National Mental Health Program

I.

Rationale: Background of the Program Vision: Mission: Goal: Objective: Better Quality of Life through Total Health Care for all Filipinos. A Rational and Unified Response to Mental Health. Quality Mental Health Care. Implementation of a Mental Health Program strategy

The National Mental Health Policy shall be pursued through a Mental Health Program strategy prioritizing the promotion of mental health, protection of the rights and freedoms of persons with mental diseases and the reduction of the burden and consequences of mental ill-health, mental and brain disorders and disabilities.

State International Support and Policies, Mandates

Stakeholders: To ensure the sustainability and effectiveness of the National Mental Health Program, certain committees and teams were organized. 1. National Program Management Committee (NPMC)

The NPMC is chaired by the Undersecretary of Health of the Policy and Standards Development Team for Service Delivery and co-chaired by the Director IV of the National Center for Disease Prevention and Control (NCDPC). Its functions are as follows:

Oversee the development of mental health measures for sub-programs and components; Integrate the various programs, project and activities from the various program development and management groups for each sub-program; Manage the various sub-programs and components of the National Mental Health Program; Oversee the implementation of prevention and control measures for mental health issues and concerns; and Recommended to the Secretary of Health a master plan for mental health aligned with the mandates and thrusts of various government agencies. Program Development and Management Teams (PDMT)

2.

Under the NPMC, PDMT shall be established corresponding to the four sub-programs of the National Mental Health Program. A PDMT shall oversee the operations of a sub-program of the National Mental Health Program. The functions of PDMT are:

Formulate and recommend policies, standards, guidelines approaches on each specifics sub-programs on mental health; Develop a plan of action for each specific sub-program in consultation with mental health advocates and stakeholders Develop operating guidelines, procedures, protocols for the mental health sub-program. Ensure the implementation of the program among all stakeholders; and

Provide technical assistance to other mental health teams according to sub-programs thrusts.

3. Regional Mental Health Teams (RMHT) To ensure an efficient and effective multi-sectoral implementation of the National Mental Health Program at the regional level, a RMHT shall be established in each of the Centers for Health Development (CHD). The functions are as follows:

Oversee the planning and operation of the National Mental Health Program at the regional level; Provide technical assistance on the issues and concerns pertaining to the implementation of the different subprograms of the National Mental Health Program; Strengthen technical and managerial capability at the local level to ensure LGU participation on the implementation of the National Mental Health Program; Ensure establishment of LGU teams for mental health; Ensure the conduct of monitoring and evaluation of the implementation of the National Mental Health Program at the regional level; and Regularly update the PDMT on the status of the regional implementation of the National Mental Health Program. Local Government Unit Mental Health Teams (LGUMHT)

4.

The suggested members of the LGUMHT are the local health board members, technical health staff, civil society groups, non-government organizations and other stakeholders. Primarily, the LGUMHT enacts necessary legislative issuances and promotes and advocates the implementation of Community-based Mental Health Program among their respective localities and constituents. 5. Other Partners and Stakeholders

Other stakeholders who may or may not belong to the above-mentioned committees or teams may contribute to the implementation of the National Mental Health Program by:

Ensuring the availability of competent, efficient, culturally and gender-sensitive health care professionals who provide mental health services; Identifying mental health needs of the population and refer findings to the appropriate mental care provider; and Promoting and advocating for the implementation of the program within their respective areas of responsibility.

II.

Scenario Global Situation:

Many people with mental health conditions, as well as their families and caregiver, experience the consequences of vulnerability on a daily basis. Stigma, abuse, and exclusion are all-too-common. Although their vulnerability is not inevitable, but rather brought about their social environments, over time it leads to a range of adverse outcomes, including poverty, poor health, and premature death. Because they are highly vulnerable and are barely noticed- expert to be stigmatized and deprive of their rights- it is crucial that people with mental health conditions are recognized and targeted for development interventions. The case for their inclusion is compelling. People with mental health conditions meet vulnerability criteria: they experience severe stigma and discrimination; they are more likely to be subjected to abuse and violence than the general

population; they encounter barriers to exercising their civil and political rights, and participating fully in society; they lack access to health and social services, and services during emergencies; they encounter restriction to education; and they excluded from income-generating and employment opportunities. As a cumulative result of these factors, people with mental conditions are at heightened risk for premature death and disability. Mental health conditions also are highly prevalent among people living in poverty, prisoners, people living with HIV/AIDS, people in emergency settings, and other vulnerable groups. Attention from development stakeholders is needed urgently so that the down-ward-spiral of even-greater vulnerability and marginalization is stopped, and instead, people with mental health conditions can contribute meaningfully to their countries development. As a starting point, development stakeholders can consider carefully the general principles for action outlined in this report, and decided how best to incorporate them into their specific areas of work. Targeted policies, strategies, and interventions for reaching people with mental conditions then should be developed, and mental health interventions should be mainstreamed into broader national development and poverty reduction policies, strategies, and interventions. To make implementation a reality, adequate funds must be dedicated to mental health interventions, and recipients of development aid should be encouraged to address the needs of people with mental health conditions as a part of their development work. At country level, people with mental health conditions should be sought and supported to participate in development opportunities in their communities. Specific areas for action address the social and economic factors leading to vulnerability. Mental health services should be provided in primary care settings and integrated with general health services. To that end, mental health issues should be mainstreamed on countries broader health policies, plans, and human resource developm ent, as well as recognized as an important issue to consider in global and multisectoral efforts, such as the International Health Partnership, the Gloring Health Workforce Alliance, and the Health Metrics Network. During and after emergencies, development stakeholders should promote the (re)construction of community-based mental health services, which can serve the population long beyond the immediate aftermath of the emergency. Development strategies and plans should encourage strong links between health/mental health services, housing, and other social services. Access to education for people with mental conditions, as well as early childhood programmes for vulnerable groups should be supported by development stakeholders in order to achieve better development outcomes. People with mental health conditions should be included in employment and income generating programmes to assist with poverty alleviation, improve autonomy and mental health. Throughout their different areas of work, development stakeholders can and should support human rights protections for people with mental conditions and built their capacity to participate in public affairs. This report provides a number of recommendation and specifics areas of action that need to be integrated into policy, planning, and implementation by development stakeholders according to their role and strategic advantage. To achieve this aim development stakeholders need to recognize people with mental health conditions as a vulnerable group requiring support from development programmes. (World Health Organization and Mental Health and Poverty Project, 2010)

Local Situation

In a local baseline survey in 1964-67 in Sta. Cruz, Lubao, Pampanga, Manapsal of the DOH Division of Mental Hygiene, Bureau of Disease Control, found that the prevalence of mental health was 36% per 1,000 adults, children and adolescents. The 1980 WHO Collaborative Studies for Extending Mental Health Care in General Health Care Services (involving seven countries) showed that 17% for adults and 16% of children who consulted at three health centers in Sampaloc, Manila have mental disorders. Depressive reactions in adults and adaptation reaction in children were most frequently found. In Sapang Palay, San Jose Del Monte, Bulacan, the prevalence of adult schizophrenia was 12 cases per 1,000 population in 1988-1989 (Manalang et al). In Region 6 (Iloilo, Negros Occidental and Antique), Perlas et al. im 1993-94 showed that the prevalence of the following mental illness in the adult population were: psychosis (4.3%), anxiety (14.3%), panic (5.6%). For the children

and adolescent, the top five most prevalent psychiatric conditions were: enuresis (9.3%), speech and language disorder (3.9%), mental subnormality (3.7%), adaption reaction (2.4%) and neurotic disorder (1.1%). The current DOH bed capacity for mental disorder is 5,465. Of these, 4,200 beds are in the NCR (at the National Center for Mental Health). The rest of the country share the remaining 1,265 beds (CAR-40 beds, Region 2-200 beds, Region3-500 beds, Region 11-200 beds). Regions 1,4,10,12, CARAGA and ARMM do not have inpatient psychiatric facilities. Only 27 DOH medical centers and regional hospitals have mental health services. Cavite is the only province with a psychiatric facility. These situations have hampered the delivery of basic services, aborted the national development, and reduced quality of life of the Filipino. Life has become severely stressful to most, whether rich or poor, young or old. The resiliency of the Filipino people to adapt to his present life situation is being stretched too far. Warning signs of restlessness abound such as increasing reports of suicides and substance abuse. Decline in the socio-economic condition may translate into mental-ill health and therefore mental health disorders and mental disabilities. However, the provision of mental health services in the country, has remained illness-oriented, institution-based, fragmented, inadequate, inequitable, inaccessible, prohibitive, and neglected. The Department of Health (DOH), the national lead agency for health recognizes the magnitude of the mental health problem as contained in the National Objectives for Health (NOH) 1999-2004. Among the objectives are set the following: Reduction of morbidity, mortality, disability and complications from mental disorder Promotion of healthy lifestyle through the promotion of mental health and less stressful life.

However, the DOH has constraints in attaining these objectives given the limited government resources. Within the health sector, mental health has to compare for resources against other equally important health objectives. Concomitant reforms are therefore being pursued in hospitals, public health, local health systems, regulation as well as financing with the end-view of improving the health of all Filipinos as embodied in the Health Sector Reform Agenda.

Statistics/Local data about the disease program Disorder Number of Cases Specific Phobias Alcohol Abuse Depression Number of Diagnosis One Diagnosis Multiple Diagnosis 2 Diagnoses 3 Diagnoses >/=4 Diagnoses Total 93 31 14

% 19 6 3

95% CI 15.98, 23.1 4.56, 8.96 1.74, 4.8 % 12 15

No. of Respondents 56 66 32 7 27 122

27

*Department of Health (DOH) and Field Epidemiology Training Program Alumni Foundation Incorporated (FETPAFI)

III.

Interventions/ Strategies employed or implemented by DOH

The National Mental Health Program has the following program strategies: 1. Health Promotion and Advocacy

Enrichment of advocacy and multimedia information, education and community (IEC) strategies targeting the general public, mental health patients and their families, and service providers shall be done through the promulgation of observances issued by the Office of the President. 2. Service Provision

Enhancement of service delivery at the national and local levels will enable the early recognition and treatment of mental health problems. To ensure continuity of care, mental health services for people with persistent disabilities shall be established close to home and the workplace. 3. Policy and Legislation

The formulation and institutionalization of national legislation, policies, program standards and guidelines shall emphasize the development of efficient and effective structures, systems, and mechanisms that will ensure equitable, accessible, affordable and appropriate health services for the mentally ill patients, victims of disaster, and other vulnerable groups. 4. Encouraging the development of a research culture and capacity

The program shall support researches and studies relevant to mental health, with focus on the following areas: clinical behavior, epidemiology, public health treatment options, and knowledge management. It aims to acquire evidence-based information that will contribute to the public health information and education, policy formulation, planning, and implementation. 5. Capability Building

The capability of national, regional and local health workers in delivering efficient, effective and appropriate mental health services shall be strengthen. Training shall be conducted on psychosocial care, the detection and management of specific psychiatric morbidity, and the establishment of mental health facilities. 6. Public-Private Partnership

Inter-sectoral approaches and networking with other government agencies, non-government organizations, academe and private service providers and other stakeholders at the locals, regional and national levels shall be pursued to develop partnership and expand the involvement of stakeholders in: a.) advocacy, promotion and provision of mental health services; b.) conduct of relevant studies, researches and surveys; c.) training of mental health workers; d.) sharing of researches, data and other information on mental issues and concerns; and e.) sharing of resources. 7. Establishment of data base and information system

This is needed to determine the magnitude of the problem, its epidemiological characteristics and knowledge and practices to serve as basis for shifting the program for being institutional and treatment focused to being preventive, family focused and community oriented. 8. Development of model programs

Best practices/models for prevention of substance abuse and risk reduction for mental illness can be replicated in different LGUs in coordination with other agencies involved in mental health and substance abuse prevention programs.

9.

Monitoring and Evaluation

A regular review process shall be conducted. Results of program monitoring and evaluation shall be used in formulating and modifying policies, program objectives and action plans to sustain the mental health initiatives and ensure continuing improvement in the delivery of mental health care. Major Activities/Celebrations: Celebration
rd

Date Every 3 Week of January February 14 to 19 Every 1st Week of September Every 2nd Week of October Every 3rd Week of October Every 3rd Week of November

Autism Consciousness Week National Mental Retardation Week National Epilepsy Awareness Week National Mental Health Week National Attention Deficit/Hyperactivity Disorder Awareness Week Substance Abuse Prevention & Control Week V. Future Plan/ Action -

2 Batches of Training on Promotion Mental Health in the Communities 1 Batch of Training on Psychosocial Intervention Series of lecture on Suicide prevention in different Schools & Colleges Mental Health Summit in celebration of World Mental Health Day

Essential Newborn Care

Profile/Rationale of the Health Program The Child Survival Strategy published by the Department of Health has emphasized the need to strengthen health services of children throughout the stages. The neonatal period has been identified as one of the most crucial phase in the survival and development of the child. The United Nations Millennium Development Goal Number 4 of reducing under five child mortality can be achieved by the Philippines however if the neonatal mortality rates are not addressed from its non-moving trend of decline, MDG 4 might not be achieved.

Vision and Mission: None to mention as these are inclusive in the MNCHN Strategy and NOH 2011-2016 Goals: To reduce neonatal mortality rates by 2/3 from 1990 levels Objectives: 1. To provide evidence-based practices to ensure survival of the newborn from birth up to the first 28 days of life 2. To deliver time-bound core intervention in the immediate period after the delivery of the newborn 3. To strengthen health facility environment for breastfeeding initiation to take place and for breastfeeding to be continued from discharge up to 2 years of life 4. To provide appropriate and timely emergency newborn care to newborns in need of resuscitation 5. To ensure access of newborns to affordable life-saving medicines to reduce deaths and morbidity from leading causes of newborn conditions 6. To ensure inclusion of newborn care in the overall approach to the Maternal, Newborn, Child Health and Nutrition Strategy

Stakeholders: 1. Both public and private sector at all levels of health service delivery providing maternal and newborn services 2. Health Professional Organizations and their member health professionals a. Pediatricians/neonatalogists of the Philippine Pediatric Society (PPS) and the Philippine Society of Newborn Medicine (PSNbM) b. Obstetrician-Gynecologists of the Philippine Obstetrical and Gynecological Society (POGS) c. Perinatologists of the Perinatal Association of the Philippines, Inc., (PAPI) d. Anesthesiologists and obstetric anesthesiologists of the Philippine Society of Anesthesiologists (PSA) and the Society for Obstetric Anesthesia of the Philippines (SOAP), e. Family medicine specialists of the Philippine Academy of Family Physicians (PAFP) f. Nurses, Maternal and child nurses, intensive care nurses of the Philippine Nurses Association and its affiliate nursing societies g. Midwives of the Integrated Midwives of the Philippines (IMAP), Philippine League of Government and Private Midwives, Inc. (PLGPMI), Midwives Foundation of the Philippines (MFP) and Well Family Midwives Clinic

3. Government regulatory bodies e.g. Professional Regulations Commission 4. Academe - professors and instructors from members schools and colleges of: a. Association of Philippine Medical Colleges (APMC) b. Association of Deans of Philippine Colleges of Nursing (ADPCN) c. Association of Philippine Schools of Midwifery 5. Hospital, health care administrator and infection control associations a. Philippine Hospital Association (PHA) b. Private Hospitals Association of the Philippines (PHAP) c. Philippine College of Hospital Administrators d. Philippine Hospital Infection Control Society 6. Local government units - local chief executives and LGU legislative bodies

Beneficiaries: a. Newborns all over the country b. Parents c. communities Program Strategies: 1. Health Sector Reform a. Policy and Guideline Issuance i) Administrative Order 2009-0025 - Adopting Policies and Guidelines on Essential Newborn Care December 1, 2009 ii) Clinical Pocket Guide on Essential Newborn Care b. Aquino Health Agenda and Achieving Universal Health Care - Administrative Order 2010-0036 c. PhilHealth Circular 2011-011 dated August 5, 2011 on Newborn Care Package d. Development of Operationalization of Essential Newborn Care Protocol in Health Facilities 2 Identification of Centers of Excellence - Adoption of essential newborn care protocol(including intrapartum care and the MNCHN Strategy) 3. Curriculum Reforms

- Curriculum integration of essential newborn care (including intrapartum care and the MNCHN Strategy) in undergraduate health courses - Integration and revision of board exam questions in licensure examinations for physicians, nurses and midwives 4. Social Marketing - Development of social marketing tools - Unang Yakap MDG 4 & 5

Major Activities and its Guidelines: a. Conduct of one-day orientation-workshop on essential newborn care (including intrapartum care and the MNCHN Strategy) b. Regional MNCHN Conference for CHDs and LGUs including DOH-retained hospitals and LGU hospitals

Current Status of the Program A. What have been achieved/done 1. Policy was issued in December 1, 2009 2. DOH/WHO Scale-up Implementation was done in 11 hospitals 3. Advocacy Partners Forum on essential newborn care (including intrapartum care and the MNCHN Strategy) 4. One-day orientation-workshop on essential newborn care (including intrapartum care and the MNCHN Strategy) among health workers in different health facilities 5. Inclusion of dexamethasone and surfactant as core medicines in the essential medicines list for children in the Philippine National Formulary

B. Statistics Early outcomes of EINC implementation has shown reduction on neonatal deaths in select DOH-retained hospitals including deaths from neonatal sepsis and complicatons of prematurity

Partner organizations/agencies:

National Nutrition Council Population Commission WHO UNICEF UNFPA AusAID USAID health professional and academic organizations mentioned above.

National Dengue Prevention and Control Program

The National Dengue Prevention and Control Program was first initiated by the Department of Health (DOH) in 1993. Region VII and the National Capital Region served as the pilot sites. It was not until 1998 when the program was implemented nationwide. The target populations of the program are the general population, the local government units, and the local health workers.

Vision:

Dengue Risk-Free Philippines

Mission: To improve the quality of health of Filipinos by adopting an integrated dengue control approach in the prevention and control of dengue infection. Goal: Reduce morbidity and mortality from dengue infection by preventing the transmission of the virus from the mosquito vector human. Objectives: The objectives of the program are categorized into three: health status objectives; risk reduction objectives; and services & protection objectives. Health Status Objectives:

Reduce incidence from 32 cases/100,000 population to 20 cases/100,000 population; Reduce case fatality rate by <1%; and Detect and contain all epidemics.

Risk Reduction Objectives:

Reduce the risk of human exposure to aedes bite by House index of <5 and Breteau index of 20; Increase % of HH practicing removal of mosquito breeding places to 80%; and Increase awareness on DF/DHF to 100%.

Services & Protection Objectives:

Establish a Dengue Reference Laboratory capable of performing IgM capture ELISA for Dengue Surveillance; Increase the % of 1 and 2 government hospitals with laboratory capable of platelet count and hematocrit; and Ensure surveillance and investigation of all epidemics.

Partner Organizations/Agencies: The following organizations/agencies take part in the achievement of the programs objectives:

World Health Organization (WHO) United Nations childrens Fund (UNICEF) Department of Interior and Local Government (DILG) Department of Education (DepEd) United States Agency for International Development (USAID) Asian Development Bank (ADB) Philippine Health Insurance Corporation (PhilHealth)

Violence and Injury Prevention Program

Accidents consistently remain one of the leading causes of morbidity and mortality in the country. The Philippine Health Statistics from 1975 to 2002 revealed that there has been increasing trend of mortality due to accidents per 100,000 populations. Mortality rate increased from 19.1/100,000 population in 1975 to 42.3/100,000 populations in 2002 corresponding to 33,617 deaths, majority of which is caused by assaults (13,276); transport accidents (6,131); accidental drowning and submersion (2,871); and accidental falls (1,536). Accidents ranked 8th in 1975, 7th in 1985 and 6th in 1995 and 5th in 2002 among the 10 leading causes of death. The Department of Health (DOH) shall serve as the focal agency with respect to violence and injury prevention. As such, it shall design, coordinate and integrate activities, plans, and programs of various stakeholders into an effective and efficient system. The Violence and Injury Prevention Program is hereby institutionalized as one of the programs of the National Center for Disease Prevention and Control (NCDPC). To ensure coordination and sustainability of the program, a Program Management Committee (PMC) shall be organized. The Committee shall then be subdivided into Sub-Committees according to the areas of concern: road traffic injuries, thermal injuries (burns and scalds), drowning, physical injuries (fall, violence), and chemical injuries (poisoning, etc.). For a comprehensive approach, the Program shall coordinate with other programs like the Maternal and Child Health and other DOH Offices such as the National Center for Health Facility Development, Health Emergency and Management Services, among others, solicit active representation from public and private stakeholders that are involved in violence and injury prevention.

The 4 Es. Strategies shall utilize the concept of the 4 Es, Education, Enforcement (in addition to Enactment), Engineering, and Economic incentives, in the prevention and control of injuries. Education entails dissemination of information related to injury prevention. Strategies and programs can be targeted at the risk group indentified in the populations. Enforcement and enactment of strategies indentify opportunities for injury prevention policy development and implementation. Engineering provides and effective way of reducing the impact of injury causes through application of energy transmission designs. Economic incentives can be instrumental in pursuing injury prevention policies.

Goals and Objectives: To establish a national policy and strategic framework for injury prevention activities for DOH and other government agencies, local government units (LGUs), non-government organizations (NGOs), communities, and individuals. Program Strategies: The program and action plan that are to be developed for each classification of injuries shall consider the following principles:

1.

Health Promotion DOH, in collaboration with other stakeholders, shall undertake advocacy, information and education, political support, and inter-sectoral collaboration on accidents/injury prevention and patterns and factors associated with incidence of accidents/injury to policy makers, government agencies, civil societies, peoples organizations, the general public and other stakeholders.

2.

Developing Institutional Arrangement and Capacity DOH, and partnership with other stakeholders, shall develop and enhance the violence and injury prevention capabilities of a wide range of sectors and stakeholders at the local and national levels. Training programs shall be made available and accessible to policy implementers at the national, regional, and local levels.

3.

Injury Surveillance System DOH shall establish and institutionalize a system of data recording, reporting, analysis at the national, regional and local levels. An information system shall be developed for this purpose. The system shall record injuries, patterns and factors that may have cause the injury as well as the available services, health status needs and circumstances of injured person. DOH shall advocate to various stakeholders involved in the management of different types of injuries through cooperated reporting, archiving and linking of new and existing databases for a more comprehensive picture.

4.

Networking and Resource Mobilization DOH shall promote partnership with among various stakeholders to build coalitions and networks and generate resources for activities related to violence and injury prevention. In the process, the department shall initiate coalition building through formal and informal instruments with stakeholders in order to ascertain their commitment in implementing defined action plans and programs and in mobilizing all available resources. Sharing of responsibilities and allocation of resources to address the problem to achieve maximum results shall be explored.

5.

Monitoring and Evaluation DOH, in consultation with various stakeholders, shall identify indicators and targets for program monitoring and evaluation purposes.

6.

Equitable Health Financing Package DOH in collaboration with various stakeholders, shall advocate to health financing institutions and financial intermediaries, insurance companies, the development and implementation of policies that would be beneficial to victims of violence and injury.

7.

Research and Development DOH shall promote the conduct of multi-disciplinary and multi-sectoral solutions and researches for purposes of developing national and local competence in injury prevention, health care services and for other purposes that may be necessary.

8.

Service Delivery In collaboration with stakeholders, DOH shall institutionalize systems and procedures for the integration and provisions of services at the community level. Information shall be utilized for continued public health information and education, planning and implementation, and policy revision. Appropriate primary prevention, care and rehabilitation of injured people shall also be crucially provided.

9.

Community Participation DOH shall aim for a successful community based violence and injury prevention to anchor upon a community-wide sense of ownership and empowerment to accomplish tasks. This is to ensure that all patients receive quality services at the appropriate levels of health care delivery system. Successful community-based programs also revolve around the formation of new partnerships between a diverse group of constituents who have vested interest in violence and injury control, including representatives of public safety, law enforcement, fire, local governments, schools, business, community groups, and health care provider. All rural health units should be linked to a referral center specific and appropriate to the type of injury sustained.

10. Policy Advocacy DOH shall advocate for the necessary policy instruments, such as laws, executive orders, administrative orders, and ordinances to the Congress, other national agencies and LGUs, respectively. This approach shall ensure sectoral and community-based interventions to propel action on violence ad injury.

Major Activities and its Guidelines: In line with the effort to reduce the incidence of firecracker - related injuries during the Holiday Season and in consonance with its present strategy, the Department of Health embarks on the project, Kontra Paputok which promotes information and awareness on the dangers of firecrackers and the prevention of firecrackers and fireworksrelated injuries. In this regard, all Center for Health Development Directors and Chiefs of DOH Hospitals are hereby directed to mobilize their respective offices and hospitals to undertake the following activities: 1. Public Information Campaign

All Centers for Health Development should take the lead and shall implement a public information campaign in their respective Region or catchments area for Kontra Paputok Activities. They should coordinate with their local radio and TV Network and assign a pool of speakers to promote the prevention of firecracker injuries, especially informing the public on the dangers of using prohibited firecrackers and watusi. As per Memorandum of the Firearms and Explosives Division-Philippine National Police (FED-PNP) dated 17 January 2002, WATUSI IS ALREADY BANNED FROM THE MARKET and no longer authorized the sale of the said firecracker. Streamers and posters should be posted in strategic and public places. The slogan for this year's campaign is "Walang Batang Magpapaputok" See the Prototypes of the streamer and poster at the DOH website. 2. Emergency Room Preparedness and Responsiveness

All DOH Hospitals are hereby declared on CODE WHITE ALERT on December 24, 25, 31, 2010 and January 1, 2011 to prepare their emergency units and ensure the provision of prompt emergency services to injured patients during the Holiday. 3. Nationwide Registry Injuries

All DOH Sentinel Hospitals shall report to the Online National Electronic Surveillance System Registry (ONEISS) of the Department of Health. The surveillance period for fireworks related injuries, stray bullets and watusi ingestion victims shall commence at 6:00 am of December 21, 2010 and will end at 5:59 am of January 5, 2011. Reporting should be done daily and strict observance of time is required.

4.

Tetanus Surveillance

The surveillance period for fireworks-related tetanus victim shall commence on December 21, 2010 and shall end on January 21, 2011. Fireworks related tetanus cases hospitalized even after the surveillance period must be reported. Availability/stocks of Tetanus Toxoid/Vaccine in hospitals should be ensured. 5. Networking with Other Government Agencies

The strategy for this year's campaign is advocating the use of safe and alternative ways of celebrating the New Year with a Healthy Bang such as street parties, concerts, amateur contests, Ati-Atihan, designation of identified area for fireworks display and other ways of noise-making like using pots and pans and torotot. And in the light of the devolution, provision of technical assistance and close coordination with the Local Government Units (LGUs) should be enhanced wherein the Local Government Executives (LGEs) should enforce strictly the Republic Act 7183 (Firecracker Law) and spread the safe and alternative celebration of the New Year in their respective areas. Coordination among the Regional Offices of various Agencies Philippine National Police, Armed Forces of the Philippines, Department of Education, Department of Trade and Industry, Department of Interior and Local Government, Department of Labor and Employment, Philippine Information Agency, Bureau of Fire Protection, National Police Commission, Department of Environment and Natural Resources, Department of Science and Technology, different Leagues of the Philippines (Provincial, Cities, Municipalities, and Barangay) and non-government agencies strengthen public information campaign and other advocacy activities especially against the use of Watusi and illegal Firecrackers, which is prohibited under Republic Act 7183 or the Firecracker Law. 6. Firecracker Ban on all DOH Facilities

All offices, hospitals of the DOH and its attached agencies are hereby declared a FIRECRACKER FREE ZONE. Moreover, SELLING OF FIRECRACKERS IS STRICTLY PROHIBITED within the premises of the Department of Health Facilities. All Heads of Agencies are hereby instructed to disseminate these guidelines to their respective personnel.

Status of the Program: As a nationwide undertaking, the NCDPC requires health facilities to adhere to all national policies and guidelines on injury reporting. The NCDPC is the central coordinating body for the evaluation, processing, monitoring, and dissemination of data or information. Each health facility is required to report on a daily basis all injury related cases through the Online National Electronic Injury Surveillance System. While the NCDPC has no regulatory power over the health facilities, it does have indirect power thru the Bureau of Health Facilities and Services. The NCDPC as the highest policy making body can make recommendations to the BHFS for appropriate actions on erring health facilities. The general objective of National Electronic Injury Surveillance System (NEISSE) is to make efficient and effective the current systems and procedures of reporting injury-related data. Specifically, NEISS aims to: 1. Promote efficiency to maximize time and effort in data collection, processing, validation, analysis and dissemination of injury-related data; 2. Improve accuracy, reliability, integrity and timeliness of injury-related data; 3. Implement the most reliable and effective technology solution to interconnect with the different agencies and/or beneficiaries/stakeholders of the injury related data; and 4. Enforce standards on inputs, processes and outputs on injury-related data collection, analysis, report generation and feedback. ONEISS shall be the standard reporting system for the collection, storage, analysis and reporting of data pertaining to injury. ONEISS is the information system being implemented by the DOH in support of the Injury Program.

The PNIDMS The Philippine Network for Injury Data Management System (PNIDMS) is a multi-sectoral organization composed of the World Health Organization, United Nations Children's Fund, Department of Health, Department of Transportation and Communication, Department of Public Works and Highway, Philippine National Police - Highway Patrol Group, Metro Manila Development Authority, Land Transportation Office and Safe Kids Philippines, which aims to establish and maintain a coordinated data management system that can link, integrate, or combine injury data from various sources or systems to provide an overall picture for policy makers and decision makers at the national, regional and local levels. Partner Organizations/Agencies: The program management committee (PMC) shall be chaired by the director IV of the National Center for Disease Prevention and Control with the following as members: Division chief of the Degenerative Disease Program: National focal person (Program Manager) for violence and injury prevention program; and representatives from DOTC, DPWH, DILG/League of municipalities. Specialty Societies and other agencies/organizations are to be identified by the committee itself. Experts in the various aspects of violence and injury prevention shall also be involved to ensure a comprehensive program approach. The following institutions/agencies partake in the achievement of the program goals:

Department of Transportation and Communication (DOTC) Philippine National Police (PNP) Department of Interior and Local Government (DILG) Department of Public Works and Highways (DPWH) Department of Education (DepEd) Metro Manila Development Authority (MMDA) Department of Social Welfare and Development (DSWD) Bureau of Fire Protection (BFP) Safe Kids Philippines, Inc. Automobile Association of the Philippines Safety Organization of the Philippines, Inc. Philippine National Red Cross Motorcycle Development Participants Association Ford Road Safety Youth Council Project CARES Trauma Centers: o Philippine Orthopedic Hospital o East Avenue Medical Center o Las Pias General Hospital and Satellite Trauma Center o UP-Philippine General Hospital o Vicente Sotto Memorial Medical Center