Republic of the Philippines 
HOUSE OF REPRESENTATIVES 
Quezon City 
EIGHTEENTH CONGRESS 
Second Regular Session 
HOUSE BILL NO. _______ 
Introduced by HON. JOY MYRA S. TAMBUNTING 
EXPLANATORY NOTE 
This measure 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. This proposal aims 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.  
Under this proposal, home births shall 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. 
On behalf of the people of Parañaque City’s Second District, and for the common good of the 
Filipino people, the approval of the said measure is earnestly sought. 
REP. JOY MYRA S. TAMBUNTING 
2nd District, Parañaque City 
May 26, 2021
12:07 pm
9481


Republic of the Philippines 
HOUSE OF REPRESENTATIVES 
Quezon City 
EIGHTEENTH CONGRESS 
Second Regular Session 
HOUSE BILL NO. _______ 
Introduced by HON. JOY MYRA S. TAMBUNTING 
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 House of Representatives of the Philippines in Congress 
assembled: 
SECTION 1. Declaration of Policy. – It is the duty of the State to protect the life of the mother 
and the life of the unborn from conception. Towards this end, the State shall endeavor to provide 
quality health interventions and appropriate facilities as well as services that shall address 
maternal and neonatal mortalities and ensure efficient strategies to lessen the risk that 
continuously occur during pregnancy and childbirth, especially of the underprivileged. 
SEC. 2. Objective. – To emphasize the government's commitment to improve maternal and 
newborn health interventions, this Act shall undertake the following objectives:  
(a) Ensure that all women and newborns have skilled care during pregnancy, childbirth and
the immediate post-natal period;
(b) Promote pre-natal health education and safe birthing practices;
(c) Improve the capacity of the local government units (LGUs) to deliver the basic health
service delivery from antenatal to post-partum care;
(d) Upgrade health facilities, both in terms of additional human resource and infrastructure
facilities suitably equipped to address basic and emergency services, when necessary;
(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;
(h) 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.
9481


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


The DOH shall, within two (2) years after the effectivity of this Act, train the traditional birth 
attendants with the modern method of delivery, to properly equip them with the skill to provide 
care during pregnancy, childbirth and postnatal periods in health clinics or birthing stations. The 
conduct of these trainings shall be made every two (2) years hereafter to facilitate the training 
of new ones upon the retirement of the other TBAs. A certification by the DOH of compliance 
with this requirement shall give the TBAs the authority to work alongside healthcare practitioners 
of the LGU.  
 
SEC. 7. Birthing Centers. – There shall be established birthing facilities that shall address 
obstetric care and delivery in Geographically Isolated and Disadvantaged Areas (GIDA), where 
distance and transportation make travelling to a health facility unsafe and poses greater risk and 
danger to the mother and her unborn child. These birthing facilities shall be required to operate 
twenty-four hours for seven days (24/7) or on an on call or as needed basis, depending on the 
pregnancy tracking.  
 
These centers shall be compliant with the Physical Facility requirements of the DOH with regards 
to the General Administrative and Clinical services. The facility shall likewise be supported by 
competent health care practitioners including DOH-trained traditional birth attendants. 
 
Clinical services to be rendered in these centers shall include pre-natal and post-natal care, normal 
spontaneous delivery for low-risk pregnant women, care of newborn and other similarly-related 
health care.  
 
There shall be barangay health workers formed into teams who shall regularly check on pregnant 
women in the community. They shall continuously advocate quality health care by accessing the 
maternal care delivery system established by the government and disseminate educational tools 
to facilitate the shift from basic societal dynamics of home-deliveries to childbirth in these centers 
equipped with facilities and skilled personnel. 
 
These ante-natal check-ups must identify at-risk pregnancies or anticipate complications in 
deliveries, which should directly be referred to clinics or tertiary hospitals with well-equipped 
facilities to handle emergencies. 
 
SEC. 8. Lay-Away Program. – In order to make these birthing centers sustainable, expectant 
mothers shall, during pre-natal visits, pay in portions the cost for her delivery. The scheme shall 
cover expenses for electricity and water bills, as well as payment for attending health workers. 
The cost shall be minimal and implementable through socialized user fees. 
 
Nothing in this Section shall however prevent the city, municipality or barangay with the capacity 
to provide full subsidies to its constituents to forego user fees, or seek for private 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. 
 
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,