MCN lab mod 13 - Scopes and Standards

60 days, 30 days, 45 days, 15 days

105-Day Expanded Maternity Leave Law (R.A. No. 11210): Paid maternity leave is available to all working mothers, regardless of their civil status and legitimacy of their child. Women who suffer a miscarriage or have an emergency termination can take up to ____ days of paid maternity leave. Leave can also be extended for additional ____ days, but it is without pay, subject to notifying their employer ____ days before the end of the leave. While mothers who are single parents can request for an additional _____ days' leave with full pay.

"in vitro fertilization" (IVF), "birth mother."

A technique called _____________________________ now makes it possible to gather eggs from the mother, fertilize them with sperm from the father, and place the embryo into the uterus of a gestational surrogate. The surrogate then carries the baby until birth. She doesn't have any genetic ties to the child because it wasn't her egg that was used. A gestational surrogate is called the ____________________. The biological mother, though, is still the woman whose egg was fertilized.

a.Surrogacy/Gestational Surrogacy b.Adoption

Alternative Methods of Birth:

"Healthcare Provider Response to Abuse -Any healthcare provider, including, but not limited to, an attending physician, nurse, clinician, barangay health worker, therapist or counselor who suspects abuse or has been informed by the victim of violence shall: (a) properly document any of the victim's physical, emotional or psychological injuries; (b) properly record any of victim's suspicions, observations and circumstances of the examination or visit; (c) automatically provide the victim free of charge a medical certificate concerning the examination or visit; (d) safeguard the records and make them available to the victim upon request at actual cost; and (e) provide the victim immediate and adequate notice of rights and remedies provided under this Act, and services available to them."

Anti-Violence Against Women and Their Children Act of 2004 (R.A. No. 9262) Section 31: The said provision states:

Section 41 "Mandatory Programs and Services for Victims. -The DSWD, and LGU's shall provide the victims temporary shelters, provide counseling, psycho-social services and /or, recovery, rehabilitation programs and livelihood assistance. The DOH shall provide medical assistance to victims."

Anti-Violence Against Women and Their Children Act of 2004 (R.A. No. 9262): To ensure protection of women and children provides f Section ____ or the mandate for the governmental agencies to provide services to the victim, it thus states:

maternal and child care, Board of Nursing in 2003

Article VI, Section 28: In this provision ___________________________ is one of the scopes of nursing practice. The same scope is echoed in the Implementing Rules and Regulations of the law issued by the ___________________ in _______.

(a) Provide nursing care through the utilization of the nursing process. Nursing care includes, but not limited to, traditional and innovative approaches, therapeutic use of self, executing health care techniques and procedures, essential primary health care, comfort measures, health teachings, and administration of written prescription for treatment, therapies, oral, topical and parenteral medications, internal examination during labor in the absence of antenatal bleeding and delivery. In case of suturing of perineal laceration, special training shall be provided according to protocol established; (b) Establish linkages with community resources and coordination with the health team; (c) Provide health education to individuals, families and communities; (d) Teach, guide and supervise students in nursing education programs including the administration of nursing services in varied settings such as hospitals and clinics; undertake consultation services; engage in such activities that require the utilization of knowledge and decision-making skills of a registered nurse; and (e) Undertake nursing and health human resource development training and research, which shall include, but not limited to, the development of advance nursing practice;

Article VI, Section 28: It shall be the duty of the nurse to:

Article VI, Section 28

Article _____, Section ____: Provided, That this section shall not apply to nursing students who perform nursing functions under the direct supervision of a qualified faculty: Provided, further, That in the practice of nursing in all settings, the nurse is duty-bound to observe the Code of Ethics for nurses and uphold the standards of safe nursing practice. The nurse is required to maintain competence by continual learning through continuing professional education to be provided by the accredited professional organization or any recognized professional nursing organization: Provided, finally, that the program and activity for the continuing professional education shall be submitted to and approved by the Board.

National Immunization Program, Expanded Program on Immunization (EPI), tuberculosis, poliomyelitis, diphtheria, tetanus, pertussis and measles

Children who are not fully immunized are more susceptible to common childhood diseases. To address this problem in 1976, the ___________________________________________ was established. It included six vaccine-preventable diseases were initially included in the ____: _____________, _________________, ______________, __________________, _____________ and ______________.

seven (7) articles and eighteen (18) sections,

Code of Ethics: The code comprises of _____________ articles and _________________ sections, which as a whole provide guidelines to nurses on how to carry out the profession.

Article I

Code of ethics: _____________ of the code provides for the primary responsibility of a nurse to preserve health at all cost including the assistance to peaceful death. It also emphasizes the responsibility to a nurse to gain knowledge to understand every aspect of a client to render effective care and to always maintain the highest possible degree of ethical conduct.

hematopoietic transplantation, corneal resurfacing with limbal stem cells, and skin regeneration with epidermal skin cells all others are considered illegal. Issues regarding this is the consent of use and ownership of the cord blood. However, to regulate cord blood banking in the Philippines the same law for blood banking is applied.

Cord Blood Banking: In the Philippines however, although with the promising results of HSC Therapy in other jurisdictions, only limited stem cell therapy is allowed. According to the Food and Drug Administration (FDA) only the following are recognized as acceptable or standard healthcare procedures:

autologous transplant, allogenic transplant

Cord Blood Banking: It is also important to consider is ________________________ wherein the blood collected at birth is used by that same child. This type of transplant is rarely done because a child's HSC cannot be used to treat genetic diseases in that child since all the HSCs have the same genes that cause the disease and that HSC of that child cannot be used to treat that child's leukemia. In most cases, _______________________ is preferred where another person's stem cells are used to treat a child's disease.

1. HSC from cord blood can be given to more people than those from bone marrow since they are less likely to cause rejection compared with the latter; 2. There is less risk in the collection of cord blood; 3. Cord blood can be frozen and store while bone marrow must be used soon after collection; 4. HSC can strengthen the immune system during cancer treatment while bone marrow do not have the same capability. It must be noted that cord blood does not contain many HSCs. Unit from several donors can be combined to increase the number of HSC needed for transplant.

Cord Blood Banking: The use of HSC to treat a disease has several benefits compared with using bone marrow namely:

Abortion

Defined as the willful killing of the fetus in the uterus, or violent expulsion of the fetus from the maternal womb which results in the death of the fetus.

1. National Safe Motherhood Programs 2. Integrated Management of Childhood Illnesses (IMCI) 3. National Family Planning Program 4. Newborn Screening Program 5. Unang Yakap (Essential Newborn Care: Protocol for New Life) 6. National Immunization Program 7. Food Fortification Program

Department of Health Programs:

National Family Planning Program

Department of Health Programs: A nationwide mandated priority public health program aiming for the country's national health development: a health intervention program and an important tool for the improvement of the health and welfare of mothers, children, and among other members of the family. The program also includes information dissemination and services for the couples of reproductive ages to plan for their family according to their beliefs and circumstances through legally and medically acceptable family planning methods.

Integrated Management of Childhood Illnesses (IMCI), five (5)

Department of Health Programs: It is an integrated approach to child health that focuses on the well-being of the whole child. Its aim is to reduce death and disability and to promote growth and development among children under ________ years of age. _______ include curative and preventive elements that are implemented by families and communities and by health facilities.

Unang Yakap(Essential Newborn Care: Protocol for New Life)

Department of Health Programs: One of the governments strategies towards the attainment of MDGs 4 and 5. _________________ is best described as "simple cost-effective newborn care intervention" intended to enable improved neonatal and maternal care.

Food Fortification Program, Republic Act No. 8976, Sangkap Pinoy Program Seal

Department of Health Programs: The Philippine government's response to the growing micronutrient malnutrition, which has been prevalent in the country. RA ____________ otherwise known as ""An Act Establishing the ________________________________ and for other purposes" mandated fortification of flour, oil, sugar with Vitamin A and flour and rice with iron by November 7, 2004 and promoting voluntary fortification through _____________________________.

National Safe Motherhood Programs

Department of Health Programs: With the vision for Filipino women to have access to health services towards making their pregnancy and delivery safer the DOH is committed to provide rational and responsive policy direction to its local partners in the delivery of quality maternal and newborn health services with integrity and accountability using proven and innovative approaches.

"It is a universally accepted principle that every human being enjoys the right to life. Even if not formally established, the right to life, being grounded on natural law, is inherent and, therefore, not a creation of, or dependent upon a particular law, custom, or belief. It precedes and transcends any authority or the laws of men. In this jurisdiction, the right to life is given more than ample protection. Section 1, Article III of the Constitution provides: Section 1. No person shall be deprived of life, liberty, or property without due process of law, nor shall any person be denied the equal protection of the laws. xxxxxx When Life Begins*Majority of the Members of the Court are of the position that the question of when life begins is a scientific and medical issue that should not be decided, at this stage, without proper hearing and evidence. During the deliberation, however, it was agreed upon that the individual members of the Court could express their own views on this matter. In this regard, the ponente, is of the strong view that life begins at fertilization. In answering the question of when life begins, focus should be made on the particular phrase of Section 12 which reads: Section 12. The State recognizes the sanctity of family life and shall protect and strengthen the family as a basic autonomous social institution. It shall equally protect the life of the mother and the life of the unborn from conception. The natural and primary right and duty of parents in the rearing of the youth for civic efficiency and the development of moral character shall receive the support of the Government. Textually, the Constitution affords protection to the unborn from conception. This is undisputable because before conception, there is no unborn to speak of. For said reason, it is no surprise that the Constitution is mute as to any prescription prior to conception or when life begins. The problem has arisen because, amazingly, there are quarters who have conveniently disregarded the scientific fact that conception is reckoned from fertilization. They are waving the view that life begins at implantation. Hence, the issue of when life begins. xxxxxxLife is not synonymous with civil personality. One need not acquire civil personality first before he/she could die. Even a child inside the womb already has life. No less than the Constitution recognizes the life of the unborn from conception, that the State must protect equally with the life of the mother. If the unborn already has life, then the cessation thereof even prior to the child being delivered, qualifies as death."

Embryonic Stem Cell Research: However, considering the strict view of the Philippines to right to life this raises an ethical concern. The Supreme Court in the benchmark case of Imbong v. Ochoa a case that petitioned the RH Law to be declared unconstitutional, the Court clearly stated the position of the State regarding the right to life of the unborn. To wit:

DSWD-licensed agency, UN Convention on the Rights of the Child (September 2, 1990), the 1995 Hague Convention on the Protection of Children and Cooperation in Respect of Inter-country Adoption (January 8, 1996), and Art. 184 of the Family Code.

Generally, the statutes provide for the guidelines and requirements needed for adoption to be legal. Adoption may be initiated by agency adoption where a _______________________ finds adoptive families for children. While intercountry adoption measures were enacted in response to the ___________________________________________________________________________________________________________________________________________________________________________________________________.

laws and policy

Hence the State by enacting ______ and _______ making ensures the health of the citizens who serves as the foundation of its existence. The State to fulfill its duties to its people is mandated to adopt and integrate comprehensive approach to health development which shall endeavor to make essential goods, health and other social services available to all the people at affordable cost.

Embryonic Stem Cell Research

Hence, considering the Court's pronouncement as to Philippine jurisdiction it can be said that ____________________________ or harvesting is illegal since it violates the basic law of the land.

Intrauterine Fetal Surgery

Historically, the gold standard for the treatment of congenital malformations has been planned delivery at tertiary care center with attempted post-natal repair or amelioration of the lesion. Over the last few decades however, rapid advances in imaging and instrumentation technology combined with superior knowledge of fetal pathophysiology has led to the development of novel intrauterine interventions for most common fetal anomalies.

therapeutic abortion

However, there are several instances where abortion is allowed this only considered necessary especially if the life of the pregnant woman is at risk. This procedure is known as ______________________.

human genome sequence, 3 billion DNA letters, 99 percent, 99.99 percent

In 2003, an accurate and complete ___________________________________ was finished and made available to scientists and researchers two years ahead of the original Human Genome Project schedule. This international effort to sequence the ________________ letters in the human genome is considered by many to be one of the most ambitious scientific undertakings of all time, even compared to splitting the atom or going to the moon. The finished sequence produced by the Human Genome Project covers about _____percent of the human genome's gene-containing regions, and it has been sequenced to an accuracy of _________ percent. In addition, to help researchers better understand the meaning of the human genetic instruction book, the project took on a wide range of other goals, from sequencing the genomes of model organisms to developing new technologies to study whole genomes.

adoption

In Philippine context _________ is regulated by the Civil Code, Family Code, Republic Act No. 8552 otherwise known as Domestic Adoption Act of 1998 and Republic Act No. Inter-Country Adoption Act of 1995.

surrogacy

In _______________, an embryo is created using an egg and sperm produced by the intended parent(s) (or donors) and is transferred into the surrogate's uterus. The surrogate has no genetic link to the child. Her eggs cannot be used to conceive the child.

therapeutic abortion

In other jurisdictions __________________________ is allowed in several cases like pregnancy is a result of incest or rape, the pregnant women suffers from a medical condition that is life or health threatening such as eclampsia, diabetes, hypertension and cancer, pregnancy is at risk of fetal death and pregnancy is at risk of fetal impairment causing the baby to develop mental or physical defects or die after birth.

Surrogacy

In the Philippines _______________ remain underdeveloped because of many risks involved in the process. ____________ is shrouded with secrecy due to its legal predicaments and its non-conformity with Catholic belief system that dominates Philippine society.

Senate Bill 2344

In the current climate, surrogacy in general is still illegal in the country. This can be gleaned upon by a ___________________ filed by former Senator Manny Villar during the 13th Congress which aims to prohibit surrogate motherhood including infant selling. However, until today, this bill is still unacted and was not yet passed into law.

Assisted reproductive technology (ART)

In the local setting although _______ is allowed in the Philippines no existing law that allows or prohibit this procedure. National registry is administered by the national health authority and/or medical organization however, in the Philippines such reporting is not compulsory. In the same note, _____ is only available to couples who are legally married in the Philippines and the same is not available or permitted outside heterosexual unions.

Assisted reproductive technology (ART)

Infertile couples prefer ______ techniques over adoption because they are deemed more viable as an option due to parent's overwhelming desire to have a genetic connection to their own children; that is, they want to play some role in the pregnancy and contribute genetic material to the baby.

Article XIII, Section 14

It also recognizes the role of women and the youth in nation building, the same is echoed in Article ______, Section _____ of the Constitution, which mandates the State to provide a safe and healthful working conditions for women, taking into account their maternal functions and to provide facilities and opportunities that will enhance their welfare and enable them to realize their full potential in the service of the nation.

Traditional surrogate

It's a woman who gets artificially inseminated with the father's sperm. She then carries the baby and delivers it for you and your partner to raise. A t______________________ is the baby's biological mother. That's because it was her egg that was fertilized by the father's sperm;

i. Comprehensive health services and health information and education covering all stages of a woman's life cycle, and which addresses the major causes of women's morbidity and mortality, including access to among others maternal care, responsible, ethical, legal, safe and effective methods of family planning, and encouraging healthy lifestyle activities to prevent diseases; ii. Gynecological leave—leave benefits of two (2) months with pay based on gross monthly income/compensation, for women employees who undergo surgery caused by gynecological disorders, provided that they have rendered continuous aggregate employment service of at least six (6) months for the last twelve (12) months; iii. Equal rights in all matters relating to marriage and family relations. The State shall ensure the same rights of women and men to: enter into and leave marriages, freely choose a spouse, decide on the number and spacing of their children, enjoy personal rights including the choice of a profession, own, acquire, and administer their property, and acquire, change, or retain their nationality. It also states that the betrothal and marriage of a child shall have no legal effect. iv. Review amendment or repeal of laws that are discriminatory to women. v. Mandate access to information and services pertaining to women's health.

Key features of the law Magna Carta of Women (R.A. No. 9710) are:

1. Abortion 2. Cord Blood Banking 3. Embryonic Stem Cell Research 4. Human Genome Project 5. Intrauterine Fetal Surgery 6. Reproductive Assistance 7. Alternative Methods of Birth 8. Privacy and Confidentiality 9. Informed Consent

Legal and Ethical Issues:

Adoption

Legally ___________ is a two-step judicial process in conformance to state statutory provisions in which the legal obligations and rights of a child toward the biological parents are terminated and new rights and obligations are created between the child and the adoptive parents.

Assisted reproductive technology (ART)

Many countries have taken steps to regulate certain aspects of _______. Specifically, what regulations and laws should be in place for ART reporting, social inequities that may arise from financial barriers to it, genetic testing, emerging laboratory techniques that have improved embryo and gamete survival when cryopreserved, and an individual's right to their genetic offspring in the setting of gamete or embryo donation are aspects of ______ which will become increasingly controversial and debated into the future. However, the lion's share of ethical and legal questions that exist surrounding ________ have yet to be resolved. Society must reconcile how to fund ________ in a responsible and equitable manner to increase access to care. Additionally, the myriad of unresolved issues surrounding gamete and embryo donation must be addressed in greater detail in future social and legal dialogues.

surrogate

Moreover, the relationship dynamic between the intended parents and the ______________ mother changes. The _______________ eventually becomes powerless after giving birth as whatever amount of contact she will have with the baby will be dictated by the intended parents afterward.

i. Collaborating with Local Government Units in establishing sustainable, cost-effective approach of delivering health services that ensure access of disadvantaged women to acceptable and high quality maternal and newborn health services and enable them to safely give birth in health facilities near their homes ii. Establishing core knowledge base and support systems that facilitate the delivery of quality maternal and newborn health services in the country.

National Safe Motherhood Programs: The Program contributes to the national goal of improving women's health and well-being by:

Component A i. Establishment of critical capacities to provide quality maternal-newborn services through the organization and operation of a network of Service Delivery Teams consisting of: 1.Barangay Health Workers 2.BEmONC Teams composed of Doctors, Nurses and Midwives ii. In collaboration with the Centers for health Development and relevant national offices: Establishment of Reliable Sustainable Support Systems for Maternal-Newborn Service Delivery through such initiatives as: 1. Establishment of Safe Blood Supply Network with support from the National Voluntary Blood Program 2. Behavior Change Interventions in collaboration with the Health Promotion and Communication Service 3. Sustainable financing of maternal -newborn services and commodities through locally initiated revenue generation and retention activities including PhilHealth accreditation and enrolment.

National Safe Motherhood Programs: The program is composed of two components. _________________ focuses with the local delivery of maternal-newborn service packages. In each province and city, the following shall continue to be undertaken:

i. Operational and Regulatory Guidelines 1. Identification and profiling of current FP users and identification of potential FP clients and those with unmet need for FP (permanent or temporary methods) 2. Mainstreaming FP in the regions with high unmet need for FP 3. Development and dissemination of Information, Education Communication materials 4. Advocacy and social mobilization for FP ii. Network of Training Providers iii. Monitoring, Evaluation, Research, and Dissemination with support from the Epidemiology Bureau and Health Policy Development and Planning Bureau 1. Monitoring and Supervision of Private Midwife Clinics in cooperation with PRC Board of Midwifery and Professional Midwifery Organizations 2. Maternal Death Reporting and Review System in collaboration with Provincial and City Review Teams 3. Annual Program Implementation Reviews with Provincial Health Officers and Regional Coordinators.

National Safe Motherhood Programs: ________________ on the other hand focuses on National Capacity to Sustain Maternal-Newborn Services:

postpartum depression

Negative emotional and psychological effects are further imposed on a surrogate during her pregnancy. Attachment to the fetus is one such effect and indeed, it is found that women who do not distance themselves from the baby tend to fall into _____________________ over the relinquishing of the baby and abdication of all parental rights.

therapeutic abortion

One specific instance is in cases of ectopic pregnancy which requires surgery as a means of saving a woman's life. But it must be noted that in Philippine jurisdiction this is the only allowed _______________________. No specific law or jurisprudence exist in the Philippines that supports or allows ______________________. Any health care worker who shall commit or assist in doing so will suffer the penalty of imprisonment, fine or both including administrative liability.

i. Enhance capacity and capability of health facilities in the early recognition, management and prevention of common childhood illness 1. This will entail improvements in the flow of services in the implementing facilities to ensure that every child receive the essential services for survival, growth and development in an organized and efficient manner. Facilities should be equipped with the essential instruments, equipment and supplies to provide the services. Health providers shall have the knowledge and skills to be able to provide quality services for children. Existing child health policies, guidelines and standards shall be reviewed and updated, and new ones formulated and disseminated to guide health providers in the standard of care. ii. Strengthening community-based support systems and interventions for children's health 1. Notable community-based projects and interventions, such as the health and nutrition posts, mother support groups, community financing schemes shall be replicated for nationwide implementation. Model building and dissemination of best practices from pilot sites has proven effective in generating support and adoption in other sites. More of these shall be initiated particularly for developing interventions to increase care-seeking and prevention of malnutrition in children. iii. Fostering linkages with advocacy groups and professional organizations and to promote children's health 1. Collaboration with the nongovernment sector and professional groups shall: a. Conduct national campaigns on children's health b. Conduct and support national campaigns for children c. Initiate and support legislations and researches on children's health and welfare d. Development of comprehensive monitoring and evaluation system for child health programs and projects.

Philippine National Strategic Framework for Plan Development for Children, 2000-2025 (Child 21): Strategies and activities under this program are the following:

(1) Family planning information and services which shall include as a first priority making women of reproductive age fully aware of their respective cycles to make them aware of when fertilization is highly probable, as well as highly improbable; (2) Maternal, infant and child health and nutrition, including breastfeeding; (3) Proscription of abortion and management of abortion complications; (4) Adolescent and youth reproductive health guidance and counseling; (5) Prevention, treatment and management of reproductive tract infections (RTIs), HIV and AIDS and other sexually transmittable infections (STIs); (6) Elimination of violence against women and children and other forms of sexual and gender-based violence; (7) Education and counseling on sexuality and reproductive health; (8) Treatment of breast and reproductive tract cancers and other gynecological conditions and disorders; (9) Male responsibility and involvement and men's reproductive health; (10) Prevention, treatment and management of infertility and sexual dysfunction; (11) Reproductive health education for the adolescents; and (12) Mental health aspect of reproductive health care.

Responsible Parenthood and Reproductive Health Law (R.A. No. 10354): It also provides reproductive health care which refers to the access to a full range of methods, facilities, services and supplies that contribute to reproductive health and well-being by addressing reproductive health-related problems. It also includes sexual health, the purpose of which is the enhancement of life and personal relations. The elements of reproductive health care include the following:

•To establish and integrate a sustainable newborn screening system with the public health delivery system; •To ensure that all health practitioners are aware of the advantages of newborn screening and of their respective responsibilities in offering newborns the opportunity to undergo newborn screening; and •To ensure that parents recognize their responsibility in promoting their child's right to health and full development, within the context of responsible parenthood, by protecting their child from preventable causes of disability and death through newborn screening.

Section 3 of this act (Newborn Screening Act of 2004 (RA No. 9288)) states the objectives of the government namely:

conscientious objectors, religious beliefs, refusal documentation, national newborn screening database

Section 3 of this act (Newborn Screening Act of 2004 (RA No. 9288)): Although this procedure is mandatory, it is one that admits an exemption, particularly when it comes to _______________________. In this case the parent or legal guardian may refuse testing on the grounds of _____________________ but shall acknowledge in writing their understanding that refusal for testing places their newborn at risk for undiagnosed hereditable conditions. A copy of __________________________ shall be made part of the newborn's medical record and refusal shall be indicated in the _______________________________________.

availability, nature and benefits, twenty-four (24) hours, three (3) days, intensive care

Section 3 of this act (Newborn Screening Act of 2004 (RA No. 9288)): It is the duty of the health practitioner who delivers or assists in the delivery, to inform the parents or legal guardian of the newborn of the _________, __________ and _____________ of newborn screening. The law also mandates that the screening shall be performed after ______________________ hours of life but not later than ____________ days from complete delivery of the newborn. A newborn that must be placed in ______________________ in order to ensure survival may be exempted from the 3-days requirement but must be tested by seven (7) days of age. It shall be the joint responsibility of the parent(s) and the practitioner or other person delivering the newborn to ensure that newborn screening is performed. An appropriate informational brochure for parents to assist in fulfilling this responsibility shall be made available by the Department of Health and shall be distributed to all health institutions and made available to any health practitioner requesting it for appropriate distribution.

Local Government Units (LGU), Department of Health (DOH)

Since health services delivery was devolved to the ______________________________ along with the new powers and functions of the varying structures of the health sector are new responsibilities that each ______ should assume. With the institutional restructuring the _____________________________ serves as the main national agency responsible for overseeing health service delivery, financing, regulation and governance of the health sector.

Section 3(a) a. A woman who gives birth as a result of rape and other crimes against chastity even without final conviction of the offender, provided that the mother keeps and raises the child. b. Parent left solo or alone with the responsibility of parenthood due to the following circumstances: c. Due to death of spouse. d. Spouse is detained or is serving sentence for a criminal conviction for at least one (1) year. e. Physical and/or mental incapacity of spouse as certified by a public medical practitioner. f. Legal separation or de facto separation from spouse for at least one (1) year, as long as he/she is entrusted with the custody of the children. g. Declaration of nullity or annulment of marriage as decreed by a court or by a church as long as he/she is entrusted with the custody of the children. h. Unmarried mother/father who has preferred to keep and rear her/his child/children instead of having others care for them or give them up to a welfare institution. i. Any other person who solely provides parental care and support to a child or children. j. Any family member who assumes the responsibility of head of family as a result of the death, abandonment, disappearance or prolonged absence of the parents or solo parent.

Solo Parent Act (R.A. No. 8972) According to Section _____, a "solo parent" is a person who has been left with the child's responsibility or care any of the following categories:

1. Magna Carta of Women (R.A. No. 9710) 2. Newborn Screening Act of 2004 (RA No. 9288) 3. THE MAGNA CARTA OF PUBLIC HEALTH WORKERS (Republic Act No. 7305) 4. 105-Day Expanded Maternity Leave Law (R.A. No. 11210) 5. Solo Parent Act (R.A. No. 8972) 6. Responsible Parenthood and Reproductive Health Law (R.A. No. 10354)

Statutes and Issuances Related to Maternal and Child Health:

Newborn Screening Act of 2004 (RA No. 9288)

Statutes and Issuances Related to Maternal and Child Health: To achieve this goal the State shall institutionalize national newborn screening system that is comprehensive , integrative and sustainable, and will facilitate collaborative among government and non-government agencies at the national and local levels, the private sector, families and communities, professional health organizations, academic institutions, and non-governmental organizations.

105-Day Expanded Maternity Leave Law (R.A. No. 11210), 60 days, 78 days, Social Security System, four pregnancies

Statutes and Issuances Related to Maternal and Child Health: In the new legislation, all working mothers—including those employed in the informal sector—can take up to 105 days of paid maternity leave. Previously, working mothers are only entitled to ______ days for normal delivery and _____ days for cesarean delivery for each pregnancy. This benefit can be claimed only if the claimant has made at least three (3) monthly contributions to the _________________________ in the twelve (12) months preceding the semester of the birth and have notified their employer. Previously, the women were entitled to this leave benefit for up to _______ pregnancies but in the new law this cap have been removed, thus claims can be filed regardless of the number of pregnancies or miscarriage.

Newborn Screening Act of 2004 (RA No. 9288), April 07, 2004

Statutes and Issuances Related to Maternal and Child Health: Passed in ________________ the law makes it a policy of the State to protect and promote the right to health of people, including the rights of children to survival and full and healthy development as normal individuals.

Magna Carta of Women (R.A. No. 9710), August 15, 2009

Statutes and Issuances Related to Maternal and Child Health: Signed in _________________, this enactment is a comprehensive women's human rights law that aims to eradicate discrimination against women by recognizing, protecting, fulfilling and promoting the rights of Filipino women, especially those in the marginalized sectors.

Responsible Parenthood and Reproductive Health Law (R.A. No. 10354)

Statutes and Issuances Related to Maternal and Child Health: The State shall eradicate discriminatory practices, laws and policies that infringe on a person's exercise of reproductive health rights. The State shall also promote openness to life; Provided, that parents bring forth to the world only those children whom they can raise in a truly humane way.

105-Day Expanded Maternity Leave Law (R.A. No. 11210), 1978 Philippine Constitution, Sections 17 and 22 of R.A. No. 9710

Statutes and Issuances Related to Maternal and Child Health: The ___________________________________________ was passed taking into account the mandate of the _______ Philippine Constitution regarding its duty to protect and promote the rights of working women, and considering their maternal functions, and to provide enabling environment in which their full potential can be achieved and in consonance with the state principle that the State recognizes the sanctity of family life and shall protect and strengthen the family as the basic autonomous social institution and that it shall equally protect the life of the mother and the life of the unborn from conception. Moreover, Sections ______ and _____ of R.A. No. ____________ , provides for women's right to health and decent work.

Responsible Parenthood and Reproductive Health Law (R.A. No. 10354)

Statutes and Issuances Related to Maternal and Child Health: This law guarantees universal access to medically-safe, non-abortifacient, effective, legal, affordable, and quality reproductive health care services, methods, devices, supplies which do not prevent the implantation of a fertilized ovum as determined by the Food and Drug Administration (FDA) and relevant information and education thereon according to the priority needs of women, children and other underprivileged sectors, giving preferential access to those identified through the National Household Targeting System for Poverty Reduction (NHTS-PR) and other government measures of identifying marginalization, who shall be voluntary beneficiaries of reproductive health care, services and supplies for free.

Magna Carta of Women (R.A. No. 9710)

Statutes and Issuances Related to Maternal and Child Health: This law provides for all rights of women under the Philippine Constitution, rights recognized under international instruments duly signed and ratified by the Philippines, in consonance with Philippine laws. It also stressed that all rights shall be enjoyed without discrimination since discrimination is prohibited by the law, whether done by or public entities or individuals.

105-Day Expanded Maternity Leave Law (R.A. No. 11210)

Statutes and Issuances Related to Maternal and Child Health: To achieve this goal, and in recognition of women's maternal function as a social responsibility, the State institutionalized a mechanism to expand the maternity leave period of working women. The purpose of this act is to provide ample transition time to regain health and overall wellness as well as to assume maternal roles before returning to work.

THE MAGNA CARTA OF PUBLIC HEALTH WORKERS (Republic Act No. 7305)

Statutes and Issuances Related to Maternal and Child Health: To ensure that the public health facilities are staffed, and delivery of quality health care comes the advent of ___________________ otherwise known as the ___________________________________________________.

Solo Parent Act (R.A. No. 8972), 7 working days, 1 year

Statutes and Issuances Related to Maternal and Child Health: Under the law a comprehensive package of social development and welfare services for solo parents and their families will be developed by the government agencies and instrumentalities in coordination with the LGU and non-governmental institutions with proven track record services for solo parents. It also provides for flexible work schedule if it will not affect individual or company productivity. Parental leave shall be provided in addition to leave privileges under existing laws, parental leave of not more than ___ working days every year shall be granted to any solo parent employee who has rendered of at least ___ year. Medical assistance shall be implemented by the DOH through their retained hospitals and medical centers and the LGU's throughtheir provincial, district, city, municipal hospitals and rural health units.

Solo Parent Act (R.A. No. 8972)

Statutes and Issuances Related to Maternal and Child Health: ___________________ provides for benefits and privileges to solo parents who are the parents of their children or relatives

(a) to promote and improve the social and economic well-being of the health workers, their living and working conditions and terms of employment; (b) to develop their skills and capabilities in order that they will be more responsive and better equipped to deliver health projects and programs; and (c) to encourage those with proper qualifications and excellent abilities to join and remain in government service. This law also provides that there shall be no understaffing or overloading of public health workers and that health staff-patient ratio shall be such as to effect a sustained delivery of quality health care at all times without overworking the public health workers. It also provides for married couples both whom are public health workers, to be employed or assigned within the same municipality, but not of the same office.

THE MAGNA CARTA OF PUBLIC HEALTH WORKERS (Republic Act No. 7305), This Act aims to:

Millennium Development Goals and Sustainable Development Goals, mortality, maternal health, good health and well-being for all

The Philippines being one of the countries who ratified the United Nations and World Health Organization Charters adopted the __________________________________ and ___________________________. In relation to Maternal and Child Health the former includes goals to reduce child ____________ and improve ____________________ while the latter aims to attain __________________________________________.

1987 Philippine Constitution, Revised Penal Code or Republic (RPC) Act No. 3815 a) Intentional Abortion (Article 256) where any person who shall intentionally cause abortion to a pregnant woman with the use of violence, or without violence but without consent of the woman, or with the consent of the woman. b) Unintentional abortion (Article 257) committed by any person who shall cause an abortion by violence, but unintentionally. c) Abortion Practiced by the woman Herself or by Her Parents (Article 258) committed by a woman who shall practice abortion upon herself or shall consent that any other person should do so or committed by the parents of the pregnant woman or either of them, and they act with consent of said woman for the purpose of concealing dishonor. d) Abortion Practiced by a Physician or Midwife and Dispensing of Abortives (Article 259) committed by any physician or midwife who, taking advantage of their scientific knowledge or skill, shall cause abortion or assist in causing the same. It also covers pharmacist who shall dispense any abortive, without proper prescription from a physician.

The ______ Philippine Constitution recognizes the sanctity of the family and mandated the State to protect the life of the mother and life of the unborn from conception. Because of this mandates the _______________________________ criminalizes any acts that constitutes abortion. The said law provides for four (4) circumstances that constitutes abortion:

Human Genome Project

The _______________________________ was a publicly funded project initiated in 1990 with the objective of determining the DNA sequence of the entire euchromatic human genome within 15 years. In its early days, the _________________________________ was met with skepticism by many people, including scientists and nonscientists alike. Today, however, the overwhelming success of this is readily apparent. Not only did the completion of this project usher in a new era in medicine, but it also led to significant advances in the types of technology used to sequence DNA.

Local Government code of 1991

The ________________________________ mandates the DOH to "formulate policies, standards and regulations, as well as provide tertiary care in tertiary hospitals and special hospitals, while the LGUs are responsible for the primary and secondary cases in hospitals and some general tertiary hospitals, which are provided by the provincial hospitals.

National Newborn Screening System

The ___________________________________________ shall ensure that every baby born in the Philippines is offered the opportunity to undergo screening and thus be spared from heritable conditions that can lead to mental retardation and death if undetected and untreated

health, health consciousness

The basic law of the country provides for the duty of the State to protect and promote the right to ________ of the people and instill _________________________ among them.

Integrated Management of Childhood Illnesses (IMCI)

The following is the flow of the ______ process. At the out-patient health facility, the health worker should routinely do basic demographic data collection, vital signs taking, and asking the mother about the child's problems. Determine whether this is an initial or a follow-up visit. The health worker then proceeds with the ______ process by checking for general danger signs, assessing the main symptoms and other processes indicated in the chart. Take note that for the pink box or urgent referral or admission, referral facility includes district, provincial and tertiary hospitals. Once admitted, the hospital protocol is used in the management of the sick child.

Devolution

The government to address the needs of the lower level of the society introduced the principle of ___________. A process in which there is decentralization of powers from the national government to local governments to ensure services are delivered to the people.

surrogacy, altruistic, "child trafficking"

The legalization of the practice of ____________ is not just a problem in the local setting but have sparked debates internationally. In places such as Australia, surrogacy is allowed if it is purely ___________ in nature. In the Philippines, on the other hand, it is often compared with ___________________ as the act of "buying a child" through its development in the body of a surrogate. It must also be noted that legally under Philippine laws the birth mother is the legal or considered biological mother of the child regardless if the surrogate and the child does not have any genetical link. This becomes a hindrance to the aim of an infertile couple to have a child of their own. The only way that the biological mother to lay claim to the child is by means of adoption. In this manner the legal ties between the child and the birth mother will be severed.

therapeutic abortion

The main issue as to ___________________ in other jurisdiction is the right of the mother and child. It would largely depend on the age of viability of the child. In most literatures before of age of viability the life of the mother takes precedence but after viability the age of the fetus is prioritized. Another issue raised is the quality of life of those fetuses diagnosed with genetic diseases.

Republic Act 9173, Philippine Nursing Act of 2002, Republic Act 7164, 1992

The main legal leg of nursing practice in the Philippines is embodied in the __________________ otherwise known as The ____________________________. This law is a repeal of _______________________________ which was passed in ________ that regulated nursing practice for two decades.

multiple pregnancy

The most common complication of ART is a _____________________. It can be prevented or minimized by limiting the number of embryos that are put into the woman's body.

Article VI, Section 28

The scope of nursing practice is embodied in Aritcle _____, Section _____ of the law which states: "A person shall be deemed to be practicing nursing within the meaning of this Act when he/she singly or in collaboration with another, initiates and performs nursing servicesto individuals, families and communities in any health care setting. It includes, but not limited to, nursing care during conception, labor, delivery, infancy, childhood, toddler, pre-school, school age, adolescence, adulthood and old age. As independent practitioners, nurses are primarily responsible for the promotion of health and prevention of illness. As members of the health team, nurses shall collaborate with other health care providers for the curative, preventive, and rehabilitative aspects of care, restoration of health, alleviation of suffering, and when recovery is not possible, towards a peaceful death.

a. Traditional surrogate. b. Gestational surrogates.

There are two kinds of surrogacy namely:

Code of Ethics

To ensure the quality of nursing care the Board of Nursing promulgated the _______________ for Registered Nurses. Aside from the requirements of finishing Bachelor of Science in Nursing Degree, passing the Philippine Nursing Licensure Exam and Registration as a Professional Nurse, all Filipino nurses must comply with the continuing requirement of abiding to existing laws and ___________________ that regulates the profession.

1) a former Filipino citizen seeking to adopt a relative by consanguinity, 2) one who seeks to adopt the legitimate child of his/her Filipino spouse, 3) joint adoption with a Filipino spouse of his/her relative by consanguinity. as well as Filipino citizens residing permanently abroad. Aliens must have lived in the Philippines at least three (3) continuous years before filing for adoption as well as have a higher minimum age of 27 compared to domestic adoption. Any other form of adoption not covered by the Domestic Adoption Act and Inter-Country Adoption Act are considered illegal in local jurisdiction.

UN Convention on the Rights of the Child (September 2, 1990), the 1995 Hague Convention on the Protection of Children and Cooperation in Respect of Inter-country Adoption (January 8, 1996), and Art. 184 of the Family Code. : The law applies to aliens except

i. Immediate and thorough drying provides warmth to the child and prevents hypothermia from setting in; ii. Early skin-to-skin contact establishes mother and child bonding and minimizes the risk of sepsis and hypoglycemia; iii. Properly timed cord clamping and cutting prevents anemia and hemorrhage; iv. Non-separation of the newborn and mother for early initiation of breastfeeding.

UNANG YAKAP emphasizes a step-by-step sequence of actions, or Four Core Steps of Essential Newborn Care:

Article II, Section 2, nursing personnel system

Under Article ____, Section ____ of this statute as a policy the State assumes responsibility for the protection and improvement of nursing profession. This is done by instituting measures that result in relevant nursing education, humane working conditions, better career prospects and dignified existence of nurses. At the same time the declaration of policy provides a guarantee that the State will deliver quality basic services through adequate _________________________ system throughout the country.

Article XIII Section 13

Under Article ______, Section ______,priority is given for the needs of the underprivileged sick, elderly disabled, women and children.

expulsion of the fetus before sixth month or before the term of its viability

Under the RPC, abortion ordinarily means ________________________________________________________________________________________________, that is, capable of sustaining life. But as long as the fetus dies as a result of the violence used, or the drugs administered, the crime of abortion exists, even if the fetus is full term.

BCG, Hepatitis B, Oral Poliovirus Vaccine, Pentavalent Vaccine, Measles Containing Vaccines (Anti-measles Vaccine, MMR) and Tetanus Toxoid.

Vaccines under the EPI are:

Anti-Violence Against Women and Their Children Act of 2004 (R.A. No. 9262), Section 31

Women and Children Protection Laws and Programs: This legislation declares that the State the dignity of women and children and guarantees full respect for human rights. The State also recognizes the need to protect the family and its members particularly women and children, from violence and threats to their personal safety and security. Hence, the law provides for a remedy for abused women and children in the form of medical assistance in coordination with the LGU. Section ____ of this Act lays the duties and responsibilities of any healthcare worker when working with the victim.

Special Protection of Children Against Child Abuse, Exploitation and Discrimination Act (R.A. No. 7610) Implementing Rules and Regulations (IRR) on the Reporting and Investigation of Child Abuse Cases, Section 32 of R.A. No. 7610

Women and Children Protection Laws and Programs: Pursuant to _________________________ the IRR of the law were made effective in 1993 after the publication requirement was complied. The objective of the IRR is to encourage reporting of cases of physical or psychological injury, sexual abuse or exploitation, or negligent treatment of children and to ensure early and effective investigation of cases of child abuse. Under Section 4 of the IRR, the head of any public or private hospital, medical clinic and similar institution, as well as the attending physician and nurse, shall report, either orally or in writing, to the Department the examination and/or treatment of a child who appears to have suffered abuse within forty-eight (48) hours from knowledge of the same. To facilitate reporting the rules also provided for immunity for reporting clause. In this provision a person who acted in good faith, shall report a case of child abuse shall befree from any civil or administrative liability arising there from and that there shall be a presumption of good faith. In the same IRR also provides referral of the child who is placed under protective custody to a government medical or health officer for a physical/ mental examination and/or medical treatment.

Philippine National Strategic Framework for Plan Development for Children, 2000-2025 (Child 21)

Women and Children Protection Laws and Programs: The health sectors contribution to the Philippine National Development Plan for Children defines the vision for children by 2025, formulates cost-effective interventions, and outlines a budget that will reflect contributions of different national and local government units, private sectors, NGOs, and international organizations. It serves as a framework for LGUs in the formulation of their development plans.

Assisted reproductive technology (ART)

_______ has emerged as one of the most widely adopted and successful medical technologies in the last century. While giving hope to millions of couples suffering from infertility, it also has presented new ethical, legal, and social questions that society must address.

Cord Blood Banking, hematopoietic stem cells (HSCs)

________________ is the blood from the baby that is left in the umbilical cord and placenta after birth. This blood contains ________________________________ that can be used to treat some types of diseases. Unlike any other cells in the body that makes copies only of themselves. ______________________________ can mature into different types of cells in the body. The same cells can also be found in the blood and bone marrow in adult and children. According to different studies they can be used to treat more than 70 types of diseases, including diseases of the immune system, genetic disorder, neurologic disorder, and some form of cancer, including leukemia and lymphoma.

Immunization, Pneumococcal Conjugate Vaccine 13, National Immunization Program

____________________ is one of the DOH Programs that has already been institutionalized and adopted by all LGUs in the region. The main objective is to reduce infant mortality and morbidity through decreasing the prevalence of six immunizable diseases. In 2014, __________________________ was included in the routine immunization of EPI. In 2016, the Expanded Program on Immunization transitioned to become the _______________________. It will include immunizations of other populations such as senior citizen immunization, school-age immunization, and adolescent immunizations.

Embryonic Stem Cell Research, inner cell mass (ICM), ES cells

___________________________ are derived from embryos at a developmental stage before the time that implantation would normally occur in the uterus. Particularly, the ________________________ that forms during the first differentiation event after fertilization are harvested. This is done because these have the potential to generate any cell type of the body. But after implantation they quickly depletes as they differentiate to other cell types with more limited developmental potential. If the )))))))) is removed from its normal embryonic environment and cultured under appropriate conditions, the _____-derived cells can continue to proliferate and replicate themselves indefinitely and still maintain the developmental potential to form any cell type of the body. These pluripotent, ______-derived cells are _____ cells.

Reproductive Assistance, Assisted reproductive technology (ART), In vitro fertilization (IVF)

____________________________________ is used to treat infertility. It includes fertility treatments that handle both a woman's egg and a man's sperm. It works by removing eggs from a woman's body. The eggs are then mixed with sperm to make embryos. The embryos are then put back in the woman's body. _______________________ is the most common and effective type of ART.

Surrogacy

is a form of assisted reproductive technology (ART) where a woman (the surrogate) offers to carry a baby through pregnancy on behalf of another person or couple and then return the baby to the intended parent(s) once it is born.

Fetal surgery rupture of the uterus after surgery (uterine rupture), fetal death, operative complications, early labor and potential failure to treat the birth defect.

is a procedure performed on an unborn baby (fetus) in the uterus (in utero) to help improve the long-term outcome of children with specific birth defects. Because these defects often worsen as a fetus develops, _______________________ done by a team of experts focuses on treating and improving the conditions before birth. Potential risks of the procedure —both the risks to the mother and those to the unborn baby —should be explained by the doctor. These risks include:

Assisted reproductive technology (ART), surrogate or gestational carrier

procedures sometimes use donor eggs, donor sperm, or previously frozen embryos. It may also involve a _________________ or ________________. A ______________ is a woman who becomes pregnant with sperm from the male partner of the couple. A ___________________ becomes pregnant with an egg from the female partner and the sperm from the male partner.