2007 O - 23 - PROVIDING FOR THE OLONGAPO CITY REPRODUCTIVE HEALTH CARE CODE OF 2007

EXCERPTS FROM THE MINUTES OF THE REGULAR SESSION OF THE SANGGUNIANG PANLUNGSOD OF OLONGAPO, HELD ON AUGUST 01, 2007 AT THE CITY HALL.

PRESENT:

Hon. Cynthia G. Cajudo - - - - - - - - - - - - - - - - - City Vice-Mayor & Presiding Officer Hon. Gina Gulanes-Perez - - - - - - - - - - - - - - - - City Councilor
Hon. John Carlos G. Delos Reyes- - - - - - - - - - - “ “
Hon. Rodel S. Cerezo - - - - - - - - - - - - - - - - - - - “ “
Hon. Marey Beth D. Marzan- - - - - - - - - - - - - - - “ “
Hon. Sarah Lugerna Lipumano-Garcia - - - - - - - - “ “
Hon. Edwin J. Piano- - - - - - - - - - - - - - - - - - - - - “ “
Hon. Angelito W. Baloy - - - - - - - - - - - - - - - - - - “ “
Hon. Aquilino Y. Cortez, Jr.- - - - - - - - - - - - - - - - “ “
Hon. Anselmo A. Aquino- - - - - - - - - - - - - - - - - - “ “
Hon. Elena C. Dabu- - - - - - - - - - - - - - - - - - - - - - “ “
Hon. Carlito A. Baloy- - - - - - - - - - - - - - - - - - - - - President, Liga ng mga Barangay

ABSENT:

Hon. Robine Rose C. Buenafe - - - - - - - - - - - - - - - SK Federation President
(Sick Leave)

WHEREAS, the Philippine Laws compel local governments to promote and advance the sovereign commitments to human rights, women’s empowerment, youth well-being and responsible parenthood;

WHEREAS, the right to reproductive health is a human right of all women and men, young and old, whose observance directly bears on the welfare and well-being of families and communities;

WHEREAS, local governments are further mandated to provide efficient and effective basic services that will upgrade the quality of community life that includes health and social welfare programs and projects on primary health care, maternal and child care, child and youth welfare, family and community welfare, women’s welfare, welfare of the elderly and disabled persons, nutrition services, and reproductive health and family planning services;

WHEREAS, several human development indicators of Olongapo City suggest a need to immediately address gaps in reproductive health care, as attested by the following:

a) Olongapo City has an annual population growth rate of 1.68%. The City population is growing steadily every year and comprised mainly of younger age groups of which 44% are 19yrs old below. This shows that majority of the population is mainly under the reproductive age group and that there is a need to curb the population growth rate for a better population management.

b) In 2006, out of 944 total deaths, 2 mothers died due to complications related to pregnancy and childbirth. Although it is low compared to national level, maternal deaths could be averted through delivery of skilled health personnel and access to emergency obstetric care in health facilities. The Department of Health guidelines emphasize no deliveries at home attended by untrained personnel. Deliveries at the health facilities willeliminate maternal deaths of which the city can ensure to achieve Zero maternal deaths leading to the achievement of Millennium Development Goals set by the Philippine government.

c) In 2006, 25 babies out of 4,900 live births died within their first 28 days of life while 39 infants out of 4,900 live births died under 12 months. Data on Infant Mortality Rate (IMR) in the city showed an increasing trend from 2004-2006.

d) There is a high percentage of malnourished children in the city based on the Operation Timbang (OPT) conducted by the CHO every year. In absolute figure, 1,634 children are malnourished that need immediate care and attention.

e) There is high unmet need for family planning with majority of women who want no more children but not practicing any family planning methods. Lack of information and access to high quality family planning services accounts for this

f) The complete phase-out of donated FP commodities from USAID in 2007 had transferred the burden to the LGU in ensuring the availability of commodities to current users of FP methods. Unmet family planning needs due to shortage of supplies may contribute to the looming surge in the City’s population in the near future.

g) Despite significant developments in addressing gender concerns, low unequal status of women prevails and incidence of domestic violence is also alarming. In 2006, data from the CSWDO revealed that there were 35 cases of VAWC victims in the city.

h) In 2004-2006, data showed that there is an increasing trend in the number of STI cases in city based on CHO records. An increasing number of STI cases are considered as high risk factor in developing HIV (+) and consequently becoming AIDS victims. To date, there were 262 STI cases while 5 AIDS positive cases were reported.

i) There were thirteen (13) reported cases of teenage pregnancies among high school students in public schools in school year 2006-2007. The reported cases may still increase when data and reports from the private schools and community specifically the out of school youths will come in.

WHEREAS, in keeping with its duties and commitment to uphold the rights and well being of its constituents, the City of Olongapo deems it necessary and appropriate to adopt measures that address these gaps in reproductive health care;

NOW, THEREFORE, on motion of Councilor Angelito “Gie” W. Baloy, with the majority decision of the Members of the Sangguniang Panlungsod present,

RESOLVED, AS IT IS HEREBY RESOLVED, by the Sangguniang Panlungsod in session to enact the following Ordinance:


ORDINANCE NO. 23
(Series of 2007)

AN ORDINANCE PROVIDING FOR THE OLONGAPO CITY REPRODUCTIVE HEALTH CARE CODE OF 2007

BE IT ORDAINED, BY THE SANGGUNIANG PANLUNGSOD IN SESSION ASSEMBLED, THAT:

SECTION 1. Title – This Ordinance shall be known as “OLONGAPO CITY REPRODUCTIVE HEALTH CARE CODE OF 2007”.

SECTION 2. Declaration of Policy – The City Government of Olongapo shall adopt an integrated and comprehensive policy on reproductive health care in line with its pursuit of sustainable human development that values human dignity and offers full protection to women, children, youth and families.

The policy is anchored on the common belief and is resolved to uphold the human rights of all persons including the right to equality and equity, the right to development, the right to reproductive health, the right to education and the right to choose and make decisions for themselves in accordance with their religious convictions, cultural beliefs and the demands of responsible parenthood.

Consistent with these principles, the City Government of Olongapo shall guarantee access to information and education, and universal access to safe, affordable and quality reproductive health care services.

SECTION 3. Objectives - The RH Code specifically aims to:

I. Provide the people of Olongapo City with timely; complete and accurate information and education on reproductive health;

II. Ensure the provision of accessible, safe, affordable and quality reproductive health care services;

III. Ensure the planning, implementations, monitoring and evaluation of appropriate and effective reproductive health care programs such as the following:

a. Maternal health care
b. Infant and child health care
c. Family planning information and services
d. Services for the prevention of abortion and management of post abortion and its complication
e. Adolescent and youth health service
f. Prevention and management of reproductive tract infections
g. HIV and AIDS and other transmittable infections (STIs)
h. Elimination of violence against women
i. Education and counseling on sexuality and sexual health
j. Treatment of breast, reproductive tract cancers and other gynecological conditions
k. Male involvement in reproductive health
l. Prevention and treatment of infertility and sexual dysfunction.

SECTION 4. Definition of Terms – For purposes of this Ordinance, the following terms shall be defined as follows:

I. Reproductive Health – the state of complete physical, mental social well-being and not merely the absence of disease or infirmity in all matters relating to the reproductive system and to its functions and processes.

II. Reproductive Rights – the rights of individuals and couples, subject to applicable laws, to freely and responsibly decide the spacing and timing of their children to make other decisions concerning reproduction free of discrimination, coercion and violence; to have the information and means to do so, and to attain the highest standard of sexual and reproductive health.

III. Gender Equality – the absence of discrimination on the basis of a person’s sex, in opportunities, in the allocation of resources or benefits or in access to services.

IV. Gender Equity – fairness and justice in the distribution of benefits and responsibilities between women and men, and often requires women-specific projects and programs to end existing incapacities;

V. Reproductive Health Care – the access to a full range of methods, techniques and services that contribute to reproductive health and well being by preventing and solving reproductive health-related problems. It also includes sexual health, the purpose of which is the enhancement of life and personal relations. The elements of reproductive health care include.

a. Maternal, infant and child health and nutrition;
b. Family planning information and services;
c. Adolescent and youth health;
d. Prevention of abortion and management of post-abortion complication;
e. Prevention and management of reproductive tract infections (RTIs), HIV and AIDS and other sexually, transmittable infections (STIs);
f. Elimination of violence against women;
g. Education and counseling on sexuality and sexual health;
h. Treatment of breast and reproductive tract cancers and other gynecological conditions;
i. Male involvement and participation in reproductive health; and
j. Prevention and the treatment of infertility and sexual dysfunction.


VI. Responsible Parenthood – the will and the ability to respond to the need and aspirations of the family and children.

VII. Family Planning – program that, enables couples and individuals to decide freely and responsibly the number and spacing of their children and to have the information and means to do so and to have informed choice and access to a full range of safe and effective natural or modern family planning methods.

VIII. Adolescent Sexuality – refers to the reproductive system, gender identity, values or beliefs, emotions, relationships and sexual behavior of young people as social beings. Adolescence refers to a life stage and pertains to people aged between 10-19 years old.

IX. Reproductive Health and Sexuality Education – is the process of acquiring complete, accurate and relevant information in all matters relating to the reproductive system, its functions and processes and human sexuality, and forming attitudes and beliefs about sex, sexual identity, interpersonal relationship, affection, intimacy and gender rules. It also includes developing the necessary skills to be able to distinguish between facts and myths on sex and sexuality and critically evaluate and discuss the moral, religious, social and cultural dimensions of related sensitive issues such as contraception and abortion.

X. Reproductive Tract Infection (RTI) – includes sexually transmitted infections, sexually transmitted diseases and other types of infections affecting the reproductive system.

SECTION 5. Role and functions of the City Health Office

I. The Olongapo City Health Department will be the lead agency in the implementation of Reproductive Health (RH) programs and services in collaboration with other major stakeholders.

II. The CHO in collaboration with other stakeholders will serve as the central advisory, planning and policy making body for the comprehensive and integrated implementation of RH program with the City Mayor as the Chairperson.

III. Formulate an integrated policy and program on reproductive health care that shall be implemented in all government and private health and educational institutions such as hospitals, rural health units, barangay health stations, schools and other health and educational facilities managed by the private sector, non government organizations, church and other civil society organizations in the city;

IV. Recommend the enactment of legislation and adoption of measures that will facilitate the comprehensive and integrated implementation of the reproductive health care programs including monitoring and evaluation.


SECTION 6. Protocols on the Execution of an Integrated and Quality RH program

I. A comprehensive communication plan shall be formulated by the RH Advisory Body to address the lack of information on the 10 elements of RH specifically the prevention and control of STI/HIV/AIDS, reduction/elimination of maternal deaths related to pregnancy, reduction in infant and child mortality, adolescent reproductive health, family planning, reproductive tract cancers, male participation in RH and VAWC.

II. An integrated and comprehensive RH counseling service shall be developed and institutionalized in the health facilities, schools, barangay multipurpose halls, PNP women’s desk, WCPU in JLGMH, temporary shelters for VAWC victims and in workplaces.

III. An integrated Monitoring and Evaluation system shall be established to assess the performance of the RH programs being addressed by the RH Code. A quarterly/semi-annual evaluation of the progress of the RH programs shall be done to assess issues, gaps and concerns in the project implementation.

IV. Cognizant to the value of the Four Pillars of the population and family planning policy as invoked by no less than President Arroyo in 2003, the City Health Office shall strictly adhere to these policies namely:

a) Responsible Parenthood where it is the will and ability to respond to the needs and aspirations of the family. Couples are free to decide on the timing and size of their families in pursuit of a better life;

b) Informed choice where couples and individuals will be provided with all the information and services on the natural and artificial methods of FP to be able to make informed choices;

c) Respect for life which is stipulated in the 1987 Constitution that protects the life of the unborn child from the moment of conception and abortion is unacceptable as a method of FP; and

d) Birth spacing where three-year birth spacing within the context of responsible parenthood is needed so that women could recover from pregnancy and childbirth and improve their potential to be more productive economically, socially and emotionally that eventually will lead to a well meaningful family life.

V. In the context of the four pillars of the population and FP policy, a comprehensive menu of family planning services for reference and information of the clients seeking family planning services shall be developed and will form as an integral part of the RH counseling services. The city health personnel shall offer all family planning methods highlighting the Natural Family Planning


method which includes the Standard Days method, Lactation Amenorrhea method, Dasal Body Temperature method and Symptom-Thermal method. After which, the modern family planning methods shall also be shared with the clients to set the tone of “Informed Choice” among the patients.

VI. A public and private sector collaboration to provide quality reproductive health care services shall be established. An active networking and collaboration with other stakeholders shall enhance inputs both from the private and public sector with an end goal of providing the quality RH care and services.

SECTION 7. Appropriations – Recognizing the program gaps, the City Government of Olongapo shall appropriate funds which are as follows:

7.1 There shall be funds for the development of the Comprehensive Communication Plan that will strengthen and enhance the information dissemination of accurate and correct facts and figures on reproductive health care services. An intensified information drive shall be installed as a system to widen the scope of providing accurate information to the men and women of reproductive health. The communication strategies may include the use of leaflets, radio and TV guesting/ads, community assemblies, organization’s meetings, schools forum, RH classes in health centers and other forms of integrating RH information to any social events within the city.

7.2 There shall be funds for the Integrated Maternal and Child Health (IMCH) program intended for the micronutrient supplementation specifically iron supplements for anemic pregnant and lactating women, low birth weight infants and malnourished children. Micronutrient supplementation shall ensure the health of the mother and the unborn child and will provide them with protection in delaying and preventing the onset of disease.

7.3 There shall be funds for Family Planning program to ensure that the wide range of safe, affordable and quality FP commodities shall be accessible to all women and men of reproductive age in the health facilities. Distribution of FP supplies to women and men shall be done in the context of cost-sharing the responsibility of family care among the clients and the local government unit. The cost-sharing mechanism is an approach where there will be a return of investment on the part of the LGU and shall avert the “dole-out mentality” among the beneficiaries. This initiative will instill among clients the “sense of being responsible” of their own family welfare with some assistance from the local government

7.4 There shall be a budget for STI/HIV and AIDS programs that will fund the voluntary HIV screening for those high-risk groups such as Men having Sex with Men (MSM) and Commercial Sex Wsorker (CSW) and medical assistance for AIDS victims. In addition, there shall also be funds to develop the AIDS surveillance system in the city for the prevention and control of STI/HIV and AIDS among the high-risk groups and even among the men, women and adolescents.

7.5 There shall be an appropriation for the establishment of the Women and Child Protection Unit in place in James L. Gordon Memorial Hospital (JLGMH) to ensure the reproductive rights of VAWC victims and survivors.

7.6 There shall be funds for the establishment of school-based Teen Centers and community-based Teen Centers to cater to the needs of adolescent reproductive health. This will serve as the venue for sharing of accurate RH information among the teachers and students and even among out of school youth. The RH sessions shall pave the way for value formation among the adolescent thereby enriching their knowledge on adolescent reproductive health. The Teen Centers shall be equipped with IEC materials on adolescent reproductive health, first aid kit, and counseling room with privacy. It may also be equipped with safe and productive game boards such as chess, scrabble, guitars and other paraphernalia suited to the needs of the adolescent. It will foster camaraderie and friendship among high school students and discuss their own RH issues and concerns with the guidance of competent teachers.

7.7 There shall be funds for the early detection and prevention of reproductive tract cancers through the provision of Pap smear for women forty years and above.

7.8 There shall be funds for women who wanted to avail of permanent method like tubal ligation when they have already four or five children which they feel they could not anymore provide the necessary support for the welfare of their children.

7.9 There shall be a yearly campaign for digital rectum examination among males forty (40) years old and above as an early detection and management of prostate cancer. The campaign shall be part of the counseling session to consider the reproductive health of men. The married men will also be encouraged to avail of permanent method like Non-Scalped Vasectomy (NSV) for those who have already more than four or five children and which they feel that they could not anymore provide the necessary support for the welfare of their children.

7.10 On the other hand, to ensure that an integrated and comprehensive quality RH care and services shall be provided to women of reproductive age, there shall be funds for the upgrading of health facilities including those in barangay health centers, in terms of equipment and supplies. Likewise, funds will also support the installation of birthing homes or Basic emergency Maternity obstetric care (BeMoc) and neonatal care/newborn screening in health centers to encourage normal deliveries and will contribute to decongest the JLGMH of patients who are having normal deliveries. The hospital may take care only of patients who are having complications or will be subjected to caesarian operation. This approach will be more cost-effective on the part of the hospital, patient and the city government.

7.11 The total financial requirement to address the gaps of the delivery of quality reproductive health services shall be appropriated by the city government in their annual budget.

SECTION 8. Source of Fund. The Reproductive Health budget will be taken from the 5% Gender and Development (GAD) fund of the Annual Appropriations of the City Government of Olongapo to carry out the provisions of the RH ordinance. Out of the 5% GAD fund of the city, only 5% of the total GAD fund will be allocated for reproductive health services.

SECTION 9. Implementing Rules and Regulations - The City Health Board with the City Mayor as the Chair, in coordination with other concerned offices, shall promulgate rules and regulations for the effective implementation of this ordinance and shall ensure its full dissemination to the public.

SECTION 10. Separability Clause - If any part, section, or provision of this ordinance is held invalid or unconstitutional, other provisions not affected thereby shall remain in full force and effect.

SECTION 11. Repealing Clause - All other ordinances, resolutions or local executive orders or rules and regulations contrary to or rules and regulations contrary to or inconsistent with the provisions of this ordinance are hereby repealed, amended or modified accordingly.

SECTION 12. Effectivity - This Ordinance shall take effect upon approval.

APPROVED, August 01, 2007.


CYNTHIA G. CAJUDO
City Vice-Mayor & Presiding Officer


GINA GULANES - PEREZ JOHN CARLOS G. DELOS REYES
City Councilor City Councilor
(Opposed)


RODEL S. CEREZO MAREY BETH D. MARZAN
City Councilor City Councilor


SARAH LUGERNA LIPUMANO-GARCIA EDWIN J. PIANO
City Councilor City Councilor

ANGELITO W. BALOY AQUILINO Y. CORTEZ, JR
City Councilor City Councilor


ANSELMO A. AQUINO ELENA C. DABU
City Councilor City Councilor


CARLITO A. BALOY ROBINE ROSE C. BUENAFE
President, Liga ng mga Barangay SK Federation President
(Sick Leave)



ATTEST:

ELFLIDA S. SALMON
Council Secretary

APPROVED BY HIS HONOR, THE CITY MAYOR ON______________________.



JAMES GORDON, JR.
City Mayor
ATTEST:

DELFIN A. JUICO, JR.
Secretary to the City Mayor