The DOH Unang Yakap Campaign

   On December 7, 2009, the Department of Health launched the Unang Yakap Campaign. With this campaign, the DOH aims to cut down infant mortality in the Philippines by at least half. The campaign employs Essential Newborn Care (ENC) Protocol as a strategy to improve the health of the newborn through interventions before conception, during pregnancy, at and soon after birth, and in the postnatal period. The ENC Protocol provides an evidence-based, low cost, low technology package of interventions that will save thousands of lives.

    Based on health statistics, the Philippines is one of the 42 countries that account for 90% of under-five mortality worldwide. 82,000 Filipino children under five years old die every year. 37% of them are newborn. Majority of them (3/4) die within the first two days of life. Mostly due to stressful events or conditions during labor, delivery and immediate postpartum period. The current practice of handling newborns, like clamping and cutting the umbilical cord and washing the baby right after birth, have been known to actually contribute to the high incidence of neonatal deaths and illnesses in the country. Thus the need for a paradigm shift from  the prevailing standard procedures into the new protocol.

    Health Secretary Duque explained that the ENC Protocol involves focusing on the first hours of life of the newborn with the manual guiding health workers in providing evidence-based essential newborn care.
 
       The guidelines categorize procedures into time-bound, non time-bound and unnecessary procedures:

• Time bound procedures should be routinely performed first - immediate drying, skin-to-skin contact followed by clamping of the cord after one to three minutes, non-separation of the newborn from the mother and breastfeeding initiation.
  
• Non time-bound intervention should only be done after the first full breastfeed. These are immunizations, eye care, Vitamin K administration and weighing. Washing must be postponed by at least 6 hours.
  
• The so-called unnecessary procedures include routine suctioning, routine separation of newborns for observations, administration of prelacteals like glucose, water formula and footprinting.

       Here's a screen capture of the ENC time-bound intervention flowchart as presented by Dr. Maria Asuncion Silvestre F.A.A.P.

   In celebration of the International Women's Month, the U.P. Manila School of Health Sciences held a symposium with the theme "Unang Yakap: Yakap ng Ina. Yakap ng Buhay" to tackle the New DOH-WHO ENC Protocol. Sadly, some participants from the medical and academe sectors commented that the new protocol is contrary with the common practices of most local hospitals today. The ENC is currently being practiced by three hospitals in Metro Manila: Quirino Memorial Medical Center in Quezon City, and Fabella Memorial Medical Center and Philippine General Hospital in Manila.

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    Now, one of my concerns as an expectant mom is to ensure that the new protocol would be observed when I give birth to Junior Pie in Gapan. Will probably discuss this with the pedia beforehand and attach a copy of Dra. Silvestre's presentation, the Administrative Order and ENC Guidebook to my birth plan.