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NINETEENTH CONGRESS OF THE ] 
REPUBLIC OF THE PHILIPPINES ] 
First Regular Session 
]
tBffiit of tile ^errcfori'
■22 AUG-8 AlO «7
SENATE
S.B. No. 1 n.ci4
RECEIVED BY;
Introduced by SEN. WIN GATCHALIAN
AN ACT
PROVIDING FOR THE IMPROVEMENT OF MATERNAL AND CHILDBIRTH
SERVICES BY ESTABLISHING BIRTHING CENTERS, TRAINING 
TRADITIONAL BIRTH ATTENDANTS, AND INSTITUTIONALIZING A LAY­
AWAY PROGRAM, AND APPROPRIATING FUNDS THEREFOR
EXPLANATORY NOTE
The Sustainable Development Goals (SDGs), also known as the Global Goals, 
were adopted by the United Nations in 2015 as a universal call to action to end 
poverty, protect the planet, and ensure that by 2030 all people enjoy peace and 
prosperity. There are 17 SDGs that are integrated—they recognize that action in one 
area will affect outcomes in others, and that development must balance social, 
economic and environmental sustainability.1
Of these, SDG 3, Good Health and Well-Being, targets (1) the reduction of the 
global maternal mortality ratio to less than 70 per 100,000 live births by 2030, and (2) 
end preventable deaths of newborns and children under 5 years of age, with all 
countries aiming to reduce neonatal mortality to at least as low as 12 per 1,000 live 
births and under-5 mortality to at least as low as 25 per 1,000 live births by 2030; 
among other goals of SDG 3.2
1United Nations Development Program, "Sustainable Development Goals". 
https://www.undp.org/sustainable-development-goals 
2 National Economic Development Authority, "Goals in Numbers SDG 3". 
https://sdg.neda.gov.ph/goal-3/


Currently, the Department of Health (DOH) is implementing three major 
programs to achieve SDG 3, as follows: (1) Public Health Programs (PHP) that would 
provide interventions on addressing the morbidity caused by infectious diseases; 
mortality by non-communicable diseases (NCDs); and emerging incidence of injuries, 
mental health, and alcohol and drug abuse; (2) Human Resource for Health (HRH) 
Deployment Program to improve access to quality basic health services, as there 
should be adequate healthcare professionals and workers across country who will 
provide these services; and (3) Health Facilities Enhancement Program (HFEP) which 
aims to improve public health facilities by constructing new and upgrading and 
rehabilitating existing public health facilities across the country such as barangay 
health stations, rural health units/urban health centers and LGU hospitals.
To fully complement the current DOH policy in achieving the SDG 3 targets, 
this bill provides mechanisms that will enhance its PHP, HRH, and HFEP for maternal, 
neonatal and children under-5 health standards to strengten the achievement. These 
mechanisms include improving access to (1) birthing facilities and reproductive health 
services, especially in Geographically Isolated and Disadvantaged Areas; (2) 
integrated reproductive health services for women, including poor adolescents, and 
men; (3) health-care services on family planning, information and education; and (4) 
training for traditional birth attendants to become part of the formal health system.
This bill further focuses on providing improved health services for the poor and 
disadvantaged Filipino women. A 2015 study3 indicated that 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.
To improve on this concern, home births should still 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
3United Nations Development Program, "Millenium Development Goals 5 Overview for the 
Philippines", http://www.ph.undp.org/content/philippines/en/home/mdgoverview/overview/mdg5/


birth attendants should be allowed to attend to the childbirth to ensure maternal and 
neonatal safety.
Moreover, this Bill, inspired by a successful United Nations program in Gattaran, 
Cagayan, proposes an innovation that provides for greater access and affordable 
childbirth in healthcare facilities through the institution of 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, in 
line with the targets under the global SDG 3, the immediate passaoe-of this worthwhile 
initiative must be supported.
TCHALIAN


NINETEENTH CONGRESS OF THE 
]
REPUBLIC OF THE PHILIPPINES 
]
First Regular Session 
]
SENATE
S. B. No. 1054
&;£'| ^enatf
5©{ftr.p of tl)f i rota I P
•22 AUG -8 AlOfl?
RECEIVED BY; /U0~'
Introduced by SEN. WIN GATCHALIAN
AN ACT
PROVIDING FOR THE IMPROVEMENT OF MATERNAL AND 
CHILDBIRTH SERVICES BY ESTABLISHING BIRTHING CENTERS, 
TRAINING TRADITIONAL BIRTH ATTENDANTS, AND 
INSTITUTIONALIZING A LAY-AWAY PROGRAM, AND 
APPROPRIATING FUNDS THEREFOR
Be it enacted by the Senate and the House of Representatives of the PhHip pines 
in Congress assembied:
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SECTION 1. Short Title. - This Act shall be known as the "Birthing Centers 
in Communities Act".
SEC. 2. 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. 3. Objective. - To emphasize the government's commitment to 
improve maternal 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, 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 (LCDs) 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.
SEC. 4. 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. 5. 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.


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b. Neonatal Mortality - number of deaths within the first 28 days of life
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per 1,000 live births in a given period.
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c. Maternal Mortality - number of women who die from any cause related
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to or aggravated by pregnancy or its management during pregnancy and
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childbirth or within 42 days of termination of pregnancy.
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d. Traditional Birth Attendants (TBAs) - independent, non-formally
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trained community-based providers of care during pregnancy, childbirth, and
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postpartum period using conventional method.
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e. Newborn - a child from the time of complete delivery to 30 days old.
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f. Health Care Practitioner - refers to a physician, nurse, midwife, nursing
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aide and traditional birth attendant.
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g. Certification - a process and procedure of external assessment or
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examination by which an individual or facility is determined to possess a
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minimally acceptable body of knowledge and/or skills or the capacity to provide
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the standard of care with adequate resources.
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h. Local Health Board (LHB) - Its creation and composition are mandated
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under R.A. 7160 or the Local Government Code of 1991.
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I. Geographically Isolated and Disadvantaged Areas (GIDA) - refer to
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communities with marginalized population physically and socio-economically
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separated from the mainstream society and characterized by physical factors
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(distance, weather conditions, transportation difficulties) and socio-economic
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factors (high poverty incidence, recovering from situation of crisis or armed
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conflict).
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j. Department of Health Physical facility requirement for Birthing Homes
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- refers to the planning and design guidelines for birthing homes contained in
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Annex C of the DOH Administrative Order No. 2016-0042, or to any guidelines
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set by the DOH thereafter.
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SEC. 6. Role of the Local Government Unit- The LHB of every province,
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city or municipality, in accordance with its mandate, shall make an Inventory of
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its existing facilities and ensure that health clinics shall be compliant with DOH
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standards in terms of strategic location, facility requirement and manpower.


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These facilities must be constructed in locations most accessible to women. It
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must upgrade existing infrastructures to accommodate improvements in
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facilities and equipment.
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With the support of the DOH, it shall provide technical assistance and
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advisory services in the continuous training of health workers or to contract out
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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
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service providers.
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SEC. 7. Role of the Department of Health. - The DOH shall ensure that
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the LGU RHUs, BHS, District Hospitals, and Birthing Centers are fully compliant
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with the physical facilities requirements set by the DOH.
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The DOH shall, within two (2) years after the effectivity of this Act, train
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the traditional birth attendants with the modern method of delivery, to properly
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equip them with the skills to provide care during pregnancy, childbirth and
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postnatal periods in health clinics or birthing stations.
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The conduct of these trainings shall be made every two (2) years
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hereafter to facilitate the training of new ones upon the retirement of the other
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TBAs. A certification by the DOH of compliance with this requirement shall give
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the TBAs the authority to work alongside healthcare practitioners of the LGU.
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SEC. 8. Birthing Centers. - There shall be established birthing facilities
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that shall address obstetric care and delivery in GIDA, where distance and
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transportation make 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
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be required to operate twenty-four hours for seven days (24/7) or on an on call
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or as needed basis, depending on the pregnancy tracking.
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These centers shall be compliant with the Physical Facility requirements
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of the DOH. The facility shall likewise be supported by competent health care
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practitioners including DOH-trained traditional birth attendants.


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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 (BHW) 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. 9. 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. 10. 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 8 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.


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SEC. 11. 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. 12. 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 BHWs 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 effectivlty of this 
Act.
SEC. 13. Impiementing Rules and Regulations (IRR). - 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 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 physical facilities and human resources for an efficient health clinic or 
birthing center in communities.
SEC. 14. Separability Cause. - If any provision of this Act is declared 
invalid or unconstitutional, the provisions not affected thereby shall remain in 
full force and effect.
SEC. 15. Repeating Cause. - All laws, presidential decrees, executive 
orders, presidential proclamations, rules and regulations or parts thereof


contrary to or inconsistent with this Act are hereby repealed or modified 
accordingly.
SEC. 16. Effectivity, -This Act shall take effect fifteen (15) days after its 
publication in the Official Gazette or in a newspaper of general circulation in the 
Philippines.
Approved,