FEATURE | General Santos City Hospital

The well-paved roads of General Santos City hint at its steady progress toward development. The city’s slogan, Magandang Gensan, strategically hoisted throughout various spots in the city and government buildings stand both as a constant reminder of the city’s collective desire for a good quality of life and testaments of the paths it has taken to get there. “The people of Gensan are very competitive but in a manner that is laid-back. It’s a paradox but perhaps this is why General Santos is a little bit more open to new practices,” Mayor Darlene Magnolia R. Antonino-Custodio. 

This openness to change has been key to inroads made by EINC in the city of General Santos. Also worth mentioning is the local government’s commitment to Millenium Development Goals to reduce maternal and infant mortality by the year 2015 that has made EINC the new standard of care for mothers and their newborns in the city and nearby areas. Such that some mothers giving birth even at the lying-in centers proudly remark, “na-Unang Yakap ako.” After only four months since EINC training was held in General Santos City, the infant mortality rate at the General Santos City Hospital has already dropped to 0.96% as of July. 

Upon training, the General Santos City Hospital (GSCH) immediately embraced the program. While it had to contend with the usual challenges of convincing the hospital’s private consultants, its staff and the whole hospital is eventually learning to imbibe a sense of ownership and pride in the program. Determined to set a precedent for the region, GSCH is working hard to maintain its >90% performance of complete EINC core steps in all of their deliveries. By end of July, 90.79% of all deliveries have been performed with complete EINC. 

The GSCH opened its doors in 1975 and became LGU-operated since 1991. A Level II hospital with tertiary functions, GSCH has a 100-bed authorized capacity but has 261 implementing beds. It caters to approximately 261 in-patients and 100 outpatients daily. Newborn deliveries comprise 22% of the total admissions in 2010. Being the only government hospital within “SoCCSKSaRGeN” (South Cotabato, Cotabato, Sultan Kudarat, Sarangani and General Santos) area with better facilities, it also caters to patients from other neighboring municipalities such as Sarangani Province, South Cotabato, Sultan Kudarat and Davao del Sur. Likewise, it also serves as a training facility for six affiliated nursing schools and six midwifery schools across the region. 

FEATURE | Dr. Jose Fabella Medical Hospital: where optimism never runs dry

One thing is for certain -- optimism never runs dry at the Dr. Jose Fabella Medical Hospital. Dubbed as one of the world’s busiest maternity hospital, seeing an average of 60-80 births a day, “Fabella” easily brings to mind images of crowded maternity wards, a cramped Neonatal Intensive Care Unit, delivering mothers coming and going like clockwork, and babies born one after another routinely depicted in local and international media channels. At one point, it has even been infamously tagged, albeit too conveniently, as “the baby-factory” owing to large portion of babies in Metro Manila being delivered there. 

Its portrayal in the recent news has, to a certain extent, become the standard fare in representing the generally lamentable state of healthcare delivery and population development in the country. And yet despite this, Fabella unwaveringly maintains to be a competitive institution providing safe, quality and compassionate maternal and newborn care while promoting sound research and training practices in the field of women’s health. And while its crowded wards may somewhat tell a different story, this only proves how it has persistently weathered limited funds to provide quality service to mothers and newborns who otherwise could not afford it on their own. “We try our best to manage even though we have limited resources,” Assistant Chief Nurse Edna Solis candidly relates.

FEATURE | San Lorenzo Ruiz Women’s Hospital: Providing a comforting, nurturing and safe environment for mothers and newborns in a hospital

Its discreet location, tucked at the far end of an almost unnoticeable alleyway along the national road, is certainly not comparable to the quality of care that San Lorenzo Ruiz Women’s Hospital (SLWH) in Malabon lives up to. We may be a very small hospital but we have managed to maintain a good reputation in delivering quality care and service to our patients. Hopefully, we want to have the same for EINC,” shares the charismatic Dr. Maria Isabelita “Happy” Estrella, hospital director and EINC Working Committee Chairman, that afternoon we dropped in for a visit.

Upon entering the premises, one senses that at SLWH things are done in a manner not quite typical of any government hospital. And yet its cozy atmosphere common of small town communities betrays the level of excellence that the hospital strives to achieve, for there is surely nothing “small town” about SLWH’s commitment to achieve the goals set by MDG 4 & 5. Their passion to constantly improve their compliance of the EINC practices while also soliciting the active involvement of their immediate community is noteworthy. Dr. Happy Estrella hopes that by involving the other health providers in Malabon and its nearby areas, the city of Malabon in their own “small way” can contribute to reducing the country’s maternal and infant mortality by 2015.

San Lorenzo Ruiz Women’s Hospital is a 10-bed capacity special First Level Referral hospital catering to the health needs of women and children residing in Malabon, parts of Valenzuela, Caloocan, Obando as well as Tanza, Navotas. It is also Philhealth accredited as a secondary hospital. Normal spontaneous deliveries and obstetric cases remain the leading cause of admission.

While not solely a maternity hospital, Dr.Estrella remarks that there is that unavoidable impression “that is why adopting the EINC is an advantage to us” since the program will strengthen their capacity to meet the needs of both mother and baby during delivery and birth. She proudly adds that implementing EINC is, if not one of, their more important accomplishments for the year.

Seven months after its implementation, EINC has “now become part of the hospital” withcorresponding hospital guidelines and policies supporting already issued from staff assignments all the way to the revision of forms, scope of work and doctors orders. More importantly, the staff—from the doctors down to the midwives and nurses, even those not part of the Working Committee—has by now internalized the program.

FEATURE | Dr. Honorata Catibog – Bringing Healthcare to Grassroots Level

For the tenacious Dr. Catibog advocacy is no lip service

As Dr. Honorata Catibog, director of DOH’s Family Health Office, fondly recall the times she has spent as Municipal Health Officer and Provincial Board Member -- combing the remotest barrios of her native Western Samar -- one can’t help but grasp that her advocacy is not one that is compulsory of her office but is borne out of years of experience accompanied with the tireless dedication to bring healthcare to those hardest to reach. Her tenacity is easily noticeable in the personal anecdotes she readily shared during our brief afternoon interview: looking back at this one time when she had sea ambulances custom made to service several island municipalities under her jurisdiction, then as provincial board member of Western Samar. Such that Dr. Catibog’s remark about understanding the “difficulties of bringing healthcare to people at grassroots level” and importance of public policies in ensuring its success is certainly no lip service.

It is no secret that the success of any health reform lie not only in the merits and benefits of the program but equally relies on a sound and robust political strategy that shall guarantee its effective and timely implementation across a wide constituency. Dr. Catibog is one of the instrumental forces in championing maternal and infant health, having headed the Task Force for Rapid Reduction of Maternal and Neonatal Mortality. The task force was responsible for institutionalization and strengthening the implementation of the Maternal, Neonatal and Child Health and Nutrition (MNCHN) Strategy.

HOSPITAL FEATURE | Tondo Medical Center: Commitments that Effect Change

by Donna Miranda | photos by Bernie Cervantes

These days the staff of Tondo Medical Center (TMC) can only recall with nostalgia what was once the harried and busy atmosphere of its Neonatal Intensive Care Unit, but not without relief.

At TMC newborn babies receive warmth from their mothers through immediate skin-to-skin contact

In fact if there were anything noticeable, it was the great deal of pride, satisfaction and enthusiasm beaming from hospital director Dr.  Victor de la Cruz who together with his hospital staff has managed to successfully initiate change within a short period of time. Nowadays the nurses at the NICU jokingly lament how awfully quiet it has become since NICU admissions have begun to dramatically decrease to 10.9 % of total deliveries from January to March 2011. In fact at the time of our visit, there were only two babies. The two nurses stationed at the NICU candidly inform us, “we don’t seem to have any use for that here anymore” pointing to the warmer where a queue would usually form to warm delivered babies.

And indeed they don’t – since they’ve started implementing the EINC program in the hospital where the only warmth that babies receive mostly come from their mothers through immediate skin-to-skin contact.

Feature Story THE QUIRINO MEMORIAL MEDICAL CENTER EXPERIENCE Accepting the challenge of change

by Monica Feria

Barely one year after adopting the new Essential Newborn Care protocols, QMMC cut newborn deaths by half and achieved a 70% reduction in neonatal sepsis. Doing away with unnecessary procedures in the delivery room also saved the hospital a minimum of P3 million. 


The Quirino Memorial Medical Center (QMMC), formerly known as the “labor “ hospital in Quezon City, was among 51 government-run hospitals included in a comprehensive study on prevailing newborn care practices in the Philippines starting November, 2008. 

In hindsight, Dr. Belle Vitangcol, head of QMMC’s pediatrics department and lead ENC trainor, remembers this as the starting point of a whirlwind that in barely one year’s time would sweep away many traditional practices and attitudes in the delivery room, and usher in a radically different regimen on essential newborn care.

Even before researchers backed by he Department of Health and the World Health Organization began setting up monitoring stations at the hospital, Vitangcol and her medical colleagues knew something had to change. QMMC, which grew steadily from a 75-bed facility when it first opened in 1953 to the 350-bed center today, was sagging with maternity patients two-to-a-bed. A tertiary referral center for high risk pregnancies, average deliveries had jumped from an average of 500-600 a month in 2008 to about 800 in 2009, among the largest number of deliveries in any single hospital that year (9,605).

The DOH-WHO study noted that QMMC, like many other hospitals, reflected the country’s high incidence of neonatal deaths.

Overall, 82,000 Filipino children die annually (2008) before the age of five, 45 % of them neonates. Almost half of newborn deaths occur in the first 28 days, a quarter of them in the first two days of life. The three major causes are complications of prematurity (41%), sepsis and pneumonia (16%), asphyxia (15%).[1]

The study confirmed that current practices in Philippine hospitals fell below recommended WHO standards and robbed newborns of the natural protection offered by four recommended basic interventions: immediate and thorough drying, skin to skin contact, properly timed cord clamping and early initiation of breastfeeding.

Cords were immediately clamped at a median of 12 seconds, far too soon. Less than 1 in 10 babies was placed in direct skin-to-skin contact with the mother. Many newborns were exposed to cold by not being dried immediately and thoroughly, and being put on cold surfaces. All were washed early and 80% were suctioned unnecessarily, according to the study.

Neonatal death rates in the Philippines had changed minimally in the past 15 years. Health authorities noted that if the country was to meet its Millennium Development Goal of reducing child deaths by two-thirds, drastic changes needed to be made in neonatal care—and fast.

QMMC medical and staff executives involved in maternal and child care were invited to seminars to review the evidence for the WHO recommended interventions and other new practices incorporated in the DOH’s Basic Emergency Obstetric and Newborn care (BEmONC) program.