Legal basis, presidential power, and intent
- Proclamation No. 1066 is issued by virtue of the powers vested in the President by law.
- Proclamation No. 1066 recognizes neonatal tetanus as a major threat to children’s lives that is preventable through vaccination of women before childbirth.
- Proclamation No. 1066 frames elimination as a continuing public health effort that should continue until newborns no longer die from neonatal tetanus in the Philippines.
- Proclamation No. 1066 links the campaign’s strategy to World Health Assembly action calling for worldwide elimination of neonatal tetanus.
National policy for elimination campaign
- Proclamation No. 1066 declares a national Neonatal Tetanus elimination campaign targeted at provinces and cities with reported NT cases.
- Proclamation No. 1066 enjoins coordinated action to ensure prevention through vaccination and community health interventions.
- Proclamation No. 1066 anchors the campaign in the role of Local Government Units (LGUs) to meet and resolve local health problems.
- Proclamation No. 1066 requires national coordination through the Department of Health to define campaign details and establish linkages.
Coverage: provinces and cities targeted
- Proclamation No. 1066 targets provinces and cities with reported NT cases.
- Proclamation No. 1066 anticipates that neonatal tetanus clusters in high-risk areas and communities.
- Proclamation No. 1066 contemplates that elimination must be achieved even where national rates appear reduced, because cases may still occur not in each province, city or municipality.
Identification of high-risk areas
- Proclamation No. 1066 requires LGUs to identify NT “high risk” areas using the following indicators:
- a high number of NT cases
- low Tetanus Toxoid (TT) vaccination coverage of women, requiring at least 2 doses of TT before delivery of the baby
- high presence of traditional birth attendants (“hilots”), especially untrained hilots that may mean high numbers of “unclean” births
- absence of available data on any of the above indicators
- Proclamation No. 1066 ties the “high risk” identification to local evidence and data availability, including reliance on data gaps when information is lacking.
LGU duties: lead and implement strategies
- Proclamation No. 1066 enjoins LGUs—specifically province and city levels—to take the lead in implementing NT elimination strategies.
- Proclamation No. 1066 requires LGUs to:
- identify NT “high risk” areas using the indicators on high case counts, TT coverage, hilots presence, unclean births, and/or absence of data
- identify reasons why these problems continue to exist
- conduct thorough information and education campaigns (IEC) to clarify and plan community-wide intervention
- plan community-wide interventions that include immunization of others and women
- monitor and sustain anti-tetanus protection among women of child-bearing age
- monitor the impact of NT elimination statistics
DOH responsibilities: define details and coordinate linkages
- Proclamation No. 1066 enjoins the Department of Health (DOH) to define the details of the NT elimination campaign.
- Proclamation No. 1066 requires the DOH to coordinate the campaign.
- Proclamation No. 1066 requires the DOH to establish necessary linkages to support implementation.
Multi-sector support and participation
- Proclamation No. 1066 enjoins other government agencies to actively support and participate in the campaign.
- Proclamation No. 1066 enjoins non-governmental organizations, civic and religious groups, and professional groups to actively support and participate.
- Proclamation No. 1066 enjoins other private sectors to actively support and participate.
- Proclamation No. 1066 requires collaboration and active participation to sustain the campaign effort.
Duration: until elimination is achieved
- Proclamation No. 1066 states that the campaign and collaboration shall continue until newborns no longer die from neonatal tetanus in the Philippines.