Background: Surgical site infection (SSI) after cesarean section occurs in 3-15% of cases. Surgical irrigation has been widely used as a measure of reducing SSI, however, there are no official guidelines for its practice. Objective: To determine the efficacy of Betaine + Polyhexanide (Prontosan) as anti-septic wound irrigating solution prior to subcutaneous layer and skin closure of cesarean section in preventing surgical site infection Methodology: One hundred thirty-two women who underwent cesarean section were included from April to October 2017. The cesarean section was done according to the standard operating procedure of the hospital. All subjects were given prophylactic antibiotics prior to the cesarean section. Subjects were then randomly assigned, 66 in Prontosan and 66 in Saline as irrigating solution prior to closure of subcutaneous layer and skin. Post-operatively, subjects were monitored and evaluated for signs and symptoms of superficial surgical site infection on Day 3, 7-10 and 30. Results: There was no demographic difference identified between the two groups (age, prepregnancy BMI, obstetric parameters and comorbidities) except that saline group had a higher proportion of emergency cesarean section (84% vs 70%). The incidence of surgical site infection 2 was similar in the two groups (15.15% vs 9.09 % on Day 3, 7.84 % vs 6.78% on Day 7-10, 3.23% vs 0 on Day 30). Conclusion Betaine + Polyhexanide (Prontosan) and Saline wound irrigation showed no reduction in the incidence of superficial surgical site infection in women undergoing cesarean section.
Cesarean Section ; Infections

Objective: To determine the impact of Mother-Baby Friendly Hospital Initiative (MBFHI) implementation on the success of breastfeeding practices among patients who gave birth in a tertiary hospital. Methodology: Seventy-one postpartum patients who have no contraindications to breastfeeding were recruited from September-November 2017. Outcome variables regarding on the success of breastfeeding initiation on the first hour postpartum and hospital stay were measured. Participants were followed-up by phone call at 3 and 6-months postpartum to determine their practice on exclusive breastfeeding. Results: The exclusive breastfeeding (EBF) rates at first hour postpartum, during hospital stay, 3 and 6 months were 91.5%, 81.7%, 65.9%, and 45.5%, respectively. The participants who had cesarean delivery and vaginal delivery were 19 (26.8%) and 52 (73.2%) respectively. There was no significant association between the route of delivery and successful breastfeeding at first hour (p = 0.179). At first hour postpartum, majority of the infants who did not initiate breastfeeding was due to respiratory distress. At 6 months, only 39% (26 out of 66) did proper breastfeeding. There were 26 out of 66 (39%) subjects who have work at 6 months, and among these, 12 subjects were not able to collect and store milk due to unavailability of lactation clinic at their workplace. Overall, approximately half of the subjects who initiated EBF were not able to continue EBF until 6 months due to inadequate milk production and resumption of work. Conclusion Half of mothers exclusively breastfed up to 6 months, regardless of age, parity and route of delivery. The main determinants of EBF cessation at 6-month postpartum include inadequate milk production, resumption of work and inability to collect milk. To promote successful EBF among mothers in the Philippines, interventions should focus on strengthening the breastfeeding policy implementation in the workplace and communities to promote, protect and maintain breastfeeding.
Breast Feeding

This capstone project of the Master in Public Health International of the Faculty of Medicine and Surgery initiated the development of community health programs. Phase 1K, Kasiglahan Village, Barangay San Jose, Rodriguez, Rizal, a partner community of the University of Santo Tomas - SIMBAHAYAN Community Development Office was chosen as the primary stakeholder for the implementation of this capstone project.

Addressing the identified priority problem of lacking a community-based strategy in the community, the project aimed to initiate community-based prevention of cardiovascular diseases (CVDs) through risk factor reduction in Phase 1K-Kasiglahan Village, Barangay San Jose, Rodriguez, Rizal at the end of the 6-week project timeline. Specifically, the project aimed (1) to increase the mobilization of the community through a consultative workshop, (2) to raise awareness of the community through Information, education, and communication (IEC) materials, and (3) to increase the baseline knowledge of the community through public health education lay forum.

The project outputs include (1) mobilization of the community leaders in identifying their own health problems and in formulating their interventions, (2) posting and distribution of IECs in the community, and (3) increased baseline knowledge after the public health education lay forum.

With the potential of influencing local policies to improve the health of the community, this project was formally and officially endorsed to the community through its local government leaders, rural health unit officials, and community leaders.

Proper maternal nutrition evidently results in good pregnancy outcomes both for the mother and born infant. However, the process leading to good nutrition during pregnancy remains a challenge most especially during public health emergencies, such as the COVID-19 pandemic, which brought limitations on access to a variety of foods as well as nutrition services. Thus, nutrition education through the provision of contextualized information, education and communication (IEC) materials was explored as an alternative delivery strategy. The delivery strategy aims to increase the number of pregnant women in Barangay Palanan, Makati City, Philippines who have adequate nutrition knowledge through IEC materials-based nutrition education that is contextualized during public health emergencies. As an outcome, the delivery strategy intends to increase the number of pregnant women who have normal nutritional status as determined by weight per month of pregnancy. Results in determining the adequacy of nutrition knowledge through pre- and post-testing show that there is a 10% increase in the passing rate from 59% at baseline to 69% at endline. From the number of pregnant women who have taken the post-test, a remarkable 52% have either post-test scores that are maintained or improved. Meanwhile, for pregnant women who have normal nutritional status, an increase of 5% was seen given by 46% at baseline to 51% at endline. Ultimately, IEC materials-based nutrition education may serve as a supplementary approach in the continuous provision of nutrition services to attain good nutrition of pregnant women amid the COVID-19 pandemic.