This is an Entry to the Government Best Practice Recognition Awards
Saving Babies, Saving Lives through Newborn Screening Confirmatory Testing
LGU Tinambac, Camarines Sur
Best practice Focus Area(s)
The project, Saving Babies, Saving Lives through Newborn Screening Confirmatory Testing, bridges the gap between babies initially diagnosed with Newborn Screening detectable diseases and having them tested for confirmation through the initiative of the LGU of Tinambac.
Tinambac Municipal Hospital–an LGU-owned and managed primary health care facility assists parents to have their babies undergo confirmatory testing to ensure the real condition of their babies, therefore helping them save their babies’ life through early detection of disease and early provision of treatment and disease management.
The practice started in 2017 when the hospital has an increased number of babies detected with G6PD deficiency – a blood condition that when not managed properly may result in severe hemolytic anemia. It is a local innovation geared towards helping babies, especially those whose parents cannot have their children confirmatory tested, achieve rightful and quality basic healthcare services.
Background and Problem
The main objective is to ensure that all newborns born in the facility are provided with rightful services including Newborn Screening. Newborn Screening does not end in just detecting if the baby has the disease or not, but it should go through confirming results and providing early treatment and management. At the end of the day, the success of the program is not just on how many babies were screened, but on how many babies with the positive condition were saved from mental retardation or death.
The facility decided to take action and paved the way to the creation of the program because of the increasing number of babies detected to have G6PD deficiency. While the majority of the mothers cannot send their babies for confirmatory testing, the hospital decided to take the risk and think of other ways aside from just telling them to go to confirmatory centers.
Solution and Impact
The first step is providing kits and doing the screening for babies because it is mandatory for PhilHealth reimbursements. In short, screening services are only for those who can afford it since the kits are not free. Those who are not PhilHealth beneficiaries were asked if they are willing to pay for their child’s screening and more often than not, they opt to save the money for other expenses.
After some time, the LGU devised a local program with an incentive scheme to attract mothers to deliver to the municipal health facility. Included in the incentive is slashing the hospital bill into half, including the fee for Newborn Screening–that is the time when all newborns born in the facility are subjected to NBS before discharge. Over time, the facility detected an increasing number of babies with G6PD deficiency. As a routine, after catching these babies, they are referred to the nearest confirmatory testing center which is in Batangas. Unfortunately, only one or two of them are able to have that confirmatory test due to financial constraints.
This led to coordination with the Mayor. Through his strong political will, the hospital earned support from the finance committee of the LGU which enabled the hospital to send the first batch of babies for extraction in Legazpi City.
Tracking of patients has been difficult because of geographical location and communication signal difficulties but this was immediately addressed through the help of the RHU. In some cases when tracking is difficult for health workers, the hospital coordinates with the barangay captains. Aside from the fact that the barangay captain knows the whereabouts of his constituents, he can also provide some transportation or financial help for sending the patient back to the facility.
Partnership with different stakeholders–parents, RHU personnel, BRTTH nurses, local and barangay leaders– has become a major key in sustaining this program and continuously saving the lives of fellow Tinambacqueños. At present, mothers with identified G6PD deficiency are more aware of the food, drinks, or even medicines to avoid that would cause harm to their babies. Often, there are now encounters with mothers coming for check-ups and readily informing the physician that her child has G6PD deficiency; that way, the doctor prescribes medicines based on the list appropriate for the baby’s condition.
As a healthcare provider, one of the remarkable results seen through this program are the saved babies. The LGU may be spending an amount for this doing but nothing compares to a child’s life saved for the rest of his lifetime.
This program has not yet received an award but it has brought convergence with other agencies to have the same vision as the hospital. In the next few years, there are plans to sustain the program through local legislation to ensure the budget for confirmatory testing is always available. Additionally, the facility is on the process to become an extraction site for NBS confirmatory testing to spare the mothers and babies from much effort of traveling from Tinambac to Legazpi City.