QuestionsQuestions (DOH ADMINISTRATIVE ORDER NO. 2010-0014)
It is a DOH administrative issuance aimed to strengthen the capacity of midwives to appropriately respond to pregnancy-related complications by allowing, under conditions, the administration of life-saving drugs and medicines to reduce maternal and neonatal morbidity and mortality.
Life-Saving Drugs are medicines used to prevent and manage pregnancy-related complications, including Magnesium Sulphate, Oxytocin, Steroids, and oral antibiotics.
Examples include pre-eclampsia, eclampsia, post-partum hemorrhage, premature labor, and infections.
It allows midwives, in addition to existing functions under Section 23 of the Midwifery Act of 1992, to administer specific life-saving drugs (MgSO4, oxytocin, steroids, oral antibiotics) when appropriately trained/certified and during emergency conditions when no physician is available.
The midwife must be appropriately trained and certified proficient to perform the necessary E/EmONC care and services, specifically through the required two-part in-service training (didactic and practicum) and passing post-training evaluation.
Training is two-part (formal/didactic and practicum) using approved modules; the midwife must pass a written post-training evaluation after the formal part before practicum, and must complete practicum within six months to be issued a certificate of proficiency.
The interventions are meant to be provided under emergency conditions when no physician is available.
It states that the listed life-saving drugs should be used in accordance with the clinical practice protocol: MgSO4 for eclampsia, oxytocin for AMTSL and initial management of post-partum hemorrhage, steroids for preterm labor, and antibiotics for infections.
POGS issues proficiency certification to midwives they directly trained practicing in the areas they covered, upon satisfactory completion of practicum.
Every midwife should be supervised by the municipal, district, city, or provincial health officer or senior midwife supervisors, with technical guidance from POGS for maternal care and PSNbM and/or PPS members for newborn/neonatal care, wherever possible.
Yes. It provides that midwives shall be provided with legal assistance if this becomes necessary in relation to their performance as E/EmONC providers, such as in administering life-saving drugs.
POGS conducts training of midwives in training institutions nationwide, issues proficiency certifications to directly trained midwives in covered areas, and conducts monitoring/coaching/field visits to assist midwives.
They coordinate with POGS for newborn care training, monitoring/coaching/field visits related to newborn care, and coordination in regular maternal and newborn death reviews (under MDR and PDR protocols).
LGUs must ensure midwives have updated licenses and provide financial support for training, ensure continuous availability of supplies/equipment/drugs, develop infrastructure for quality E/EmONC, support training and death reviews in LGU facilities, activate membership of the local health board, ensure PhilHealth MCP accreditation, and set up functional referral systems for continuum of care.
It requires quality assurance and clinical audit at least once a month by DOH-CHDs’ local health support division and its retained hospitals, with progress reports submitted to the Office of the Secretary; it also provides for an annual implementation review with stakeholders.
It revises, modifies, repeals, or rescinds prior orders and related issuances inconsistent or contrary to the provisions of DOH AO 2010-0014; other provisions of existing issuances not affected remain valid.
It takes effect immediately 15 days after publication in major newspapers.