Hospital del Sur in 1911Southern Islands Hospital in 1913Southern Islands Medical Center in 1984
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
VISION
A safe and globally competitive center
in health service, training and
research.
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
MISSION
As a collaborating center of excellence, VSMMC commits to :
• Provide quality health care services to all clients
• Serve as a training center for medical , allied medical and related hospital support services;
• Conduct significant , relevant, quality research to improve health care delivery system;
• Sustain an environment that promotes self reliance and fiscal autonomy
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
SERVICE TRAINING
RESEARCHHVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
Accredited as a Mother-Baby Friendly Hospital by DOH-UNICEF
on June 25, 1992
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
Department of Obstetrics and GynecologyTRAINING PROGRAMS
Aim: to reduce maternal and child mortality
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
Situationer on Teenage Pregnancy
Navarro J 2012. A Retrospective Study on the
Maternal and Fetal Outcome of Teenage Pregnancy in Vicente
Sotto Memorial Medical Center (January 2011-December 2011)
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
Teenage Pregnancies in 2011
Navarro 2012
Deliveries No. of cases Percent
Deliveries ≥ 20 yo 5139 88% Teenage Pregnancy 698 12% Total 5837 100%
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
Navarro 2012.
Include 19yo pregnant patients: • 66% are ≤ 18 yo• 33% are 19 yo
Age (years) No. of Cases Percent
15 37 5% 16 79 11% 17 135 19% 18 214 31% 19 233 33%
total 698 100%
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
Navarro 2012
The main high risk complication is preterm labor (18%) and severe preeclampsia, occurring in 6% of teenage pregnancies.
Type of Hypertension Total No. of Cases Percent
Teenage Pregnancy Percent p-value
Antepartum Eclampsia: 121 2% 19 3% Severe Preeclampsia: 979 19% 42 6% Gestational hypertension: 284 6% 31 4% Mild preeclampsia: 654 13% 26 4% 0.000
Fetal Outcome Preterm: 702 14% 129 18% Fullterm: 4421 86% 561 80% Posterm: 16 0% 8 1% 0.000
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
PROGRAM FOR YOUNG PARENTS
VICENTE SOTTO MEMORIAL MEDICAL CENTER
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
PROPONENTS• Hospital Executive Committee• Department of Pediatrics• Department of Obstetrics and Gynecology• Women and Child Protection Center• Nursing Services• Department of Internal Medicine• HACT (HIV and AIDS Core Team)• Department of Mental Health Services and Behavioural
Sciences• Hospital Training Division• Medical Social Services• Support Services (Dietary Section, Dental Services
Pharmacy, Security etc.)• Peer support groups
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
PROGRAM FOR YOUNG PARENTSPlanning Workshop for the PYP Feb 1, 2014 at Be Resort, Mactan
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
INAUGURATION OF THE PYP CLINIC
March 4, 2014 at the Outpatient Department, VSMMC
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
PROGRAM FOR YOUNG PARENTS
VICENTE SOTTO MEMORIAL MEDICAL CENTER
HELEN V. MADAMBA MD MPH-TM
PROGRAM FOR YOUNG PARENTS
1. Gateway service2. Obstetric Evaluation and Care3. Adolescent Health Assessment4. Psychosocial Evaluation5. Health Classes6. Delivery at VSMMC7. Post-natal Check-up & Family Planning Services8. Gateway Service9. Adolescent Health Care10. Pediatric Care11. Parenting Classes12. Personal Advancement and Development13. Peer/Breastfeeding Support Group Sessions14. Endorsement to Appropriate Services for Preventive &
Promotive Care
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
GENERAL OBJECTIVE
to provide comprehensive “one-stop shop” care to the
pregnant adolescent, her partner, and infant
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
SPECIFIC OBJECTIVES
1. Provide comprehensive pre-natal, intra-partum (EINC) and post-natal care including immunization to the pregnant adolescent
2. Provide ENC and post natal care, including immunization to the baby
3. Promote exclusive breastfeeding up to 6 months and continue breastfeeding up to 3 years
4. Reduce pregnancy among women 19 years old and below
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
SPECIFIC OBJECTIVES
5. Increase FP acceptance to prevent subsequent unplanned pregnancies
6. Promote active participation of patients’ support group (i.e. husbands/ partners/ significant others/ peers) during pregnancy, care of the newborn and children and family planning
7. Prevent STIs and HIV among pregnant adolescents
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
Vicente sotto memorial medical center
SERVICE
RESEARCHTRAINING
COMPONENTS
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
SERVICE1. Medical
a. Obstetrical Care/Adolescent Healthb. Medical/ Pediatrics Carec. Nutritional Support
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
SERVICE2. Psychosocial
a. Counselingb. Social Servicesc. Women and Child Protectiond. Peer-support Group (Breast is Best
Brigade (BIBB), The Share a Child Movement, others to be identified)
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
SERVICE3. Health and Parenting
Education4. Personal Advancement (i.e.
Self-sufficiency Education, Vocational, Income Generation, Higher Education)
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
SERVICE5. Referral Services and
Networking (i.e. Legal, Police, Social Services LGUs, Spiritual)
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
PYP PROTOCOL
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
Step 1: Gateway service
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
Step 1: Gateway service
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
Step 1: Gateway service
• Triage at PHN at OPD• Referred from admitted patients• Referred from or refer to WCPC• Identify pregnant patients ≤ 20
yo• Enrollment to the PYP clinic
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
61% of ER admissions aged <20 yo due to
abortions
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
Age in years
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
Step 2: Obstetric
Evaluation and Care
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
Step 2: Obstetric
Evaluation and Care• PYP clinic on Wednesdays
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
Patients <20 year old Seen at the
PYP Prenatal Clinic from October 2014 - April2015
Month Prenatal ≥20yo
PYP <20yo %
October 2014 710 64 9.01
November 2014 623 41 6.58
December 2014 408 33 8.09
January 2015 454 30 6.61
February 2015 476 47 9.87
March 2015 563 39 6.93
April 2015 1094 38 3.47
TOTAL 4,328 292 6.75
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
Step 3: Adolescent Health Assessment
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
Step 4: Psychosocial Evaluation
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
Step 5: Health Classes
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
Attendance to “Usapan” Sessions
1. Danger Signs of Pregnancy
2. Birth Planning and Philhealth
3. Family Planning4. Breastfeeding before
delivery5. Breastfeeding after
delivery – return demonstration
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
Step 6: Delivery at
VSMMC
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
15.7% of all babies delivered to pregnant
teenagers in 2014 were preterm
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
Antenatal Corticosteroid Use for all pregnant patients at risk
for preterm birth
o Preterm laboro Preterm pre-labor
rupture of membranes o Severe preeclampsiao Antepartum hemorrhage
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
UNDELIVERED PATIENTS
3.6% of all pregnant teenagers admitted in 2014 required perinatal specialist care for control of high risk conditions:
• preterm labor• antepartum haemorrhage• elevated blood pressure• elevated blood sugar
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
Intensive Maternal Unit
•10-bed capacity• focused management of high risk pregnancies supervised by perinatalogist
• dedicated nursing staff• fetal monitoring equipment
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
Age Distribution of Pregnant Teenagers at VSMMC in 2014
• Out of 1,888 teenage pregnant patients admitted in 2014, 35% were 19 years old and 65% were 13-18 years old.
• There is an increasing frequency of teenage pregnancies with increasing age. Age in years
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
17.5% of pregnant teenagers were delivered by cesarean
section
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
Step 7: Post-natal Check-up
& Family Planning Services
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
Step 7: Post-natal Check-up
• 1st visit: first Wednesday after discharge follow up at PYP clinic
• 2nd visit: 4 weeks postpartum• 3rd visit: 6 weeks postpartum
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
Step 7: Post-natal Check-up
Subsequent visits• Every month for 6 months• Every 2 months for 6 months• Every 3 months for the 2nd year
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
Patients <20 year old Seen at the
PYP Postnatal Clinic from October 2014 - April2015
Month Postnatal ≥ 20yo
PYP <20 yo %
October 2014 131 2 1.53
November 2014 124 2 1.61
December 2014 103 7 6.80
January 2015 148 6 4.05
February 2015 109 13 11.9
March 2015 116 10 8.62
April 2015 85 11 12.94
TOTAL 816 41 5.02
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Acceptance of Family Planning
• Counselling Tracking Family Planning Method
# patients
Patients <20 yoIUD 15Pills 6Implant 9Total patients counselled in 2014
675
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
Step 8: Gateway Service
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
Step 9: Adolescent Health Care
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
Step 10: Pediatric Care
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
Kangaroo Mother Care Month #Patients #Discharged #Follow up
Sept 2014 19 23 19
Oct 2014 66 38 66
Nov 2014 45 24 45
Dec 2014 51 27 51Jan 2015 32 23 32
Feb 2015 63 17 63
Mar 2015 66 23 66
Apr 2015 50 21 50
May 2015 48 17 48
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
Pediatric Follow up Statistics
Feb 2015 March 2015
April 2015 May 2015
Prenatal 15 13 16 24
Prenatal consult for the pregnant teenagers
Postnatal consult for the newborn Most referred to LGUs
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
Step 11: Parenting Classes
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
Step 12: Personal
Advancement and
Development
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
Step 13: Peer/Breastfeed
ing Support Group Sessions
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
Initiation of Breastfeeding
• EINC core steps ensure successful breastfeeding.
• All postpartum patients are offered breastfeeding.
• Formula feeding is not allowed in the hospital.
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
Breastfeeding Support Group
Breast is Best Brigade
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
Step 14: Endorsement
to Appropriate Services for Preventive &
Promotive Care
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
TRAINING OBJECTIVES
1. To enhance the skills of hospital staff and residents in dealing with health issues of young parents, in management of pregnant adolescents, and in responding to their reproductive health needs
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
TRAINING OBJECTIVES
2. To develop skills of service providers, specifically the nurses, midwives and social workers in the conduct of health education
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
TRAINING Dealing with Adolescent Patients Gender Adolescent Friendly Health Facility and Adolescent Job Aid
Promoting Male Partners Participation Interpersonal Communication e.g. Increasing Spousal Communication
Conduct of Usapan Refresher Training for Breastfeeding Support Group
Essential Intrapartum Newborn Care
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
Gender Orientation on May 3, 2014 at the Crown Regency Hotel
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
Workshop on Adolescent Job Aid ManualAugust 7, 2014 at Quest Hotel
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
RESEARCH PROJECTS
• To encourage research on issues related to adolescent health such as teenage pregnancy
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
RESEARCH PROJECTS
• Helen Madamba. Association of Human Immunodeficiency Virus (HIV) Knowledge, Testing Attitudes and Perception of Teenage Pregnant Patients with the Uptake of HIV Counselling and Testing and Prevalence of HIV Infection Among Teenage Pregnant Patients in Selected Government Hospitals and Barangay Health Centers in Central Visayas, Philippines
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
RESEARCH PROJECTS
• Helen Madamba. Registry of teenage postpartum patients and the Impact of the two-year program for young parents (PYP) at Vicente Sotto Memorial Medical Center
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
RESEARCH PROJECTS
• Carolyn Tabaloc. Comparison of Abstinence Counseling against Conventional Family Planning Methods on the Teenage Mothers in Vicente Sotto Memorial Medical Center.
• Carolyn Tabaloc. Predictors of teenage pregnancy: a case control study.
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
RESEARCH PROJECTS
• Princess Lorezo. Clinical Profile of Teenage Pregnancies in Vicente Sotto Memorial Medical Center from 2005-2014.
• Christine Rose Nonan. Incidence of Dexamethasone Use among Patients at Risk of Preterm Birth from January 2014 to December 2014.
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
RESEARCH PROJECTS
• Gladys Hojas. Knowledge and attitudes on family planning among teenage mothers seen at Vicente Sotto Memorial Medical Center
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
RESEARCH PROJECTS
• Virdel Marie Senica-Isidro. A review of factors related to the pregnant teenagers in Sambag II from January to September 2014.
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
CHALLENGES ENCOUNTERED
o no dedicated social worker and psychologist to focus on teenage patients
o teenage pregnant patients who deliver at VSMMC are referred from distant municipalities, hence poor follow up postpartum
o strengthen referral system with LGUs for follow up of mother and baby postpartum
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
FUTURE DIRECTIONS
• USE OF SOCIAL MEDIA FOR CREATION OF SUPPORT GROUPS FOR YOUNG PARENTS
• COMPUTERIZED REGISTRY• MONTHLY AND QUARTERLY ASSEMBLIES• DEDICATED SOCIAL WORKER FOR PYP• RESEARCH FUNDING GRANTS
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
FUTURE DIRECTIONS
• Skills Training at TESDA• Alternate Learning System by
DepEd• Job Opportunity at DSWD
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
PROGRAM FOR YOUNG
PARENTSVICENTE SOTTO MEMORIAL MEDICAL CENTER
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
AKO PARA SA BATA CONFERENCECyber Safety of Children: Internet and Mobile Protection for Minors
December 1-2, 2015Marco Polo Plaza Hotel, Cebu
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING