QuestionsQuestions (DOH Administrative Order No. 2015-0006)
The Order is anchored on Republic Act No. 10354 (Responsible Parenthood and Reproductive Health Act of 2012), particularly Section 19.2 and Rule 12 of its IRR, which require the DOH to ensure access to modern family planning services and the inclusion of new and modern methods. Its purpose is to recognize progestin subdermal implants as safe and effective under the national family planning program.
The Order states that the method is considered safe and effective by the National Family Planning Program in line with RA 10354. It also notes FDA certification/registration for Etonogestrel implants and FDA continuing tests to ensure safety, efficacy, quality, and non-abortifacient property, consistent with relevant Supreme Court guidance on the constitutionality/implementation of reproductive health measures.
Progestin subdermal implants are described as long-acting reversible hormonal contraceptives that inhibit ovulation (by suppressing the luteinizing hormone surge) and increase cervical mucus viscosity. They are effective for at least three (3) years upon insertion and are stated to have a low failure rate (5 per 10,000 users).
It requires adherence to the Philippine Clinical Standards Manual on Family Planning (2014 Edition, DM 2014-0311) or subsequent updated versions.
The Order applies to the whole health sector, including both public and private sectors; DOH offices; POPCOM; PhilHealth; LGUs (including ARMM); development partners; private health care providers; and other concerned parties. It is not limited to public facilities.
Provision must follow the principles of informed choice and voluntarism as mandated in DOH AO 2011-0005.
They must be provided at service delivery points (e.g., RHUs, private clinics, public or private hospitals) as part of the full range of modern FP methods. These include all DOH-retained hospitals except special and specialty hospitals not focusing on women’s health, and they may also be offered in outreach settings following the mobile outreach guidelines.
Procurement must be guided by mechanisms and steps specified in relevant issuances, including Rule 4, Sec. 4.10 of the RPRH IRR, the Guidelines on Estimation of Unmet Need for Family Planning (AO 2014-0043), and AO 2012-0009.
It requires distribution through a full-service logistics management system with deliveries made direct to service delivery points, pursuant to the Guidelines on Engaging the Services of a Full Service Logistics Provider (DO 2014-0184). The Logistics Management Division oversees full-service logistics providers subject to procurement laws.
DPCB/WMHDD ensures implementation by developing policies/standards/tools, training design, technical assistance, ensuring implant availability, mobilizing resources, and establishing FP reporting/recording systems. LMD oversees full-service logistics management and monitoring logistics databases (e.g., NOSIRS). HPCS develops and implements FP communication plans and materials. The Epidemiology Bureau provides technical oversight on FHSIS data collection/processing/reporting and helps estimate unmet need for modern FP services for forecasting.
They implement the Order locally by coordinating technical assistance to LGUs/NGOs and stakeholders; reproducing/distributing IEC and training materials; monitoring and evaluating implementation using information systems like FHSIS; ensuring capacity building and quality service provision; and certifying/accrediting training institutions and service providers.
They must include implants in the full range of modern FP methods, create FP outreach teams for insertion/removal needs (especially for urban and rural poor communities), serve as resource/learning centers for technical assistance/training/research, and act as referral facilities for complications and to complement implant services provided by LGUs and other facilities.
It requires continual enhancement of FP clinical competencies and training specifically on provision of progestin subdermal implants. It also requires systems for monitoring and evaluation of performance prior to certification. All DOH regional hospitals and medical centers are designated as training centers, with other institutions eligible for recognition.
Recording and reporting must use existing Field Health Services Information System (FHSIS) forms, including FP Form 1, following FHSIS guidelines. Public providers submit reports through the usual levels of care, while private sector and NGO providers submit service statistics to designated LGU health facilities.
It takes effect fifteen (15) days after approval and publication in a newspaper of general circulation, and after filing a copy with the National Administrative Register (NAR).
It repeals/amends/modifies only those orders, rules, regulations, and issuances inconsistent with or contrary to the Order. Existing provisions in related issuances not affected remain valid. If any provision is declared unauthorized or invalid by a competent authority, the unaffected provisions remain valid and effective.
The FDA must continually conduct appropriate tests prior to issuing authorizations to ensure safety, efficacy, quality, and that the implants are non-abortifacient.
It directs PhilHealth to review existing benefit packages for modern FP and give due consideration to developing mechanisms to finance the provision of progestin subdermal implants.
It tasks POPCOM with generating demand for modern family planning services, including progestin subdermal implants, coordinating with DPCB and HPCS, and ensuring prospective clients with unmet need are referred to appropriate health care providers.