Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City

FIFTEENTH CONGRESS
Second Regular Session

5096

House Bill No.

Introduced by Representatives
DIOSDADO MACAPAGAL ARROYO and GLORIA MACAPAGAL ARROYO.

AN ACT
MANDATING THE APPOINTMENT OF ONE MIDWIFE FOR EACH
BARANGAY, AND FOR OTHER PURPOSES

EXPLANATORY NOTE

Infant and matemal mortality rates worldwide are still alarmingly high,
particularly in developing countries like the Philippines. According to the World
Health Organization and the United Nations Children's Fund, more than half a
million women succumb to complications due to pregnancy or childbirth. Around
99% of all maiemal deaths occur in developing countries, with some 84%
concentrated in sub-Saharan Africa and South Asia.

As an attempt to address this appalling global problem, member-states of
the United Nations, together with more than 23 international organizations,
adopted the Millennium Development Goals (MDGs), which intended to eradicate
poverty and improve social and economic conditions in the world’s poorest
countries by 2015. The Philippines is one of the signatories.

The National Economic Development Authority (NEDA), the agency
tasked to monitor compliance with the MDGs, reports that the Philippines is on
track with most of the eight (8) goals. However, it was quick to admit that most
likely, the Philippines will fail to achieve at least two of these goals: (1) universal
primary education and (2) improvement in matemal and neonatal health

Based on 2006 figures, maternal mortality rate (MMR) in the Philippines
stands at 162 per 100,000. The target MMR under the MDGs is 52 per 100,000
population by 2016.


Health workers play a vital role in lowering our country’s MMR but
unfortunately, there is lack of access to professional healthcare practitioners
Healthcare professionals are sorely lacking and unequally distributed in rural and
urban areas. Most of our healthcare professionals, in particular doctors and
nurses, have left the country in search for greener pastures abroad. Given this
problem, health experts have recommended that the gap on the delivery of
matemal and infant healthcare services be covered by the appointment of
midwives who are similarly trained to provide healthcare services, especially in
the field of maternal and infant healthcare

As mentioned in an article by the late Ms. Alice dela Gente, former
President of the Integrated Midwives Association of the Philippines (MAP) in
early 2008, ‘midwives comprise one of the largest occupational groups in the
Philippine public and private health system. Records show that there are
150,722 registered midwives as of June 2007. Midwives work in the private or
public sector in hospitals, birthing clinics, barangay heaith stations, or rural health
units. They comprise 65% of the public health workforce. in 2005, there were
16,967 government midwives in the country, delivering frontine services in
15,436 barangay health stations and 2266 rural health units.” Midwives are the
first point of contact for patients coming into the health system in the rural areas.
In fact, midwives are currently implementing public health programs in these
areas. With such a role and significant contribution in augmenting the presence
of professional healthcare practitioners in rural areas, their increased community
presence is of vita! importance.

Although the recommended ratio is one midwife for every 5,000, most
midwives, at present, cater to the needs of 10,000-30,000 individuals in their
assigned area, Recognizing the importance of primary healthcare and the
presence of midwives in the country, especially in the rural areas, the bill not only
mandates the appointment of one midwife for each barangay but further seeks to
increase the number of midwives in a barangay where there is a population of
more than 5,000, This will enable midwives to provide quality and efficient
healthcare services.

The midwifery profession is central to the delivery of efficient and effective
healthcare services, particularly in the rural areas. By making midwives and the
services they provide accessible, affordable and appropriate to the needs of
patients, the Philippines may be well on its way of achieving one of the remaining
MDGs with regard to the Improvement in maternal and neonatal heath

In view of the foregoing, approval of this bill is earnestly requested.

DIOSDADO' Al AL ARROYO. GLORIA MACAPAGAL ARROYO
Second District, Camarines Sur Secofd District, Pampanga

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Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City

FIFTEENTH CONGRESS,
Second Regular Session

House Bill No. 5096

Introduced by Representatives
DIOSDADO MACAPAGAL ARROYO and GLORIA MACAPAGAL ARROYO

AN ACT
MANDATING THE APPOINTMENT OF ONE MIDWIFE FOR EACH
BARANGAY, AND FOR OTHER PURPOSES

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 "Midwife to the
Barangay Act of 2011."

SECTION 2. Statement of Poticy. - it is the policy of the State to protect
and promote the right to health of the people. The State shall provide
appropriate programs and measures to provide access to affordable and quality
health and social services, especially in rural areas.

The services of midwives, as front liners in the country's health care
delivery system, are essential in achieving the State's health policy, especially
with regard to pre-natal and post natal matemai, and newborn, care. Toward this
end, this Act shall mandate the appointment of midwives for each barangay to
increase access to health care services for the people, especially the
underprivileged.

SECTION 3. Ratio of Midwives to the Barangay. — All barangays shall be
equipped with one (1) midwife; Provided, That if the population of a barangay
exceeds five thousand (5,000), the number of midwives shall be increased, as
determined by the Department of Health (DOH)


SECTION 4. Role of Midwives to the Barangay. — All Midwives to the
Barangay are mandated to ensure that mothers and infants, in their respective
jurisdictions, are given quality and essential health care services, including, but
not limited to, prenatal and post natal care, breastfeeding support, providing
information on the importance of immunization and ensuring that infants are
given the proper vaccines as provided in the DOH Expanded Program on
immunization, and proper care and nutrition of both the mothers and the infants.

SECTION 5. Appointment of Midwives to the Barangay. — The DOH,
through its Center for Health Development, is mandated to appoint the Midwife to
the Barangay. It shalt immediately determine which areas are in need of
midwives. Priority in appointments shall be given to remote areas where there
are no existing healthcare professionals providing for the healthcare services of
the population and areas which have high maternal mortality rate.

SECTION 6. Qualifications of Midwives to the Barangay. - The DOH shatl
provide for the qualifications of the Midwife to the Barangay, who shall, as much
as possible, come from the same barangay or municipality where he or she will
be appointed.

SECTION 7. Basic Emergency Obstetric Care. ~ The DOH shall ensure
that the midwives are equipped with Basic Emergency Obstetric Care. It shall
also determine, subject to guidelines that it may issue, the need to further provide
these midwives with training on Comprehensive Emergency Obstetric Care.

SECTION 8. Compensation and Benefits. - All Midwives to the Barangay
shall be appropriately compensated by the DOH and shall be entitled to all the
benefits provided in Republic Act No. 7305, otherwise known as the "Magna
Carta of Public Health Workers.”

SECTION 9. Implementing Rules and Regulations. ~ The OOH, in
cooperation with the Department of Interior and Local, Government, the Civil
Service Commission, and other concemed government agencies and non
government organizations, shall formulate and promulgate, within ninety days
(90) from its effectivity, the rules and regulations necessary to implement this Act.

SECTION 10. Appropriations. — For a period of five (5) years from the
passage of this Act, the amount necessary to implement the provisions of this Act
shall be charged against the appropriations of the DOH. Thereafter, such funds
as may be necessary for the continued implementation of this Act shall be
included in the appropriations of the respective Local Govemment Units.

SECTION 11. Separability Clause. - If any part or provision of this Act
shall be held unconstitutional or invalid, other provisions thereof which are not
affected thereby shall continue to be in full force and effect.

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SECTION 12. Repeating Clause. — All laws, decrees, executive orders,
and other presidential issuances which are inconsistent with this Act are hereby
repealed, amended or modified accordingly.

SECTION 13. Effectivity Clause. — This Act takes effect immediately after
its pubiication in at least two (2) national newspapers of general circulation.

Approved,