Congenital disorders cause a global estimate of 240,000 deaths in newborns and 170,000 deaths in children ages 1 month up to 5 years every year. 1 In order to detect metabolic, hematologic, or endocrine disorders in newborns, newborn screening (NBS) is conducted in many countries around the world. In the Philippines, NBS was introduced by the Newborn Screening Study Group in 1996, with the aim of establishing the incidence of six metabolic conditions, namely, congenital hypothyroidism, congenital adrenal hyperplasia, galactosemia, phenylketonuria, homocystinuria, and glucose-6-phosphate dehydrogenase deficiency, and creating recommendations for the adoption of NBS nationwide.2 The Republic Act No. 9288, otherwise known as the Newborn Screening Act of 2004, requires that the Department of Health shall ensure the establishment and accreditation of newborn screening centers (NSCs) in strategically located areas across the Philippines.3 At present, there are seven operational NSCs in the country,4 with the Newborn Screening Center-Mindanao (NSC-Mindanao) in Southern Philippines Medical Center (SPMC) as the only center catering to all NBS facilities all over Mindanao.5 NSC-Mindanao initially performed screening tests for five disorders, but now tests for a panel of 29 metabolic and other congenital disorders.
Neonatal Screening ; Adrenal Hyperplasia, Congenital ; Glucosephosphate Dehydrogenase Deficiency ; Congenital Hypothyroidism

In 2003, the secretaries of the Department of Health (DOH) and the Department of Science and Technology (DOST) signed a memorandum of understanding to institutionalize the Philippine National Health Research System (PNHRS) for the management of research in the country.1 One of the groups constituted under the PNHRS was the Technical Working Group (TWG) on Ethics, which created strategies that highlight the role of ethics in a responsible health research system. Among the recommendations of the Ethics TWG was the establishment of the Philippine Health Research Ethics Board (PHREB).2 In 2006, the PHREB was formally created through DOST Special Order 2006-91 “to ensure that all phases of health research shall adhere to universal ethical principles that value the protection and promotion of the dignity of health research participants.” Since then, PHREB has become the country’s policy making body on health research ethics.2 3 In 2013, the Republic Act 10532一or the PNHRS Law一was enacted.4 The Act strengthened the mandate of PHREB to ensure protection of the welfare, rights, and safety of human research participants, and the implementing rules and regulations (IRR) of the Act specified the policies that facilitate the achievement of the PHREB mandate.5 In 2017, through DOST Special Order 2017-248, DOST established research ethics monitoring boards (REMBs) in Region I, Region VI, and Region XI to assist in the comprehensive and consistent implementation of PHREB policies at the regional level.6 The creation of PHREB in 2006 initiated several other mandates from PHREB and other agencies that implement the PNHRS. These mandates一shown in the infographic一support human research participant protection through ethical reviews of research protocols, establishment of research ethics committees, and maintenance of quality standards of these committees through accreditation. Many of these mandates are national in scope, but a few are specific to Davao Region (Region XI).
Ethics Committees, Research

The Republic Act No. 11494, also known as the "Bayanihan to Recover as One Act," mandates the allocation of funds and provides guidance for the procurement of COVID-19 vaccines.1 However, with the limited availability of COVID-19 vaccines, the Department of Health (DOH) established different policies and guidelines for the selection, access, and deployment of these vaccines throughout the country.2 3 4 5 To date, the Philippine Food and Drugs Authority (FDA) has granted emergency use authorizations for eight COVID-19 vaccines, namely: Pfizer-BioNTech COVID-19 Vaccine, COVID-19 Vaccine AstraZeneca, CoronaVac, Sputnik V, Janssen COVID-19 Vaccine, Covaxin, COVID-19 Vaccine Moderna, and COVID-19 Vaccine BIBP/Sinopharm.6 One of the guidelines established by the DOH is the implementation of a prioritization scheme, wherein citizens are categorized into different prioritization groups based on risk of exposure to the virus and risk of mortality from COVID-19.4 In Davao City, the COVID-19 vaccination roll out started last 5 March 2021 among health care workers at Southern Philippines Medical Center. 7 Aiming to vaccinate 1,200,000 individuals in Davao City,8 the City Government of Davao, DOH Davao Region, and other participating sectors established 59 vaccination sites throughout the city.9 We gathered online data posted in the official facebook pages of DOH Davao Region and the City Government of Davao. According to the DOH Davao Region reports, as of 27 July 2021, a total of 742,710 doses of COVID-19 vaccines were allotted for Davao City. From the total allotted doses, the City Government of Davao City has successfully administered a total of 330,954 first doses, and 149,122 second doses of COVID-19 vaccines.10 According to the City Government of Davao, as of 25 July 2021, Davao City has administered a total of 85,260 doses (1st dose - 47,332 doses, 2nd dose - 37,928 doses) of COVID-19 vaccine among individuals in the A1 prioritization group, 103,837 doses (1st dose - 76,472 doses, 2nd dose - 27,365 doses) among those in the A2 prioritization group, 179,479 (1st dose - 101,833 doses, 2nd dose - 77,646 doses) among those in the A3 prioritization group, 98,502 doses (1st dose - 97,446 doses, 2nd dose - 1,056 doses) among those in the A4 prioritization group, and 12,998 doses (1st dose - 7,871 doses, 2nd dose - 5,127 doses) among those in the A5 prioritization group.11 All in all, as of 27 July 2021, 149,122 individuals out of Davao City's target of 1,200,000 individuals (12.43%) have received complete COVID-19 vaccination. In addition, 181,832 individuals have already received the first dose of a two-dose COVID-19 vaccine.8
COVID-19

In November 2009, through Republic Act 9792, Davao Medical Center was renamed Southern Philippines Medical Center (SPMC). This act also provided for the increase in the bed capacity of the hospital from 600 to 1,200 beds.1 The set of implementing rules and regulations for the legislation subsequently specified the increase in the number of health human resources in SPMC to cope up with the hospital's growing number of clients.2 Currently, SPMC has a total of 4,737 personnel, composed of 3,329 employees with plantilla positions and 1,408 employees with non-plantilla positions, deployed to the different divisions of the hospital. Roughly a third of the total personnel are administrative staff, and two thirds are medical and allied medical staff. The Medical Center Chief (MCC) oversees the operations of the whole hospital. Five administrators directly assist the MCC in hospital management: the Chief of Medical Professional Services, the Chief Nurse, the Chief Administrative Officer, the Financial and Management Officer, and the Chief of Allied Professional Services. Due to the increasing bed occupancy rates and the pressing need to increase health human resources in SPMC, an increase in the institution’s bed capacity from 1,200 to 1,500 is presently being proposed through House Bill 7061.3 Once the bill is passed into law, it is expected that additional plantilla items will be created in order to meet the greater operational demands of a bigger hospital.
Hospital Administration ; Hospital Administrators

The Southern Philippines Medical Center (SPMC) is one of the 16 hospitals retained by the Department of Health in Mindanao.1 It has a diverse clientele, mostly coming from the Davao Region (Region XI), SOCCSKSARGEN (Region XII) and Caraga Region (Region XIII). The SPMC Outpatient Department (OPD) consists of the following specialty clinics: Dental Medicine, Dermatology, Otorhinolaryngology - Head and Neck Surgery, Family and Community Medicine, Internal Medicine, Obstetrics & Gynecology, Ophthalmology, Orthopedics, Pediatrics, Physical Therapy and Rehabilitation Medicine, General Surgery, Urology, Cancer Institute, Heart Institute, Institute of Psychiatry and Behavioral Medicine, and Animal Bite and Treatment Center.2 This infographic shows the number of outpatient consultations in SPMC from January to December 2017, which totalled 449,355. The three outpatient departments with the highest numbers of outpatient consultations were: Family and Community Medicine (64,388 consultations), Obstetrics & Gynecology (58,757 consultations), and Internal Medicine (53,270 consultations). SPMC will expand its services in the future with the construction of the institutes or centers for Women and Newborn Health, Cancer, Kidney and Transplant, Orthopedics, Ophthalmology, Dermatology, Pediatrics, and Acute Care and Trauma. Each of these centers is projected to also run its own specialized outpatient services.
Outpatients

The Mindanao Heart Center (MHC) was inaugurated on 14 February 2007. On 10 October 2013, through Hospital Administration No. 174 series of 2013, MHC was renamed Southern Philippines Medical Center Heart Institute (SPMCHI). The Institute offers a wide range of cardiovascular medical and surgical services, including major heart surgeries such as ventricular septal defect (VSD) repair, tetralogy of Fallot (TOF) correction, and coronary artery bypass graft (CABG).
General Surgery

Diseases of epidemic potential are on surveillance using the Philippine Integrated Disease Surveillance and Response (PIDSR) system maintained by the Department of Health (DOH) regional offices. Southern Philippines Medical Center (SPMC) contributes data to this system through the Regional Epidemiology Surveillance Unit of Region XI (RESU XI), which releases summary surveillance reports on a weekly basis. The report itself is a count of patients with disease signs or symptoms, suspected disease conditions, specific clinical diagnoses, or laboratory-confirmed diagnoses. Per DOH policy, a single notification of a measles diagnosis needs confirmation and investigation. An increasing number of cases warrants the initiation of outbreak response immunizations (ORI) by the local government, even before an epidemic is formally declared. Serologic confirmation of measles is performed at the Research Institute for Tropical Medicine (RITM) in Muntinlupa, Alabang.
Disease Outbreaks ; Measles

The Southern Philippines Medical Center (SPMC) is one of the 16 hospitals retained by the Department of Health in Mindanao.1 It has a diverse clientele, mostly coming from the Davao Region (Region XI), SOCCSKSARGEN (Region XII) and Caraga Region (Region XIII). The SPMC Outpatient Department (OPD) consists of the following specialty clinics: Dental Medicine, Dermatology, Otorhinolaryngology - Head and Neck Surgery, Family and Community Medicine, Internal Medicine, Obstetrics & Gynecology, Ophthalmology, Orthopedics, Pediatrics, Physical Therapy and Rehabilitation Medicine, General Surgery, Urology, Cancer Institute, Heart Institute, Institute of Psychiatry and Behavioral Medicine, and Animal Bite and Treatment Center.2 This infographic shows the number of outpatient consultations in SPMC from January to December 2017, which totalled 449,355. The three outpatient departments with the highest numbers of outpatient consultations were: Family and Community Medicine (64,388 consultations), Obstetrics & Gynecology (58,757 consultations), and Internal Medicine (53,270 consultations). SPMC will expand its services in the future with the construction of the institutes or centers for Women and Newborn Health, Cancer, Kidney and Transplant, Orthopedics, Ophthalmology, Dermatology, Pediatrics, and Acute Care and Trauma. Each of these centers is projected to also run its own specialized outpatient services.
Outpatients

Medical assistance programs are government-funded programs that provide financial assistance to low-income individuals and families. These programs aim to reduce financial burdens and improve health care access. Coverage may include outpatient visits, hospital care, mental health services, diagnostic work-ups, prescriptions, and other services. This increases the detection of health conditions and improves drug utilization.1 2 3 Even though government health schemes and compulsory contributory health care financing schemes (e.g., PhilHealth) accounted for the majority of health expenditures in the Philippines, household out-of-pocket (OOP) payment still remains high. In 2022, the country’s total health expenditure (THE) was Php 1.12 trillion, with government health schemes and compulsory contributory health care financing schemes accounting for 44.8% of the THE and household OOP payment accounting for 44.7%. Thus, every Filipino spent an average amount of Php 10,059.49 for health care goods and services in 2022
Medical Assistance ; Health Services Accessibility ; Mental Health Services

Before the COVID-19 pandemic, almost all outpatient consultation services in Southern Philippines Medical Center (SPMC)一from triaging up to the actual consultations with doctors一were done face-to-face (FTF). Seeking medical care during the pandemic became more difficult. Since the start of the community quarantine last March 2020,1 all stakeholders in health care一health care workers, and patients alike一have had to comply with infection control measures like FTF interactions and travel restrictions to reduce COVID-19 transmission. When Davao City was placed under enhanced community quarantine (ECQ) last April 4, 20202, SPMC became the primary government tertiary care institution tasked to handle patients with COVID-19.3 Since then, most of the outpatient services, conducted by clinical departments, were limited to teleconsultations. SPMC created a set of procedures for doing teleconsultations in the Outpatient Department (OPD) to screen patients who need either urgent or routine care, and to either connect these patients to their physicians in the OPD or direct them to an SPMC department/unit outside of the OPD. A patient seeking outpatient consultation should send a private message via the SPMC Virtual Consultation Facebook page. A nurse moderator inquires about the patient’s concern or chief complaint through an online messaging platform and obtains a written informed consent by requesting the patient to reply with “Yes, I give consent” if, after reading the information form, they agree to the terms of the teleconsultation. New patients need to fill up a pre-formatted information sheet and download an app into their communication device. Returning patients are required to send their hospital numbers for record retrieval. The nurse then triages the patient to their designated clinical department. Through phone or online calls via the downloaded app, the resident-on-duty (ROD) contacts the patient, takes the patient’s medical history, requests diagnostic examinations, prescribes medications, and discusses diagnostic examination results and therapeutic plans with the patient, as appropriate. If the need for a physical examination in order to further assess the patient’s condition arises, the ROD obtains another informed consent for an FTF consultation. Before scheduling the patient for an FTF consultation, the ROD determines the patient’s risk of exposure to COVID-19 and directs them to the COVID-19 hotline if their risk is considered to be high. Low-risk patients, on the other hand, are given an appointment schedule and a checklist of requirements needed prior to FTF consultation. On the scheduled date of FTF consultation, the patient is reassessed for the risk of exposure to COVID-19. High-risk patients are redirected to the SPMC COVID-19 isolation area. All patients who physically walk in for outpatient consultation receive instructions from the outpatient triage nurses to follow this teleconsultation process. This report includes data from June 2020 to March 2021. Although the system for teleconsultation was immediately established in SPMC after the city was placed under ECQ,1 the procedures were only refined and strictly implemented in June 2020. Data in this report does not include appointments or consultations directly done in other departments such as SPMC Cancer Institute, Mindanao Heart Center, and Institute of Psychiatry and Behavioral Medicine. With the exception of some patients seen by the Family Medicine (FM) department, all patients who had FTF consultations in this report initially underwent the teleconsultation process, but were subsequently advised to show up for physical examination for further assessment of their conditions. The FM department sees both patients from the general public and those who come to the Personnel Health Services (PHS) of SPMC一including SPMC employees and their dependents. PHS patients, especially those who are already physically within the hospital vicinity when they decide to look for medical attention, have been allowed to seek outpatient care directly by FTF consultations, without the need for prior appointments arranged by teleconsultations. In this report, the FM census is presented as two graphs一the graph for the general public, and that for PHS patients. In general, there was a gradual increase in the frequency of teleconsultations across all departments over the months following June 2020. During the start of 2021, the frequencies of FTF consultations significantly rose in the Internal Medicine and Obstetrics-Gynecology departments. The FTF consultation frequencies also increased, albeit to a lesser degree, in the Dermatology, Ophthalmology, General Surgery, Urology, and ENT-HNS departments. The Orthopedics and Pediatrics departments had very minimal FTF consultations. The Dental Medicine department had no FTF consultations at all from June 2020 to March 2021. We calculated the OPD consultation ratio by dividing the number of FTF consultations with the number of teleconsultations. A higher ratio, expressed in decimals, would imply a higher number of FTF consultations done after teleconsultation. Excluding PHS data, the overall OPD consultation ratio for all departments from June 2020 to March 2021 was 0.17 (i.e., there were 2,557 FTF consultations done after 15,264 initial teleconsultations). The three departments who had the highest OPD consultation ratios for the entire report duration were the Urology (0.38), Internal Medicine (0.34), and Obstetrics and Gynecology (0.25) departments. On the other hand, the three departments with the lowest OPD consultation ratios for the entire report duration were the Orthopedics (0.01), Pediatrics (0.01), and General Surgery (0.10) departments. Data on specific morbidities/diagnoses and dispositions of patients after the teleconsultations or the FTF consultations are not included in this report.