Republic of the Philippines

Province of Albay
Municipality of Guinobatan
OFFICE OF THE SANGGUNIANG BAYAN
EXCERPTS FROM THE MINUTES OF THE 18 TH REGULAR SESSION OF THE
SANGGUNIANG BAYAN HELD ON MAY 14, 2012 AT 9:34 IN THE MORNING AT THE
SANGGUNIANG BAYAN SESSION HALL, GUINOBATAN, ALBAY.
Present:

Hon. Wilfredo O. Arevalo, Sr.Hon. Juris L. Villareal

Hon. Rolando P. Palabrica
Hon. Julio S. Tingzon IV
Hon. Maria Sofia O. Orpiada
Hon. Stephen O. Ocfemia
Hon. Robert M. Baaga
Hon. Carlomagno P. Flores
Hon. Paul N. Garcia
Hon. Patrick Polly C. Pintor

Vice Mayor & Presiding Officer

Councilor
Councilor
Councilor
Councilor
Councilor
Councilor
Councilor
Councilor
Councilor

Absent:

Hon. Reynaldo O. Namia

Councilor (O.B.)

MUNICIPAL ORDINANCE NO. 04-2012

ESTABLISHING A FACILITY-BASED DELIVERY FOR ALL PREGNANT MOTHERS
TO BE ATTENDED BY SKILLED BIRTH ATTENDANTS IN THE MUNICIPALITY OF
GUINOBATAN, ALBAY AND FOR OTHER PURPOSES.
Proponent/Sponsors:Councilors Maria Sofia O. Orpiada & Robert M. Baaga
BE IT ORDAINED, by the Sangguniang Bayan of Guinobatan, Albay in session assembled
that:
WHEREAS, every year, almost 500,000 lives are lost around the world due to maternity
related causes, 99% of such deaths occurring in developing countries and almost
of them preventable;
WHEREAS, the Philippine Government reaffirmed its commitment to reduce maternal deaths
and contribute to the achievement of the Millennium Development Goals (MDG)
during the 2005 World Summit in New York;
WHEREAS, hemorrhage, hypertensive disorders during pregnancy and infection constitute the
majority of complication related to maternal fatalities. All of these problems are
preventable and can be addressed through adequate medical care such as the
presence of skilled Birth Attendants, Emergency Obstetric and New-born Care
(BEmONC), and when necessary, access to family planning services;
WHEREAS, in an effort to reduce this burden, the Department of Health (DOH) adopted a new
paradigm shift where each pregnancy is to be considered as High Risk;
WHEREAS, the DOH has further adopted a 3 pronged strategy to address the three delays
associated with saving a womans life: (1) the decision when to seek care
(knowledge on danger signs, empowered decision making), (2) reaching the
health facilities (expenses especially for communication/transportation, clinic or
hospital service area significant concern), and (3) receiving appropriate care in the
facility (availability of gender and culture sensitive doctor/health staff, adequate
medicine supplies, safe blood equipment);
WHEREAS, the current level of maternal mortality in the Philippine is mostly attributed to the
predominance of home births, (61% per 2003 National Demographic and Health

Survey (NDHS) and the relatively high proportion (37%) of these births assisted
by the Traditional Birth Attendants (TBAs) or Hilots). TBA practice is usually
handed down from one generation to the next. This makes their knowledge and
skill highly uneven. Thus, efforts to train them on safe birthing practices have
been largely unsuccessful, as the review of the literature on international
experience reveals;
WHEREAS, the NDHS further shows that 88% of women who had a live birth during the
survey period saw a health professional for antenatal care. Yet, a significant
number eventually ended up giving birth at home, attended by a TBA. This
indicates that woman is generally aware of the importance of skilled care by a
health professional during pregnancy. However, when it comes to childbirth, a
significant number are either unwilling to seek the same level of care are unable
to overcome obstacles to accessing such care. Thus, any intervention that seeks to
address the maternal mortality of pregnant mothers at home will help women
overcome these obstacles;
WHEREAS, private practicing midwives attend deliveries of pregnant mothers at home which
is not equipped to handle basic emergency obstetric care and newborn care;
WHEREAS, maternal deaths occur also in Guinobatan, Albay, thus suggesting the need to
address the root causes of this problem and contribute to the attainment of MDG
in 2015;
a) Guinobatan, Albay has annual population growth rate of 1.74% translated into
more than 2,000 births. The Municipal population is growing steadily yearly
and every pregnant mother is at risk.
b) In 2006, one mother died and in 2010, another maternal death had been
reported in the first quarter.
WHEREAS, steadfast on its duties and commitment to uphold and protect the lives of its
constituents, the Municipality of Guinobatan deems it necessary and appropriate
to adopt and establish measures to reduce and finally eliminate maternal deaths in
the Municipality;
WHEREFORE, in view of the foregoing premises:
BE IT ORDAINED, by the Sangguniang Bayan in session assembled, that:
Section 1.

Title. This ordinance shall be known as the FACILITY-BASED BIRTH

DELIVERY ORDINANCE for pregnant mothers in the municipality of
Guinobatan, Albay or simply as FBBDO.

Section 2.

Declaration of Policy. The Municipal Government shall adopt measures to

uphold and protect the lives of mother and child in line with its pursuit of
sustainable human development that values human dignity and offers full
protection to women and unborn and their babies to wit:
a.) To ensure that all women and newborns have skilled care during pregnancy,
childbirth and the immediate postnatal period. Such care is to be provided by
skilled birth attendant like doctor, nurse or midwife; and,
b.) To ensure that private practicing midwives will handle their deliveries at
Health Facilities, they shall be allowed to deliver pregnant mothers at RHUBEmONC Facility or other identified back up birthing facility (i.e. BHS)
Consistent with these principles, the Municipality of Guinobatan shall guarantee
access to information and education, and universal access to safe, affordable and
quality Basic Emergency Obstetric and New-born Care (BEmONC) for all
pregnant mothers.

Section 3.

OBJECTIVES. This ordinance aims to achieve the following objectives:

a.) Provide the pregnant mothers with adequate and affordable basic emergency
obstetric and newborn care.
b.) Ensure that all pregnant mothers are encouraged to access the health facilities
during deliveries.
c.) Enhance accurate information dissemination and education on the value of
preventing maternal deaths. And,
d.) Illicit the support of the Barangay Officials through the passage of Barangay
Resolution encouraging all pregnant mothers in their respective areas to
access and take advantage of health facilities for delivery and skilled birth
attendants for safe deliveries.

Section 4.

Definition of Terms. For purposes of this ordinance, the following terms shall be
defined as follows:
1.) Maternal Mortality Ratio (MMR) is the number of maternal deaths during
a given time period per 100,000 live births. It measures the risk of deaths once
a woman has become pregnant.
2.) Maternal Deaths is the death of a woman while pregnant or within 42 days
of termination of pregnancy, irrespective of the duration and site of the
pregnancy, from any cause related to or aggravated by the pregnancy or its
management but not from accidental or incidental causes.
3.) BEmONC is defined as Basic Emergency Obstetric and New-born Care
provided to pregnant mothers during deliveries.
4.) MNCHN Service Delivery consist of health services, both preventive and
curative, established to lower the risk and respond to the direct causes of
maternal and neonatal deaths and consequently improves womens and
childrens health. The interventions cater to the spectrum of needs of women
and children. For women, this consist of services that span the period before
pregnancy to post childbirth services that include essentials new-born care
during the first week of life. For children, the service package covers
essentials health care of the new-born after the week to adolescent stage. This
service packages must be made available and easily accessible to targeted
population.
5.) Skilled Birth Attendant an accredited health professional that has been
educated and trained in the skills needed to manage the critical stages in
pregnancy and childbirth as well as in the identification, management and
referral of complication. Skilled Birth Attendants are Midwives, Nurses or
Doctors.
6.) Neonatal Mortality Rate refers to the number of deaths within the first 28
days of life per 1,000 live births in a given period. It serves as an
INDICATOR OF MATERNAL AND NEONATAL HEALTH CARE.
7.) Infant Mortality Rate refers to the number of infants dying before reaching
the age of one year per 1,000 live births in given year. It represents an
important component of less than five mortality rate.
8.) Traditional Birth Attendant (TBAs) are independent, non formally trained
community based providers of care during pregnancy, childbirth, and
postpartum period using conventional method. UNDER THE MNCHN
STRATEGY, THEY ARE MADE PART OF THE FORMAL HEALTH
SYSTEM AS MEMBER OF THE COMMUNITY BASED WOMENS
HEALTH TEAMS AND SERVE AS ADVOCATES FOR SKILLED
PROFESSIONAL CARE.
9.) WHSMP2 Womens Health Safe Motherhood Project

Section 5.

The WHSMP2 shall allow private health care providers such as midwives, nurses
and doctors to practice midwifery, nursing and medicine in a designated
BEmONC facility provided that said Health Care Providers meet the following
requirements:
1.) Holder of a professional license issued by the Philippine Regulation
Commission.

2.) Holder of Professional PhilHealth accredition. And,

3.) Has an existing Memorandum of Agreement (MOA) with the concerned
Provincial Government and Provincial Health Officer and Municipal
Government and Municipal Health Officer.
Section 6.

ROLE AND FUNCTION OF THE MUNICIPAL HEALTH OFFICER

(MHO)
1.) The Municipal Health Officer (MHO) will be the lead agency in the
implementation of this ordinance and ensure that system programs and
services are available at all times,
2.) The MHO in collaboration with other stakeholders will serve as central
advisory, planning and policy making body with the Municipal Mayor as
Chairperson. And,
3.) Recommend the enactment of legislation to support this program and adopt
measures to reduce maternal deaths in the Municipality.

Section 7.

PROTOCOLS ON THE EXECUTION OF THE MATERNAL HEALTH

PROGRAM.
1.) Approaches for Measuring Maternal Mortality
Routine Maternal Deaths Reporting
Community Death Reporting Womens Health Team
2.) Periodic Maternal Deaths Review
Quarterly/Yearly Review
3.) Improved womens health and ensure safe pregnancy and childbirth.
Increase access for the poor and disadvantage to the delivery service.
Optimize resource
Improve service delivery and utilization
At the Individual Level
1.) Every mother will have access to skilled care during delivery.
2.) Access to skilled attendants such as midwives, nurses or doctors.
3.) Emergency treatment for all complications during pregnancy, childbirth and
after birth.
4.) Post-partum Family Planning
5.) Basic Neonatal Care
At the Service Level
1.) A transmission to a more appropriate distribution of childbirths along
continuum of care.
2.) More childbirth in Basic Emergency Obstetric and New-born Care
(BEmONC) facilities.
3.) Obstetric and New-born Care (BEmONC)
4.) No childbirths at home.
Rationale
To ensure that all pregnant women in the community, particularly the poor and
disadvantage, are adequate served. A shift from home delivery to Facility-Based
Delivery (FBD) and attended by skilled birth attendants such as Doctor, Nurse or
Midwife in order to meet the Millennium Development Goals (MDG 4 and 5
Reduction of Maternal and Child Mortality).

FUNCTION OF THE Womens Health Team (WHT)

1.) To track every pregnancy in the community.
2.) To assist in accomplishing the birth plan.

3.) To provide quality maternal care, family planning, STD prevention, and HIV
Control and adolescent and youth health services appropriate at the
community level.
4.) To make accurate recordings.
5.) To provide good counseling and information dissemination services.
6.) To refer clients appropriately.
7.) To report maternal deaths.
8.) To discuss relevant womens issues with the community.
Section 8.

Appropriations. Recognizing the program gaps, the Municipal Government of

Guinobatan, Albay shall appropriate funds for the following:
1.) There shall be funds for the maintenance of BEmONC facilities.
2.) There shall be funds for the equipment and supplies in the delivery of
BEmONC services.
3.) There shall be funds for intensive information drive on this program concern.
On the other hand, a mechanism to implement and enhance
sustainability is also encouraged.

financial

1.) Attain Financial Self-Sufficiency through.

Identification of the poor and non-poor using the NHTS 2011 data (Non
poor will pay, Poor will not pay)
Revenue generation
Collection of users fees to be deposited as Trust Fund
PhilHealth accredition and reimbursement
CSR + Policy
Regular Budget

2.) Implement Uniform and Affordable Charges.

For PhilHealth Cardholders FREE OF CHARGE (Reimbursement per

patient by PhilHealth) up to 4th pregnancy only including newborn
screening.
For Non-PhilHealth Members but are not classified as Indigent (Level 5
CHLSS poorest among the poor with ID issued) and 5 th pregnancy
onwards shall have a corresponding fee per tax ordinance on delivery.
For Private practicing Midwives who deliver pregnant mothers at RHU
BEmONC facility, charging fee will be in accordance with the approved
Municipal Tax Measure.

Section 9.

Exemption. Based on NHTS data 5 poorest among the poor families, who are
fifth pregnancy and above, are exempted to pay including the new-born screening
fee.

Section 10.

Source of Funds. The budget for this ordinance shall be taken from the GAD
fund of the Annual Appropriation of the Municipal Government, PhilHealth
reimbursement and drug revolving fund and DOH Grant. The budget will focus
on the maintenance of Health Centers.

Section 11.

Separability Clause. If any part, section or provision of this ordinance is declared

invalid or unconstitutional, other provision not affected thereby shall remain in
full force and effect.

Section 12.

Penalty Clause. Any person who violates this ordinance will be charged/fined of
the following:
For the Skilled (Doctor, Nurse or Midwife) :
1st Offense

PhP 500.00

2nd Offense
:
rd
3 & Succeeding Offenses :

PhP 1,500.00
PhP 2,500.00 plus a written report
to the PRC of the violation

For Non-Skilled/Trained Birth Attendants (TBAs) :

1st Offense
:
2nd Offense
:
rd
3 & Succeeding Offenses :

Warning
PhP 500.00
Php 1,000.00

Section 13.

Effectivity. This Ordinance shall take effect immediately upon its approval.

Enacted:

May 14, 2012 (Third and Final Reading)

Voting on the Ordinance:
In favor:
All SB Members Present
Not in favor: None

WE HEREBY CERTIFY to the correctness of the foregoing.

MARIA SOFIA O. ORPIADA

Proponent/Sponsor

ROBERT M. BAAGA
Co-Proponent/Co-Sponsor

WILFREDO O. AREVALO, SR.

Vice Mayor & Presiding Officer
ATTESTED:
MARIA SUSAN O. NAVARRO
Records Officer I
& Designated Temporary Secretary to the SB
APPROVED: May 29, 2012

JUAN MIGUEL MITRE GARCIA

Municipal Mayor