EIGHTEENTH CONGRESS OF THE 
REPUBLIC OF THE PHILIPPINES 
First Regular Session
]
of 'Ijf slii-T c'/irn
SENATE
S. No. 
882
‘19 
AUG - 8  
P 4 .-52
Introduced by SEN. SHERWIN T. GATCHALIAN
u
AN ACT
PROVIDING FOR THE IMPROVEMENT OF MATERNAL AND CHILDBIRTH SERVICES BY 
ESTABLISHING BIRTHING CENTERS AND TRAINING TRADITIONAL BIRTH 
ATTENDANTS, AND APPROPRIATING FUNDS THEREFOR
EXPLANATORY NOTE
The commitment of the Philippines to the Millennium Development Goals (MDG) of 
reducing maternal mortality rate (MMR) has not been achieved and the decline appears to have 
stalled, making the target reduction in MMR of 52 deaths per 100,000 live births by 2015 highly 
improbable. The high rate of maternal deaths may be attributed to inadequate access to 
integrated reproductive health services by women, including poor adolescents and men. For 
one, significant number of Filipino women lack access to qualified reproductive health services. 
Over half of births in the country occurred at home, and a third of them were assisted by 
traditional birth attendants. Poor women are greatly disadvantaged with around 75 percent of 
the poorest quintile having no access to skilled birth attendants compared to only 20 percent of 
the richest quintile.1
The filing of this bill was spurred by several calls for the ban of home births and the 
practice by many in the urban areas to avail of the services of traditional birth attendants or 
"Mote"because of the relative ease and accessibility which they bring to expectant mothers. It
1http://w w w .ph.undp.org/content/philippines/en/home/mdgoverview/overview/mdg5/


is the humble proposal of this representation to improve maternal and newborn care by 
establishing birthing facilities as well as the training of traditional birth attendants to become 
part of the formal health system. It seeks the improvement of local health facilities towards 
services that can provide the underserved or underprivileged women with comprehensive care 
and access to safe maternal and newborn care delivery system.
Instead of a complete ban, home births should be allowed, except where health clinics 
and birthing centers are present in the community. In the absence of these facilities, where 
greater risks and danger to the life of the mother and the unborn is imminent if transport to a 
health facility is made, midwives and trained traditional birth attendants should be allowed to 
attend to the childbirth to ensure maternal and neonatal safety. In order to ensure the 
competency of traditional birth attendants in assisting during childbirth, the Department of 
Health will conduct the necessary training to properly equip them with the skills to provide 
proper care during pregnancy, childbirth and postnatal periods in health clinics or birthing 
stations.
Inspired by a successful United Nations program in Gattaran, Cagayan, this bill proposes 
an innovation to provide greater access and affordable childbirth in healthcare facilities by 
instituting a lay-away program where a pregnant woman shall pay in portions the fees to cover 
for the expenses in delivery.
In view of the necessity to complement the efforts of the DOH and the local government 
units to contribute in the improvement of maternal and neonatal care, we urge the support of
the legislature in the immediate passage of this worthwhile initiative.
rGATCHALTAN


i T*.1
EIGHTEENTH CONGRESS OF THE 
]
REPUBLIC OF THE PHILIPPINES 
]
First Regular Session 
]
o( tl)c ^rrrrtnrj*
SENATE
S. No. 
882
'19 AUG-8 P4 52
RECblV.L !;v.
Introduced by SEN. SHERWIN T. GATCHALIAN
u
AN ACT
PROVIDING FOR THE IMPROVEMENT OF MATERNAL AND CHILDBIRTH SERVICES BY 
ESTABLISHING BIRTHING CENTERS AND TRAINING TRADITIONAL BIRTH 
ATTENDANTS, AND APPROPRIATING FUNDS THEREFOR
Be it enacted by the Senate and the House o f Representatives o f the Philippines in 
Congress assembled:
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SECTION 1. Declaration o f Policy. -  It is the duty of the State to protect the life of the
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mother and the life of the unborn from conception. Towards this end, the State shall endeavor
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to provide quality health interventions and appropriate facilities as well as services that shall
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address maternal and neonatal mortalities and ensure efficient strategies to lessen the risk that
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continuously occur during pregnancy and childbirth, especially of the underprivileged.
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SEC. 2. Objective. -  To emphasize the government's commitment to improve maternal
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and newborn health interventions, this Act shall undertake the following objectives:
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(a) 
Ensure that all women 
and newborns have skilled care during pregnancy,
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childbirth and the immediate post-natal period;
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(b) 
Promote pre-natal health education and safe birthing practices;
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(c) 
Improve the capacity of the local government units (LGUs) to deliver the basic
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health service delivery from antenatal to post-partum care;
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(d) 
Upgrade health facilities, both in terms of additional human resource and
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infrastructure facilities suitably equipped to address basic and 
emergency services, when
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necessary;
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(e) 
Introduce local strategies to improve mechanisms for demand to access or seek 
care and health interventions in health clinics;
(f) 
Train health workers, including traditional birth attendants, to deliver quality 
obstetric and newborn care services;
(g) 
Develop incentives to entice and promote antenatal care in a Barangay Health 
Station (BHS), Rural Health Unit (RHU) and the District and Community Hospitals;
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Establish an effective referral and monitoring system in barangays to monitor 
maternal and newborn care; and
(i) 
Deploy birthing facilities equipped with trained obstetric and newborn care 
provider in areas where health facilities are unavailable.
SEC. 3. Scope and Coverage. -  This Act aims to improve maternal and newborn care by 
establishing birthing facilities as well as the training of the traditional birth attendants to 
become part of the formal health system. It seeks the improvement of local health facilities 
towards services that can provide comprehensive care in order to encourage underserved or 
underprivileged women access to safe maternal and newborn care delivery system.
SEC. 4. Definition o f Terms. -  As used in this Act, the following shall mean:
a. Birthing Center - a health facility that provides maternity service on pre-natal and 
post-natal care, spontaneous delivery and care of newborn babies.
b. Neonatal Mortality -  number of deaths within the first 28 days of life per 1000 live 
births in a given period.
c. 
Maternal Mortality -  number of women who die from any cause related to or 
aggravated by pregnancy or its management during pregnancy and childbirth or 
within 42 days of termination of pregnancy.
d. Traditional Birth Attendants (TBAs) -  independent, non-formally trained community- 
based providers of care during pregnancy, childbirth, and postpartum period using 
conventional method.
e. Newborn -  a child from the time of complete delivery to 30 days old.
f. 
Health Care Practitioner -  refers to a physician, nurse, midwife, nursing aide and 
traditional birth attendant.


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g. Certification -  a process and procedure of external assessment or examination by
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which an individual or facility is determined to possess a minimally acceptable body
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of knowledge and/or skills or the capacity to provide the standard of care with
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adequate resources.
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h. Local Health Board -  its creation and composition are mandated under R.A. 7160 or
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the Local Government Code of 1991.
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Geographically Isolated and Disadvantaged Areas (GIDA) -  refer to communities
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with marginalized population physically and socio-economically separated from the
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mainstream society and characterized by physical factors (distance, weather
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conditions, transportation difficulties) and socio-economic factors (high poverty
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incidence, recovering from situation of crisis or armed conflict).
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j. 
Department of Health Physical facility requirement for Birthing Home -  Annex D,
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DOH Administrative Order No. 2012-0012.
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SEC. 5. Role o f the Local Government Unit -  The Local Health Board of every province,
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city or municipality, in accordance with their mandate, shall make an inventory of its existing
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facilities and ensure that health clinics shall be compliant with DOH standards in terms of
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strategic location, infrastructure and manpower. These facilities must be constructed in locations
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most accessible to women. 
It must upgrade existing infrastructures to accommodate
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improvements in facilities and equipment. With the support of the Department of Health, it shall
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provide technical assistance and advisory services in the continuous training of health workers
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or to contract out skilled health practitioners for an integrated system that addresses the risks
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identified with maternal and childbirth mortality, in terms of capability of health service
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providers.
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SEC. 6. Role o f the Department o f Health. -  The DOH shall ensure that the LGU Rural
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Health Units, Barangay Health Stations, District Hospitals, Birthing Centers are fully compliant
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with the amenities and infrastructure requirements set by the DOH.
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The DOH shall, within two (2) years after the effectivity of this Act, train the traditional
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birth attendants with the modern method of delivery, to properly equip them with the skill to
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provide care during pregnancy, childbirth and postnatal periods in health clinics or birthing
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stations. The conduct of these trainings shall be made every two (2) years hereafter to facilitate


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the training of new ones upon the retirement of the other TBAs. A certification by the DOH of
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compliance with this requirement shall give the TBAs the authority to work alongside healthcare
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practitioners of the LGU.
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SEC. 7. Birthing Centers. -  There shall be established birthing facilities that shall address
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obstetric care and delivery in Geographically Isolated and Disadvantaged Areas (GIDA), where
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distance and transportation makes travelling to a health facility unsafe and poses greater risk
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and danger to the mother and her unborn child. These birthing facilities shall be required to
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operate twenty-four hours for seven days (24/7) or on an on call or as needed basis, depending
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on the pregnancy tracking.
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These centers shall be compliant with the Physical Facility requirements of the DOH with
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regards to the General Administrative and Clinical services. The facility shall likewise 
be
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supported by competent health care practitioners including DOH-trained traditional birth
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attendants.
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Clinical services to be rendered in these centers shall include pre-natal and post-natal
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care, normal spontaneous delivery for low-risk pregnant women, care of newborn and other
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similarly-related health care.
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There shall be barangay health workers formed into teams who shall regularly check on
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pregnant women in the community. They shall continuously advocate quality health care by
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accessing the maternal care delivery system established by the government and disseminate
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educational tools to facilitate the shift from basic societal dynamics of home-deliveries 
to
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childbirth in these centers equipped with facilities and skilled personnel.
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These ante-natal check-ups must identify at-risk pregnancies or anticipate complications
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in deliveries, which should directly be referred to clinics or tertiary hospitals with well-equipped
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facilities to handle emergencies.
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SEC. 8. Lay-Away Program. 
-  In order to make these birthing centers sustainable,
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expectant mothers shall, during pre-natal visits, pay in portions the cost for her delivery. The
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scheme shall cover expenses for electricity and water bills, as well as payment for attending
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health workers. The cost shall be minimal and implementable through socialized user fees.
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Nothing in this Section shall however prevent the city, municipality or barangay with the
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capacity to provide full subsidies to its constituents to forego user fees, or seek for private


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partnerships, aid or donations to cut costs or subsidize the expenses for the deliveries in 
birthing centers.
SEC. 9. Home-Births. -  Pursuant to the objectives of this Act, home births shall be 
disallowed where health clinics and birthing centers are present in the community, and where 
there is absence of the risk contemplated under Section 7 paragraph 1. In cases where greater 
risk and danger to the life of the mother and the unborn is imminent if transport to a health 
facility is made, midwives and trained traditional birth attendants shall attend to the childbirth to 
ensure maternal and neonatal safety.
SEC. 10. Incentives to Barangays. -  The commitment to reduce maternal and neonatal 
mortality must generate the coordinated effort of the community, hence, the local health board 
shall assess and recommend economic incentives to promote the initiative and make zero 
maternal and neonatal death possible.
SEC. 11. Appropriations. -  The primary source of funding for the operation, maintenance 
and improvement of the health facilities shall be the LGU. It shall likewise cover the salaries and 
other benefits of the local human resource including the incentives for the barangay health 
workers and other community volunteer workers.
The capital outlay for the birthing centers, additional health clinics, improvements of 
existing health facilities in terms of equipment and the amount to be expended for the training 
of the traditional birth attendants shall be included in the budget of the DOH in the year 
following the effectivity of this Act.
SEC. 12. Implementing Rules and Regulations. -  Within ninety (90) days from the 
approval of this Act, the Secretary of Health and the Secretary of the Interior and Local 
Government shall promulgate the necessary implementing rules and regulations (IRR) for the 
effective implementation of this Act. The IRR shall cover the implementation of performance- 
based incentive of rural communities toward achieving zero maternal and neonatal mortality 
and the program of training for the traditional birth attendants. The DOH shall provide the 
manual for the minimum requirements in terms of facilities and human resource for an efficient 
health clinic or birthing center.


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SEC. 13. Separability Clause. -  If any section or provision of this Act is held 
unconstitutional or invalid, the remaining sections or provisions not affected shall remain in full 
force and effect.
SEC. 14. Repealing Clause. -  All laws, presidential decrees, executive orders and rules 
and regulations, or parts thereof, inconsistent with the provisions of this Act are hereby 
repealed or modified accordingly.
SEC. 15. Effectivity. -  This Act shall take effect fifteen (15) days from the date of its 
complete publication in at least two (2) newspapers of general circulation.
Approved,