Policy Guidelines for the Intensified Implementation of the National Program on Family Planning (NPFP) Towards Better Health Outcomes, Poverty Reduction and Socio-Economic Development

July 29, 2019

DOH-NEDA-POPCOM JOINT MEMORANDUM CIRCULAR NO. 2019-0001

 

I. BACKGROUND AND RATIONALE

The Philippine Development Plan (PDP) 2017-2022, which is anchored on AmBisyon Natin 2040 (Matatag, Maginhawa at Panatag na Buhay), aims to build a strong foundation for inclusive growth, a high-trust and resilient society and a globally competitive economy. As its major goal, it aims to reduce poverty to 14 percent by 2022.

Recognizing the critical role of population and development in socio-economic development in the country, the PDP explicitly included the achievement of demographic dividend as a key strategy for achieving the socio-economic agenda of President Duterte's Administration in pursuing this strategy, the President issued Executive Orders No. 12 and 71 to direct key agencies to implement the RPRH law, which ensures universal access to sexual and reproductive health (RH) services, in particular the Family Planning Program as an essential RH element.

The current state of the country's population, however, continues to provide a significant challenge to the government's capacity to actualize its socio-economic goals Filipino women, particularly the poor and those with low level of education, continue to have high fertility and unplanned pregnancies and births, and pregnancies among adolescents continue to persist at historically high levels. While the country has a Responsible Parenthood and Reproductive Health (RPRH) Law in place, its implementation has been delayed by legal barriers and institutional factors.

Family Planning is likewise a key element or strategy in promoting the overall health and well-being of the population. Specifically, its role is crucial in illegal abortion, unintended pregnancy, malnutrition, stunting, and high level of infant and maternal mortality.

As the country's age structure is changing towards a situation for a possible demographic divided, there is a need to improve the needed conditions for this opportunity to happen. A crucial strategy is to reduce unplanned pregnancies by enabling couples and individuals to have their desired number, timing and spacing of children within the context of responsible parenthood, and informed choice and voluntarism. Thus, the need to strengthen and intensify the country's national family planning program to ensure access of couples and individuals to needed information and services that can help them plan their families and consequently contribute to poverty reduction and socio-economic development.

II. LEGAL BASES

A. Republic Act 10354 (December 12, 2012), "Responsible Parenthood and Reproductive Health Act";

B. Republic Act 7160 (October 10, 1991), "Local Government Code of the Philippines";

C. Presidential Decree No. 79 (December 8, 1972), "Revised Population Act of the Philippines";

D. Executive Order No. 12, s. 2017, "Attaining and Sustaining 'Zero Unmet Need for Modern Family Planning' through the Strict Implementation of Responsible Parenthood and Reproductive Health Act Providing Funds Therefor and for Other Purposes";

E. Executive Order No. 71, s. 2018, "Renaming the Commission on Population as the Commission on Population and Development and Reverting its Attachment to National Economic and Development Authority from the Department of Health and for Other Purposes";

F. Relevant POPCOM Board Resolutions:

1. POPCOM Board Resolution No. 1, series of 2016 "Adopting the Collaborative Framework and Strategies for the Implementation of National Family Planning Program as a Public Health and Population Management Intervention";

2. POPCOM Board Resolution No. 2, series of 2018, "Resolution Strengthening the National Program on Family Planning and The POPCOM Secretariat by Designating the Executive Director of The Commission on Population as The Manager of The National Family Planning Program Among Other Purposes";

3. POPCOM Board Resolution No. 5, series of 2018 "Amending Board Resolution No. 2, Series of 2018 Resolution Strengthening the National Program on Family Planning and The POPCOM Secretariat by Designating the Executive Director of The Commission on Population as The Manager of The National Family Planning Program, Among Other Purposes," adopting a Co-management scheme for the National Program on Family Planning between the Department of Health and the Commission on Population.

G. Relevant DOH Issuances:

1. DOH Administrative Order No. 2017-0005, "Guidelines in Achieving Desired Family Size through Accelerated and Sustained Reduction in Unmet Needs for Modern Family Planning Methods";

2. DOH Administrative Order No. 2012-0009, "National Strategy Toward Reducing Unmet Need for Modern Family Planning as a Means to Achieving Millennium Development Goals on Maternal Health";

3. DOH Administrative Order No. 50-A, series of 2001, National Family Planning Policy."

III. PURPOSE

This JMC shall establish an efficient and effective collaborative mechanism for management and implementation of the national family planning program towards the achievement of the following targeted reproductive health outcomes by 2022.

a) Zero unmet need for modern family planning methods;

b) Modern contraceptive prevalence rate of 55%;

c) Increased use of FP methods among males;

d) Zero-gap between actual and wanted fertility; and

e) Adolescent birth rate of 40 per 1,000 adolescent women (15-19 years old) reduced teenage pregnancy).

Specifically, this JMC aims to:

a) Institute strategies to strengthen the national family planning program towards better health, poverty reduction and socio-economic development;

b) Define and implement effective collaborative management and implementing mechanisms between DOH and POPCOM including their respective regional offices, as the mandated agencies for the coordination of the National Program Family Planning (NPFP); and

c) Enjoin other concerned institutions and agencies at all levels to support and integrate within their mandates the intensified, cohesive and well-coordinated national family planning program.

IV. STATEMENT OF POLICY

It shall be the policy of the Government to intensify all efforts to improve the conditions for the country's capacity to achieve and optimize the demographic dividend to accelerate the achievement of the government's reproductive health and socio-development goals particularly the reduction of poverty. In particular the Government shall strengthen the coordination and implementation of the National Program on Family Planning (NPFP) as both a public health and socio-economic strategy at all levels. Towards this end, it shall pursue an efficient co-management scheme by the Department of Health (DOH) as the lead agency in implementing the RPRH Law and Commission on Population and Development (POPCOM) as the lead agency in implementing the Philippine Population Management Program (PPMP).

The NPFP shall adopt the existing "Collaborative Framework and Strategies for a National Family Planning Program" approved by the POPCOM Board of Commissioners (POPCOM Board Resolution No. 1, series of 2016) as hereby further defined and the "Family Planning Clinical Standards Manual" (DOH 2014 as well as its succeeding editions) as is technical policy and operational guidelines.

All future policy issuances for the NPFP shall be issued jointly by the Chairperson of POPCOM Board and the Secretary of Health.

V. COLLABORATIVE FRAMEWORK FOR PROGRAM MANAGEMENT

A. Designation and Collaboration of Co-Managers from DOH and POPCOM

1. To jointly take the lead in the implementation of the NPFP the Chair of the POPCOM Board and the Secretary of Health shall designate Co-Managers from POPCOM and DOH respectively. For this purpose, the Undersecretary for Population and Development and Executive Director of POPCOM is hereby designated as the Co-Manager for POPCOM, and an Undersecretary for Health as the Co-Manager for DOH.

2. The Co-Managers shall be tasked to oversee and ensure the efficient and intensified coordination and implementation of the NPFP. The Co-Manager from POPCOM shall ensure that the NPFP is aligned with the objectives of the population management program and the Co-Manager from DOH to ensure that the program is responsive to the National Objectives for Health (NOH). Both shall ensure that the common program significantly contributes to the NOH and socio-economic agenda of the Administration.

3. In setting the direction for the NPFP the Co-Managers are hereby authorized to make further joint operational issuance for the NPFP. These issuances shall not be contrary to the stated policy of this JMC.

4. The Regional Directors of DOH and POPCOM shall likewise serve as the Co-Managers of the NPFP at the regional level. As such, they are tasked to establish an efficient collaborative mechanism to intensify the implementation of the program of the regional and local levels.

B. Development and Implementation of an Annual Unified Work and Financial Plan

1. The Co-Managers in consultation with various stakeholders, shall jointly identify and set the common targets and objectives for the NPFP particularly at the national level. Interventions to address these objectives shall be spelled out in a Unified Work and Financial Plan which shall be jointly formulated annually.

2. The unified WFP shall cover complementary strategies and activities with corresponding funds to ensure well-coordinated initiatives.

3. The Regional Offices of DOH and POPCOM, in collaboration with regional partner agencies, local government units (LGUs) and CSOs shall also develop common objectives/targets and a unified WFP for regional implementation.

4. Pursuant to the pertinent provisions of RPRH Law, EO12 and RA7160, all Local Government Units (LGUs) are enjoined to integrate the national and regional NPFP standards, objectives, targets, and strategies in their respective Local Development Plans and investment programs, and pursue their implementation thereof.

C. Specific Collaborative Roles of DOH and POPCOM

1. DOH and POPCOM shall collaborate and work with LGUs and CSOs in the provision of the full range of Family Planning services at all levels. For this purpose, Family Planning service delivery shall be defined as the provision of the full range of FP services including:

a. Basic information and education on family planning (i.e., benefits and various types of FP methods);

b. counseling services (both at the facility and community level);

c. referral to appropriate health facilities and service providers;

d. full range of modern FP services following the principles on informed choice and voluntarism; and

e. follow-up services. The NPFP shall work with the National Implementation Team (NIT) for family planning in accordance with the RPRH Law.

2. DOH and POPCOM will work collaboratively in major program areas of Family Planning including:

a) Policy formulation and plan development;

b) Demand generation (including promotion, communication, and advocacy strategies);

c) Service delivery and logistics management;

d) Quality assurance and standards setting;

e) Capacity building; and

f) Monitoring and evaluation.

3. To ensure that the National Program on Family Planning (NPFP) is aligned with the goals and strategies of the Responsible Parenthood and Responsible Parenthood Law (RA 10354), the program shall collaborate with the National Implementation Team (NIT) for RPRH law in its major program areas.

4. DOH and POPCOM shall endeavor to harmonize and unify their interventions to ensure greater impact of strategies and activities and efficiency in resource allocation and utilization.

5. The specific collaboration roles of DOH and POPCOM to be applied at the national and regional levels are defined in the Collaborative Matrix between DOH and POPCOM, hereto attached as "Annex A" and forms an integral part of this JMC.

VI. HARMINIZATION OF FORMS AND DATA BASES

To ensure a more collaborative and harmonized implementation of the NPFP, DOH and POPCOM, in coordination with the NIT for RPRH Law, shall harmonize existing forms and databases used for program implementation and coordination. The two agencies shall likewise ensure access of both agencies to information generated from the databases for planning and program decisions.

VII. REPORTING, MONITORING AND EVALUATION

For efficient and effective planning and program implementation of the NPFP, the DOH and POPCOM shall establish a reporting monitoring and evaluation system.

VIII. ROLES OF OTHER RELEVANT AGENCIES

The member agencies of the POPCOM Board of Commissioners which includes the Department of Social Welfare and Development (DSWD), Department of Education (DepEd), Department of Interior and Local Government (DILG), Department of Agriculture (DA), Department of Agrarian Reform (DAR), Department of Labor and Employment (DOLE), Department of Public Works and Highways (DPWH), Department of Trade and Industry (DTI), University of the Philippines Population Institute (UPPI) and other relevant agencies are highly encouraged to closely collaborate with DOH, POPCOM and NEDA to support the implementation of this JMC within their respective mandates.

DOH and POPCOM may enter into various institutional arrangements in relation to the implementation of the NPFP to specifically define roles and responsibilities among relevant National Government Agencies.

IX. BUDGET AND FUNDING

All programs, strategies and activities to be undertaken by DOH and POPCOM in the implementation of NPFP shall be sourced from their respective annual approved budget. The two agencies shall work together to ensure adequate funding for the key strategies of the NPFP.

X. DISSEMINATION

DOH and POPCOM shall ensure the dissemination of this JMC to all its Regional Offices, partner agencies including Civil Society Organization (CSOs).

XI. SEPARABILITY CLAUSE

If any section or part of the this JMC is held unconstitutional invalid or unauthorized by any court of Law or any competent authority, the other sections or provisions not otherwise affected shall remain in full force and in effect.

XII. REPEALING CLAUSE

All other orders, issuances, rules and regulations or any provisions of any related circular which are or may be inconsistent or contrary herewith are hereby repealed amended, or modified accordingly.

XIII. EFFECTIVITY

This JMC shall take effect immediately upon approval.

(SGD.) ERNESTO M. PERNIA, Ph.DSecretary of Socio-Economic Planning and ChairpersonDate: February 15, 2019

(SGD.) FRANCISCO T. DUQUE III, MD, MScSecretary of HealthDate: February 15, 2019

Published in the Official Gazette, Vol. 115, No. 30, Page 7987 on July 29, 2019.

ANNEX A

Matrix of Collaboration Roles of DOH and POPCOM

 

DOH

POPCOM

A. Policy Formulation and Plan Development

• Develop plans including setting of objectives for health in general and program targets for FP performance indicators in particular which will be inputted in the PPMP. • Provide relevant data on performance indicators	• Develop the medium-term directional plan, strategies and objectives for the population management program particularly for RPFP component. • Relate targets to outputs and outcomes • Monitor and evaluate output and outcomes vis-à-vis PDP results matrix
• Ensure resources and budget allocation for FP program in the Department's annual budget and work and financial plan of Disease Prevention and Control Bureau (DPCB)	• Ensure budget allocation for RPFP in the agency's and other stakeholders' (including POPCOM Board Members) annual budget and work and financial plan

B. Demand Generation (Conduct of promotional and communication activities for FP)

• Initiate, develop, sustain and heighten nationwide multi-media campaign to raise the level of public awareness on family planning as a health intervention: o Develop a comprehensive, inclusive, and evidenced-based health promotion and communication plan for FP; o Regularly review, assess and revise existing communication and education materials for FP;

• Develop and implement communication and demand generation strategies for RPFP at the national and sub-national level: o Coordinate with LGUs and engage CSOs in the conduct of RPFP classes; o Develop, produce, and disseminate IEC materials for RPFP classes; o Organize, capacitate, and mobilize community population volunteers for RPFP education and referrals; o Coordinate and strengthen the Pre-Marriage Orientation and Counseling Program through technical assistance in capacitating PM counselors and facilitators enhancement of modules, and establishment of reporting system.

• DOH Regional Offices to provide technical assistance to LGUs in developing and implementing their local communication and promotional strategies for family planning.

• Support DOH Regional Offices in providing technical assistance to LGUs in developing and implementing their local communication and promotional strategies for RPFP.

C. Service Delivery including Logistics Management

Service Delivery

• Assist LGUs through DOH Regional Offices in establishing and capacitating integrated Service Delivery Network (SDN) for FP	• Provide counseling services (at community level) through population workers and refer couples and individuals with unmet need for modern FP (both natural and artificial) to health facilities to access appropriate FP services. • Engage CSOs through POPCOM Regional Offices in linking identified couples with unmet need to FP service delivery mechanisms.
• Ensure the upgrading and improvement of health facilities to ensure the delivery of quality family planning services (through HFEP of DOH).
• Provide support for the procurement and mobilization of Mobile Health Care Service vehicles (through HFEP of DOH).
• Provide support to LGUs upon request in order to meet the adequate number of skilled health professionals through the contracting and deployment of midwives and/or nurses.
• Ensure financing for the access to FP services through PhilHealth reimbursement.

FP Logistics Management

• Utilize an efficient logistics management system in the procurement and distribution process as well as monitoring and evaluation of FP supply usage in the country.	• Provide inputs in forecasting of FP commodities • Coordinate and supervise the FP Logistics Management at the regional and local level by: o monitoring stock level of FP commodities at facility level; o reporting stock-out of commodities; and o reporting utilization of FP commodities thru the management of FP Logistics hotline, starting at the national level and to expand to the regional level.
Ensure adequate supply of FP commodities at the service delivery points	• Support the storage of FP commodities from the national level to the regional level by utilizing POPCOM warehouses.
• Help through POPCOM Regional Offices the redistribution of FP commodities stored in the regional warehouses.

D. Quality Assurance and Standards Setting

• Develop, monitor and evaluate compliance of health facilities and service providers to set standards for the provision of FP services in all levels.
• Ensure compliance to informed choice and voluntarism (ICV) principles in the provision of FP services.	• Ensure compliance to ICV principles in the provision of FP information and counseling services by the population workers and community volunteers.
• Develop and ensure standards for training of health and non-health service providers on FP.	• Develop training curriculum or standards on demand generation for RPFP.

E. Capacity Building

• Provide trainings to health and non-health service providers on provision of information and counseling on FP.

• Support the cascading of trainings to municipal and community levels in the implementation of demand generation for RPFP service delivery.

F. Monitoring and Evaluation

• Prescribe monitoring and evaluation strategies and tools to measures expected FP program outcomes.	• Coordinate the FP Data management at the regional and local level such as FP report collection from public and private service facilities by mobilizing the local population officers/workers to this effort.
	• Monitor and evaluate the application of skills learned by the FP service providers during FP related trainings as input in updating the FP Training Plan Design.
• Consolidate regional and national FP reports (FHSIS) on a regular basis.	• Sustain online and offline database system for identifying and tracking unmet need for modern FP and reconcile, if necessary, this system to existing service facility systems.
• As lead agency in the RPRH Act implementation, monitor the implementation of work and financial plans in Family Planning of stakeholders and supervise the development and submission of the annual report of RPRH Law Implementation.	• As head of the Secretariat of the NIT and RITs of the RPRH Act, coordinate the collection, consolidation, monitoring and evaluation of stakeholders' accomplishment reports as well as annual work and financial plans in support of the RPRH Law implementation.