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Republic of The Philippines Department of Health Office of The Secretary

DEPARTMENT CIRCULAR No. 24 s 1987

TO:
The Undersecretaries of Health Bureau and Regional Directors, Chiefs of Offices, Services, Special, Regionals, Provincial Hospitals/Unit Heads and Other Concerned

SUBJECT:
Guidelines for the Implementation of Executive Order No. 51 “Adopting a National Code of Marketing of Breastmilk Substitutes, Breastmilk Supplements and other related products”
The following guidelines are issued for the guidance of all concerned in the implementation of Executive Order No. 51, “National Code of Marketing of Breastmilk Substitues, Breastmilk Supplements and other related products

I. INFORMATION EDUCATION COMMUNICATION AND TRAINING

The promotion of breastfeeding and the implementation of the Milk Code shall be integral parts of all IEC, training and other relevant activities of the Department of health and concerned agencies. As such:

1. The Department of Health shall plan, provide, design, disseminate and regulate information related to infant nutrition and Milk Code implementation in collaboration with other agencies (government and non government). It shall:

1.1 Mobilize existing network and other units within the DOll at all levels involved in IEC and Training.
1.2 Strengthen the National Movement for the Promotion of Breastfeeding (NMPB) and other organizations concerned with the promotion of breastfeeding and implementation of the Milk Code.
1.3 Harness other available resources for IEC and Training.
1.4 Serves as clearinghouse for all information materials on infant nutrition and the Milk Code.

2. The focal targets for information and education on breastfecding practices shall be rural and urban women, their families, health population and nutrition \Vorkers as well as professional and special groups.

3. Contents of IEC and training programs shall be based on the needs of specific target groups and of the service.

4. Strategies for local IEC and training programs shall be based on the conditions and situations of the area and the specific characteristics of the local target groups.

II. MONITORING The Department of Health assumes the primary responsibility of monitoring compliance and violations of the provisions of the Milk Code. At the national level, a task force will be crated chaired by the Assistant Secretary for Public

Health and with membership drawn from other various offices of DOH, representatives of NMPB and other concerned NGOs.

The Milk Code Monitoring Task Force shall have the following functions:

1. Monitors compliance as well as problems encountered in the implementation of the Milk Code.

2. Reviews/acts on reports of violations of the provisions of the Code from the national and field levels.

3. verifies reports of violations of the Milk Code.

4. Monitors labels of products within the scope of the Code and marketing practices in various distribution centers.

5. Recommends sanctions or punitive actions for violations of the Milk Code to the Undersecretary of the Public Health.

6. Submits regular reports on the status of the Milk Code implementation to the Undersecretary of Public Health.

Monitoring at Regional/Provincial/City Levels

1. In the field, the task of monitoring shall be the primary responsibility of the Regional Health Director and Provincial/City Health Officers in collaboration with the Regional/Provincial/City Council for Health Concerns.

2. A Task force shall be created at the regional level composed of representatives of the DOH, other GOs and NGOs. A regional Milk Code Coordinator from DOH shall be designated to head the Task Force.

3. The Task Force shall serve as the focal group in charge of coordinating and monitoring activities relevant to the field implementation of the Milk Code.

4. The Task Force shall verify reports of violations of the Milk Code.

5. monitors labels of products within the scope of the Code and marketing practices in various distribution centers.

6. Problems/violations arising at the field levels shall be investigated and resolved at these levels whenever appropriate to institute prompt and timely actions. Only cases that require prosecution shall be elevated to the national level (Refer to policy guidelines on sanctions or violations of the Code for details).

7. The Milk Code Coordinator shall submit reports to the Regional Health Director.

III. DONATIONS FROM MANUFACTURERS/DISTRIBUTORS OF PRODUCTS WITHIN THE CODE

1. No health facility or health worker shall receive directly or indirectly samples, donations, supplies or products within the scope of the Code.

2. Charitable institutions like orphanages that care for infants and children who had been abandoned/orphaned; and lack access to wet nurses and lactating mothers may receive donations from manufacturers/ distributors of product within the scope of the Code, provided requests are made to the proper authorities.

3. Request(s) shall be addressed to:

a. Undersecretary for Public Health Services – National Level
b. Regional Health Director – Regional Level (including Metro Manila)
c. Provincial Health Officer – Provincial/Municipal level
d. City Health Officer – City Level

4. Request(s) for authority to receive donations shall include the following information

a. Name, address and telephone no. of institutions
b. no. of infants, including sex and age
c. Estimated amount/ quantity of requirements per month or per quarter.
d. Items requested (products, supplies, materials, equipments, etc.)
c. Administrator or head of institutions making the request.

5. Recipient charitable institutions shall submit required reports to the Department of Health.

6. In cases of disasters/emergencies, donations from manufacturers/ distributors of products within the scope of the Code may be received/distributed to the affected population under the provision of government agencies or non-government organizations. The organizations concerned shall submit a written report within thirty (30) days from receipt of donations to the abovementioned officials indicating name of organization, donations received, distribution list and other permanent details.

7. Receiving institutions shall not participate in any promotional activity of manufacturers/ distributors of products within the scope of the Code.

ASSISTANCE/SPONSORSHIP OF RESEARCH FELLOWSHIPS/CONTINUING EDUCATION AND OTHER RELATED RESEARCHES

1. A formal request for assistance/sponsorships is submitted by the proponent/recipient to the Undersecretary for Public Health with the following information:

a. For Research Project
:Name of Proponent
:Manufacturer/ distributor from whom assistance/ sponsorship is solicited
:Research Protocol
:Kind of assistance solicited
:Budgetary requirements

b. Fellowships
:Name of Participant
:Manufacturer I distributor from whom sponsorship is solicited
:Field of study
:Duration
:Training institutions, Justification/contribution to health development of the country
:Budgetary requirements

c. Continuing Education
Name of applicant (professional organization/ group) Manufacturer/distributor from whom sponsorship is solicited Nature of activity (workshop, seminar, etc.)
:Objective
:Theme
Participants (number I categories)
:Program of activities
Speakers
:Expected outputs

2. The manufacturers who wish to conduct clinical trials/evaluation make a formal request to the Undersecretary for Public Health providing the following inforrnation:

a. Name of proponent
b. Institution involved
c. Objective of study
d. Period covered by the study e. Experimental Design
f. Products involved and quantity of products

3. Assistance/sponsorship shall be utilized strictly for the specific objective/purposes for which they are solicited.

4. Clinical trials/ evaluation shall be conducted in accordance with the approved protocol.

5. Recipients (individuals/ organizations/ groups) shall not allow themselves to be used directly or indirectly for any promotional activity related to products within the scope of the Code such as display of posters and streamers patronizing the company and their products or use as lecturer in the promotion of products to idealize bottlefeeding.

6. The DOH shall monitor researches and activities relating to assistance. sponsorships, fellowships and continuing education. Reports by recipients/participants/proponents shall be submitted according to the required format as part of the monitoring activity.

SANCTIONS FOR THE VIOLATIONS OF THE MILK CODE 1 . Reports of violations of the Milk Code at the provincial and city levels shall be investigated and resolved at such level.

2. Reports of findings, decisions and actions taken shall be sent and forwarded to the Office of the Undersecretary for Public Health through the Regional Health Director.

3. In cases of repeated violations which require the application of sanctions, the Regional Health Director shall conduct an investigation of the violations and submit a report of the findings and recommendations to the Undersecretary for Public Health for appropriate action.

4. For violations committed at the national level, an investigation shall be conducted by the Legal Office of the Department of Health and the findings submitted to the Undersecretary for Public Health for appropriate action.

5. The following punitive actions shall apply:

5.1 For the first violation, a letter of warning/reprimand from the health officer concerned shall be sent to the offenders.

5.2 For repeated violations, appropriate sanctions shall be applied.

ALFREDO R.A. BENGZON, M.D.
Secretary of Health

Republic of the Philippines
Department of Health OFFICE OF THE SECRETARY Manila

DEPARTMENT CIRCULAR
No. 122-a s. 1987

TO:
The Undersecretaries of Health, Bureau and Regional Directors, Chiefs of Offices, Services, Regionals, Provincial Hospitals/ Unit Heads and Other Concerned.

SUBJECT:
Amendment to Dept. Circular No. 24 dated April3, 1987 on guidelines to implement E.O. 51 on the Milk Code, in particular, Section IV Assistance/ Sponsorship of Research Fellowship/ Continuing Education & Other Related Researches
Section IV, beginning at p. 4 of above circular is hereby amended as follows:

1. Approval of requests by manufacturers & distributors of products within the scope of the Milk Code to aggist continuing education activities like trainings, workshops, conferences and similar activities is hereby delegated further to Regional Health Directors in addition to the Undersecretary of Public Hcslth, Requirements for approval remain as stated in section VI, no. I (c).

2. Approval for covered manufacturers and distributors to assist research projects, clinical trials and fellowships shall continue to be made only by the Undersecretary of Public Health.

3. In order to facilitate documentation of action at the Regional Health Offices, attached t(,rm is provided. Duplicate copies of these forms shall be collected and forwarded every quarter to the Office for Public Health Services as a report of action in this regard.

Please be guided accordingly.

(Sgd) ALFREDO R.A. BENZON, M.D. Secretary of Health

CERTIFIED T
RUE COPY GREGORIA V. BAUTISTA
Chief, Records Section
Department of Health

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