Adolescent and Youth Health and Development Program (AYHDP)

In line with the global policy changes on adolescents and youth, the DOH created the Adolescent
and Youth Health and Development Program (AYHDP) which is lodged at the National Center for
Disease Prevention and Control (NCDPC) specifically the Center for Family and Environmental Health
(CFEH). The program is an expanded version of Adolescent Reproductive Health (ARH) element of
Reproductive Health which aims to integrate adolescent and youth health services into the health
delivery systems.

The DOH, with the participation of other line agencies, partners from the medical discipline, NGOs
and donor agencies have developed a policy on adolescent and youth health as well as
complementary guidelines and service protocol to ensure young peoples’ health needs are given
attention.
The Program shall mainly focus on addressing the following health concerns regardless of their sex,
race and socioeconomic background:

* Growth and Development concerns Nutrition Physical, mental and emotional status
* Reproductive Health Sexuality Reproductive Tract Infection (STD, HIV/AIDS) Responsible
Parenthood Maternal & Child Health

* Communicable Diseases Diarrhea, Dengue Hemorrhagic Fever, Measles, Malaria, etc.

* Mental Health Substance use and abuse

* Intentional / non-intentional injuries Disability

Other issues and concerns such as vocational, education, social and employment needs where the
DOH has no direct mandate nor control, shall be coordinated closely with other concerned line
agencies, and NGOs.

Vision:

Well-informed, empowered, responsible and healthy adolescents and youth.

Mission:

Ensure that all adolescent and youth have access to quality health care services in an adolescent
and youth friendly environment.
Goal:

The total health, well being and self esteem of young people are promoted.

Objectives:

By the year 2004:

Health Status Objectives:

* reduce the mortality rate among adolescents and youth

Risk Reduction Objectives:

* reduce the proportion of teenage girls (15-19 years old) who began child bearing to 3.5 %
(baseline-7% in 1998 NDHS)

* increase the health care – seeking behavior of adolescents to 50% (baseline: still to be
established)

* increase the knowledge and awareness level of adolescent on fertility, sexuality and sexual health
to 80% (baseline: still to be established)

* increase the knowledge and awareness level of adolescents on accident and injury prevention to
50% (baseline: still to be established) Services and Protection Objectives:
* increase the percentage of health facilities providing basic health services including counseling for
adolescents and youth to 70%. (baseline- still to be established)

* establish specialized services for occupational illnesses, victims of rape and violence, substance
abuse in 50% of DOH hospitals

* integrate gender-sensitivity training and reproductive health in the secondary school curriculum.

* Establish resource centers or one stop shop for adolescents and youth in each province.

Guiding Principles:

1. Involvement of the youth

The AYHDP shall involve the young people in the design, planning implementation, monitoring and
evaluation of activities and program to ensure that it is acceptable, appealing and relevant to them.
In so doing, they become part of the solution rather than the problem. Further, it:

(1) favors the acquisition of valuable skills including interpersonal skills,

(2) gives young people self confidence,

(3) promotes individual self esteem and competence, and

(4) contributes to a sense of belonging.

2. Rights Based Approach

In all aspects of program implementation, the promotion of young peoples’ rights shall be applied.
This is to ensure protection of adolescent and youth against neglect, abuse and exploitation and
guaranteeing to them their basic human rights including survival, development and full participation
in social, cultural, educational and other endeavors necessary for their individual growth and well
being.

3. Diversity of adolescents needs and problems

The program shall recognize the diverse characteristic and needs of adolescents in different
situations. Their concerns and perception vary by demographic and socio-economic characteristics,
sex and circumstances. But even how diverse the problems are, oftentimes they have common
roots, its underlying causes are closely connected and the solutions are similar and interrelated.
They are addressed most effectively by a combination of intervention that promote healthy
development.

4. Gender & health perspective

A gender perspective shall be adopted in all processes of policy formulation, implementation and in
the delivery of services, especially sexual and reproductive health. This perspective will act upon
inequalities that arise from belonging to one sex or the other, or from the unequal power relation
between sexes. Adolescents have distinct and complex gender differences in behavior patterns,
socialization process and expected roles in family, community and society. A gender gap exist in
terms of opportunities in education and employment and access to health services. Girls are often
victims of traditional, discriminatory and harmful practices, including sexual abuse and exploitation.
Besides, their individual development needs are also neglected because of the persistent and
stereotypical roles that they are expected to perform. On the other hand, young boys can be
particularly vulnerable, such as those in situations in armed conflict or crises. Adults often
perpetuate traditional gender roles that trap young people in high – risk behavior. They can
therefore play a major role in helping them change their attitudes and prevent exploitation of
adolescents.

Program Strategies:
The DOH shall adopt a two pronged inextricably linked and overarching strategies:

* To Promote healthy development among young adults by building their life coping skills;
promoting positive values and by creating a safe and supportive environment for their growth and
development;

* To prevent and respond to adolescent health problems through provision of adequate, accurate
and timely information about their health, rights and other issues and through the availability of
integrated, quality and gender sensitive adolescent health services that will bring about positive
behavior and healthy lifestyle.

1. Service provision The program shall ensure the access and provision of quality gender responsive
biomedical and psychosocial services. Eventually, these will contribute to the reduction of maternal,
infant, child and young peoples’ morbidity and mortality, ensure the quality of life of the families
and communities; and promote total health and well being of Filipino adolescents and youth.

2. Education and Information

Early education and information sharing for adolescents and service information providers: the
parents, teachers, communities, church, health staff, media and NGOs on adolescent health
concerns and an intensified and responsive counseling services geared towards adolescent health
shall be done. This aims to increase knowledge and understanding of a particular health issue, and
with the explicit intention of motivating the young people to adopt healthy behavior and to prevent
health hazards such as unwanted pregnancies, STDs, substance use / abuse, violent behavior and
nutritional deficiencies.

3. Building skills

Adolescents and youth shall have life skills training to enable them to deal effectively with the
demands and challenges of everyday life. It refers to skills that enhance psychosocial development,
decision making and problem solving; creative and critical thinking; communication and
interpersonal relations , self awareness, coping with emotions and causes of stress. Examples of
these skills are:

* Self care skills eg. how to plan and prepare healthy meals or ensure good personal hygiene and
appearance. * Livelihood skills eg. how to obtain and keep work.

* Skills for dealing with specific risky situations eg. how to say no when under peer pressure to use
drug. Further, life skills shall be integrated in the training module for health workers as well as in
the school curricula. On the other hand, service providers, parents and teachers shall also be
equipped with competencies to influence behavior of adolescents and promote healthy development
and prevent health problems.

4. Promoting a safe and supportive environment

A safe and supportive environment is part of what motivates young people to make healthy
decisions. It refers to an environment that:

(1) nurtures and guides young people towards healthy development;

(2) provides the least trauma, excessive stress, violence and abuse;

(3) provides a positive close relationship with family, other adults and peers;

(4) provides specific support in making individual responsible behavior choices. While intervention
should now focus on the action that will facilitate growth and development and encourage
adolescents and youth to practice healthy behavior, the following major aspects of social
environment have to be considered:

1. Relationship with families, service providers and significant others.

Adults contribute to a supportive climate for behavioral choices through positive relationship. They
can substantially enrich the lives of young people through their fundamental role as parents and
care-givers

2. Social norms and cultural practices

This involve what people typically do in all areas of life and peoples expectation of others. These
forces usually shape the lives of young people thus it is important to take note of the attitudes and
practices that are harmful to them. Attitudes and norms concerning (a)early marriage, (b)sexual
behavior among young people, (c)access to information about sexuality may need to be addressed.

3. Mass Media and entertainment

The media is a very important component in influencing social norms that encourage adolescent to
make responsible health behavior choices. It also provides great potential to communicate and
mobilize community support on adolescent health issues.

4. Policies and legislation

Promoting policies and legislation for adolescent health can ensure young people have the
opportunities and services they need to promote and protect their own health.

5. Monitoring and Evaluation

This is to ensure the smooth implementation of the program. Regular monitoring and evaluation will
be conducted to identify the status, issues, gaps and recommendations. A scheme shall be
developed which will include indicators, monitoring tools and checklist. Monitoring will be through
conduct of field visits, consultative meeting and program implementation review.

6. Resource mobilization

The Department of Health have prepared a 10 year work plan for AYHDP. The budgetary
requirements will be sourced out from national and international donor agencies. Advocacy with
LGUs, other GOs and NGOs shall be conducted on sharing of existing resources where AYHDP will be
integrated.

Promotion of Breastfeeding program / Mother and Baby Friendly Hospital Initiative

(MBFHI)
Realizing optimal maternal and child health nutrition is the ultimate concern of the Promotion of
Breastfeeding Program. Thus, exclusive breastfeeding in the first four (4) to six (6) months after
birth is encouraged as well as enforcement of legal mandates.

The Mother and Baby Friendly Hospital Initiative (MBFHI) is the main strategy to transform all
hospitals with maternity and newborn services into facilities which fully protect, promote and
support breastfeeding and rooming-in practices. The legal mandate to this initiative are the RA
7600 (The Rooming-In and Breastfeeding Act of 1992) and the Executive Order 51 of 1986
(The Milk Code). National assistance in terms of financial support for this strategy ended year
2000, thus LGUs were advocated to promote and sustain this initiative. To sustain this initiative, the
field health personnel has to provide antenatal assistance and breastfeeding counseling to pregnant
and lactating mothers as well as to the breastfeeding support groups in the community; there
should also be continuous orientation and re-orientation/ updates to newly hired and old personnel,
respectively, in support of this initiative.

Child Health and Development Strategic Plan Year 2001-2004

Introduction

The Philippine National Strategic Framework for lan Development for CHildren or CHILD 21 is a
strategic framework for planning programs and interventions that promote and safegurad the rights
of Filipino children. Covering the period 2000-2005, it paints in borad strokes a vision for the quality
of life of Filipino children in 2025 and a roadmap to achieve the vision.
Children's Health 2025, a subdocument of CHILD 21, realizes that health is a critical and
fundamental element in children's welfare. However, health programs cannot be implemented in
isolation from the other component that determine the safety and well being of children in society.
Children's Health 2025, therefore, should be able to integrate the strategies and interventions into
the overall plan for children's development.

Children's Health 2025 contains both mid-term strategies, which is targeted towards the year 2004,
while long-term strategies are targeted by the year 2025. It utilizes a life cycle approach and
weaves in the rights of children. The life cycle approach ensures that the issues, needs and gaps are
addressed at the different stages of the child's growth and development.

The period year 2002 to 2004 will put emphasis on timely diagnosis and management of common
diseases of childhood as well as disease prevention and health promotion, particularly in the fields
of immunization, nutrition and the acquisisiton of health lifestyles. Also critical for effective pallning
and implementation would be addressing the components of the health infrastructure such as
human resource development, quality assurance, monitoring and disease surveillance, and health
information and education.

The successful implementation of these strategies will require collaborative efforts with the other
stakeholdres and also implies integration with the other developmental plan of action for children.

VISION

A healthy Filipino child is:

* Wanted, planned and conceived by healthy parents

* Carried to term by healthy mother
* Born into a loving, caring. stable family capable of providing for his or her basic needs
* Delivered safely by a trained attendant
* Screened for congenital defects shortly after birth; if defects are found, interventions to corrrect
these defects are implemented at the appropriate time
* Exclusively breastfed for at least six months of age, and continued breasfeeding up to two years
* Introduced to compementary foods at about six months of age, and gradually to a balanced,
nutritious diet
* Protected from the consequences of protein-calorie and micronutirent deficiencies through good
nutrition and access to fortified foods and iodized salt
* Provided with safe, clean and hygienic surroundings and protected from accidents
* Properly cared for at home when sick and brought timely to a health facility for appropriate
management when needed.
* Offered equal access to good quality curative, preventive and promotive health care services and
health education as members of the Filipino society
* Regularly monitored for proper growth and development, and provided with adequate
psychosocial and mental stimulation
* Screened for disabilities and developmental delays in early childhood; if disabilities are found,
interventions are implemented to enabled the child to enjoy a life of dignity at the highest level of
function attainable
* Protected from discrimination, explitation and abuse
* Empowered and enabled to make decisions regarding healthy lifestyle and behaviors and included
in the formulation health policies and programs
* Afforded the opportunity to reach his or her full potential as adult

Current Situation

Deaths among children have significantly decreased from previous years. In the 1998 NDHS, the
infant mortality rate was 35 per 1000 livebirths, while neonatal death rate was 18 deaths per 1000
livebirths. Among regions IMR is highest in Eastern Visayas and lowest in Metro Manila and Central
Visayas. Death is much higher among infants whose mothers had no antenatal care or medical
assistance at the time of delivery. Top causes of illness among infants are infectious diseases
(pneumonia, measles, diarrhea, meningitis, septicemia), nutritional deficiencies and birth-realted
complications.
The probability of dying between birth and five years of age is 48 deaths per 1000 livebirths. The
top five leading causes of deaths (which make up about 70%) of deaths in this age group) are
pneumonia, diarrhea, measles, meningities and malnutrition. About 6% die of accidents i.e.
submersion, foreign bodies, and vehicular accidents.

THe decline in mortality rates may be attributed partly to the Expanded Program of Immunization
(EPI), aimed to reduce infant and child mortality due to seven immunizable diseases (tuberculosis,
diptheria, tetanus, pertussis, poliomyelities, Hepatitis B and measles).

The Philippines has been declared as polio-free druing the Kyoto Meeting on Poliomyelities
Eradication in the Western Pacific Region last October 2000. This. however, is not a reason to be
complacent. The risk of importing the poliovirus from neighboring countries remains high until
global certification of polio eradication. There is an urrgent need for sustained vigilance, which
includes strengthening the surveillance system, the capacity for rapid response to importation of
wild poliovirus, adequate laboratory containment of wild poliovirus materials, and maintaining high
routine immunization until global certification has been achieved.

Malnutrition is common among children. The 1998 FNRI survey show that three to four out of ten
children 0-10 years old are underweight and stunted. The prevalence of low vitamin A serum levels
and vitamin A deficiency even increased in 1998 compared to 1996 levels as reported by FNRI.
Vitamin A supplementation coverage reached to more than 90%, however, a downward trend was
evident in the succeeding years from as high as 97% in 1993 to 78% in 1997.

Breastfeeding rate is 88% (NSO 2000 MCH Survey), with percentage higher in rural areas (92%)
than in urban areas (84%). Exclusive breastfeeding increased from 13.2% to 20% among children
4-5 mos of age (NDHS).

Several strategies were utilized to omprove child health. THe Integrated Management of Childhood
Illness aims at reducing morbidity and deaths due to common chldhood illness. The IMCI strategy
has been adopted nationwide and the process of integration into the medical, nursing, and
midwifery curriculum is now underway.

The Enhanced Child Growth strategy is a community-based intervention that aims to improve the
health and nutritional status of children through improved caring and seeking behaviors. It operates
through health and nutrition posts established throughout the country.

Gaps and Challenges

Many Local Health Units were not adequately informed about the Framework for Children's Health
as well as the policies. There is a need to disseminate the two documents, CHILD 21 and Children's
Health 2025 to serve as the template for local planning for childrens health. There is also the need
to update and reiterate the policies on children's health particularly on immunization, micronutrient
supplementation and IMCI.

LGUs experienced problems in the availability of vaccines and essential drugs and micronutrients
due to weakness in the procurement, allocation and distribution.

Pockets of low immunization coverage is attributed largely to the irregular supply of vaccines due to
inadequate funds. Moreover, there is a need to revitalize the promotion of immunization.

Goal

The ultimate goal of Children's Health 2025 is to achieve good health for all Filipino children by the
year 2025.

Medium-term Objectives for year 2001-2004

Health Status Objectives

1. Reduce infant mortality rate to 17 deaths per 1,000 live births

2. Reduce mortality rate among children 1-4 years old to 33.6% per 1000 livebirths
3. Reduce the mortality rate among adolescents and youths by 50%
Risk Reduction Objectives

1. Increse the percentage of fully immunized children to 90%

2. Increase the percentage of infants exclusively breastfed up to six months to 30%
3. Increase the percentage of infants given timely and proper complementary feeding at six months
to 70%
4. Increase the percentage of mothers and caregivers who know and practice home management of
childhood illness to 80%
5. Reduce the prevalence of protein-energy malnutrition among school-age children
6. Increase the health care-seeking behavior of adolescents to 50%

Services and Protection Objectives

1. Ensure 90% of infants and children are provided with essential health care package
2. Increase the percentage of health facilities with available stocks of vaccines and esential drugs
and micronutrients to 80%
3. Increase the percentage of schools implementing school-based health and nutrition programs to
80%
4. Increase the percentage of health facilities providing basic health services including counseling
for adolescents and youth to 70%

Strategies and Activities

* Enhance capacity and capability of health facilities in the early recognition, management and
prevention of common childhood illness

This will entail improvements in the flow of services in the implementing faciities to ensure that
every child receive the essential services for survival, growth and development in an organized and
efficient manner. Facilities should be equipped with the essential instruments, equipment and
supplies to provide the services. Health providers shall have the knowledge and skills to be able to
provide quality services for children. Existing child health policies, guidelines and standards shall be
reviewed and updated, and new ones formulated and disseminated to guide health providers in the
standard of care.

* Strengthening community-based support systems and interventions for children's health

Notable community-based projects and interventions, such as the health and nutrition posts,
mother support groups, community financing schemes shall be replicated for nationwide
implementation. Model building and dissemination of best practices from pilot sites has proven
effective in generating support and adoption in other sites. More of these shall be initiated
particularly for developing interventions to increase care-seeking and prevention of malnutrition in
children.

* Fostering linkages with advocacy groups and professional organizations and to promote children's
health

Collaboration with the nongovernment sector and professional groups shall

* Conduct national campaigns on children's health

* Conduct and support national campaigns for children
* Initieate and support legislations and researches on children's health and welfare
* Development of comprehensive monitoring and evaluation system for child health programs and
projects

Diabetes
Do you suspect you have diabetes?

Do you have to urinate three to four times at bedtime?

Do you feel unusual thirst?
Do you get tired easily?
Did you have a rapid loss of weight?

If you do, you may be suffering from Diabetes. Don’t waste time. Consult your doctor immediately.
What is diabetes?

Diabetes is a serious chronic metabolic disease characterized by an increase in blood sugar levels
associated with long term damage and failure or organ functions, especially the eyes, the kidneys,
the nerves, the heart and blood vessels.
How does one become a diabetic?

Diabetes occurs when insulin is not adequately produced by the pancreas. It also happens when the
body cannot properly use insulin.
Insulin is a hormone necessary for the proper utilization of sugar by muscles, fat and liver.

What are the complications of diabetes?

In diabetics, blood sugar reaches a dangerously high level which leads to complications.

• Blindness
• Kidney failure
• Stroke
• Heart Attack
• Wounds that would not heal
• Impotence

Is diabetes common in Filipinos?

Yes! It is estimated that there are about 3 million Filipinos who are diabetic, 50% are undiagnosed.
Another 3 million Filipinos have impaired glucose tolerance which is a risk factor for future diabetes
and cardiovascular disease.

What are the types of diabetes?

Type 1 – Insulin dependent diabetes

Develops during childhood or adolescence and affects about 10% of all diabetic patients. Sufferers
require a lifetime of insulin injection for survival since their pancreas cannot produce insulin.
Type 2 – Non-insulin dependent diabetes

Comprises about 90% of all diabetic patients; most patients are overweigh or obese. They have
insulin or insulin resistance. This type of diabetes frequently goes undiagnosed for many years. This
is because hyperglycemia or high blood sugar develops gradually. The symptoms usually go
unnoticed.
How will you know if you are a diabetic?

If you urinate frequently, experience excessive thirst and unexplained weight loss.
If your casual blood sugar (plasma glucose) level is higher than 200mg/dl.
If you have fasting plasma glucose level of not more than 126mg/dl.

If you have any these symptoms, especially if you are overweight or hypertensive, you should see
your doctor right away for proper guidance and treatment.
Who are at risk of diabetes?

children of diabetics
obese people
people with hypertension
people with high cholesterol levels
people with sedentary lifestyles
What can you do to control your blood sugar?

1. Diet Therapy
Avoid simple sugars like cakes and chocolates. Instead have complex carbohydrated like rice, pasta,
cereals and fresh fruits.
Do not skip or delay meals. It causes fluctuations in blood sugar levels.
Eat more fiber-rich foods like vegetables.
Cut down on salt.
Avoid alcohol. Dietary guidelines recommend no more than two drinks for men and no more than
one drink per day for women.

2. Exercise
Regular exercise is an important part of diabetes control.

Daily exercise . . .
Improves cardiovascular fitness
Helps insulin to work better and lower blood sugar
Lowers blood pressure and cholesterol levels

Reduces body fat and controls body weight Exercise at least 3 time a week for ate least 30 minutes
each session. Always carry quick sugar sources like candy or softdrink to avoid hypoglycemia (low
blood sugar) during and after exercise.

3. Control your weight

If you are overweight or obese, start weight reduction by diet and exercise. This improves your
cardiovascular risk profile.

It lowers your blood sugar

It improves your lipid profile
It improves your blood pressure control

4. Quit smoking.
Smoking is harmful to your health. 5. Maintain a normal blood pressure.
Since having hypertension puts a person at high risk of cardiovascular disease, especially if it is
associated with diabetes, reliable BP monitoring and control is recommended. See your doctor for
advice and management.
If there is no improvement in blood sugar what advice can I expect my doctor to give?

There are drug therapies using oral hypoglycemic agents. Your doctor can prescribe one or two
agent, depending on which is appropriate for you.

1. Sulfonylurea – Glibenclamide, Gliclazide, Glipizide, Glimepiride, Repaglinide

2. Biguanide – Metformin
3. Alpha-glucosidase Inhibitors – Acarbose
4. Thiazolidindione – Troglitazone, Rosiglitazone, Proglitazone. Remember

If you have the classic symptoms of diabetes:

See your doctor for blood sugar testing

Start dieting

• eat plenty of vegetables

• avoid sweets such as chocolates and cakes
• cut down on fatty foods

Exercise regularly
If you are obese, try to lose some weight
Avoid alcohol drinking and stop smoking
If you are hypertensive, consult your doctor for advice and management

Diabetes
Do you suspect you have diabetes?
Do you have to urinate three to four times at bedtime?
Do you feel unusual thirst?

Do you get tired easily?

Did you have a rapid loss of weight?

If you do, you may be suffering from Diabetes. Don’t waste time. Consult your doctor immediately.
What is diabetes?

Diabetes is a serious chronic metabolic disease characterized by an increase in blood sugar levels
associated with long term damage and failure or organ functions, especially the eyes, the kidneys,
the nerves, the heart and blood vessels.
How does one become a diabetic?

Diabetes occurs when insulin is not adequately produced by the pancreas. It also happens when the
body cannot properly use insulin.
Insulin is a hormone necessary for the proper utilization of sugar by muscles, fat and liver.

What are the complications of diabetes?

In diabetics, blood sugar reaches a dangerously high level which leads to complications.

• Blindness
• Kidney failure
• Stroke
• Heart Attack
• Wounds that would not heal
• Impotence

Is diabetes common in Filipinos?

Yes! It is estimated that there are about 3 million Filipinos who are diabetic, 50% are undiagnosed.
Another 3 million Filipinos have impaired glucose tolerance which is a risk factor for future diabetes
and cardiovascular disease.

What are the types of diabetes?

Type 1 – Insulin dependent diabetes

Develops during childhood or adolescence and affects about 10% of all diabetic patients. Sufferers
require a lifetime of insulin injection for survival since their pancreas cannot produce insulin.
Type 2 – Non-insulin dependent diabetes

Comprises about 90% of all diabetic patients; most patients are overweigh or obese. They have
insulin or insulin resistance. This type of diabetes frequently goes undiagnosed for many years. This
is because hyperglycemia or high blood sugar develops gradually. The symptoms usually go
unnoticed.
How will you know if you are a diabetic?

If you urinate frequently, experience excessive thirst and unexplained weight loss.
If your casual blood sugar (plasma glucose) level is higher than 200mg/dl.
If you have fasting plasma glucose level of not more than 126mg/dl.

If you have any these symptoms, especially if you are overweight or hypertensive, you should see
your doctor right away for proper guidance and treatment.
Who are at risk of diabetes?

children of diabetics
obese people
people with hypertension
people with high cholesterol levels
people with sedentary lifestyles
What can you do to control your blood sugar?

1. Diet Therapy

Avoid simple sugars like cakes and chocolates. Instead have complex carbohydrated like rice, pasta,
cereals and fresh fruits.
Do not skip or delay meals. It causes fluctuations in blood sugar levels.
Eat more fiber-rich foods like vegetables.
Cut down on salt.
Avoid alcohol. Dietary guidelines recommend no more than two drinks for men and no more than
one drink per day for women.

2. Exercise
Regular exercise is an important part of diabetes control.

Daily exercise . . .
Improves cardiovascular fitness
Helps insulin to work better and lower blood sugar
Lowers blood pressure and cholesterol levels

Reduces body fat and controls body weight Exercise at least 3 time a week for ate least 30 minutes
each session. Always carry quick sugar sources like candy or softdrink to avoid hypoglycemia (low
blood sugar) during and after exercise.

3. Control your weight

If you are overweight or obese, start weight reduction by diet and exercise. This improves your
cardiovascular risk profile.

It lowers your blood sugar

It improves your lipid profile
It improves your blood pressure control

4. Quit smoking.
Smoking is harmful to your health. 5. Maintain a normal blood pressure.
Since having hypertension puts a person at high risk of cardiovascular disease, especially if it is
associated with diabetes, reliable BP monitoring and control is recommended. See your doctor for
advice and management.
If there is no improvement in blood sugar what advice can I expect my doctor to give?

There are drug therapies using oral hypoglycemic agents. Your doctor can prescribe one or two
agent, depending on which is appropriate for you.

1. Sulfonylurea – Glibenclamide, Gliclazide, Glipizide, Glimepiride, Repaglinide

2. Biguanide – Metformin
3. Alpha-glucosidase Inhibitors – Acarbose
4. Thiazolidindione – Troglitazone, Rosiglitazone, Proglitazone. Remember

If you have the classic symptoms of diabetes:

See your doctor for blood sugar testing

Start dieting

• eat plenty of vegetables

• avoid sweets such as chocolates and cakes
• cut down on fatty foods

Exercise regularly
If you are obese, try to lose some weight
Avoid alcohol drinking and stop smoking
If you are hypertensive, consult your doctor for advice and management

Dental Health Program

ComprehensiveDental Health Program aims to improve the quality of life of the people through
the attainment of the highest possible oral health. Its objective is to prevent and control dental
diseases and conditions like dental caries and periodontal diseases thus reducing their prevalence.

Targeted priorities are vulnerable groups such as the 5-12 year old children and pregnant women.
Strategies of the program include social mobilization through advocacy meetings, partnership with
GOs and NGOs, orientation/updates and monitoring adherence to standards.

To attain orally fit children, the program focuses on the following package of activities: oral
examination and prophylaxis; sodium fluoride mouth rinsing; supervised tooth brushing drill; pit
and fissure sealant application; a-traumatic restorative treatment and IEC. The Program also
integrates its activities with the Maternal and Child Health Program, the Nutrition Program and
theGarantisadong Pambata activities of the WHSMP.

Emerging Disease Control Program

Emerging infectious diseases are newly identified and previously unknown infections which cause
public health problems either locally or internationally. These include diseases whose incidence in
humans has increased within the past two decades or threatens to increase in the near future.

Environmental Health
Environmental Health is concerned with preventing illness through managing the environment and
by changing people's behavior to reduce exposure to biological and non-biological agents of disease
and injury. It is concerned primarily with effects of the environment to the health of the people.

Program strategies and activities are focused on environmental sanitation, environmental health
impact assessment and occupational health through inter-agency collaboration. An Inter-Agency
COmmittee on Environmental Health was created by virute of E.O. 489 to facilitate and improve
coordination among concerned agencies. It provides the venue for technical collaboration, effective
monitoring and communication, resource mobilization, policy review and development. The
Committee has five sectoral task forces on water, solid waste, air, toxic and chemical substances
and occupational health.

Vision:

Health Settings for All Filipinos

Mission:

Provide leadership in ensuring health settings

Goals:

Reduction of environmental and occupational related diseases, disabilities and deaths through
health promotion and mitigation of hazards and risks in the environment and worksplaces.

Strategic Objectives:

1. Development of evidence-based policies, guidelines, standards, programs and parameters for

specific healthy settings.

2. Provision of technical assistance to implementers and other relevant partners

3. Strengthening inter-sectoral collaboration and broad based mass participation for the promotion
and attainment of healthy settings

Key Result Areas:

 • Appropriate development and regular evaluation of relevant programs, projects, policies
and plans on environmental and occupational health
• Timely provision of technical assistance to Centers for Health Development (CHDs) and
other partners
• Development of responsive/relevant legislative and research agenda on DPC
• Timely provision of technical inputs to curriculum development and conduct of human
resource development
• Timely provision of technically sound advice to the Secretary and other stakeholders
• Timely and adequate provision of strategic logistics

Components:

• Inter- agency Committee on Environmental Health

• IACEH Task Force on Water
• IACEH Task Force on Solid Waste
• IACEH Task Force on Toxic Chemicals
• IACEH Task Force on Occupational Health
• Environmental Sanitation
• Environmental Health Impact Assessment
• Occupational Health

Expanded Program on Immunization

Children need not die young if they receive complete and timely immunization. Children who are not
fully immunized are more susceptible to common childhood diseases. The Expanded Program on
Immunization is one of the DOH Programs that has already been institutionalized and adopted by
all LGUs in the region. Its objective is to reduce infant mortality and morbidity through decreasing
the prevalence of six (6) immunizable diseases (TB, diphtheria, pertussis, tetanus, polio and
measles)

Special campaigns have been undertaken to improve further program implementation, notably
the National Immunization Days (NID), Knock Out Polio (KOP) and Garantisadong Pambata
(GP) since 1993 to 2000. This is being supported by increasing/sustaining the routine immunization
and improved surveillance system.

Family Planning
Brief Description of Program

A national mandated priority public health program to attain the country's national health
development: a health intervention program and an important tool for the improvement of the
health and welfare of mothers, children and other members of the family. It also provides
information and services for the couples of reproductive age to plan their family according to their
beliefs and circumstances through legally and medically acceptable family planning methods.

The program is anchored on the following basic principles.

* Responsible Parenthood which means that each family has the right and duty to determine the
desired number of children they might have and when they might have them. And beyond
responsible parenthood is Responsible Parenting which is the proper ubringing and education of
chidren so that they grow up to be upright, productive and civic-minded citizens.
* Respect for Life. The 1987 Constitution states that the government protects the sanctity of life.
Abortion is NOT a FP method:
* Birth Spacing refers to interval between pregnancies (which is ideally 3 years). It enables women
to recover their health improves women's potential to be more productive and to realize their
personal aspirations and allows more time to care for children and spouse/husband, and;
* Informed Choice that is upholding and ensuring the rights of couples to determin the number and
spacing of their children according to their life's aspirations and reminding couples that planning size
of their families have a direct bearing on the quality of their children's and their own lives.
E. Intended Audience:

Men and women of reproductive age (15-49) years old) including adolescents

F. Area of Coverage:

Nationwide

G. Mandate:

EO 119 and EO 102

H. Vision:

Empowered men and women living healthy, productive and fulfilling lives and exercising the right to
regulate their own fertility through legally and acceptable family planning services.

I. Mission

The DOH in partnership with LGUs, NGOs, the private sectors and communities ensures the
availability of FP information and services to men and women who need them.

J. Program Goals:

To provide universal access to FP information, education and services whenever and wherever these
are needed.

K. Objectives

General:

To help couples, individuals achieve their desired family size within the context of responsible
parenthood and improve their reproductive health.

Specifically, by the end of 2004:

Reduce

* MMR from 172 deaths 100,000 LB in 1998 to less than 100 deaths/100,000 LB
* IMR from 35.3 deaths/1000 livebirths in 1998 to less than 30 deaths/1000 live births
* TFR from 3.7 children per woman in 1998 to 2.7 chidren per woman

Increase:

* Contraceptive Prevalence Rate from 45.6% in 1998 to 57%

* Proportion of modern FP methods use from 28>2% to 50.5%

L. Key Result Areas

1. Policy, guidelines and plans formulation

2. Standard setting
3. Technical assistance to CHDs/LGUs and other partner agencies
4. Advocacy, social mobilization
5. Information, education and counselling
6. Capability building for trainers of CHDs/LGUs
7. Logistics management
8. Monitoring and evaluation
9. Research and development

M. Strategies
I. Frontline participation of DOH-retained hospitals
II. Family Planning for the urban and rural poor
III. Demand Generation through Community-Based Management Information System
IV. Mainstreaming Natural Family Planning in the public and NGO health facilities
V. Strengthening FP in the regions with high unmet need for FP: CAR, CHD 5, 8, NCR, ARMM
VI. Contraceptive Interdependence Initiative

N. Major Activities

I. Frontline participation of DOH-retained hospitals

* Establishment of FP Itinerant team by each hospital to respond to the unmet needs for permanent
FP methods and to bring the FP services nearer to our urban and rural poor communities
* FP services as part of medical and surgical missions of the hospital
* Provide budget to support operations of the itenerant teams inclduing the drugs and medical
supplies needed for voluntary surgical sterilization (VS) services
* Partnership with LGU hospitals which serve as the VS site

II. Family Planning for the urban and rural poor

* Expanded role of Volunteer Health Workers (VHWs) in FP provision

* Partnership of itenerant team and LGU hospitals
* Provision of FP services

III. Demand Generation through Community-Based Management Information System

* Identification and masterlisting of potential FP clients and users in need of PF services (permanent
or temporary methods)
* Segmentation of potential clients and users as to what method is preferred or used by clients

IV. Mainstreaming Natural Family Planning in the public and NGO health facilities

* Orientation of CHD staff and creation of Regional NFP Management Committee

* Diacon with stakeholders
* Information, Education and counseling activities
* Advocacy and social mobilization efforts
* Production of NFP IEC materials
* Monitoring and evaluation activities

V. Strengthening FP in the regions with high unmet need for FP: CAR, CHD 5, 8, NCR, ARMM

* Field of itinerant teams by retained hospitals to provide VS services nearer to the community
* Installation of COmmunity Based Management Information System
* Provision of augmentation funds for CBMIS activities

VI. Contraceptive Interdependence Initiative

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

VIII. Development /Updating of FP CLinical Standards

IX. Formulation of FP related policies/guidelines. E.g. Creation of VS Outreach team by retained

hospitals and its operationalization, GUidelines on the Provision of VS services, etc.

X. Production and reproduction of FP advocacy and IEC materials

XI. Provision of logistics support such as FP commodities and VS drugs and medical supplies
O. Other Partners

1. Funding Agencies

* United States Agency for International Development (USAID)

* United Nations Funds for Population Activities (UNFPA)
* Management Sciences for Health (MSH)
* Engender Health
* The Futures Group

2. NGOs

* Reachout foundation
* DKT
* Philippine Federation for Natual Family Planning (PFNFP)
* John Snow Inc. - Well Family Clinic
* Phlippine Legislators Committee on Population Development (PLPCD)
* Remedios Foundation
* Family Planning Organization of the Philippines (FPOP)
* Institute of Maternal and CHild HEalth (IMCH)
* Integrated Maternal and CHild Care Services and Development, Inc.
* Friendly Care Foundation, Inc.
* Institute of Reproductive Health

3. Other GOs

* Commission on Population
* DILG
* DOLE
* LGUs

Food and Waterborne Diseases Prevention and Control Program

Profile:

Food and Waterborne Diseases (FWBDs) are among the most common causes of diarrhea. In
the Philippines, diarrheal diseases for the past 20 years is the number one cause of morbidity and
mortality incidence rate is as high as 1,997 per 100,000 population while mortality rate is 6.7 per
100,000 population. From 1993 to 2002, FWBDs such as cholera, typhoid fever, hepatitis A and
other food poisoning/foodborne diseases were the most common outbreaks investigated by the
Department of Health. Also, outbreaks from FWBDs can be very passive and catastrophic. Since
most of these diseases have no specific treatment modalities, the best approach to limit economic
losses due to FWBDs is prevention through health education and strict food and water sanitation.

The Food and Waterborne Disease Prevention and Control Program (FWBDPCP) established in 1997
but became fully operational in year 2000 with the provision of a budget amounting to
PHP551,000.00. The program focuses on cholera, typhoid fever, hepatitis A and other foodborne
emerging diseases (e.g. Paragonimiasis). Other diseases acquired through contaminated food and
water not addressesd by other services fall under the program.

The Food Fortification program is the government's response to the growing micronutrient
malnutrition, which have been prevalent in the Philippines for the past several years.

Food Fortification is the addition of Sangkap Pinoy or micronutrients such as Vitamin A, Iron
and/or Iodine to food, whether or not they are normally contained in the food, for the purpose
of preventing or correcting a demonstrated deficiency with one or more nutrients in the
population or specific population groups.

Sangkap Pinoy or micronutrients are vitamins and minerals required by the body in very
small quantities. These are essential in maintaining a strong, healthy and active body; sharp
mind; and for women to bear healthy children.

Past studies have shown that worldwide, the problem of malnutrition has been the cause of
death of 60% of children less than 5 years old.

For the Philippines, Nutrition surveys since 1993 have been showing increasing prevalence
of micronutrient malnutrition, particularly that of Vitamin A Deficiency Disorder (VADD), Iron
Deficiency Anemia (IDA) and Iodine Deficiency Disorder (IDD) among children and women of
reproductive age, who are the most at-risk groups to micronutrient malnutrition.

Based on the results of the 2003 National Nutrition Survey of the Food and Nutrition
Research Institute (FNRI), the prevalence of VADD and IDA among children and women of
reproductive age continue to be high, and for children, they're even higher than that of 1998.
Iodine Deficiency Disorder (IDD) has substantially declined among children and pregnant
women although it remains high among lactating women.

To address this problem, the Philippines has embarked on a three-pronged strategy of

micronutrient supplementation, dietary diversification and food fortification. While all
strategies are simultaneously implemented to complement one another, studies show that
food fortification is the most cost-effective and sustainable to address micronutrient
malnutrition.

INTRODUCTION

Sangkap Pinoy is a term used by the DOH for micronutrients added to food to enhance its
nutritional quality.

These micronutrients are vitamin A, iron and iodine, which cannot be synthesized by the
human body, and therefore must be provided through the diet. The intake of these
micronutrients through the Filipino diet is often inadequate and is responsible for the
micronutrient malnutrition afflicting a majority of the population.

Fortification of foods with micronutrients is generally recognized as the most cost

effective long-term strategy for eliminating micronutrient malnutrition. It is also socially
acceptable, requires none or little change in food habits and characteristics, and provides
a means for reaching the greatest percentage of the population requiring the
micronutrients.

The Department of Health (DOH) in collaboration with other government and non-
government organizations, donor agencies, private sector and other stakeholders is
implementing a program on food fortification known as the Sangkap Pinoy Seal Program
(SPS Program).

The SPS Program is a strategy of the DOH to encourage food manufacturers to fortify
food products with essential micronutrients at levels approved by the DOH. The DOH
matches this encouragement by authorizing food manufacturers to use a seal of
acceptance known as the Sangkap Pinoy Seal (SPS) on product labels that meet a set of
defined criteria. The seal indicates that the product is recognized by the DOH as a vehicle
for the delivery of micronutrients and which can therefore contribute to the elimination of
micronutrient malnutrition.

In 2004, the Diamond Sangkap Pinoy Seal was introduced to be used solely for staple
products mandated for fortification, namely cookingoil, wheat flour, rice, refined sugar
and salt. while the original or rectangular seal is voluntarily applied for by companies
when they meet the fortification standrds, the diamond seal is automatically awarded to
staple companies.

DEFINITION OF THE SANGKAP PINOY SEAL

The Sangkap Pinoy Seal (SPS) is a mark of DOH recognition of a food product that is
properly fortified with either vitamin A, iodine or iron or a combination of these
micronutrients and that complies with regulations of the Bureau of Food & Drug (BFAD) of
the DOH for quality, labeling and addition of fortificants.

MISSION, GOAL AND OBJECTIVES OF THE SANGKAP PINOY SEAL PROGRAM

The mission of the Sangkap Pinoy Seal Program (SPS Program) is to provide an umbrella
channel for implementing the national food fortification strategy for the elimination of
micronutrient malnutrition at the soonest possible time. The goal of the SPS Program will be to
provide DOH with a seal of acceptance for fortified food products, particularly for commonly
consumed foods that could contribute at least an additional 50% to the recommended daily
allowance of micronutrients to target populations, by the year 2004.

The SPS program will have the following objectives:

1. To encourage food manufacturers particularly of commonly consumed foods as rice,

sugar, edible oil, flour, salt and condiments, to fortify their products with one or more
of the three essential micronutrients, vitamin A, iron and iodine, in accordance with
the rules and regulations of the DOH.
2. To make the public aware of the availability of fortified foods and to encourage their
consumption, by strengthening public awareness of the SPS Program and public
confidence in products carrying the Sangkap Pinoy Seal.
3. To provide a vehicle for public-private sector collaboration on technology, promotions,
research, monitoring and surveillance, and other activities that will lead to the success
of food fortification as a strategy for the elimination of micronutrient malnutrition.
 MANAGEMENT OF THE SANGKAP PINOY SEAL
PROGRAM
A. Organizational Structure
The management of the Sangkap Pinoy Seal Program shall be the responsibility of four
groups linked with one another as shown in Figure 1. These groups are the Office of the
Secretary (OSEC) - Department of Health, the Food Fortification Project Steering
Committee the Bureau of Food and Drugs or the National Food Authority (NF A), in the
case of rice and the Food Fortification Management Team.

The Office of the Secretary shall issue the final approval on the applications for the SPS.

The Food Fortification Project Steering Committee shall be the policy making body of the
Food Fortification Program and shall be composed of representatives from the private and
public sector.

The Bureau of Food and Drug shall handle all administrative and technical activities
related to recommending the award of the Seal to the DOH Secretary for all fortified
foods except rice. This will involve acceptance, review and evaluation of applications;
conduct of plant inspections; recommendation of products for the award of the Seal to the
Office of the DOH Secretary; and monitoring of approved products for compliance with
the requirements of the Seal. The National Food Authority as part of its mandate as the
regulatory agency for rice shall perform similar functions as BFAD in relation to rice
fortification only.

The Food Fortification Project Management Team (FFMT) of the DOH shall coordinate the
implementation of activities on advocacy and promotions and shall coordinate with the
Food Fortification Project Steering Committee and BFAD and NFA, in the implementation
of policies related to the Sangkap Pinoy Seal Program. The FFMT shall likewise document
and monitor the progress of Program.

In addition, a Specialized Group of consultants may be tapped to give advice on highly

technical matters as may be necessary.
APPLICABILITY OF THE SANGKAP PINOY SEAL PROGRAM

A. Target Clientele
All food manufacturers producing fortified food products with vitamin A, iron and iodine
shall be encouraged to carry the Sangkap Pinoy Seal.

Manufacturers of commonly consumed foods (flour, sugar, rice, salt, edible oil and
condiments such as fish sauce and soy sauce) which are DOH target vehicles for the food
fortification program, shall be encouraged to fortify their products to fast track the
elimination of micronutrient malnutrition.

B. Fortification Levels
1. For DOH Target Food Vehicles

The minimum level of fortification for DOH target vehicles based on the DOH Food
Fortification Strategic Plan 2000-2004 is shown below. Levels of fortification suggested
below are subject to change based on results of new research that will be made available
in the future.

Food Vellicle Fortificant/s Minimum Level of Fortification at Production

Flour Vitamin A 490 RE/100 grams

Iron 45 ppm

Sugar Vitamin A 175 RE/15 grams

Edible oil Vitamin A 300 RE/15 grams

Rice Iron 6 mg/100 grams Raw Rice

Salt Iodine 60 ppm (retail pack) 70 ppm (bulk pack)

Condiments Iron Level will be in accordance with Food Fortification Guidelines

Technology assistance will be provided by the government to food manufacturers of the

above target vehicles, based on current technology available. Where applicable, BFAD will
recognize and use relevant data and reports from government technical assistance, in the
evaluation of a company for use of the Seal.

2. For Other Food Vehicles

For all other food vehicles and processed foods fortified with vitamin A and/or iron and/or
iodine, levels of fortification should be in accordance with the Guidelines on Micronutrient
Fortification of Processed Foods. Technology for fortification will be developed by the food
manufacturer.

MECHANICS FOR SECURING SANGKAP PINOY SEAL FOR BFAD REGULATED FOOD
PRODUCTS

Figure 2 shows the process now for SPS application, evaluation and approval for all food
products except fortified rice. Figure 3 shows the procedure for fortified rice. The detailed
steps, documents required and action to be implemented for each step are shown in Table I.
Following is a description of the sequential actions to be taken by an applicant and of the
organizations involved in the application, evaluation and approval processes.

A. Application Process
1. The food company applying for the Sangkap Pinoy Seal should submit to the Bureau of Food
and Drugs presently located at the Filinvest Corporate City, Alabang, Muntinlupa, Metro Manila
the following documentary requirements:

1.1 Duly accomplished application Form IA (see schedule 1).

1.2 A certified true copy of License to Operate issued by the Bureau of Food and Drugs.

1.3 Results of product analysis of vitamin A, iron and/or iodine from a BF AD recognized
laboratory.

1.4 Proposed label with the Sangkap Pinoy Seal.

1.5 Results of storage/shelf life studies with respect to fortificant stability (if available). If this
is not available at the time of evaluation and approval, this should be submitted during the
first year of Sangkap Pinoy Seal usage.

2. Applicants should pay a processing fee of P500.00 to the BFAD Cashier for every
application, in accordance with the nature of the product being applied for as stated below:

Provision No. of Applications

2.1 Products with the same formulation, one application
process and brand

2.2 Products with the same formulation, one application

process and brand but different flavors

2.3 Products with the same formulation, one application

process, but different brands

2.4 Products with the same formulation one application per process
but different process and brands

2.5 Products with the same process but one application per
different formulation and brand formulation<![endif]>

B. Evaluation Process
1. Upon receipt of application, the BFAD conducts a desk review to check completeness of the
documentary requirements.

2. If documentary requirements are incomplete, the BFAD informs applicant and defers
conduct of further evaluation until company submits complete requirements.

3. If documentary requirements are complete, BFAD conducts a plant inspection to evaluate

compliance with Good Manufacturing Processes (GMP). BFAD may choose to forego plant
inspection if the plant's License to Operate, LTO, which is issued to check for compliance with
GMP, was conducted after the fortification of the product. It may also choose to forego the
plant inspection for DOH target vehicles receiving government assistance for the development
of fortification technology. For rice fortification, BFAD submits to NFA the documentary
requirements for NFA evaluation.
4. BFAD conducts a plant visit (if it chooses to do so), using the recommended checklist on the
fortification process in Schedule I.

5. BFAD makes a final evaluation of the applicant based on the plant visit (if done) and review
of documentary requirements using Form IIB (see schedule 1).

6. If application is approved, BFAD fills Form IIB. The BFAD will prepare the Letter of Award
and SPS Program Certificate of Acceptance for the signature of the Secretary of the DOH.

7. If application is disapproved, BFAD informs the applicant of the deficiencies. BFAD issues
the Letter of Rejection containing instructions on appropriate corrective action.

8. Rejected applicant can reapply for the seal after instituting corrective action required.
The application begins in step 1 above.

C. Awarding of the Sangkap Pinoy Seal

1. Food manufacturer will be provided with a Sangkap Pinoy Seal Certificate of Acceptance and
a Letter of Award detailing the conditions for the use of the SPS signed by the DOH Secretary.

2. Companies pay a non-refundable fee of P 8,000.00 for the first year of validity of the SPS
Program Certificate of Acceptance and an annual fee of P5,000.00 for each succeeding year
that the SPS Program Certificate of Acceptance is renewed. The fee is paid to the BFAD
Cashier for the use of the latter in monitoring product compliance.

3. Companies display the SPS Program Certificate of Acceptance issued by the Department of
Health in the plant site where the approved fortified food product is manufactured.

4. Companies use Sangkap Pinoy Seal on the approved product label.

5. The effectivity of the SPS Program Certificate of Acceptance and Letter of Award shall be
from the date of issue and shall be valid for an indefinite period unless revoked for a cause as
when monitoring indicates non-compliance and failure to immediately implement corrective
action

6. If a shelf life study on the fortificant was not submitted, this should be submitted within one
year of Sangkap Pinoy Seal Usage.

MECHANICS FOR SECURING SANGKAP PINOY SEAL FOR FORTIFIED RICE

For fortified rice, which is a non-BF AD regulated food product, the process for securing the
Sangkap Pinoy Seal will be the same as in Section VI B 3- 7, except that the regulatory
agency that will be responsible for assuring the credibility of the Sangkap Pinoy Seal will be
the NFA (see Fugure 2). It submits results of evaluation to BFAD for preparation of letter of
award or rejection.

For the rice fortified by the NFA, the use of the Sangkap Pinoy Seal will be governed by a MOA
between the NFA and DOH. The MOA will include the responsibilities of NFA in assuring proper
fortification of both NFA and non-NFA fortified rice.

Figure 2. Process Flow for Sangkap Pinoy Seal Application, Evaluation and Approval
Table 1. Workflow for the processing and evaluation of Sangkap Pinoy Seal
applications.

STEPS FORMS ACTION

TAKEN

1. Submission of documents and Form IA BFAD to check

application to BFAD and payment of completeness of
application fee to BFAD cashier. documentary
requirements and
proof of payment

2. Evaluation of documents by BFAD Form IB FFMT evaluates

documents using
Form IB. BFAD
transfers to NFA
for rice.

3. Final evaluation of documents and Form IA, BFAD/NFA

conduct of plant inspection, if needed, evaluates
by BFAD/NFA Form IB, documents,
carries out plant
Documentary inspection if it
requirements, deems this
Form IIA necessary and
transmits its
Internal documents of decision if
BFAD/NFA product will be
approved or not
to carry the
Sangkap Pinoy
Seal using Form
IIB

4. Recommendation by BFAD/ NFA Form IIB NFA (for rice)

submits results to
BFAD. BFAD
either
recommends
approval to the
Secretary of
Health or informs
company of
 disapproval and
deficiencies of
applicant

Action recorded
to Form IIB

5. Preparation of SPS Program SPSP Certificate of BFAD facilitates

Certification of Acceptance and Letter Acceptance Letter of SPS signing of SPSP
of SPS Award, by BFAD. Award or Letter of Certificate of
Rejection Acceptance and
If disapproved, preparation of Letter of Letter of SPS
Rejection by BFAD and notification of Award by the
applicant DOH Secretary,
for those
approved

Or

BFAD prepares
Letter of
Rejection

BFAD notifies
applicant of the
results

6. Payment of fees to BFAD for approved Receipt of payment to Approved

applicants BFAD applicant pays
BFAD/NFA
cashier and give
copy of receipt to
BFAD

7. Certificate and letter of award to Same as No. 6 BFAD gives

applicant certificate and
letter of award to
successful
applicants

SANGKAP PINOY SEAL USAGE GUIDELINES

1. Successful Sangkap Pinoy Seal applicant firms shall be authorized the

non-exclusive right to use the Sangkap Pinoy Seal.
2. The seal is designed as indicated in Schedule 6.

3. The size of the seal should be prominent, but should never encroach on
the mandatory label information.

4. Only the nutrient/fortificant with the approved level shall be printed

below the seal.

5. The designated colors of the logo are golden yellow, green, red and black
with white background. Other combination of color that may be used is
black with white background. No other combinations of colors are to be
used.

6. All reproductions of the logo on the product label and promotional

materials must be approved by the DOH at artwork stage through the Food
Fortification management Team.
 MONITORING SANGKAP PINOY SEAL PRODUCTS
Figure 5 shows the process now for monitoring, renewal and cancellation of Sangkap
Pinoy Seal usage.

1. All approved products from any market source shall be monitored for compliance with
requirements for the use of the seal at least once a year.

2. Monitoring shall be done through market sampling by BFAD/NFA (for rice only) as part
of their regular monitoring of food products. BFAD has the option to assign market
sampling to personnel or regional offices working with the DOH and similarly NFA to its
regional offices. Analysis of market samples may be done by BFAD/NFA. BFAD/NFA also
has the option to send samples to its recognized laboratories. Plant visits will be
conducted by BFAD/NFA as part of their regulatory process for the renewal of licenses of
food processing plants.

3. BFAD/NFA (for rice only) shall inform the food company of the results of monitoring.
The SPS Program Certificate of Acceptance for companies that have passed BFAD/NFA
monitoring can be automatically renewed upon payment of the P5,000.00 renewal fee to
BFAD/NFA.

4. Companies with samples of products that do not comply with acceptable levels of
fortification shall be warned accordingly by BFAD through a letter informing the company
of non-compliance.

5. Companies are expected to adopt corrective measures and inform the BFAD of these
corrective measures within one month from their receipt of the BFAD letter of non-
compliance. A second monitoring will be initiated by BFAD/NFA of the corrective action
that had been taken.

6. Failure to pass the second BFAD/NFA monitoring of the product shall mean cancellation
of SPS usage. BFAD will inform the company of the cancellation of SPS usage and request
the company to return SPS Program Certificate of Acceptance and conduct product recall.
BFAD/NFA will monitor non-usage of the seal.

7. Appropriate sanctions shall be made by the Secretary of Health to the company that
fails to upgrade the product's nutrient level after due warning through cancellation of the
permit to use the Sangkap Pinoy Seal and order the recall of products with the Sangkap
Pinoy Seal.

Schedules

Schedule 1: Forms

Form IA - Product Application Form

Form IB - Preliminary Evaluation of Application Form IA for SPSP

Form IIA - Sangkap Pinoy Seal Program Plant Visit Inspection Checklist on
Fortification

Form IIB -Sangkap Pinoy Seal Program Final Evaluation of Application

Schedule 2: Letter of Award

Schedule 3: Sangkap Pinoy Seal Program Certificate of Acceptance

Schedule 4: Seal Designs

Schedule 5: Guidelines on Micronutrient Fortification of Processed Foods

Leprosy Control Program

Leprosy Control Program envisions to eliminate Leprosy as a human disease by 2020 and is
committed to eliminate leprosy as a public health problem by attaining a national prevalence rate
(PR) of less than 1 per 10,000 population by year 2000. Its elimination goals are: reduce the
national PR of <1 case per 10,000 population by year 1998 and reduce the sub-national PR to <1
case per 10,000 population by year 2000. Kilatis Kutis Campaign.

Program thrust is towards finding hidden cases of leprosy and put them on Multi-Drug Therapy
(MDT), emphasizing the completion of treatment within the WHO prescribed duration.

Strategies are case-finding, treatment, advocacy, rehabilitation, manpower development and

evaluation.

Malaria Control Program

Malaria is endemic in 65 of the 78 provinces in the country, affecting approximately 10.2 million
Filipino who are at risk of the disease. The commonly affected groups are the farmers, indigenous
cultural groups, forest product gatherers, agricultural workers, miners and soldiers.

The program was not affected by devolution, thus direct services are still being provided by the
Regional Offices to affected areas. The Malaria Control Program provides support to active and
passive case detection and treatment and simultaneous mosquito vector control to eradicate malaria
in the Region

Ligtas Tigdas 2004 is a special nationwide vaccination month for children who are at high risk
of getting measles. The Department of Health identified these children to be those between the
ages of 9 months to less than 8 years old.

During the Ligtas Tigdas 2004, 100% of the children in this age group will be vaccinated. Other
children are not classified as high risk.

The Philippine Measles Elimination Campaign of which the Ligtas Tigdas 2004 is only one
component. PMEC includes continuing routine vaccination of infants at 9 months old after
Ligtas Tigdas 2004; the catch-up mass vaccination done in 1998; continuing monitoring or
disease surveillance and Follow-up campaign such as Ligtas Tigdas 2004 which may have to
be repeated every 4 or 5 years.Vitamin A capsules will also be given to children 9 months to
below 6 years of age.

The “LIGTAS TIGDAS” should be done to rapidly reduce the number of children at risk of
getting measles infection which has accumulated in the past years. This nationwide campaign
supports the routine vaccination given on a regular basis at the health centers.
 It is a Door-to-Door campaign. “BakunaDOORS” (Vaccination Teams) led by doctors, nurses
and midwives will visit every home and school to vaccinate children against measles which will
be done in the whole month of February 2004

National Filariasis Elimination Program

Brief Description of Program:

Filariasis is a major parasitic infection, which continues to be a public health problem in the
Philippines. It is the second leading cause of permanent and long-term disability. A control program
was created in 1963 and was placed under the Communical Disease Control Service in 1987 under
E.O. 119. It is one of the vertical programs of the Department of Health , which is being
implemented through the Filariasis COntrol Units in Region 5, 8 and 11. In other endemic areas
without Filariasis Control Units, the program is implemented by the designated personnel from the
Center for Health Development. It was only in 1996, that the program was given a separate budget.
It objective is to eliminate filariasis, in line with the World Health Organization call for global
elimination of filariasis as a public health problem. Preparatory activities on elimination started in
1998 such as determining the real magnitude of the problem through Endemic Mapping, field
testing of the new rapid assessment diagnostic method, the Immunochromatographic test for
filariasis, pilot testing of the new treatmetn strategy using Mass Annual Treatment with combination
drugs, Diethylcarbamazine Citrate and Albendazole and creation of the National Advisory Group for
Filariasis. THe Mass Annual Treatment of all established endemic municipalities started in 2000 and
is ongoing. The Mass Treatment scheme is integrated with otehr programs such as the Soil
Transmitted Helmenthiasis and the Schistosomiasis Control Programs.

Target Population/Clients:

Individuals, families and communities living in endemic municipalities in 13 regions except Region 2,
6 and NCR.

Area of Coverage:

Forty-eight (48 provinces in regions 1, 2, 3, 4, 5, 7, 8, 9, 10, 11, 12, CARAGA, ARMM and CAR.

Mandate:

A.O. No. 25-A

Program Vision:

Healthy and productive individuals and families

Mission:

Universal access to quality health services

Program Objectives:

General Objective: To reduce the Prevalence Rate to <1/1,000 population

Specific Objective:

1. To establish the endemicity of municipalities at the end of two years.

2. To perform Mass Treatment in established endemic municipalities for at least four years.

3. To continue surveillance of established endemic areas five years after Mass treatment.

Key Result Areas (KRAs)

1. Institution of Rapid assessment in the diagnosis of filariasis

2. Mapping of endemic municipalities

3. Prevention, control and elimination of filariasis using the Mass Annual Treatment scheme with
Diethylcarbamazine Citrate and Albendazole in all established endemic municipalities

4. Integration with other parasitic control programs

5. Build-up the capabilities of the field healthworkers in the implementation of the Filariasis
Elimination Program

6. Improved efficiency of the National Filariasis Elimination Program

M. PROGRAM STRATEGIES

1. Mapping of endemic areas using Rapid Assessment Methods

2. Advocacy and Capability building through training and establishment of Family Support System

3. Mass Treatment using Diethylcarbamizine Citrate and Albendazole

4. Support Control strategies which includes Morbidiy and vector control

5. Monitoring of process indicators

N. PROGRAM COMPONENTS

1. Mapping of Endemic areas

2. Capability building
3. Mass Treatment
4. Integration with other parasitic control programs
5. Support Control Strategies
6. Monitoring and Supervision
7. Evaluation
8. National Certification of Elimination
9. International Certification of Elimination

O. MAJOR ACTIVITIES

1. Endemic Mapping
2. Mass Treatment
3. Integration with other parasitic control programs

P. Collaborating Centers

1. Collaborating Center for Helminthiasis in CHD 8

Q. Other Partners

1. Endemic LGUs
2. Academes (UST & UP-CPH)
3. OTher GOs (UP-NIH and RITM)
4. WHO
5. NGOs (Christian Mobile Medical Service and Teknotropheo, Inc)

R. Contact Person

Name : DR. JAIME LAGAHID

Title : Office-in-Charge
Tel. No. : 711-68-04/711-68-08/723-24-93
Fax No. : 711-68-04/723-24-93
Postal Address : Bldg. 13, 3rd Flr., San Lazaro Compound
Sta. Cruz, Manila

National Mental Health Program

Program/Project

The National Mental Health Program (NMHP) now, under the Degenerative Disease Office of
the National Center for Disease Prevention and Control (NCDPC), Department of Health. It
aims at integrating mental health within the total health system, initially within the DOH system,
and the local health system. Within the DOH, it has initiated and sustained the integration process
within the hospital and public health systems, both at the central and regional level. Furthermore, it
aims at ensuring equity in the availability, accessibility, appropriateness and affordability of mental
health and psychiatric services in the country.

Brief Situationer

Mental health is an integral component of total health. Issues on mental health includes not only the
traditional mental disorders but as important are the concerns of target populations vulnerable to
psychosocial risks brought about by extreme life experiences (e.g. disasters, near death
experiences, heinous and violent crimes, internal displacement brought about by religious and civil
unrest) as well as the psychosocial concerns of daily living (e.g. maintaining a sense of well being in
these difficult times).

Services for mental health must be available within the public health as well as the hospital system
of the country. Such services must have promotive, preventive, curative and rehabilitative
component.

Vision

Full integration of Mental Health in the national system

Mission

To make available, accessible, affordable and equitable quality mental health care/services to the
Filipinos especially the poor, the underserved and high risk populations.

Mandate

To provide the Department of Health with necessary services related to planning, programmming
and project development in mental health.

Functions

1. Advisory body to the Secretary of Health regarding mental health concerns.

2. Acts as a policy making body regarding mental health concerns
3. Involves itself in training, research, supervision and, monitoring of mental health
resources/programs services.
4. Mobilizes mental health resources for advocacy, planning, implementation and service
delivery.

Guiding Principles

• Mental health is not only limited to traditional mental illnesses but also includes the
psychosocial concomitants of daily living.
• Mental health programs must recognize the importance of community efforts with
multisectoral and multidisciplinary involvement.
 • Mental health programs must address the promotive,preventive, curative and rehabilitative
aspects of care.
• Psychiatric patient care extends beyond the mental hospitals, and must be made available
in general hospitals, health centers and homes.
• Mental health activities and interventions must be done closest to where the need or the
patient is.

Strategies

• National diffusion and democratization of capabilities of mental health facilities.

• Intensification and strengthening the training in psychiatry and mental health.
• Peripheral development
• Development of clinical policies
• Institution building
• Focus on research
• Advocacy
• Networking

Priority Areas of Concern

• Substance abuse
• Disaster and crisis management
• Women and children and other vulnerable groups
• Traditional mental illnesses (schizophrenia, depression and anxiety)
• Epilepsy and other neurological disorders
• Overseas Filipino workers

Natural Family Planning

Natural Family Planning
Population/Family Planning Issue

Senate Bill No. 1546: "Reproductive Health Act of 2004"

House Bill No. 16: "Reproductive Health Act of 2004"

The Truth About the P50M CFC Contract with DOH

CFC-DOH Partnership

Letter to the Editor: Philippine Daily Inquirer

Family Planning
Brief Description of Program

A national mandated priority public health program to attain the country's national health
development: a health intervention program and an important tool for the improvement of the
health and welfare of mothers, children and other members of the family. It also provides
information and services for the couples of reproductive age to plan their family according to their
beliefs and circumstances through legally and medically acceptable family planning methods.

The program is anchored on the following basic principles.

* Responsible Parenthood which means that each family has the right and duty to determine the
desired number of children they might have and when they might have them. And beyond
responsible parenthood is Responsible Parenting which is the proper ubringing and education of
chidren so that they grow up to be upright, productive and civic-minded citizens.