Newborn Screening in the Philippines: Experiencing the Promise of Precision Public Health

Transcription

1 Newborn Screening in the Philippines: Experiencing the Promise of Precision Public Health

2 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: * **

3 Newborn Screening Pilot Implementation in Hospitals In Metro Manila 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 Spirit of Voluntarism Newborn Screening Study Group The Philippine Newborn Screening Project was born

4 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: hospitals 1) to establish the incidence of CH, CAH, Gal, PKU, HCY, G6PD def; and 2) to make recommendations for adoption of nationwide newborn screening.

5 Landmark Publications Acta Medica Phililppina, Vol 43 No 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.

6 Slow expansion of NBS hospitals hospitals Target: 7000 hospitals and birthing centers hospitals hospitals hospitals Newborn Screening Bill filed in Congress hospitals

7 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)

8 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

9 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

10 Governance Department of Health Lead Agency University of the Philippines Technical Partner Philippine Health Insurance Corporation Funder of the program

11 Landmarks and Coverage Research DOH Pres Proclamation RA 9288 (law) 90% NBS fee covered by insurance 19.7% 15.5% 0.7% 1.9% 2.1% 1.5% 2.3% 2.7% 3.5% 3.9% 5.2% 7.6% 10.7% 26.9% 100% NBS fee covered by insurance Expanded NBS considered 33.2% 39.6% 49.6% 57.3% Expanded NBS started 65.0% 77.0% 67.9% 70.4% 78.6% 2.8% 6.9% 10.2%12.5% NBS vs. Est. Live Birth ENBS vs Est. Live Birth Based on the estimated population provided by the Department of Health with birth rate of 22/1000 population Based on PSY screening as of July

12 Conditions covered OPTIONS Covered by insurance Basic Panel of 6 CH CAH GaL MSUD PKU G6PD def Will soon be covered by insurance Expanded Newborn Screening 29 conditions

13 From 24 hospitals in 1996 to hospitals in 2018 This is the product of a PUBLIC HEALTH APPROACH!

14 Newborn Screening Laboratories NSC - NORTHERN LUZON Mariano Marcos Memorial Hospital and Medical Center (Batac Ilocos Norte) NSC SOUTHERN LUZON Daniel Mercado Medical Center (Tanauan City, Batangas) NSC - CENTRAL LUZON Angeles University Foundation Medical Center (Angeles, Pampanga) NSC NIH UP Manila NSC VISAYAS West Visayas State University Medical Center (Iloilo City) Future NSCs NSC MINDANAO Southern Philippines Medical Center (Davao City)

15 Societal effort Neonatologist Nurse Community Health Workers Midwives Organizations Families of Saved Babies Nursery Team

16 Twin Legislation Newborn Screening Act of 2004 Rare Disease Act of 2016

17 Newborn Screening The Largest Precision Public Health Program Critical role of the PUBLIC HEALTH APPROACH in bringing precision medicine to the people Medicine Public Health Individuals Healthcare Newborn Screening Population Screening The largest Precision Public Health Program in the Philippines Total Health Health Clinical Treatment Genomics/Biology poverty national insurance Community Engagement Prevention of complications Social/Environmental effort/environmental

18 Newborn Screening in the Philippines: Experiencing the Promise of Precision Public Health