Monday, March 3, 2014

CamSur town to impose high fees for birthing facility services (Feature)
By Danny O. Calleja

BUHI, Camarines Sur, Feb. 28 (PNA) – Delivering a baby in birthing facilities run by the local government will be more expensive in this outskirt Bicol municipality.

The municipal legislative council is now in the process of enacting a measure entitled “An Ordinance Prescribing Fees, Charges and Establishing Systems in the Operations of Maternal Health and Newborn Care” facilities in the locality.

Under the proposed measure which the Sangguniang Bayan (SB), presided over by Vice-mayor Diones Belza, submitted to a public hearing over the weekend, states that the amount of P3,500 in “service fee” shall be collected from residents of the municipality who would avail of the services of the birthing facilities.

For non-residents, the proposed ordinance says that the amount of P6,500 shall be charged.

Such facilities that include rural health centers were established in the municipality through funding granted by the national government through the Department of Health (DOH) and operate through local funds and DOH-accredited personnel.

Barangay officials, however, decry the payment as exorbitant as chairmen Antonio Samantela and Nilo Enfante of Barangay De Los Angeles and Barangay Sta. Elena, respectively, said during the public hearing that at present their constituents, especially expectant mothers, cannot afford to pay the required amount of P3,500 due to poverty.

Samantela said the imposition of the fee defeats the purpose of the DOH in campaigning for safe motherhood, reduction of child mortality and improved maternal health in relation to the commitment of the Philippine government to the United Nations Millennium Development Goals (MDGs).

The DOH Safe Motherhood Program, he explained, is focused on making pregnancy and childbirth safer and sought to change fundamental societal dynamics that influence decision making on matters related to pregnancy and childbirth while it tries to bring quality emergency obstetrics and newborn care facilities nearest to homes.

This move ensures that those most in need of quality health care from reliable public facilities and by competent doctors, nurses and midwives have easy access to such care.

“What happens now when the burden of high cost is put on the shoulders of these mothers, especially those coming from the poorest of the poor which is the dominant sector in the locality?” Samantela queried.

In that case, he stressed, the multi-faceted challenges of high maternal mortality ratio, increasing neonatal deaths, unmet need for reproductive health services and weak maternal care delivery system confronting the local health services system will continue to hound the locality.

Besides, according to Enfante, local government units (LGUs) are mandated to collaborate with the DOH in establishing sustainable, cost-effective approach of delivering health services that ensure access of disadvantaged women to acceptable and high quality maternal and newborn health services, as well as enable them to safely give birth in health facilities.

Town councilor Maria Bella Nonato, author of the proposed ordinance, said, on the other hand, the payment of service fee which also includes the “professional fee” for attending health personnel could be shouldered by the Philippine Health Insurance Corp. (PhilHealth) when mothers who would avail of the birthing services are members.

But just the same, the barangay officials appealed that the required fee be reduced if not set aside, “considering that most of the attending midwives, nurses or physicians are permanent employees of the government.”

Nonato, however, said the operation of birthing centers is an additional function on the part of health workers who are only required as government employees to render service only eight hours a day or 40 hours within a week.

Besides, manning the birthing facilities is not the only functions of these workers as they have other jobs to do from Monday to Friday, Nonato said, as she insisted that they need an additional remuneration in the form of service fee instead of professional fee, lest it be interpreted as double compensation.

Local government physicians, Nonato said, are insisting that they need additional fees because they often exceed the number of working hours, as required by the Civil Service Commission, while attending to expectant mothers.

These excess hours of work that they routinely render could be considered overtime with pay and the LGU does not have allocation for this, she said.

If the LGU would only allow them to claim overtime pay and provide them adequate operating expenses like medical supplies, the service or professional fee would no longer be necessary in the proposed ordinance, Nonato added.

So, instead of enacting ordinance imposing service fee on users of birthing facilities, what should be passed by the SB is a measure that will compel the LGU to provide these needs of public health workers, Samantela stressed. (PNA) CTB/FGS/DOC/cbd/