Being chosen as one of the best practices of VSMMC to be presented during the 2nd DOH National Staff Meeting, the Program for Young Parents is a collaborative project to address the health needs of pregnant adolescents and provide comprehensive "one-stop shop" care for the pregnant adolescent, her partner and her infant.

2. Hospital del Sur in 1911
Southern Islands Hospital in 1913
Southern Islands Medical Center in 1984
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING

3. HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING

4. VISION
A safe and globally
competitive center
in health service,
training and
research.
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING

5. 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

6. HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING

7. Accredited as a Mother-Baby Friendly
Hospital by DOH-UNICEF on June 25, 1992
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8. Department of Obstetrics and Gynecology
TRAINING PROGRAMS
Aim: to reduce maternal and child mortality
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING

9. 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

10. 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

11. 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

12. 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

13. PROGRAM FOR
YOUNG PARENTS
VICENTE SOTTO MEMORIAL MEDICAL CENTER
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING

14. 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

15. PROGRAM FOR YOUNG PARENTS
Planning Workshop for the PYP Feb 1, 2014 at Be Resort, Mactan
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING

16. INAUGURATION OF THE PYP CLINIC
March 4, 2014 at the Outpatient Department, VSMMC
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING
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17. PROGRAM FOR
YOUNG PARENTS
VICENTE SOTTO MEMORIAL MEDICAL CENTER
HELEN V. MADAMBA MD MPH-TM

18. PROGRAM FOR
YOUNG PARENTS
1. Gateway service
2. Obstetric Evaluation and Care
3. Adolescent Health Assessment
4. Psychosocial Evaluation
5. Health Classes
6. Delivery at VSMMC
7. Post-natal Check-up & Family Planning Services
8. Gateway Service
9. Adolescent Health Care
10. Pediatric Care
11. Parenting Classes
12. Personal Advancement and Development
13. Peer/Breastfeeding Support Group Sessions
14. Endorsement to Appropriate Services for Preventive &
Promotive Care
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING

19. GENERAL OBJECTIVE
to provide comprehensive
“one-stop shop” care to the
pregnant adolescent, her
partner, and infant
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING

20. 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

21. 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

22. Vicente sotto memorial medical center
SERVICE
RESEARCHTRAINING
COMPONENTS
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING

23. SERVICE
1. Medical
a. Obstetrical Care/Adolescent Health
b. Medical/ Pediatrics Care
c. Nutritional Support
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING

24. SERVICE
2. Psychosocial
a. Counseling
b. Social Services
c. Women and Child Protection
d. Peer-support Group (Breast is Best
Brigade (BIBB), The Share a Child
Movement, others to be identified)
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING

25. SERVICE
3. Health and Parenting
Education
4. Personal Advancement (i.e.
Self-sufficiency Education,
Vocational, Income
Generation, Higher
Education)
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING

26. SERVICE
5. Referral Services and
Networking (i.e. Legal, Police,
Social Services LGUs,
Spiritual)
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27. PYP PROTOCOL
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28. Step 1: Gateway service
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29. Step 1: Gateway service
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30. 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

31. 61% of ER admissions aged
<20 yo due to abortions
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING

32. Age in years
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33. Step 2: Obstetric
Evaluation and Care
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34. Step 2: Obstetric
Evaluation and Care
• PYP clinic on Wednesdays
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35. 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

36. Step 3: Adolescent
Health Assessment
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING

37. Step 4: Psychosocial
Evaluation
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING

38. Step 5: Health Classes
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING

39. Attendance to
“Usapan” Sessions
1. Danger Signs of
Pregnancy
2. Birth Planning and
Philhealth
3. Family Planning
4. Breastfeeding
before delivery
5. Breastfeeding after
delivery – return
demonstration
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING

40. Step 6: Delivery at
VSMMC
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING

41. HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING

42. HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING

43. HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING

44. HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING

45. 15.7% of all babies delivered to
pregnant teenagers in 2014 were
preterm
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING

46. Antenatal Corticosteroid Use for all
pregnant patients at risk for preterm
birth
o Preterm labor
o Preterm pre-labor
rupture of membranes
o Severe preeclampsia
o Antepartum hemorrhage
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING

47. 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

48. 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

49. 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
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50. 17.5% of pregnant teenagers
were delivered by cesarean
section
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51. Step 7: Post-natal
Check-up & Family
Planning Services
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52. 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

53. 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

54. 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
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING

55. Acceptance of Family Planning
• Counselling Tracking Family
Planning
Method
# patients
Patients <20 yo
IUD 15
Pills 6
Implant 9
Total patients
counselled in
2014
675
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING

56. Step 8: Gateway
Service
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING

57. Step 9: Adolescent
Health Care
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING

58. Step 10: Pediatric Care
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING

59. 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 51
Jan 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

60. 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

61. Step 11: Parenting
Classes
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING

62. Step 12: Personal
Advancement and
Development
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING

63. Step 13:
Peer/Breastfeeding
Support Group
Sessions
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING

64. 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

65. Breastfeeding Support Group
Breast is Best Brigade
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING

66. Step 14:
Endorsement to
Appropriate Services
for Preventive &
Promotive Care
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING

67. 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

68. 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

69. 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

70. Gender Orientation on May 3,
2014 at the Crown Regency Hotel
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING

71. Workshop on Adolescent Job Aid Manual
August 7, 2014 at Quest Hotel
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING

72. RESEARCH
PROJECTS
• To encourage research on issues
related to adolescent health such as
teenage pregnancy
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING

73. 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

74. 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

75. 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

76. 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

77. 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

78. 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

79. 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

80. 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

81. FUTURE DIRECTIONS
• Skills Training at TESDA
• Alternate Learning System by
DepEd
• Job Opportunity at DSWD
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING

82. HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING

83. HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING

84. HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING

85. HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING

86. HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING

87. PROGRAM FOR
YOUNG PARENTS
VICENTE SOTTO MEMORIAL MEDICAL CENTER
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING

88. AKO PARA SA BATA CONFERENCE
Cyber Safety of Children: Internet and Mobile
Protection for Minors
December 1-2, 2015
Marco Polo Plaza Hotel, Cebu
HVMADAMBA 2015 DOH 2ND NATIONAL STAFF MEETING