Ao 2022 Omnibus
Ao 2022 Omnibus
Ao 2022 Omnibus
of
Republic of the Philippines
Department of Health
OFFICE OF THE SECRETARY
TN 30 an
ADMINISTRATIVE ORDER :
SUBJECT: Utilization
per
Omnibus
Guidelines
Lifestage :
and
I. RATIONALE
In line with the constitutional mandate to protect and promote the health of Filipinos
and pursuant to Executive Order (EO) No. 102 series of 1999, followed by EO No.
366 series of 2004, the Department of Health (DOH), as the national technical
authority on health, seeks to establish the highest achievable standards of quality
health care, health promotion and health protection, on which local government units
Health
(LGUs), non-government organizations (NGOs), other private organizations, and
individual members of civil society will anchor their health programs and strategies.
Development
the adoption, implementation, and utilization by the LGUs and government and
non-government health care providers in terms of health systems planning and service
delivery. Acknowledging the necessary resource requirements to adopt a
whole-of-system, whole-of-government, and whole-of-society approach in the
development of quality standards for clinical care for existing and emerging diseases,
conditions, and disorders in all life stages and settings, there is a need to integrate
existing policies on health services and to gradually incorporate and update standards
across the entire spectrum of clinical care.
Strengthened by the enactment of the Republic Act (RA) No. 11223, also known as
the “Universal Health Care (UHC) Act”, current health reforms aim to provide an
integrated and comprehensive set of quality and cost-effective services covering the
spectrum of care from promotion, prevention, screening, diagnosis, treatment,
rehabilitation, and palliation, and transform the health system focus from curative and
hospital care to a primary care-oriented and people-centered care. With this, the DOH
is mandated to institutionalize the process of standards setting for service delivery and
to strengthen efforts to provide a comprehensive and coordinated approach to health.
The Omnibus Health Guidelines (OHG) per Lifestage are hereby developed to serve
as the overarching policy issuance integrating key policy provisions governing
various health programs and integrating various standards: of care. These guidelines
shall provide a life course approach for the delivery of services appropriate to each
Filipino and guide the functional and efficient linking of health services across
different levels of care, different care settings, and across the entire spectrum of care,
with primary care as the foundation, and intersectoral participation as a key principle.
Building 1, San Lazaro Compound, Rizal Avenue, Sta. Cruz, 1003 Manila ® Trunk Line 651-7800 local 1113, 1108, 1135
Direct Line: 711-9502; 711-9503 Fax: 743-1829 e URL: http://www.doh.gov.ph; e-mail: [email protected].,ph
V &
II. OBJECTIVES
IIL SCOPE
This Order shall apply to all DOH Central Office Bureaus and Services, Centers for
Health Development (CHDs), including the Ministry of Health - Bangsamoro
Autonomous Region in Muslim Mindanao (BARMM) subject to the applicable
provisions of RA No. 11054 or the “Bangsamoro Organic Act” and subsequent rules
and policies issued by the Bangsamoro government, DOH-retained hospitals, public
and private hospitals, treatment and rehabilitation centers, other health facilities,
LGUs, partners from national government agencies (NGAs), development partners,
civil society organizations (CSOs) including NGOs, community-based organizations
(CBOs), advocacy groups, the academe, and all other stakeholders concerned.
Bs
49 years of age.
4. Adult - refers to an individual aged 20 years to 59 years and 11 months.
5. Elderly or Senior Citizen - refers to a person at least 60 years old (RA No.
9994 “Expanded Senior Citizens Act of 2010”).
. Levels of Care - refer to the different types of facilities that deliver health
services, including primary care services, intermediate care services, and
specialized care services, guided by the Resource Stratified Frameworks in the
Philippine Health Facility Development Plan (PHFDP) 2020-2040 (DOH, 2020).
. Life Course Approach - refers to an approach that recognizes that all stages of a
person’s life are intricately intertwined with each other, with the lives of other
people in society, and with past and future generations of their families; that
health and well-being depend on interactions between risk and protective factors
throughout people’s lives; and that takes action early to ensure the best start in
life, appropriately to protect and promote health during life’s transition periods,
and together, as a whole society, to create healthy environments, improve
conditions of daily life, and strengthen people-centered health systems (World
Health Organization, 2018).
V. GENERAL GUIDELINES
A. The OHG shall be the main policy reference in the fulfillment of the mandate of
DOH in setting standards of care to ensure the safety and quality of health
services, based on CPGs and best available evidence, in cooperation with
professional societies and the academe, as outlined in Section 27 of the UHC
Act.
. The OHG shall define the standards of care using the life course approach in the
provision of individual- and population-based services, along the continuum of
care, in health facilities and settings.
The OHG shall be updated every three years or as necessary based on new
evidence, new policy directions, and stakeholder and client feedback. Updates
shall be prioritized, if necessary, based on strength of evidence, burden of
disease, and practice variation. The evidence to be considered in the periodic
updating of the OHG shall include the following: recommendations from NPGs
and international high-quality CPGs, high-quality research studies, and
supplementary references that pass quality appraisal, which address conditions
that contribute significantly to the burden of disease per life stage.
The OHG shall be developed with a focus on primary care service delivery, and
progressively expanded to include standards for intermediate and specialized
care, in order to guide integrated service delivery across different levels of care.
The OHG shall be used as the main reference for developing guidance to
individuals and households on self-care and household care; healthcare providers
for clinical care; LGUs and primary care managers for community-based care;
settings-based managers for care in schools, workplaces. or closed settings; and
NGA for national policies and incentives on quality health service delivery.
G. The OHG and quality appraised CPGs shall be considered in the development of
health entitlements and expansion of benefit packages, but shall not replace the
established processes for prioritization and evaluation by the Health Technology
Assessment Council (HTAC) and the Philippine Health Insurance Corporation
(PhilHealth).
H. All individuals involved in the development of the OHG shall declare their
conflicts of interest, including those related to breast milk substitutes, tobacco,
vapor products, heated tobacco products, alcoholic beverages, and
pharmaceutical products, in accordance with the National Code of Marketing of
Breastmilk Substitutes, Breastmilk Supplements, and Other Related Products
(EO No. 51 series of 1986), Protection of the Bureaucracy Against Tobacco
Industry Interference (Civil Service Commission-DOH Joint Memorandum
Circular No. 2010-001), Implementing Guidelines of Section 35 of the Republic
Act No. 11223, otherwise known as the “Universal Health Care Act’, on
Standards on Receipt, Assessment, and Management of Conflict of Interest
(DOH AO No. 2021-0011), Adoption and Implementation of “The Mexico City
Principles for Voluntary Codes of Business Ethics in the Biopharmaceutical
Sector” (Food and Drug Administration Circular No. 2013-024), and other
relevant laws, policies and guidelines.
I. This AO shall not preclude the DOH from releasing new policies on health
service delivery and implementation, particularly in the context of disasters and
public health emergencies. The relevant provisions in new policies shall be
included in the updates of the OHG.
I. The DOH - Disease Prevention and Control Bureau (DPCB) shall provide
direction and oversight on the development and updating of the OHG and
shall ensure the declaration, assessment, and appropriate management
of
the
interests of all individuals involved in the development and updating of the
OHG.
3. The DOH may invite additional external experts to review and provide
comments and technical inputs on topics that are beyond the expertise of the
TWG.
4. The DOH shall invite other relevant stakeholders such as the representatives
of other government agencies, NGOs, clinical experts, community leaders,
Cy
)
representatives of marginalized and underprivileged sectors, and the public,
among others, to review and provide inputs on the OHG.
I. The initial version of the OHG shall include SOCs from existing policies,
which are valid, evidence-based, and consistent with UHC principles, and
supplemented by quality local and international CPGs and other quality
references, which are consistent with the best available evidence and
international standards.
The DPCB shall perform rational priority setting in developing and updating
the OHG based on the following criteria: burden of disease including
magnitude, severity, and urgency; new or emerging evidence that passed
quality appraisal; presence of practice variation; and stakeholder feedback.
The OHG per life stage and setting shall be issued as Department Circulars
and divided as follows:
Omnibus Health Guidelines for Children
oe
Omnibus Health Guidelines for Adolescents
Omnibus Health Guidelines for Adults
oe Omnibus Health Guidelines for the Elderly
Omnibus Health Guidelines for Managers of Various Settings
The monitoring and evaluation of the OHG shall be led by DPCB and shall be
a shared responsibility of all stakeholders involved in its implementation,
including the different DOH offices and attached agencies, CHDs, LGUs,
other concerned NGAs, schools and other learning institutions, workplaces,
development partners, academic and health professional partners, and other
CSOs. The DPCB shall gather inputs on accomplishments or feedback from
the respective mandated offices and stakeholders or their representatives, as
listed in Section VII. Further guidelines on the methodologies of monitoring
and evaluation, and other related details shall be provided by DPCB through a
separate issuance.
A. The DPCB shall lead the development and regular updating of the OHG based
on the latest available evidence. Additionally, the DPCB shall:
1. Scope, appraise, review, and synthesize evidence to formulate
evidence-based provisions of the OHG;
2. Conduct capacity building and strengthening activities on evidence
synthesis and knowledge translation;
3. Coordinate the formation, internal proceedings, and external relations of
the TWG;
Facilitate the declaration, assessment, and management of conflicts of
interests of all individuals involved in the OHG development and
updating;
Develop and disseminate Guideline Implementation Tools, particularly
Clinician Support Tools (algorithms, clinical pathways, flowcharts, forms,
and checklists), Implementation Support Tools (manuals, human,
infrastructure and funding resources), and Evaluation Support Tools
(audit tools, quality indicators, performance measures), based on the
OHG;
6. Ensure the dissemination and advocate the adoption and implementation
of the OHG and Guideline Implementation Tools by target users; and
7. Lead the monitoring and evaluation of the implementation of the OHG.
B. The Health Policy and Development and Planning Bureau (HPDPB) shall
ensure alignment of the OHG to the general thrusts and directions of the DOH.
The Health Facilities and Services Regulatory Bureau (HFSRB) shall use the
OHG
as
one of itsreferences in setting the scope of services and the standards for
the licensing of health facilities and services.
. The Health Facility Development Bureau (HFDB) shall align plans, policies
and strategies relative to the health facility development, planning, operation, and
maintenance with the provisions of the OHG.
K. The PhilHealth shall use the OHG for prioritizing the costing of services and
designing benefit packages, with due consideration given to the HTA process.
N. Other NGAs are enjoined to align their policies, programs and services with the
OHG.
R. Workplaces are enjoined to facilitate the inclusion of the provisions of the OHG
as part of the services in occupational health.
S. Members of the private health sector are enjoined to align their policies,
programs, and services to the OHG.
Relevant provisions or parts of issuances listed in Annex A and all other related
issuances that are inconsistent with this Administrative Order are hereby amended,
modified or repealed by succeeding Omnibus Health Guidelines to be released as
Department Circulars.
IX. SEPARABILITY CLAUSE
EFFECTIVITY
This Order shall take effect immediately fifteen (15) days after publication to the
Official Gazette or in any newspaper of general circulation.
10
References
Civil Service Commission - Department of Health Joint Memorandum Circular No. 2010-01.
Protection of the Bureaucracy Against Tobacco Industry Interference.
Department of Health. (2018). Administrative Order No. 2018 - 0019 Guidelines on the
Institutionalization and Implementation of the National Clinical Practice Guidelines
Program.
Department of Health & Philippine Health Insurance Corporation. (2018). Manual for
Clinical Practice Guidelines Development.
Department of Health. (2020). Philippine Health Facility Development Plan (PHFDP) 2020-
2040.
https://doh.gov.ph/sites/default/files/publications/DOH_PHILIPPINE%20HEALTH%
20FACILITY %20DEVELOPMENT%20PLAN%202020 2040
0.pdf
Department of Health. (2021). Administrative Order No. 2021-0011 Implementing Guidelines
of Section 35 of the Republic Act No. 11223, otherwise known as the “Universal Health
Care Act’, on Standards on Receipt, Assessment, and Management of Conflict
of
Interest.
Executive Order No. 102, s. 1997. Redirecting the Functions and Operations of the
Department of Health.
CL
Liang, L., Abi Safi, J., Gagliardi, A., Armstrong, M., Bernhardsson, S., Brown, J., Chraborty,
S., Fleuren, M., Lewis, S., Lockwood, C., Pardo-Hernandez, H., Vemnooij, R., &
Willson, M.. (2017). Number and type of guideline implementation tools varies by
guideline, clinical condition, country of origin, and type of developer organization:
content analysis of guidelines. Implementation Sci 12, 136.
https://doi.org/10.1186/513012-017-0668-7
Neufeld, J. & Kettner, J. (2014). The Settings Approach in Public Health: Ti hinking about
Schools in Infectious Disease Prevention and Control. Purple Paper 45.
https://nccid.ca/wp-content/uploads/sites/2/2015/03/ PP_45 EN.pdf
Republic Act No. 9994: An Act Granting Additional Benefits and Privileges to Senior Citizens,
Further Amending Republic Act No. 7432, As Amended”
Republic Act No. 10354: The Responsible Parenthood and Reproductive Health Act 2012”
of
Republic Act No. 11054: An Act Providing for the Organic Law for the Bangsamoro
Autonomous Region in Muslim Mindanao
Republic Act No. 11223: An Act Instituting Universal Health Care Jor All Filipinos,
Prescribing Reforms in the Health Care System, and Appropriating Funds Therefore”
and its Implementing Rules and Regulations
ii
ANNEX A: LIST OF POLICIES WITH AMENDED PROVISIONS
Department of Health (2008). Administrative Order No. 2008-0201 “Strategy for the
Maternal Newborn Child Health and Nutrition (MNCHN)”
Department of Health (2009). Administrative Order No. 2009-0025 “Adopting New Policies
and Protocol on Essential Newborn Care”
Department of Health (2019). Administrative Order No. 2019-0026 “National Policy in the
Provision of Birthing Assistance to Primigravid and Grand Multigravid Women”