments:
1.Akapulko(Cassia alata)
– alsoknown as “bayabas-
bayabasan”and “ringworm bush” in English,this herbal medicine is used totreat ringworms and sk
in fungalinfections.Benefits & Treatment of Akapulko: • External Use: Treatment of skin
diseases: Tinea infections, insect bites,ringworms, eczema, scabies anditchiness.• Mout
hwash in stomatitis• Internal use:Expectorant for bronchitis anddyspnoea• Alleviation of
asthma symptoms• Used as diuretic and purgative• For cough & fever• As a laxative to
expel intestinalparasites and other stomachproblems.Note: A strong decoction of Akapu
lko leaves is an abortifacient.Pregnant women should not takedecoction of the leaves or
any partof this plant.Preparation & Use: • For external use, pound theleaves of the Aka
pulko plant,squeeze the juice and apply onaffected areas.• As the expectorant for bronc
hitisand dyspnoea, drink decoction(soak and boil for 10 to 15 minutes)of Akapulko leave
s. The samepreparation may be used as amouthwash, stringent, and washfor eczema.• A
s laxative, cut the plant parts(roots, flowers, and the leaves) intoa manageable size then
prepare adecoction Note: The decoctionlooses its potency if not used for along time. Di
spose leftovers afterone day.• The pounded leaves of Akapulko
has purgative functions, specificallyagainst ringworms.It should be noted that thepounded l
eaves of this plant maybe applied thinly on the affectedpart twice a day. Markedimprove
ment may be expectedafter two to three weeks of continuous application to theaffected
area(s) where theprepared Akapulko leaves wereapplied.
2.Ampalaya(Momordicacharantia)
– known as “bittergourd” or “bitter melon” in English,it most known as a treatment of dia
betes (diabetes mellitus), for thenon-
insulin dependent patients.Note: In large dozes, pure Ampalaya juice can be a purgative
andabortifacient.Herbal Benefits of Ampalaya: • G o o d f o r r h e u m a t i s m a n d g o u t
• A n d d i s e a s e s o f t h e s p l e e n a n d liver• A i d s i n l o w e r i n g b l o o d
s u g a r levels• Helps in lowering blood pressure• R e l i v e s
h e a d a c h e s • D i s i n f e c t s a n d h e a l s w o u n d s & burns•
C a n b e u s e d a s a c o u g h & f e v e r remedy• T r e a t m e n t o f i n t e s t i n a l w o r m s
, diarrhea• H e l p s p r e v e n t s o m e t y p e s o f cancer• E n h a n c e s i m m
une system tof i g h t i n f e c
t i o n • F o r t r e a t m e n t o f h e m o r r h o i d s • Is an antioxidant an
d parasiticide• Is antibacterial and antipyreticPreparation & Use of Ampalaya: • F o r
c o u g h s , f e v e r , w o r m s , diarrhea, diabetes, juice Ampalayaleaves
and drink a spoonful daily.• For other ailments, the fruit andl e a v e s c a n
both be juiced andt a k e n o r
a l l y . • F o r h e a d a c h e s w o u n d s , b u r n s and ski
n diseases, apply warmedl e a v e s t o a f f l i c t e d a
r e a . • Powdered leaves, and the rootd e c o c t i o n , m a
y b e u s e d a s s t r i n g e n t a n d a p p l i e d t o t r e a t hemorrhoid
s.• Internal parasites are proven tob e e x p e l l e d w h e n t h e a m p a l a y a j u
i c e , m a d e f r o m i t s l e a v e s , i s extracted. The ampalaya juice, andground
ed seeds is to be taken ones p o o n f u l t h r i c e a d a y , w h i c h a l s o t r e a t s d i a
r r h e a , d y s e n t e r y , a n d chronic colitis.
3.Bawang(Allium sativum)
–
popularly known as “garlic”, itmainly reduces cholesterol in theblood and hence, helps c
ontrolblood pressure.
Health Benefits of Bawang-
Garlic: • Good for the heart• Helps lower bad cholesterollevels (LDL)• Aids in lowering bloo
d pressure• Remedy for arteriosclerosis• May help prevent certain types of cancer• Boost
s immune system to fightinfection• With antioxidant properties• Cough and cold remedy•
Relives sore throat, toothache• Aids in the treatment of tuberculosis• Helps relieve rheu
matism pain• With anticoagulant propertiesPreparation of Bawang-
Garlic: • For disinfecting wound, crush and juice the garlic bulb and apply. Youmay cove
r the afflicted area with ag a u z e a n d b a n d a
g e . • For sore throat and toothache,peal the skin and chew. Sw
allowt h e j u i
c e . • Cloves of garlic may be crusheda n d a p p l i e d t
o a f f e c t e d a r e a s t o reduce the pain caused by arthritis,t o o t h a c h e ,
h e a d a c h e , a n d rheumatism.• D e c o c t i o n o f t h e b a w a n g b u l b s and
leaves are used as treatmentf o r f
e v e r . • For nasal congestion, steam
andi n h a l e : v i n e g a r , c h o p p e d g a r l i c , and water.
4.Bayabas(Psidium guajava)

–
“guava” in English. It is primarilyused as an antiseptic, to disinfectwounds. Also, it can b
e used as amouth wash to treat tooth decayand gum infection.Uses of Bayabas : • A n
t i s e p t i c , a s t r i n g e n t & anthelminthic• K i l l s b a c t e r i a , f u n g
i and ameba• U s e d t o t r e a t d i a r r h e a , noseblee
ding• F o r H y p e r t e n s i o n , d i a b e t e s a n d Asthma• P r o m o t e s m e
n s t r u a t i o n T h e f r e s h l e a v e s a r e u s e d t o facilitate t
he healing of wounds andcuts. A decoction (boiling in water)or infusion of fresh leav
es can beused for wound cleaning to preventinfection. Bayabas is also effectivefor to
othaches. Note: Bayabas can Top of Form

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10 approved herbal plants by DOH

Uploaded by jhommmmm on Sep 20, 2009

10 Herbal Medicines Approved by DOH

These is the list of the ten (10) medicinal plants that the PhilippineDepartment of Health (
DOH) through its “Traditional Health Program” haveendorsed. All ten (10) herbs have been
thoroughly tested and have beenclinically proven to have medicinal value in the relief and
treatment of various aliments:
1.Akapulko(Cassia alata)
– alsoknown as “bayabas-
bayabasan”and “ringworm bush” in English,this herbal medicine is used totreat ringworms and skin
fungalinfections.Benefits & Treatment of Akapulko: • External Use: Treatment of skin disea
ses: Tinea infections, insect bites,ringworms, eczema, scabies anditchiness.• Mouthwash in
stomatitis• Internal use:Expectorant for bronchitis anddyspnoea• Alleviation of asthma sy
mptoms• Used as diuretic and purgative• For cough & fever• As a laxative to expel intestina
lparasites and other stomachproblems.Note: A strong decoction of Akapulko leaves is an ab
ortifacient.Pregnant women should not takedecoction of the leaves or any partof this plant.
Preparation & Use: • For external use, pound theleaves of the Akapulko plant,squeeze the ju
ice and apply onaffected areas.• As the expectorant for bronchitisand dyspnoea, drink deco
ction(soak and boil for 10 to 15 minutes)of Akapulko leaves. The samepreparation may be
used as amouthwash, stringent, and washfor eczema.• As laxative, cut the plant parts(roots, f
lowers, and the leaves) intoa manageable size then prepare adecoction Note: The decoction
looses its potency if not used for along time. Dispose leftovers afterone day.• The pounded l
eaves of Akapulko
has purgative functions, specificallyagainst ringworms.It should be noted that thepounded lea
ves of this plant maybe applied thinly on the affectedpart twice a day. Markedimprovement
may be expectedafter two to three weeks of continuous application to theaffected area(s)
where theprepared Akapulko leaves wereapplied.
2.Ampalaya(Momordicacharantia)
– known as “bittergourd” or “bitter melon” in English,it most known as a treatment of diabe
tes (diabetes mellitus), for thenon-
insulin dependent patients.Note: In large dozes, pure Ampalaya juice can be a purgative an
dabortifacient.Herbal Benefits of Ampalaya: • G o o d f o r r h e u m a t i s m a n d g o u t • A n
d d i s e a s e s o f t h e s p l e e n a n d liver• A i d s i n l o w e r i n g b l o o d s u g a
r levels• Helps in lowering blood pressure• R e l i v e s h
e a d a c h e s • D i s i n f e c t s a n d h e a l s w o u n d s & burns• C a n b e
u s e d a s a c o u g h & f e v e r remedy• T r e a t m e n t o f i n t e s t i n a l w o r m s , diarrhea•
H e l p s p r e v e n t s o m e t y p e s o f cancer• E n h a n c e s i m m u n e s y s t e
m tof i g h t i n f e c t i o
n • F o r t r e a t m e n t o f h e m o r r h o i d s • Is an antioxidant and parasiticide• Is a
ntibacterial and antipyreticPreparation & Use of Ampalaya: • F o r c o u g h s , f
e v e r , w o r m s , diarrhea, diabetes, juice Ampalayaleaves and drink a spoonful
daily.• For other ailments, the fruit andl e a v e s c a n b o t h b e j u i c e d
andt a k e n o r a l l
y . • F o r h e a d a c h e s w o u n d s , b u r n s and skin diseases, apply
warmedl e a v e s t o a f f l i c t e d a r e a . • Powdere
d leaves, and the rootd e c o c t i o n , m a y b e u s e d a s
s t r i n g e n t a n d a p p l i e d t o t r e a t hemorrhoids.• Internal parasites are
proven tob e e x p e l l e d w h e n t h e a m p a l a y a j u i c e , m a d e f r o m i t s l
e a v e s , i s extracted. The ampalaya juice, andgrounded seeds is to be taken ones p o
o n f u l t h r i c e a d a y , w h i c h a l s o t r e a t s d i a r r h e a , d y s e n t e r y , a n d chronic c
olitis.
3.Bawang(Allium sativum)
–
popularly known as “garlic”, itmainly reduces cholesterol in theblood and hence, helps cont
rolblood pressure.

Health Benefits of Bawang-

Garlic: • Good for the heart• Helps lower bad cholesterollevels (LDL)• Aids in lowering blood pr
essure• Remedy for arteriosclerosis• May help prevent certain types of cancer• Boosts imm
une system to fightinfection• With antioxidant properties• Cough and cold remedy• Relives
sore throat, toothache• Aids in the treatment of tuberculosis• Helps relieve rheumatism pa
in• With anticoagulant propertiesPreparation of Bawang-
Garlic: • For disinfecting wound, crush and juice the garlic bulb and apply. Youmay cover th
e afflicted area with ag a u z e a n d b a n d a g
e . • For sore throat and toothache,peal the skin and chew. Swallow
t h e j u i c
e . • Cloves of garlic may be crusheda n d a p p l i e d t o a f f e c t e
d a r e a s t o reduce the pain caused by arthritis,t o o t h a c h e , h e a d a c
h e , a n d rheumatism.• D e c o c t i o n o f t h e b a w a n g b u l b s and leaves are used
as treatmentf o r f e v
e r . • For nasal congestion, steam andi n h a l e : v i n e g a
r , c h o p p e d g a r l i c , and water.
4.Bayabas(Psidium guajava)
–
“guava” in English. It is primarilyused as an antiseptic, to disinfectwounds. Also, it can be us
ed as amouth wash to treat tooth decayand gum infection.Uses of Bayabas : • A n t i s e
p t i c , a s t r i n g e n t & anthelminthic• K i l l s b a c t e r i a , f u n g i a n d a
meba• U s e d t o t r e a t d i a r r h e a , nosebleeding• F o r
H y p e r t e n s i o n , d i a b e t e s a n d Asthma• P r o m o t e s m e n s t r u
a t i o n T h e f r e s h l e a v e s a r e u s e d t o facilitate the healing of w
ounds andcuts. A decoction (boiling in water)or infusion of fresh leaves can beused for
wound cleaning to preventinfection. Bayabas is also effectivefor toothaches. Note: Baya
bas can

cause constipation when consumedin excess.Preparation: • Boil one cup of Bayabas leaves i
nt h r e e c u p s o f w a t e r f o r 8 t o 1 0 m i n u t e s . L e t
c o o l . • U s e d e c o c t i o n a s m o u t h w a s h , gargle.• Use as wound disinfect
ant - washaffected areas with the decoctionof leaves 2 to 3 times a day. Freshl e
a v e s m a y b e a p p l i e d t o t h e wound directly for faster healing.• F
or toothaches, chew the leavesi n y o u r
m o u t h . • F o r d i a r r h e a , b o i l t h e c h o p p e d leaves fo
r 15 minutes in water, ands t r a i n . L e t c o o l , a n d d r i n k a c u p e v e r y t h
r e e t o f o u r h o u r s . • T o s t o p n o s e b l e e d , d e n s e l y r o l l Bayab
as leaves, then place in thenostril cavities
5.Lagundi(Vitex negundo)
–known in English as the “5-
leavedchaste tree”. It’s main use is forthe relief of coughs and asthma. Herbal Benefits of La
gundi: • R e l i e f o f a s t h m a & p h a r y n g i t i s • R e c o m m e n d e d
 r e l i e f o f r h e u m a t i s m , d y s p e p s i a , b o i l s , diarrhea• Treat
ment of cough, colds, fevera n d f l u a n d
o t h e r b r o n c h o p u l m o n a r y d i s o r d e r s • Alle
v i a t e s y m p t o m s o f C h i c k e n Pox• Removal of worms, and boilsPreparation & Use: • B
oil half cup of chopped fresh ordried leaves in 2 cups of water for1 0 t o 1 5 m i n
utes. Drink half cupt h r e e t i m e s a
d a y . • F o r s k i n d i s e a s e s o r d i s o r d e r s , apply the decoction of leav
es andr o o t s d i r e c t l y o n s k i n . • The root is sp
e c i a l l y g o o d f o r treating dyspepsia, worms, boils,colic and rheumatism.A decocti
on (boiling in water) of the roots and leaves of Lagundi are appliedto wounds, and used as a
romatic baths for skin diseases. Boiled seeds areeaten in order to prevent the spreading of t
oxins and venom from bites of poisonous animals. Juice extracted from the flowers of lagun
di is taken in asan aid for disorders like fever, diarrhea, liver disorders, and even cholera.W
hile a decoction of the plant leaves is suggested to be taken by individualsto help increase t
he flow and production of milk, as well as to inducemenstruation.
6.Niyog-niyogan(Quisqualisindica L.)
– is a vine known as“Chinese honey suckle”. It iseffective in the elimination of intestinal wo
rms, particularly theAscaris and Trichina. Only the driedmatured seeds are medicinal-
crack and ingest the dried seeds.

two hours after eating (5 to 7 seedsfor children & 8 to 10 seeds foradults). If one dose does
noteliminate the worms, wait a weekbefore repeating the dose.B e n e f i t s & T r e a t
ment of Niyog-
Niyogan: A l m o s t a l l o f i t s p a r t s a r e u s e d i n d i v i d u a l l y , o r m i x e d w i
t h o t h e r ingredients, as remedy to differentailments. In the Philippines, theseare tak
en to rid people of parasiticw o r m s . S o m e a l s o u s e t h e s e t o help alleviate co
ughs and diarrhea.Medical experts, advice patients toconsult their doctors as imprope
rdosing may cause hiccups. Niyog-
niyogan’s leaves are used to cureb o d y p a i n s b y p l a c i n g t h e m o n s p e c i
f i c p r o b l e m a t i c a r e a s o f t h e body. Compound decoctions of theleaves of niyog-
niyogan are used inIndia to alleviate flatulence.Preparation & Use: S e e d s o f n i y o g -
n i y o g a n c a n b e t a k e n a s a n a n t h e l m i n t i c . T h e s e are eaten raw two hou
rs before thep a t i e n t ’ s l a s t m e a l o f t h e d a y . A d u l t s m a y t a k e 1 0 s e
e d s w h i l e c h i l d r e n 4 t o 7 y e a r s o f a g e m a y eat up to four seeds only. Childr
enf r o m a g e s 8 t o 9 m a y t a k e s i x s e e d s a n d s e v e n s e e d s m
a y b e e a t e n b y c h i l d r e n 1 0 t o 1 2 y e a r s old. D e c o c t i o n s o f i t s r o o t s
a r e a l s o sometimes used as a remedy forr h e u m a t i s m w h i l e i t s f r
u i t s a r e used as an effective way to relievetoothaches.
7.Sambong(Blumeabalsamifera)-
English name:Blumea camphora. A diuretic thathelps in the excretion of urinarystones. It can
also be used as anedema.Health Benefits of Sambong: • Good as a diuretic agent• Effective in
the dissolving kidneystones• Aids in treating hypertension &rheumatism• Treatment of co
lds & fever• Anti-diarrheic properties• Anti-
gastralgic properties• Helps remove worms, boils• Relief of stomach pains• Treats dysente
ry, sore throatPreparation & Use: • A decoction (boil in water) of Sambong leaves as like
tea anddrink a glass 3 or 4 times a day.• The leaves can also be crushedor pounded and mix
ed withcoconut oil.• For headaches, apply crushedand pounded leaves on foreheadand tem
ples.• Decoction of leaves is used assponge bath.• Decoction of the roots, on theother hand,
is to be taken in ascure for fever
8.Tsaang Gubat(Ehretiamicrophylla Lam.)
– Prepared liketea, this herbal medicine iseffective in treating intestinalmotility and also us
ed as a mouthwash since the leaves of this shrubhas high fluoride content. Health Benefits
of Tsaang Gubat:• Stomach pains• Gastroenteritis• Intestinal motility• Dysentery• Diarrhea
or Loose BowelMovement (LBM)• Mouth gargle• Body cleanser/washPreparation & Use: •
Thoroughly wash the leaves of tsaang gubat in running water.Chop to a desirable size and boil 1
cup of chopped leaves in 2 cups of water. Boil in low heat for 15 to 20minutes and drain.• T
ake a cupful every 4 hours fordiarrhea, gastroenteritis andstomach pains.• Gargle for stronge
r teeth andprevent cavities.• Drink as tea daily for generalgood health.
9. Ulasimang Bato (Peperomiapellucida)
– also known as“pansit-
pansitan” it is effective infighting arthritis and gout. Theleaves can be eaten fresh (about acu
pful) as salad or like tea. For thedecoction, boil a cup of cleanchopped leaves in 2 cups of wa
ter.Boil for 15 to 20 minutes. Strain, letcool and drink a cup after meals (3times day).
10. Yerba Buena(Clinopodiumdouglasii)
– commonly known asPeppermint, this vine is used as ananalgesic to relive body aches andpai
n. It can be taken internally as adecoction or externally bypounding the leaves and appliedd
irectly on the afflicted area. Yerba Buena may be used to treat: • Arthritis• Head aches• To
oth aches• Mouth wash• Relief of intestinal gas• Stomach aches• Indigestion• Drink as tea f
or general goodhealth.Preparation & Use: • Wash fresh Yerba Buena leavesin running water. C
hop to size fordried leaves,
crush) and boil 2teaspoons of leaves in a glass of water. Boil in medium heat for 15to 20 mi
nutes.• As analgesic, take a cupful every3 hours