BARRIERS/CHALLENGES ENCOUNTERED BY STATE AND OTHER HEALTH SERVICE PROVIDERS 1. RESTRICTIVE POLICY ENVIRONMENT Health workers are unable to provide RH goods and services according to the RH Law because of EO 3. They find themselves in a dilemma between the two policies on RH. For NDP nurses, distribution of RH goods from the DOH had to be discreet or in ‘safe’ venues. As NDPs openly defy the ‘Pro-Life’ Ordinance, they also risk their personal security. According to one nurse: “May takot po ang mga midwives lalo na po iyong mga contractual para mag dispense ng commodities…doon po nakatago sa bodega, hindi ginagalaw…ang ginagawa po namin, pag may dumadating na client, either doon sa puno ng mangga, sa labas po, basta outside po ng facility. Ang medyo risk langdoon ay ang privacy ng client.” Another nurse added, “May mga times nanaka-encounter po ako na pag nagfi-field kami at magbibigay kami ng commodities, may nagsasabi ng ‘Oy, bawal yan!’ Medyo mahirap din po.” 2. LACK OF SUPPORT FOR HEALTH WORKERS The CHO of Sorsogon City cited the lack of training on providing RH services for employees in health centers as a factor that hindered the quality of their implementation. Apart from that, health service providers are antagonized by through the “Pro-Life” Ordinance. As Catherine Tumalad of the FPOP recounted, “Noong January 28-30, nagkaroon ng Summit ang Pro-Life…doon din sinabi nila na ang FPOP is NO. 1 abortionist in the Philippines.” Other issues which affect delivery or RH services raised during the Public Hearing are as follows: 1. Nurse deployment is not a continuing program. Their contract will end in June 2016. They were told it is renewable and until December 2016. Who will dispense FP commodities and services once the NDPs were pulled out? 2. Facility based delivery and deliveries attended by skilled-birth attendants is not made mandatory for all pregnant women. Maternal deaths is at 11 and 4 came from Sorsogon City. From January to May 2016 there were 7 maternal deaths in the entire provinces and one came from Sorsogon City. (Cause: eclampsia) 3. Maternal and fetal death reviews are not used to improve service delivery, despite the data being reported to the Mayor. Recommendations to resume distribution of FP goods for the sake of the marginalized and vulnerable sectors of women were ignored 4. Local health providers were not given adequate training of on life-saving skills. The training should not be only for nurses. DOH assured them that BHWs and midwives will receive training. Nurses are trained to dispense injectables. The CHO request for training for BHW and midwives and all health workers involved in RH prior to redistribution or reintroduction of artificial and natural FP methods. 34