In July 2016, the Government of the Philippines shared an update on progress in achieving its policy, financial and program and service delivery commitments to FP2020.
The Government of the Philippines has engaged in the following activities to establish a national policy on reproductive health and population development and to allocating funds to implement the policy:
- The National Implementation Team (NIT) and Regional Implementation Teams (RITs) created in 2015 served as the oversight and steering committee for RPRH implementation across the country. As provided in Department of Health (DOH) AO No. 2015-0002, they served as venue to discuss and resolve issues confronting implementation of the RPRH Law at all levels. Moreover, they also served as the coordinating bodies at the national and regional levels in harmonizing work and financial plans for various RPRH programs and monitor progress of implementation. Among the key NIT accomplishments of 2015 are: the development of the Monitoring and Evaluation Framework for the 5 Key Areas on Reproductive Health (Maternal and Newborn Health, Family Planning, Adolescent Reproductive Health, STI and HIV-AIDS, and Gender-Based Violence), the development of the Philippine Health Insurance (PHIC or PhilHealth) benefit packages to improve access to services (such as the progestin subdermal implant and post-partum IUD), the active involvement of other national government agencies (such as the DSWD, DepEd, DILG, NAPC and PCW) in RPRH Law implementation; and the development of modalities for greater participation of civil society organizations and professional groups in government’s RH program.
- The Women, Men’s Health Development Division and Children’s Health Development Divisions (WMCHDDs) under the Disease Prevention and Control Bureau (DPCB) also provided technical oversight to the implementation of the RPRH Law. Through its various programs and resources, the WMCHDD were able to provide national, regional, and local technical guidance on the conduct of capacity building and demand generation activities, and provision of care, including distribution of essential RPRH commodities. The DOH awaits the creation of the Family Health Bureau (FHB) through an Executive Order as specified in the IRR of the RPRH Law to “expand organizational structure that will ensure provision of the needed technical guidance and coordination support for the systematic and integrated provision of reproductive health care to all citizens, prioritizing women, the poor, and the marginalized population groups”. The creation of the FHB is now awaiting the endorsement of Office of Organization, Position, Classification and Compensation Bureau (OPCCB) of Department of Budget and Management (DBM) to the Office of the President for final approval.
- POPCOM led in drafting the Planning, Monitoring and Evaluation (PME) Guide, which provided guidance not only for the development of RPRH work and financial plan for 2015, but also for monitoring progress of its implementation. More specifically, the PME identified the process of collection, consolidation and processing of data coming from the reports of the different agencies and units, CSOs and other implementation partners.
- In support of the various provisions under the RPRH Act and its Implementing Rules and Regulations, the DOH in coordination with other agencies and with technical assistance from CSOs and other development partners issued the following Administrative Orders (AO) related to Family Planning in 2015.
- Administrative Order No. 2015-0006 Re: Inclusion of Progestin Subdermal Implant as One of the Modern Methods Recognized by the National Family Planning Program. This AO provides for guidelines in introducing Progestin Subdermal Implant as a new family planning program method to both the public and private sector providers as well as program managers and key stakeholders. It specifically described the key elements on how it will be integrated in existing FP services in the field.
- Department Circular No. 2015-0300. Re: Clarification of Annex A Section 4 of Administrative Order 2015-0006 entitled "Inclusion of Progestin Subdermal Implant as one of the Modern Methods recognized by the National Family Planning Program." Note however that implementation is temporarily on hold due to the TRO issued by the Supreme Court.
- Administrative Order 2015-0037 Re: Guidelines on the Registration and Mapping of Conscientious Objectors and Exempt Health Facilities Pursuant to the Responsible Parenthood and Reproductive Health Act. The DOH issued these guidelines for the registration and mapping of conscientious objectors and exempt health facilities to ensure delivery of the full range of reproductive health services and minimize encumbrance to clients seeking such services.
- Department Memorandum No. 2015-0186 Re: Access to the Family Planning (FP) Commodities by DOH Regional Hospitals and Medical Centers and Provincial Hospitals. In support of the setting up family planning services in hospitals, this Department Memorandum was issued to provide guidance in the allocation and distribution of FP commodities to DOH retained hospitals and medical centers and provincial hospitals. It also includes the allocation of FP commodities to Civil Society Organizations.
- Department Memorandum No. 2015-0174 Re: Reiteration of Compliance to the Policy on Informed Choice and Voluntarism in Delivery of Family Planning Services. The Department Memorandum directs all DOH Bureaus, Offices, Medical Centers and attached agencies and Regional Offices to organize the key staff and monitoring mechanism to observe compliance with the policy on Informed Choice and Voluntarism in the delivery of Family Planning services nationwide.
- Administrative Order 2015-0021 Re: Guidelines on the Deployment of Physicians Graduating from the Residency Training Programs in the Department of Health DOH) –Retained Teaching and Training Hospitals. This AO responds to the growing inequitable distribution of medical professionals in the urban and rural areas thru expanding its residency training programs as human resource for health complements in government hospitals in priority poor and underserved areas.
- Department Memorandum No. 2015-0341 Re: Reiteration of Access to Family Planning (FP) Commodities by DOH Regional Hospitals and Medical Centers, Provincial Hospitals and Civil Society Organizations (CSOs).This Department Memo further defines instrumentalities that will be used by Regional Offices in engaging the civil society organizations as partners in the delivery of FP services to include the use of appropriate forms such as the revised FP Form1, and the reporting forms for service utilization
- Department Memorandum No. 2015-0366. Re: Hiring of Consultants for the Fast Tracking of Service Delivery of Family Planning (FP) Services. The DM supports Section 6 of the RPRH IRR specifying the hiring and engagement of skilled health professionals for Maternal Health Care and Skilled Birth Attendance at the local levels with assistance from the DOH.
- Department Memorandum No. 2015-0357. Re: Use of the Revised FP Form 1. This DM provides instructions to all health providers on using the revised FP Form 1 as standard client record of family planning acceptors at the service delivery points.
- Department Memorandum No. 2015-0384. Re: Establishment of the Family Planning Logistics Hotline. This DM supports Section 8.10 on Tracking and Monitoring of health products purchased or received and distributed to local health systems. The FP Logistics Hotline monitors distribution and status of commodity stocks at the distribution points (local health service delivery points).
- Other national agencies such as the DSWD and DILG also contributed to policy development covering FP concerns as specified in the RPRH IRR. DSWD has a finalized Memorandum Circular which deals with Institutionalization of Women Friendly Space in Camp Coordination and Camp Management. DILG has issued Memorandum Circular No. 2015-145: Reiteration of Local Government Unit’s Role and Function in the Implementation of RA No. 10354 or The RPRH Act Of 2012 and its IRR. The circular addressed to all DILG field units and LGUs reiterate the observance of the RH Law’s provisions to the LGUs. It also specifies that each LGU to designate a Reproductive Health Officer (RHO) and to submit all data related to RPRH implementation to the DOH.
Since 2013, the DOH has been centrally procuring FP commodities that are then distributed to various service delivery points.
- In 2015, the DOH distributed FP commodities to public facilities like RHUs, hospitals, and CSO FP providers. The following are the quantity of commodities distributed by the DOH: 11,125,623 cycles of Combined Oral Contraceptive (COC) pills; 1,338,162 cycles of Progestin Only Pills (POP); 3,228,950 vials of DMPA or injectables; 82,918 IUDs; and 449,464 Progestin Subdermal Implants (PSI).
- Some of the DOH Regional Offices procured various modern FP commodities to augment the supply coming from the DOH Central Office. The procurement, distribution and use of these commodities were in accordance with existing government rules and regulations. These also include recertification of FP commodities by the Food and Drugs Administration as non-abortifacient, as required by the RPRH Law.
- In addition, UNFPA donated 74,546 subdermal implant (PSI) units to POPCOM, other DOH-retained hospitals, LGU health facilities and CSOs providing FP services. These were then translated to PSI users. Note, however, that in June 17, 2015, a Temporary Restraining Order (TRO) was issued by the Supreme Court preventing the DOH and its attached agency, the Food and Drug Authority, “granting any and all pending application for reproductive products and supplies, including contraceptive drugs and devices; and DOH and its agents and representatives from “procuring, selling, distributing, dispensing or administering, advertising and promoting the hormonal contraceptive Implanon and Implanon NXT”.
- Distribution of Progestin Subdermal Implants were temporarily put on hold after the issuance of the TRO. The issuance of the TRO has affected not only the provision of PSI services at the service delivery level but eventually will impact on the availability of all FP commodities in the local market. This has to be addressed with urgency at the national level.
- Commodities that were proposed for procurement in 2015 by the DOH are expected to be delivered in the 1st quarter of 2016 to the service delivery points. CSOs can also access and utilize DOH FP commodities delivered to the DOH Regional Offices as provided in the DOH Department Memoranda (DM) No. 2015-0186 and DOH DM No. 2015-0341.
- The DOH, with technical assistance from development partners established a Technical Working Group for Supply Chain Management. In addition to recommending evidence-based policy and operational reforms, USAID further assisted in establishing a tracking system for family planning commodities. Through the FP Hotline, reports from the field via emails, phone calls, short messaging system and Facebook posts, the Department of Health is alerted when there are stock outs and low stock levels in specific geographic areas and facilities, enabling a rapid response to replenish stocks. While the FP Hotline provides a quick assessment on commodity stock status on the service delivery level, however, there is a need to establish a more long term system that will be able to track field level consumption data to capture the commodities that are actually being required in the service delivery points. This way a more realistic way of computing allocation of FP commodities based on actual MFP needs will be more effective.