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Presented by: Ma. Joyce U. Ducusin, MD, MPH Medical Specialist IV, NCDPC Department of Health

Hepatitis B Immunization In the Philippines: A Progress Report. Presented by: Ma. Joyce U. Ducusin, MD, MPH Medical Specialist IV, NCDPC Department of Health. Background. Hepatitis B Immunization Coverage, PHL 1995-2009. % Coverage. HBV Activities (2005 – 2009). 2005-2007:

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Presented by: Ma. Joyce U. Ducusin, MD, MPH Medical Specialist IV, NCDPC Department of Health

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  1. Hepatitis B Immunization In the Philippines: A Progress Report Presented by: Ma. Joyce U. Ducusin, MD, MPH Medical Specialist IV, NCDPC Department of Health

  2. Background

  3. Hepatitis B Immunization Coverage, PHL 1995-2009 % Coverage

  4. HBV Activities (2005 – 2009) • 2005-2007: • 100% HBV budget secured from DOH • 2006-Jan 1 2007: • DOH Issuance of HBV at birth and inclusion of HBV3 in FIC • Start of birth dose implementation • 2007-9 (“We’re back” It’s all in the follow up…) • Hospital Assessments • Community HBV birth dose scale-up in NCR • Strengthening Routine Immunization

  5. Hospital assessments • Followed our usual Formula of 3 A’s+3 F’s : • Assess • Analyze with staff present • Agree on next steps • Follow-up (at least 3 visits) • 91 largest hospitals, expanded to 300 • Surveys showed HBV birth dose increase from 22% to 70% • Provided focus on what needed to be done to scale up in hospitals

  6. Community HBV Birth Dose Scale-up in National Capital Region (NCR) • Followed our usual Formula of 3 A’s+3 F’s : • Assess: Target Client Lists were evaluated, health facilities assessed (using a modified Child Survival Monitoring Checklist) • Analyze with staff present to reach particularly home births • Agree on next steps • Follow up (at least 3 visits) • Sites: • 2007: 9 (2 cities) • 2008: 77 (5 per city) • 2009: 4 complete cities

  7. Community HBV Birth Dose Scale-up in National Capital Region (NCR), 2007

  8. HBV Birth Dose Immunization Rate: District II and by LGU in NCR

  9. Strengthening Routine Immunization • Followed our usual Formula of 3 A’s+3 F’s : • Assess, Analyze, Agree on next steps • Follow up (at least 3 visits) • Since 2004; national/subnational staff, WHO and STOP teams have followed this procedure for more than 650 Health Centers and Barangay Health Stations using the Child Survival Monitoring Checklists • Pentavalent vaccine (DPT-HBV-HiB) introduced in 3 regions

  10. Reaching the Urban Poor • Population Included: • 2004: 2000 • 2010: 600,000

  11. Concern Administration of Hepatitis B at birth is done at a time that interrupts other time bound essential newborn care procedures…

  12. Essential Newborn Care Protocol was developed to address these and other issues

  13. The Way Forward: Principles • Follow our usual Formula of 3 A’s+3 F’s for all hospitals and local facilities nationwide: • Assess • Analyze with staff present • Agree on next steps • Follow up (at least 3 visits) • Evidence-based policies • Reaching home births with a HBV birth dose as an interim measure until facility deliveries increases to >90%

  14. The Way Forward • Continued Hospital Improvements: • Cost to assess 100 hospitals: USD 20,000 • Total Hospitals: 1500 • Each hospital will need at least 3 assessments to get meaningful change • Total Expected Cost: USD 300,000 x 3 visits • USD 900,000

  15. The Way Forward: • Continued Health Facility Improvements with a community focus: • Cost to scale up to ¼ NCR (4 LGUs): • USD 50,000 • Total Local Government Units: 121 • Total Expected Cost: USD 1.5 Million

  16. The Way Forward: • Continued Scale-up of Reaching the Urban Poor: • Total cost to scale up to 600,000: USD 500,000 • Total urban poor: 12.3 million • Each health facility will need at least 3 assessments • Total Expected Cost: USD 10.3 Million

  17. External Inputs Needed to Achieve 2012 Targets • Support resource mobilization • When the time comes, technical and financial assistance for the serosurvey…

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