EKRA Maternal Health Program 1

Maternal
Health
Program
LUZVIMINDA Z. SANCHEZ
DOH ROI- Maternal Health Program
Coordinator
OUTLINE
I. Background and Rationale
II. Current Situation
III. Program Goals and Objectives
IV. Priority Strategies and Interventions
V. Current Actions and Steps
VI. Impact/Outcome Indicators
VII.Service Delivery Network
VIII.Maternal Death Review
IX. Reporting Forms
I. BACKGROUND AND
RATIONALE
 The Philippine government commit to
contribute to achieving Sustainable
Development Goal 3 of ensuring healthy
lives and promoting well-being for all and
for all ages.
 In maternal health, the commitment is to

implement initiatives that will reduce
the maternal mortality ratio to
70/100,000 live births by end of 2030.
The challenges in maternal health
care in the country are still high.
 More than 10 mothers die

every day due to pregnancy
and delivery related reasons.
 30 children are left motherless

every day (UNFPA Philippines).
II. CURRENT SITUATION

CAUSES OF MATERNAL DEATHS Number
I. Post-Partum Hemorrhage 13
II. Eclampsia 10
III. Amniotic Fluid Embolism 4
IV. Sepsis 4
V. Pregnancy Induced Hypertension 2
VI. Cerebrovascular Accident (Stroke, 2
Hypertension)
VII. Uterine Atony 1
VIII. Ectopic Pregnancy 1
III. PROGRAM GOALS &
OBJECTIVES
 Rapidly reduce maternal and
neonatal mortality
 Establishment of critical
capacities to provide quality
maternal-newborn services
ADMINISTRATIVE ORDER NO. 2008-
0029:
“Implementing Health Reforms for Rapid

Reduction of Maternal and Neonatal
Mortality”
• To increase the number of deliveries attended

by skilled health professionals.
• Decreases the number of deliveries occurring

at home.
• Promoting deliveries at adequately –equipped

birthing facilities.
IV. PRIORITY STRATEGIES
AND INTERVENTIONS
A. Paradigm Shift
- from the risk approach that identifies high risk
pregnancies during the period to an approach that
prepares all pregnant for the complications during
childbirth
- this change brought about the establishment of the
BEmONC/CEmONC network which is now part of the
MNCHN service delivery network and the ILHZ.
B. Upgrading health facilities and
personnel of their critical capacity to
provide quality maternal and newborn
services.
C. Increase awareness among

communities of their Maternal PhilHealth
benefits and ensures their facilities to be
DOH-licensed and PhilHealth accredited.
D. Reliable Sustainable Support
Systems –Maternal-Newborn
service delivery through:
1. Essential BEmONC drugs and
supplies.
2. Establishment of safe blood supply
network.
3. Behavior change interventions
4. Sustainable financing
5. Monitoring and Evaluation
V. CURRENT ACTIONS AND
STEPS
A. Collaborating with Local Government
Units in establishing sustainable, cost
effective approach of delivering health
services.
B. Strengthen Service Delivery Network

with attention to improving of 2 way
referral systems among RHUs and
hospitals and strengthen blood
networking.
C. Technical assistance in the provision of
drugs/medicines and supplies/equipment to
support health facilities.

D. Monitor and evaluate program targets
accomplishments and compliance to
program protocols:
1. Maternal death reporting and review
2. Training on BEmONC
3. BEmONC provision - BEmONC
provision assessment/Post training
Evaluation
VI. IMPACT / OUTCOME
INDICATORS
PERFORMANCE COVERAGE INDICATORS (target

– 90%)
 4 ANC - 94%
 FBD - 98%
 SHP - 98%
2 PPV - 92%
VII. SERVICE DELIVERY
NETWORK
3 Levels of MNCHN Service
Delivery Network (SDN)
A. Community Level Providers
- give primary health care services.
◦ Rural Health Units (RHUs)
◦ Barangay Health Stations (BHS)
◦ Private clinics
B. Basic Emergency Obstetric
and Newborn Care (BEmONC)
- capable network of facilities
and providers can be based in:
◦ District Hospitals
◦ RHUs, BHS, lying-in clinics or birthing
homes.
6 SIGNAL BEmONC
FUNCTIONS
 Parenteral administration of oxytocin in the
third stage of labor (AMTSL)
 Parenteral administration of loading dose of
anticonvulsants
 Parenteral administration of initial dose of
antibiotics
 Performance of assisted deliveries (Imminent
Breech Delivery)
 Removal of retained products of conception
 Manual removal of retained placenta
C. Comprehensive Emergency
Obstetric and Newborn Care
(CEmONC)
- facility or network of facilities that are
capable of managing complicated
deliveries and newborn emergencies.
- It should be able to perform the six
signal BEmONC functions, provide
caesarian delivery services, blood
banking and transfusion services
MATERNAL DEATH
The death of a woman while
pregnant or within 42 days of
termination of pregnancy,
irrespective of the duration and
the site of pregnancy, from any
cause related to or aggravated by
the pregnancy of its management,
but not from accidental or
incidental causes.
OBJECTIVES OF MATERNAL
DEATH REVIEW
A. To generate accurate and timely
maternal mortality data.
B. To identify major medical and non-
medical causes of maternal mortality.
C. To formulate appropriate interventions
to address these causes.
D. To institute improvements in the health
delivery system.
The 3 delays model
 Delay in decision to seek care
 Delay to reach proper medical

care
 Delay
in receiving appropriate &
adequate health care
MATERNAL DEATH SURVEILLANCE AND RESPONSE (MDSR)
REPORTING FORM
REGION I
Date of Review: ______________________
Number of Maternal Death Recorded as of Date of Review: __________
Number of Maternal Death (not reviewed): ________________________
Causes of Maternal Death Noted: (by place of origin)
Cause of Death Number

Death Review Findings:
Description of the case >Place of Origin:
>Age:
>Gravida:
>Place of Death:
>Place of Delivery:
Medical Cause of Death
Contributory Factors: Describe the
circumstances noted that contributed
to the death.
Health System Gap Noted that Need
to be Addressed Immediately
Plan to Respond to the Systems Gap
Noted
Time Frame for the Response
Expected Result
Prepared By: Reviewed By:

SUMMARY
 MDG 4 - to reduce the child mortality
1. EINC protocol : (4 time-bound

steps)
 Immediate thorough drying
 Skin-to skin-contact
 Properly timed cord clamping
 Early initiation of breast feeding
 MDG 5 – to improve maternal health
and reduce maternal mortality
1. All pregnant women should have at

least 4 PNC visits.
2. All pregnancies are considered high

risk and should be delivered only by
“adequately trained health
personnel” in a “health facility or
DOH- accredited birthing facility”.
3. Post partum mothers should
have at least 2 PNC visits.
4. Practice Family planning

“Favour is deceitful,
and beauty is vain: but
a woman that feareth
the LORD, she shall be
praised.”
Proverbs 31:
30

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Maternal

 In maternal health, the commitment is to

 More than 10 mothers die

 30 children are left motherless

“Implementing Health Reforms for Rapid

• To increase the number of deliveries attended

• Decreases the number of deliveries occurring

• Promoting deliveries at adequately –equipped

C. Increase awareness among

B. Strengthen Service Delivery Network

PERFORMANCE COVERAGE INDICATORS (target

 Delay to reach proper medical

Cause of Death Number

Prepared By: Reviewed By:

1. EINC protocol : (4 time-bound

1. All pregnant women should have at

2. All pregnancies are considered high

4. Practice Family planning

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