Regulation of Birthing Homes

November 28, 2007

DOH ADMINISTRATIVE ORDER NO. 2007-0039

REGULATION OF BIRTHING HOMES

I

Background/Rationale

One of the challenges that the Department of Health (DOH) currently faces is the achievement of the Millennium Development Health Goals (Health MDGs) by 2015. One of the Health MDGs is to improve maternal health, specifically, to reduce maternal mortality ratio by two-thirds.

To achieve the goal of maternal mortality reduction, a new strategy has been adopted by the DOH for implementation under the FOURmula One for Health (F1) reform initiatives. This strategy is based on a new world view that considers all pregnant women to be at risk for complications and therefore needing easy access to both basic and comprehensive emergency obstetric care. This strategy calls for deliveries that are conducted in primary-level facilities (i.e., health centers), to be backed up by access to referral-level facilities. Part of this strategy is ensuring that these health facilities are compliant with DOH licensure and Philippine Health Insurance Corporation (PHIC) accreditation standards. TADaES

At present, the DOH, through the Bureau of Health Facilities and Services (BHFS), issues licenses to all birthing home facilities, whether they are government-owned or privately-owned facilities. The mandate to regulate birthing homes comes from provisions in Republic Act 4226 "Hospital Licensure Act" and its revised implementing rules and regulations (Administrative Orders Nos. 147 s. 2004 and No. 2005-0029.) On the other hand, PHIC grants accreditation to birthing homes for reimbursement for maternity services being availed of by PHIC members.

Stakeholders from both private and public sectors representing birthing home owners, administrators and health workers, clamor for a simplification of the regulatory processes for birthing homes. In particular, they advocate for a unification of the licensing and accreditation processes and standards. In response to this clamor from stakeholders, it is proposed that in lieu of the license to operate that is issued by BHFS, birthing homes shall seek accreditation from PHIC. The preference for accreditation over licensing recognizes the fact that accreditation promotes higher standards of quality in health care. Furthermore, the proposal is in accordance with ongoing reforms in health regulation under the FOURmula One for Health, particularly with the harmonization and streamlining of regulatory systems and processes. HCTAEc

II

Objective

This Order sets the guidelines for the regulation of birthing homes.

III

Scope

This Order shall apply to all birthing homes.

IV

Guidelines

A. Beginning January 1, 2008, the BHFS and CHDs shall no longer issue a license to operate to birthing homes.

B. In lieu of obtaining a license to operate, birthing homes shall be accredited by PHIC.

V

Repealing Clause

Provisions from previous issuances that are inconsistent or contrary to the provisions of this order are hereby rescinded and modified accordingly.

VI

Separability Clause

In the event that any provision or part of this Order be declared unauthorized or rendered invalid by any court of law or competent authority, those provisions not affected by such declaration shall remain valid and effective. EADCHS

VII

Effectivity

This Order shall take effect fifteen (15) days after its approval and publication in the Official Gazette or newspaper of general circulation.

Adopted: November 28, 2007

(SGD.) FRANCISCO T. DUQUE III, M.D., M.Sc.Secretary of Health

Published in the National Administrative Register, Vol. XIX No. 1 (January-March 2008).