EINC Don’ts & Do’s | Unnecessary Suctioning and Bathing & Properly Timed Cord Clamping

DON’Ts Unnecessary Suctioning and Bathing

Routine suctioning


Routine suctioning has been the norm in newborn resuscitation because it was believed to be necessary to clear the baby’s airway and to stimulate him to breath. However in the presence of clear amniotic fluid especially in a baby who is crying and breathing at birth, routine suctioning has been associated with bradycardia, apnea, and delays in achieving normal oxygen saturations. It also causes mucosal trauma with an increased risk for infection. In a pilot implementation study of the Essential Newborn Care Protocol at a large government hospital in the National Capital Region, unnecessary suctioning of vigorous newborns increased the risk for sepsis (OR 4.49 95% CI 2.26-8.89), mortality (OR 8.75 95%CI 2.60 – 29.4) and severe disease (OR 4.44 95% CI 2.72 – 7.25). Routine suctioning of the newborn is a harmful practice that should be discontinued.

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.

NEWS | 1st MNCHN EINC Advocacy Partners Forum held in Manila

July 13 to 15 at the Century Park Hotel in Manila saw the realization of the first MNCHN (Maternal Child Health and Nutrition Policy) EINC (Essential Intrapartum and Newborn Care) Advocacy Partners Forum to meet the demand for EINC training by building up the pool of speakers for rapid scaling up efforts. The forum was carried out for the benefit of new EINC trainers who themselves require not only training but also updates on the Department of Health’s ongoing efforts in the Scale-Up Project. Their motto being “I commit to life”—it is the first declaration in their official Partners Pledge—the group by way of this forum also commits to keeping their advocacy alive by empowering their personnel with the expertise necessary for pursuing the quality of maternal child health they aspire for.


Funded by JPMNH and WHO, EINC has either trained or oriented approximately 9000 healthcare workers in the short timespan between May and October 2011–a testament to the ongoing demand for capacity building in EINC among various key medical institutions. Requests for training come from both private and public hospitals, some even outside the National Capital Region, no to mention a handful of LGUs and private institutions. This is possibly due to the effectiveness of the EINC social marketing plan and training methodology, where administrative circulars as well as technical and professional training are brought directly to facility-based healthcare workers, emphasizing the significance of a peer-to-peer system of learning. 

The course was designed to build up a speakers bureau comprised of of EINC advocates–the healthcare professionals who, after training, are committed to improving dominant hospital practices when it comes to caring for mothers and newborns–and dedicated to ginding even more advocates given the abovementioned demand for EINC training. The demand is expected to grow further once Philhealth goes public with its new packages meant to address issues of maternal and newborn healthcare–a demand to be met by the pool of advocacy partners in collaboration with DOH and its Centers for Health Development.

After receiving their official IDs after completion of training, healthcare professionals maintain their status as EINC advocates by conducting workshops, the progress of which will be monitored via the EINC Advocacy Partners Forum website. The engagement of Advocacy Partners such as those coming from professional societies can also function as a kind of PPP mechanism of the Centers of Health Development, identifying specialists per region who can voluntarily lead orientations and trainings for the CHDs who will fund such venues for training. Besides the CHDs, the Advocacy Partners will also be working closely with DOH hospitals and their Health Education and Promotions Officer (HEPO), the DOH Family Health Office/NCDPC, the National Center for Health Promotions (NCHP), and the Local Government Unit (LGU).

The feedback has been positive with participants excited to return to their communities and impart their new learning's. Dr. Catherine Torres-Jison of Bacolod, for instance has committed to conduct EINC trainings and workshops at The Corazon Locsin Montelibano Regional Hospital, Bacolod City Lying-In Clinis and at University of St. Las Salle. She shares "learning about the evidence-based practices has empowered us to push for the advocacy because we are confident that the safety and wellness of both mother and baby are always prioritized over everything else." Moreover, she is anticipating that "bringing EINC to medical schools" as the best way to promote EINC protocol that way "[future] doctors and other health professionals will no longer be confused."

The 70 “graduates” who have completed the training were enjoined to know by the heart the

MNCHN EINC Advocacy Partners Pledge, a simple oath comprised of seven lines that capture the essence of what EINC stands for:

          “I commit to life. / From its earliest stirrings in a mother’s womb, through

          its intricate journey of development, until the moment of birth. / I will safeguard the      

          mother’s wellbeing, to maintain a nurturing environment for the life growing within. / I will

          shield this new life, and ensure it begins its existence safely nestled in a mother’s warm  

          embrace. / I will protect this new life, and allow only milk from a mother’s breast for

          nourishment. / I will zealously preserve the bond between mother and child. / All these

          things I hold sacred, and will form my lifelong commitment.”

NEWS | Upcoming Technical Conference on EINC Best Practices

Almost a year has passed since Essential Intrapartum and Newborn Care (EINC) began “Unang Yakap” or “First Embrace,” its social marketing campaign, designed to transform hospitals with interventions aimed at the high-risk periods of labor, delivery, and immediate postpartum. Now that its practices have been established and are ready to be implemented in 11 DOH hospitals—thanks to the efforts not only of the EINC team but also of these hospitals, JPMNH, WHO Philippines, and the National Center for Disease Prevention and Control/Family Health Office—EINC is eager to share its experience with health stakeholders for adoption and replication on a national scale by way of a conference.

The MNCHN EINC Scale Up Project Technical Conference, to be held on September in Metro Manila, is meant to convene such stakeholders, including DOH Centers for Health Development and more hospitals who can surely benefit from EINC’s progressive methods and learnings. Heads of professional societies, key personnel from medical academies, as well as physicians, nurses, and midwives have been invited to attend. Expected presentations include a showcase of the results of the EINC Scale Up Project that mark improvements in the deployment of practices from baseline to project completion, an enumeration of the best practices carried out in model hospitals that are worth emulating, even a set of technical recommendations for the adoption of EINC in all health facilities across the entire nation in order to arrest maternal and newborn within this high-risk period.

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.