Republic of the Philippines
House of Representatives
Quezon City, Metro Manila

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Avcceyen
© RGF
the EEA

EIGHTEENTH CONGRESS
First Regular Session

House Bill Number rus

Introduced by Representative MARISSA LOURDES M. ANDAYA

EXPLANATORY NOTE

The Philippines has been identified by the World Health Organization (WHO)
as among those countries that account for 90% of under-five mortality worldwide. In
its 2013 statistical report, WHO reported that a total of 82,000 Filipino children under
5 years old die every year. In 2012, newborns account for 48% of children who die
under the age of five in the Philippines, and of this figure, 39% die of preterm
complications. It has also been found out that newborns may die due to lack of access
to newborn care.

To abate this disturbing trend in neonatal mortality, the Department of Health
(DOH), launched in 2009 the Unang Yakap campaign which advocates the Essential
Intrapartum Newborn Care (EINC), a concept fully supported by WHO. DOH describes
EINC as a series of time-bound and evidence-based interventions in caring for
newborn babies and their mothers. Through the EINC protocol, there is a potential to
decrease newborn death by at least half.

The Unang Yakap campaign is a non-costly way that has the potential of
saving newborn babies from dying. It involves simple steps to improve health care
services for babies during the first critical hours:

1. Immediate and thorough drying of the newborn — Immediate and thorough
drying for 30 seconds to one-minute warms the newborn and stimulates
breathing.

2. Early skin-to-skin contact between mother and newborn — Early skin to skin
contact between mother and newborn, and delayed washing for at least 6 hours
prevents hypothermia, infection, and hypoglycemia.

3. Properly-timed cord clamping and cutting — Properly-timed cord clamping
and cutting prevents anemia and protects against brain hemorrhage in



premature newborns. Properly timed cord-clamping means waiting for the cord
pulsations to stop (between 1-3 minutes).

4. Non-separation of newborn and mother for early breastfeeding —
Continuous non-separation of newborn and mother for early breastfeeding
protects infants from dying from infection. The first feed provides colostrum, a
substance equivalent to the babies’ first immunization in its protective
properties. Evidence shows that breastfeeding in the first hour of life prevents
about 19% of newborn deaths.

Inspite of DOH's strong advocacy of the Unang Yakap campaign through its
implementation of Administrative Order 2009-0025, not all health practitioners and
providers adopt this protocol, particularly the timely manner by which it should be
implemented. Worse, expectant mothers are not informed about this protocol that can
potentially save their infants.

This measure aims to strengthen said AO 2009-0025 and institutionalize this
very important campaign in order to save thousands of newborn lives.

This bill also aims to train frontline maternal and newborn healthcare
practitioners in order to strengthen their skills, engaging both public and private
healthcare facilities. It also aims to educate pregnant women of the importance of
observing the Unang Yakap protocol.

Immediate passage of this bill is earnestly requested.

MARISSA Aetkfeu ANDAYA


Republic of the Philippines
House of Representatives
Quezon City, Metro Manila

EIGHTEENTH CONGRESS
First Regular Session

House Bill Number __ 6103

Introduced by Representative MARISSA LOURDES M. ANDAYA

AN ACT INSTITUTIONALIZING THE UNANG YAKAP CAMPAIGN, ADOPTING
THE PROTOCOL ON ESSENTIAL NEWBORN CARE

Be it enacted by the Senate and House of Representatives of the Philippines in
Congress assembled:

Section 1. Short Title. — This Act shall be known as the “Unang Yakap Act of
2020”.

Sec. 2. Declaration of Policy. — It is the policy of the State to adopt measures
that will ensure the provision of globally-accepted evidence-based essential newborn
care that focuses on the first week of the newborn's life.

Towards this end, the State shall endeavor to guarantee that quality time-bound
interventions are provided to newborns to ensure that newborn morbidity and mortality
are significantly reduced through the following:

a. providing guidelines to health workers and medical practitioners in providing
evidence-based essential newborn care;

b. defining the roles and responsibilities of the Department of Health (DOH),
healthcare facilities and practitioners in the implementation of the Newborn
Protocol

Sec. 3. Coverage — This Act shalll include all healthcare practitioners involved
in the provision of maternal and newborn care and all healthcare facilities nationwide,
both private and public.

Sec. 4. Interventions. - The DOH shall adopt guidelines to ensure that:

a. quality provision of time-bound newbom care and interventions are
implemented, such as:


i Immediate and thorough drying of the newborn;

ii. Early skin-to-skin contact between mother and newborn;

iii. Properly-timed cord clamping and cutting;

iv. Non-separation of newborn and mother for early breastfeeding.

b. non-immediate interventions and unnecessary procedures are delayed
until after the newborn has initiated breastfeeding, unless the newborn or
the mother are in need of immediate medical attention;

c. ensure the provision of maternal care.

SEC. 5. Continuing Education, Re-education and Training of Health Workers
and Health Institutions. - The Department of Health with the assistance of other
government agencies, professional and nongovernmental organizations shall conduct
continuing information, education, re-education, and training programs for physicians,
nurses, midwives, nutritionist-dietitians, community health workers and traditional birth
attendants (TBAs) and other health workers on the Unang Yakap Protocol or
immediate Essential Newborn Care.

Information materials shall be given to all health workers involved in maternal
and infant care health institutions.

Sec. 6. Information Dissemination and Educational Programs of Pregnant
Women and Women of Reproductive Age. - To immediately and continuously educate
women and expectant mothers on current and updated newborn protocols and infant
care and to distribute written information materials on such matters free of charge
during the prenatal and perinatal consultations and/or confinements in health
institutions.

Sec. 7. Implementing Agency. - The Department of Health shall be principally
responsible for the implementation and enforcement of the provisions of this Act.

Sec. 8. Sanctions. — Any healthcare or birthing facility which unjustifiably
refuses or fails to comply with the provisions of this Act shall be imposed a fine of not
less than Fifty thousand pesos (Php50,000.00) but not more than Two hundred
thousand pesos (Php200,000.00) on the first offense.

On the second offense, a fine of not less than Two hundred thousand pesos
(Php200,000.00) but not more than Five hundred thousand pesos (Php500,000.00).

On the third offense, a fine of not less than Five hundred thousand pesos
(Php500,000.00) but not more than One million pesos (Php1,000,000.00) and the
cancellation or revocation of the business permits or licenses to operate.


In addition, the Secretary of Health is hereby empowered to impose sanctions
on health institution for the violation of this Act and the rules issued thereunder. Such
sanctions may be in the form of reprimand or censure and in case of repeated willful
violations, suspension of the permit to operate of the erring health institution.

Heads, officials and employees of government health institutions with birthing
facilities who violate this Act shall further be subject to the following administrative
penalties:

1. First offense — Reprimand;
2. Second offense — Suspension for one (1) to thirty (30) days; and
3. Third offense — Dismissal.

This shall be without prejudice to other liabilities applicable under civil service
law and rules.

Section 9. Rules and Regulations. — The Department of Health shall issue
within one hundred and twenty (120) days upon its effectivity the rules and regulations
necessary to carry out the provisions of this Act.

Section 10. Separability Clause. — If any clause, sentence, paragraph or part
of this Act shall be declared to be invalid, the remainder of this Act or any provision
not affected thereby shall remain in force and effect.

Section 11. Repealing Clause. — All laws, presidential decrees, executive
orders, rules and regulations or parts thereof which are not consistent with this Act are
hereby repealed, amended or modified accordingly.

Section 12. Effectivity Clause. — This Act shall take effect fifteen (15) days after

its publication in the Official Gazette or in at least two (2) newspapers of general
circulation, whichever comes earlier.

Approved,