Essential Newborn Care (ENC) TThe ENC Protocol is a step-by-step guide for health workers and medical practitioners

issued by the Department of Health for implementation under Administrative Order 2009-0025. What are these step-by-step interventions?

Immediate drying Using a clean, dry cloth, thoroughly dry the baby, wiping the face, eyes, head, front and back, arms and legs.

Uninterrupted skin-to-skin contact Aside from the warmth and immediate bonding between mother and child, it has been found that early skin-to-skin contact contributes to a host of medical benefits such as the overall success of breastfeeding/colostrum feeding, stimulation of the mucosaassociated lymphoid tissue system, and colonization with maternal skin flora that can protect the newborn from sepsis and other infectious disease and hypoglycemia.

Proper cord clamping and cutting Waiting for up three minutes or until the pulsations stop is found to reduce to chances of anemia in full term and pre-term babies. Evidence also shows that delaying cord clamping has no significant impact on the mother.

Non-separation of the newborn from the mother for early breastfeeding initiation and rooming-in The earlier the baby breastfeeds, the lesser the risk of death. Keeping the baby latched on to the mother will not only benefit the baby (see skin-to-skin contact) but will also prevent doing unnecessary procedures like putting the newborn on a cold surface for examination (thereby exposing the baby to hypothermia), administering glucose water or formula and foot printing (which increases risk of contamination from ink pads) and washing (the WHO standard is to delay washing up to 6 hours; the vernix protects the newborn from infection). On the other hand, necessary actions such as eye care, vitamin K administration must be timed. Eye care must be done after the infant has located the mothers breast. Unang Yakap Campaign In September 2000, the Philippines committed to the UN Millennium Declaration, targeting reduction of poverty, hunger and ill health in the country, including reduction of maternal, newborn and child mortality. The Philippines is currently "on track" to reach its Millennium Development Goal #4 target of reducing under-five mortality. However, some 40,000 Filipino newborns still die every year. Half of these newborns die in the first two days of life. Administrative Order 2009-0025 The current state of newborn care needs urgent action. To this end, the Department of Health has issued Administrative Order 2009-0025 which outlines specific policies and principles for health care providers with regard the prescribed systematic implementation of interventions that address health risks known to lead to preventable neonatal deaths. This AO is consistent with AO No. 2008-0029 on Implementing Health Reforms for Rapid Reduction of Maternal and Newborn Mortality and supports all DOH initiatives and programs for newborn and child health. Iligtas sa Tigdas ang Pinas Iligtas sa Tigdas ang Pinas A Door-to-Door Measles-Rubella (MR) Immunization Campaign Vaccinating All Children, 9 months to below 8 years old From April 4 to May 4, 2011 The Philippines has committed to eliminate measles in 2012, the target year agreed upon with the other countries in the Western Pacific Region. Three (3) mass measles immunization campaigns were conducted in 1998, 2004 and 2007, achieving 95% coverage in each round. In contrast, the annual coverage for routine measles vaccination given to infants ages 9-11 months never reached the target of at least 95%. The highest coverage ever attained is 92% and the lowest coverage was 67% (1987 DOH EPI Report). The lower the coverage, the faster is the accumulation of unimmunized susceptible infants, resulting in measles outbreaks in different areas of the Philippines. Laboratory confirmed measles cases continued to be reported all over the country, which indicates uninterrupted circulation of measles virus transmission resulting to illness and deaths among children. Mass measles immunization campaigns provide a second opportunity to catch missed children, but these are done every 2-3 years interval and therefore not enough to prevent seasonal outbreaks from occurring in areas with low immunization coverage.

The administration of a 2nd dose of measles containing vaccines on a routine schedule will provide this second opportunity at an earlier time and ensure the protection against measles of infants/children who failed to be protected during the first dose. As a response to interrupt the transmission of the measles virus and prevent a potential large measles outbreak to occur, there is an urgent need to conduct a measles supplemental immunization activity this April 2011. All children ages 9-95 months old nationwide should be given a dose of measles-rubella vaccine through a door-to-door vaccination campaign. Unlike previous campaign, a measles-free certification will be issued to city/province meeting all the criteria of (1) all barangays passed the RCA with no missed child and 95% and above house marking accuracy; (2) there are no measles cases for the next 3 months after the campaign and (3) measles surveillance indicators have met the national standards. What is Iligtas sa Tigdas ang Pinas? y Iligtas sa Tigdas ang Pinas is a measles supplemental immunization activity (SIA) for a measles-free Philippines. This is a sequel to the 1998, 2004 and 2007 mass measles campaign. What vaccination strategy will be used in this activity? y Strictly Door-to-Door immunization strategy What are the doors referred to in this campaign? y It includes all doors of houses, condominiums, apartments, tenements, orphanages and halfway homes as well as nonconventional doors in the community y Non-conventional doors include the following: 1. Informal settlements such as families/persons living under the bridge, inside the parks, cemeteries and open spaces; in tents, carts, abandoned buildings, old vehicles/trains/motorboats, under the trees, in islands on the middle of the street, etc. 2. All business/commercial establishments and market stall where children may reside 3. Institutions 4. Eligible children of mobile and roaming families with no houses or no permanent house shall be identifies and given immunization. y All eligible children found in the parks, playgrounds, streets, markets, and other public places shall be directed to go home to be vaccinated. y Areas like day care centers, schools, malls, groceries, or churches shall not be visited anymore (if and only if no family resides). How is this different from the previous campaign? Measles-free certification will be issued to provinces and cities if all the following criteria are met: y All barangays have passed the Rapid Coverage Assessment (RCA) with no missed child AND 95% house marking accuracy; and y There are no measles cases for the next 3 months after the campaign; and y Measles surveillance indicators have met the national standard: 1. At least 80% of surveillance sites should report each week on the presence or absence of suspected measles cases. 2. At least 80% of the reported suspected cases should be reported within 48 hours of rash onset. 3. At least 80% of the reported suspected cases should be investigated within 48 hours of report. 4. At least 80% of specimens should be taken from initial contact until 28 days post rash onset and reach the laboratory in a suitable state for testing. 5. At least 80% of specimens must be tested and the results reported back to the surveillance unit within 7 days of receipt of the specimen in the laboratory. The certification process will be conducted at the end of the campaign.