BACKGROUND & OBJECTIVE: Midwives have been the country's frontline health care providers in communities. Their role was expanded from largely providing maternal and child care services in the 1920s to provision of basic Primary Health Care services since 1970s. Despite their extensive roles, there has been no comprehensive enquiry on the professional practice of midwifery in the Philippines since it formally started in 1901. This study was conducted to (1) describe the evolution of midwifery education and regulation; (2) describe professional practice of midwifery and the midwives' role in the local health system; (3) identify gaps in the current midwifery practice, and; (4) recommend to improve and standardize the competencies of practicing midwives.

METHODOLOGY: The study is qualitative with a grounded theory approach using face-to-face Key Informant Interview (KII), Focus Group Discussion (FGD), and document review. The study, conducted from January to December 2015, purposively sought experts from different fields of midwifery, including midwifery-service providers, birthing home managers from public and private sector, academe, Department of Health (DOH), development partners, the country's three leading midwifery organizations, and the Board of Midwifery (BOM) of the Philippine Professional Regulation Commission (PRC).

RESULTS: Changes in midwifery education, scope of practice and standards were in response to the country's health challenges in maternal and child health. Public midwives were frontline implementors of 57 DOH programs. Despite their vital role and expanded workload, the tenure or plantilla positions of government midwives continued to have the same salary grade promulgated in 2000 while others, although the numbers are unknown, do not have security of tenure. There were no learning and development initiatives designed to enable midwives to become implementors of multiple programs. Regulation of midwifery practice was not cohesive. The standards of practice were program-based and were scattered in different policies.

RECOMMENDATION: The study recommends that the DOH, PRC, and midwives' organizations review and revise the scope of midwifery practice in line with global standards, as well as to implement a competency-based career development pathway that is integrated with the regulatory system.

Professional Practice ; Midwifery ; Primary Health Care

Objective: Despite the provision of local health policies promoting the utilization of sexual and reproductive health (SRH) services of adolescents, SRH services utilization remains very low and little information is known concerning the factors which may influence adolescents' use of these SRH services. This study aimed to determine the prevalence and determinants of school-based SRH services utilization among secondary school students.

Materials and Methods: This is a cross-sectional study that used a self-administered questionnaire to gather data among students in one public secondary school in the City of Dasmariñas. A total of 24 sections from Grades 8 to 12 were randomly selected using stratified cluster sampling. Both descriptive and inferential statistics were used to analyze the data using Epi Info version 7.3.2.1.

Results: Among 1,218 students who answered the questionnaire, 168 students (13.8%) utilized the SRH services in the Teen Health Kiosk (THK) during SY 2019-20. Students with favorable attitudes towards SRH issues (predisposing factor) were twice more likely to utilize the SRH services (Adjusted odds ratio, AOR 1.75, 95% CI 1.12-2.74) and those who have positive perceived accessibility on the SRH services (enabling factor) were 2.5 times more likely to utilize the SRH services (AOR 2.46, 95% CI 1.66 - 3.66).

Conclusion: Attitudes towards SRH issues and perceived accessibility to SRH services were found to be determinants of SRH services utilization in the THK of the selected public secondary school in the City of Dasmariñas. Even with the marked increase in the utilization of SRH services in the THK from 0.2% in SY 2018-19 to 13.8% in SY 2019-20, intensified efforts are still needed in order to target students' attitudes on SRH and accessibility of THK and the SRH services it offers to its clients. It is recommended that the existing THK Club be strengthened as this will play a significant role in changing the attitudes of students towards SRH issues, thus increasing the utilization of SRH services. Additionally, formulating an SRH policy at the school level targeting THK's accessibility will be helpful in increasing the utilization of school-based SRH services. For one, a policy mandating THK service providers to deliver services beyond school hours may be discussed such that it can also cater students who are attending the school during weekends (i.e. ALS students, Open High students). Likewise, policy makers in the City Schools Division Office including their top management and personnel from the Health and Nutrition Unit as well as school administrators must endeavor to provide a more conducive THK where privacy and confidentiality can be maintained at all times and clients can freely discuss SRH issues with the THK service provider. An initiative to provide a separately detached room for the THK is encouraged in order to provide a more suitable counselling area and to ensure privacy and confidentiality of student clients and their shared information.

Adolescent ; Sexual Health ; Reproductive Health

BACKGROUND: New findings on the detrimental health effects of electronic nicotine delivery system (ENDS)/ electronic non-nicotine delivery system (ENNDS) confounds the "harm reduction" perspective of using it as an alternative to conventional cigarettes. In the Philippines, the pressing debate on its safety and efficacy had initiated actions from policy makers on legislative issues such as draft DOH Administrative Order, House Bill 4325 and House Bill 532.

OBJECTIVE: The study aimed to craft an evidence-based policy position on the regulation of ENDS/ENNDS.

METHODS: Review of literature was conducted, and the proposed scope and measures on electronic cigarette regulation were compared with WHO Framework Convention on Tobacco Control (WHO-FCTC) and existing policies of US FDA regulations on ENDS. Further, UP Manila convened experts of various related fields for evidence-based review and discussion of policy issues to arrive at a consensus policy statement and recommendations. Results. Findings showed that ENDS/ENNDS still need further research to have conclusive results on long term safety and efficacy as smoking cessation methods.

CONCLUSION: Regulations for tobacco control should be clear and supported with strict guidelines in manufacturing, distribution, advertisement, selling, and usage restrictions in public. With the current review, it is recommended that ENDS/ENNDS regulation be under the mandate of the FDA in alignment to WHO-FCTC and to engage different stakeholders from policy makers, implementers, and other involved organizations.

Human ; Smoking, Non-tobacco Products--legislation & ; Jurisprudence ; Smoking Devices

Background: The College of Public Health, University of the Philippines Manila (CPH-UPM) was engaged by the Center for Health Development Calabarzon (CHD 4A) to design, implement and manage the retooling of their personnel following implementation of Executive Order No. 336 on the rationalization of the Philippine government’s executive branch. Objective: To describe the training design and present outputs of the training modules designed for the CHD 4A staff. Methods: We reviewed the project documentation, which included the inception report, minutes of meetings, training modules, and post-training reports. Abstracted information was validated through internal discussion by a core group, which had representatives from the two organizations involved from project inception to close-out. Results: The design, development and implementation of the training were the product of collaborative efforts between CHD 4A and the technical team from the College of Public Health, University of the Philippines Manila. Technical staff of CHD 4A were trained in the competency areas in which gaps between the expected and perceived level of performance across all salary grades were highest: results orientation, planning and organizing, technical expertise, quality service focus, coordination and networking, and managing change. Nine training courses were implemented from May to July 2016, which was attended by 230 participants. All training modules were highly rated by participants (range: 3.60 to 3.85) based on a four-point scale, with 4 as the highest rating and 1 as the lowest. Comparison of pre- and post-tests for the modules on coordination and networking, and managing change showed a statistically significant increase in scores at the conclusion of their respective sessions. Conclusion The design of a training program for an organization’s personnel must be tailor-fit to and answer the needs of its employees. Trainers must be willing to make dynamic changes and adapt to immediate feedback from participants. The implementing party and organization itself must both ensure thorough evaluation of the effects of the training to achieve the organization’s long-term goals.
Staff Development ; Teaching ; Education ; Workforce