Newborn Screening in the Philippines: Experiencing the Promise...
Transcript of Newborn Screening in the Philippines: Experiencing the Promise...
Newborn Screening in the Philippines: Experiencing the Promise of
Precision Public Health
The Philippines
Composition (7,107 Islands)
Population (100 M)*
Livebirths (1.7M)*
Infant Mortality Rate (22 per 1000)**
Neonatal Infant Mortality Rate (13 per 1000 )**
Sources:
* https://psa.gov.ph/content/births-philippines-2016
**https://data.unicef.org/country/phl/
Newborn Screening Pilot Implementation in 1996
NCR
Capitol Medical Center
Cardinal Santos Medical Center
Chinese General Hospital and Medical Center
De Los Santos Medical Center
Dr. Fe Del Mundo Memorial Medical Center
Foundation Philippines, Inc.
Dr. Victor R. Potenciano Medical Center
FEU-Nicanor Reyes Medical Foundation Hospital
Mary Chiles General Hospital
MCU-FDT Medical Foundation Hospital
Medical Center Manila
Metropolitan Medical Center
Our Lady of Lourdes Hospital - Manila
University of Perpetual Help Rizal Medical
Center-Las Piñas
Philippine General Hospital
Quezon City General Hospital
Rizal Medical Center
St. Luke's Medical Center
UERM Memorial Medical Center Hospital
United Doctors Medical Center
Manila Doctors Hospital
Ospital ng Maynila
Philippine Children's Medical Center
Quirino Memorial Medical Center
St. Martin De Porres Hospital - San Juan
24Hospitals
InMetro Manila
Newborn Screening Study Group
The Philippine Newborn Screening Project was born
Spirit of Voluntarism
Landmark Publications
Padilla, CD and Domingo, C for the Newborn Screening Study Group. Implementation of newborn screening in the Philippines. Philippine J
Pediatr. 2002;51:2-10.153 hospitals
1) to establish the incidence of CH, CAH, Gal, PKU, HCY, G6PD def; and
2) to make recommendations for adoption of nationwidenewborn screening.
Landmark Publications
Acta Medica Phililppina, Vol 43 No 2. 2009
If screening coverage is 100%, there is a net benefit of US$11.42M every year.
With the current exchange rate, the net benefit is P593M every year.
Slow expansion of NBS
1996 24 hospitals
1999 69 hospitals
2000 153 hospitals
2001 153 hospitals
2002253 hospitals
2003323 hospitals
Target: 7000 hospitals and birthing centers
Newborn Screening Bill filed in Congress
The life of the Newborn Screening Study Group ended with the passage of the Newborn screening Law (RA9288).
Enactment of the
RA 9288
(April 6, 2004)
Signing of the
Implementing Rules and Regulation
of RA 9288
(October 5, 2004)
Highlights of Newborn Screening Law (RA9288)
Sec 2. Declaration of Policy:• Institutionalize a National Newborn Screening System that is…
- Comprehensive- Integrative- Sustainable- Collaborative
• Opportunity of every baby born in the Philippines to undergo NBS
Highlights of Newborn Screening Law (RA9288)
• Sec 5 Obligation of Health Workers to inform parents or legal guardians of the newborn about newborn screening
• Sec 9 DOH and PHIC shall require health institutions to provide newborn screening services as condition for licensure and accreditation
• Sec 10 Defining DOH as the lead agency
• Sec 11 Creation of an Advisory Committee
• Sec 13 Creation of the Newborn Screening Reference Center
• Sec 16 PHIC will include newborn screening in benefits package*PHIC – NATIONAL INSURANCE
Governance
Department of Health Lead Agency
University of the Philippines Technical Partner
Philippine Health Insurance Corporation Funder of the program
Landmarks and Coverage
2016-2018 Based on the estimated population provided by the Department of Health with birth rate of 22/1000 population.1996-2015 Based on PSY 2015 | 2018 screening as of July
Research
DOH
Pres Proclamation
RA 9288 (law)
90% NBS fee covered by insurance
100% NBS fee covered by insurance
Expanded NBS started
Expanded NBS considered
0.7% 1.9% 2.1% 1.5% 2.3% 2.7% 3.5% 3.9% 5.2% 7.6% 10.7%
15.5%19.7%
26.9%
33.2%
39.6%
49.6%
57.3%
65.0%
77.0%
67.9%70.4%
78.6%
2.8% 6.9% 10.2%12.5%
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NBS vs. Est. Live Birth ENBS vs Est. Live Birth
Conditions covered
Covered by insuranceBasic Panel of 6CHCAHGaLMSUDPKUG6PD def
Will soon be covered by insuranceExpanded Newborn Screening
29 conditions
OPTIONS
From 24 hospitals in 1996 to 6800+ hospitals in 2018
This is the product of a PUBLIC HEALTH
APPROACH!
Newborn Screening Laboratories
NSC – MINDANAOSouthern Philippines
Medical Center (Davao City)
NSC - CENTRAL LUZONAngeles University Foundation
Medical Center (Angeles, Pampanga)
NSC – NIHUP Manila
NSC – VISAYASWest Visayas State University
Medical Center (Iloilo City)
NSC – SOUTHERN LUZONDaniel Mercado Medical Center
(Tanauan City, Batangas)
NSC - NORTHERN LUZONMariano Marcos Memorial Hospital
and Medical Center (Batac Ilocos Norte)
Future NSCs
Societal effort
Neonatologist Nurse
Nursery Team
Community Health Workers Midwives Organizations
Families of Saved Babies
Twin Legislation
Rare Disease Act of 2016Newborn Screening Act of 2004
Newborn ScreeningThe Largest Precision Public Health Program
Medicine Public Health
Individuals
Healthcare
Clinical
Treatment
Genomics/Biology
Population
Health
Community
Prevention
Social/Environmental
Critical role of the PUBLIC HEALTH APPROACH in bringing precision medicine to the people
Population Screening
Total Health
Community Engagement
Prevention of complications
Social effort/Environmentalpoverty – national insurance
Newborn ScreeningThe largest Precision Public Health Program in the Philippines
Newborn Screening in the Philippines: Experiencing the Promise of
Precision Public Health