Philippine Midwifery Act

Sellate Office of the shetcetary 25 DEC 10 P5:08 TWENTIETH CONGRESS OF THE REPUBLIC OF THE PHILIPPINES First Regular Session RECEIVED BY: SENATE S. No. 1599 Introduced by Senator Ronald "Bato" Dela Rosa AN ACT STRENGTHENING THE PRACTICE OF MIDWIFERY AS A PROFESSION IN THE PHILIPPINES, PROVIDING FUNDS THEREFOR, REPEALING FOR THE PURPOSE REPUBLIC ACT NUMBERED 7392 OTHERWISE KNOWN AS THE PHILIPPINE MIDWIFERY ACT OF 1992 EXPLANATORY NOTE Article II, Section 15 of the 1987 Constitution provides that the State shall protect and promote the right to health of the people and instill health consciousness among them. Towards this end, it is the duty of the State to ensure that the country's health workforce are, in the best of health, too, not just physically but also professionally. Among those who are part of this health workforce are our midwives. Unfortunately, despite being a quiet and reliable support system health-wise, our midwives have been seeking refuge under the umbrella of a law that is more than three decades old. Republic Act No. 7392, or the "Philippine Midwifery Act of 1992," laid the groundwork for the regulation and development of the midwifery profession more than thirty years ago. But much has changed in that span of time. The demands of our healthcare system have evolved. Medical technologies have advanced. The standards of training, ethical practice, and professional support must likewise rise to meet the present- day realities faced by our midwives and the communities they serve. This bill seeks to repeal Republic Act No. 7392 and in its place establish a more comprehensive, responsive, and future-proof Philippine Midwifery Act.

Among its key features are the following: • It strengthens the powers and functions of the Professional Regulatory Board of Midwifery, under the supervision of the Professional Regulation Commission; • It sets a clear, expanded, and evidence-based scope of midwifery practice, with appropriate safeguards, referrals, and clinical protocols aligned with Department of Health guidelines; • It ensures that midwives-whether in government, private facilities, or self- managed birthing centers-receive fair compensation, security of tenure, and timely access to PhilHealth accreditation; • It mandates the creation of a National Midwifery Office under the Department of Health to provide policy direction, leadership support, and knowledge development for the profession; • It introduces penalties for the unauthorized practice of midwifery, misuse of credentials, and other prohibited acts that undermine the integrity of the profession. This measure reaffirms the State's commitment to safeguard our nation's health. This covers not only the lives of mothers and newborns, but also the rights and dignity of midwives who have, for the longest time, served as the first line of healthcare for many Filipino families. By modernizing the legal framework that governs their practice, this bill empowers and professionalizes the work that goes into childbirth, which, after all, is the bedrock for nation building. In view of the foregoing, the immediate passage of this bill is earnestly sought. RONALD "BATO" DELA ROSA

Senate Office of the ericetary TWENTIETH CONGRESS OF THE REPUBLIC OF THE PHILIPPINES 25 DEC 10 P5:08 First Regular Session SENATE RECEIVED BY: S. No. 1599 Introduced by Senator Ronald "Bato" Dela Rosa AN ACT STRENGTHENING THE PRACTICE OF MIDWIFERY AS A PROFESSION IN THE PHILIPPINES, PROVIDING FUNDS THEREFOR, REPEALING FOR THE PURPOSE REPUBLIC ACT NUMBERED 7392 OTHERWISE KNOWN AS THE PHILIPPINE MIDWIFERY ACT OF 1992 Be it enacted by the Senate and the House of Representatives of the Philippines in Congress assembled: ARTICLE I TITLE, DECLARATION OF POLICY, AND DEFINITION OF TERMS

Section 1. Short Title. - This Act shall be known as the "Philippine Midwifery

Act."

Sec. 2. Declaration of Policy. - It is hereby declared the policy of the State to

assume responsibility for the protection and enhancement of the midwifery profession. 7 The State shall adopt measures that will continuously improve the knowledge, skills and competence, and ethical standards of midwives to prevent the increase in maternal and infant mortality rates. The State also recognizes the critical role of midwives in the provision of preventive and promotive health care services for women, children and other members of the community.

Sec. 3. Definition of Terms. - As used in this Act :

a) Accredited Integrated Professional Organization (AIPO) refers to the concerned Board and PRC Accredited Integrated Professional Organization for a given profession which is specifically mandated

by the provision of Professional Regulatory Law (PRL) to integrate the professionals into one national organization and where the membership therein by the professional is automatic and mandatory; b) Bachelor of Science in Midwifery refers to a four (4) year degree program consisting of general education and professional courses leading to a Bachelor's degree in Midwifery; c) Code of Ethics refers to the set of principles of practices and standards of behavior that shall govern the ethical conduct, moral obligations and professional duties to be observed by all registered and licensed midwives; d) DOH Clinical Practice Guidelines refers to the evidence-based document developed by the Department of Health (DOH), in consultation with relevant public and private stakeholders, that presents the appropriate health care for specific clinical circumstances, with the goal of delivering the optimal care to clients; e) Life Saving Drugs refers to the drugs such as oxytocin, magnesium sulfate, antenatal steroids and antibiotics among other medicines used to prevent and manage pregnancy related complications; f) Medicine Delivery Network refers to the network of organizations that provides or makes arrangements to provide equitable, comprehensive, integrated, and continuous good quality health services to a defined population, with minimum duplications and inefficiencies; g) Midwife refers to a person who has successfully completed midwifery education, program and, who is registered and licensed to practice by the Professional Regulatory Board (Board) of Midwifery and the Professional Regulation Commission (PRC) as defined under R.A. No. 7392 or the "Philippine Midwifery Act of 1992 ;" and h) Skilled Health Professionals refers to the providers such as midwives, doctors or nurses who were educated, licensed and trained to proficiency in the skill needed to manage pregnancies, childbirth and the immediate newborn period and in the identification, management and referral of complications in mothers and newborns.

ARTICLE II THE BOARD OF MIDWIFERY

Sec. 4. Composition of the Board. - There shall be a Board of Midwifery,

hereinafter referred to as the Board, which shall be under the direct supervision 5 of the PRC . It shall be a collegial body composed of a chairperson and four (4) members to be appointed by the President of the Republic of the Philippines.

Sec. 5. Qualifications of the Chairperson and Members of the Board. -

A. The Chairperson of the Board of Midwifery shall at the time of appointment must have the following qualifications: a) A natural born citizen and resident of the Philippines; b) Of good moral character; c) A graduate registered midwife; d) Have at least 10 years in practice as a midwife; and e) A holder of master's degree or doctorate degree in any of the following fields: public health, maternal and child health (MCH), community health, primary health care, health services administration, health systems or health care management; B. The three (3) members of the Board of Midwifery shall at the time of the appointment must have the following qualifications: a) A natural born citizen and resident of the Philippines; b) Of good moral character; c) A graduate registered midwife; d) Have at least ten (10) years in practice as a midwife; and e) A holder of master's degree or doctorate degree in any of the following fields: public health, maternal and child health (MCH), community health, primary health care, health services administration, health systems or health care management; f) Have at least ten (10) years in practice as a midwife prior to their appointment, C. One (1) member of the Board of Midwifery shall at the time of the appointment must have the following qualifications:

a) A natural born citizen and resident of the Philippines; b) Of good moral character; and c) Have at least five (5) years in practice as an obstetrician- gynecologist preferably diplomate prior to the appointment.

Sec. 6. Disqualifications of the Board Members. -

a) Member of the faculty, whether full time or part time or lecturer of any school, college or university where a regular course is midwifery; b) Those who have pecuniary interest, directly or indirectly in any school, college or university during their term of office as member of the Board; c) Officer or member of the Board of Trustees of Midwifery Organization; 11 and d) Those who hold positions which violate the provisions of Republic Act No. 6713 or the Code of Conduct and Ethical Standards for Public Officials and Employees or which violate incompatibility of office under items a to c.

Sec. 7. Terms of Office. - The Chairperson shall hold office for six (6) years

without reappointment. Two (2) members shall hold office for four (4) years without reappointment. Two (2) members shall hold office for three (3) years subject to reappointment for only one term. Any vacancy in the Board occurring within the term of a member shall be filled for the unexpired portion of the term only.

Sec. 8. Compensation of Board Members. - The Chairperson, and members of

the Professional Regulatory Board of Midwifery shall receive compensation and allowances or other benefits pursuant to the provisions of Republic Act No. 8981 or the PRC Modernization Act of 2000 and other pertinent laws and comparable to the compensation and allowances received by the chairperson and members of existing professional regulatory boards.

Sec. 9. Removal of Board Members. - Any members of the Board may be removed

by the President of the Republic of Philippines, upon the recommendation of the PRC , for neglect of duty incompetence or unethical, immoral and dishonorable conduct after having been given the opportunity to defend oneself in a proper administrative investigation conducted by the PRC

Sec. 10. Powers and Duties of the Board. - The Board shall supervise and regulate

the practice of midwifery profession and shall have the following powers, duties and functions: a) Enforce the provisions of this Act; b) Conduct Professional Licensure Examination for midwives; c) Administer oaths in accordance with the provision of this Act; d) Issue, suspend or revoke certificates of registration for the practice of midwifery; e) Maintain a registry of midwives in good standing in cooperation with AIPO; f) Shall maintain and collect data of midwives in the country in coordination with PRC Information and Communications Technology Service and the DOH by requiring the registration of all midwives in the National Health Workforce Registry (HHWR) or other human resource for Health (HRH) data collection system of the government and during their initial registration and renewal of licenses; g) Shall provide inputs on national and global midwifery practice to the commission on Higher Education (CHED) to be considered in the development and periodic updating of the midwifery curriculum; h) Conduct hearings and investigations to resolve complaints against midwives for malpractice, unethical and unprofessional conduct and violation of this Act or its implementing rules and regulations and in connection therewith; i) Issue subpoena ad testificandum and subpoena duces tecum and to punish with contempt persons obstructing, impeding or otherwise interfering with the conduct of such proceedings upon application with the court, or both; j) Promulgate a Code of Ethics in coordination and consultation with AIPO and professional organizations representing registered and practicing midwives in the Philippines within one (1) year from the effectivity of this Act;

k) Conduct inspection and monitoring of educational institutions and facilities where midwifery services are offered or midwifery programs are taught to ascertain that the standards of midwifery education are properly complied with and maintained at all times; 1) Shall submit an annual report to the PRC at the end of each calendar year, giving a detailed account of its proceedings and the accomplishments and recommending measures to upgrade and improve the conditions affecting the midwifery practice and education; m) To adopt an official seal to authenticate its official documents; n) Attend meetings regularly; o) Study the conditions affecting midwifery education and the practice of the midwifery profession in the Philippines; p) Mandated to assess the standards pertaining to the retraining and skills enhancement programs designed for midwives seeking advanced training or those in need of bridging education; q) Undertake initiatives and establish support mechanisms aimed at enhancing the retirement preparedness of midwives, with the objective of ensuring their post-retirement years are marked by financial security, personal fulfillment, and strong support; r) Adopt a proactive approach in actively engaging a diverse range of stakeholders within the sector to foster the advancement and development of midwifery practice in the Philippines; s) Subject to the approval of the PRC, the Board shall set ethical and professional standards for the practice of midwifery and adopt such rules and regulations as may be necessary to carry out the provisions of this Act. Such standards, rules and regulations shall take effect thirty (30) days after publication in two (2) national newspapers of general circulation; and t) Represent the Board in sectoral management.

Sec. 11. Meetings of the Board. - The Board shall hold a regular meeting at least

once a month within the PRC premises or in such other places as may be agreed upon on such date and time fixed by the Board. A special meeting may be called by

1 the chairperson or any of its two (2) members to consider, deliberate or act upon 2 urgent and important matters. The Board Secretary shall keep the minutes of the regular and special meetings of the board. The minutes shall be signed and certified as correct by the members of the board present.

Sec. 12. Administrative Supervision of the Board and Custodian of its Records. -

6 The members of the Board shall be under the general supervision of the PRC . All records, including examination paper, applications for examinations, administrative and other investigative cases conducted by the Board shall be under the custody of the PRC . ARTICLE III MIDWIFERY EDUCATION

Sec. 13. Standards for Midwifery Education. - To ensure quality midwifery

CHED education in the Philippines, the has the following duties and responsibilities in coordination with the Professional Regulatory Board of Midwifery: a) Establish standards for midwifery education, including the setting of minimum qualifications of faculty, and the facility requirements for training, and among others; b) Develop and periodically review the basic curriculum in consultation with the Department of Health (DOH), the Board, AIPO, Association of Philippine Schools of Midwifery, and other midwifery organization; c) Monitor and evaluate the performance of midwifery programs of schools, colleges, and institutions; d) Examine the facilities of universities and colleges of midwifery, and those seeking permission to open the midwifery courses prescribed; and e) Impose appropriate sanctions to institutions that do not fulfill the aforementioned standards, such as downgrading or withdrawal of accreditation, and termination of the program or school course, among others in coordination with the Board.

Sec. 14. Schools of Midwifery. - To become a duly accredited and legally

constituted higher education institution for midwifery education and training as provided for in R.A. No. 7392, a school of midwifery shall have applied and secured a permit from the CHED . The school shall operate a midwifery program in

accordance with the existing policies, standards and guidelines for midwifery education.

Sec. 15. Qualifications of Faculty. - The faculty shall have academic preparation

appropriate to teaching assignment, as follows: a) A holder of a Master's degree on Health and social sciences or doctor of medicine; b) Has a proof of competence in the field of specialization assigned; c) A registered nurse or registered midwife in the Philippines with at least one (1) year of satisfactory teaching experience or one (1) year of efficient performance in maternity ward, Provided, that a registered midwife may be allowed to follow up student midwives in the community ward provided that a person has at least two (2) years of experience in the area of assignment and has undergone training in the supervision of students; and d) A member of good standing of AIPO or other national association of midwives. ARTICLE IV EXAMINATION AND REGISTRATION OF MIDWIVES

Sec. 16. Examination Required. - All applicants for registration to the practice of

midwifery in the Philippines, shall be required to pass a written examination which shall be given by the Board in such places and dates as may be designated by the PRC : Provided, T that it shall be in accordance with R.A. No. 8981; Provided, further, That for those who are graduates of a two (2) year diploma courses and are already registered midwives prior to the passage of this Act shall be given an equivalency to a four (4) year degree program. The parameters to such equivalency shall be based on the following: a) Years of experience; b) Ladderized education or training already taken; and c) Continuing professional development requirements. shall issue the Upon compliance with the established parameters, the PRC appropriate registration to the midwives. Those who fail to comply with the established parameters shall be allowed to take the Professional Board Examination for a four year degree course

Sec. 17. Scope of Examination. -The scope of Examination for the practice of

midwifery shall consist of the following: a) Newborn, infant and child health related procedures to midwifery; b) Obstetrical anatomy and physiology; c) Obstetrics including essential intrapartum and basic emergency obstetric care; d) Principles of Microbiology and parasitology as applied to midwifery practice; e) Pharmacology as applied to midwifery practice; f) Midwifery procedures; g) Primary Health Care which covers community care, public health, and preventive care; h) Maternal nutrition, newborn, infant and young child feeding including breastfeeding and complementary feeding; i) Responsible parenthood, family planning, adolescent health and reproductive health; j) Ethics and legal jurisprudence of midwifery practice; k) Professional growth and development, and entrepreneurship; and I) Other subjects that the Board may deem necessary for inclusion from time to time.

Sec. 18. Prerequisite and Qualifications of Applicants for Examination. - In order

to be admitted to the Professional Licensure Examination for midwifery all applicants must possess all qualifications and none of the disqualifications hereunder set forth as follows: a) Is mentally, emotionally and physically sound with a certificate of good moral character signed by the Head of a recognized and duly government midwifery institution or midwifery school from where the applicant graduated; b) A graduate of midwifery in a government recognized and duly accredited and institution; c) At the time of the issuance of a certificate of registration, the applicant shall be a citizen of the Philippines and at least eighteen (18) years of age.

For the purposes of admission to the midwives' professional licensure examination, the applicant must submit the following documentary requirements: a) Philippines Statistic Authority authenticated copy of the certificate of live births; b) Certified true copy of the official transcript of records; c) Duly accomplished form, certified as true and correct by the clinical instructor and dean or principal of the school of midwifery attesting to the applicant's: 1. Handling of at least twenty (20) actual deliveries; 2. Suturing of at least five (5) perineal lacerations; 3. Insertion of at least five (5) intravenous fluids; and 4. Conduct of at least ten (10) internal examinations; d) Other documents that the Board may require provided any additional requirement has been subject of prior consultation and is duly announced in a public document.

Sec. 19. Fees for Examination. - The Applicants for examination for the practice of

midwifery shall pay an examination fee as prescribed by the PRC

Sec. 20. Ratings in the Board Examination. - To be qualified as having passed the

professional licensure examination for midwives, the examinee must obtain a general rating of seventy-five percent (75% in the written test with no grade lower than fifty percent (50%) in any of the examination subjects.

Sec. 21. Report on the Results of the Board Examinations. - As a result of a fully

computerized examination, the Board shall, within a maximum of thirty (30) days after the examination, report the ratings obtained by each examinee to the PRC . The PRC shall, after days from receipt, release to the public the results of the Board examinations.

Sec. 22. Oath of Profession. - All successful examinees shall be required to take

an oath of profession before the Board or any government official authorized to administer oaths prior to entering the midwifery practice.

Sec. 23. Issuance of Certificate of Registration / Professional License and

Professional Identification Card. - A certificate of Registration and Professional License as a midwife shall be issued to an applicant who passed the application upon payment

1 of the prescribed fees. Every certificate of registration and professional license shall and of the members of the show the full name of the chairperson of the PRC Board, and the official seal of the PRC

Sec. 24. Registration of Nurse Midwife. - A Certification of Registration may be

issued to registered nurses who passed the examination for midwives: Provided, T hat the nurse, before being allowed to take the examination submit written evidence to the Board that one has handled at least twenty (20) delivery cases as certified by the municipal, city or Provincial Health Officer or chief of a duly registered or recognized hospital, DOH and PhilHealth accredited birthing centers.

Sec. 25. Inhibition against the Practice of Midwifery. - No person shall practice or

offer to practice midwifery in the Philippines, as defined in this Act without holding a valid Certificate of Registration and Professional License as midwife.

Sec. 26. Foreign Reciprocity. - A certificate of registration and professional license

may be issued to midwives registered under the laws of a foreign country or state: Provided, T hat the requirements for registration or licensing of midwives in said country are substantially the same as those prescribed under this Act: Provided further, T hat the laws of such state or country grant the same privileges to registered midwives of the Philippines.

Sec. 27. Exemption in Taking a Bridging Course. - Midwives who possess a diploma

degree and obtained a PRC license prior to the implementation of this Act shall be no longer required to undertake bridging courses for the eventual attainment of a Bachelor's degree. Their status as midwives with valid licenses shall be maintained. Conversely, midwives with a diploma degree who acquired their PRC license after the implementation of this Act are obligated to successfully complete bridging courses leading to the conferment of a Bachelor's degree while retaining their license to practice. ARTICLE V PRACTICE OF MIDWIFERY

Sec. 28. Practice of Midwifery Defined. - The practice of midwifery consists of

performing, rendering or offering for a fee, salary or other reward or compensation services requiring an understanding of the principles and application of procedures and techniques in:

a) Managing normal and uncomplicated pregnancies and deliveries; b) Identifying pregnancy complications and danger signs, and immediate referral of high-risk pregnancy woman to the appropriate facility in the service delivery network; c) Caring for the newborn, and proper assessment initial management, and immediate referral of newborn complications; d) Carrying out the written order of physicians on natal, ante-natal, intra- natal and post-natal care of the normal pregnant mother which includes the following: 1. oral and parenteral dispensing of oxytocic drug before or after delivery of placenta as a measure to prevent postpartum hemorrhage. Provided the delivery is normal spontaneous and single birth; and 2. Suturing of 1st degree (small, skin-deep tears which usually heal naturally) and 2d degree (deeper tear affecting the muscle of the perinium as well as the skin this require stitches) of perineal lacerations to control bleeding and giving of intravenous fluid insertion during obstetrical emergencies provided they have been trained for that purpose. e) Providing family planning services which include modern and natural family planning method including counseling on informed choices to women of reproductive age; f) Administering recommended vaccines related to Maternal and child health care and as vaccinator as stated in Sec. 9 of RA 115251 otherwise known as the "Vaccination Program Act"; g) Providing primary care in the community, with emphasis on preventive and promotive health care services; and h) May perform the following procedures to a newborn, infant or young child: 1. Four core-time bound interventions during the first 60- 90 minutes of life of the newborn in accordance to the Essential Newborn Care (EINC)

a. Immediate and thorough drying; b. Early skin to skin contact; c. Properly-timed clamping and cutting of the cord after 1 to 3 minutes; and d. Non-separation of the newborn from the mother for early breastfeeding initiation and rooming in. 2. Administration of the following after the first full breastfeeding of the newborn: a. Recommended dose of Intramuscular Vitamin K to prevent Hemorrhagic disease of the newborn; b. Ophthalmic prophylaxis ointment to prevent neonatal conjunctivitis; c. Intramuscular administration of Hepatitis B vaccine; d. Intradermal administration of Bacillus Calmette Guerin (BCG) vaccine; e. Newborn Screening; and f. Performing other tasks or procedures to be determined by the Department of Health (DOH). Provided, that the scope, requirements and interpretation of said functions shall be specified in the Clinical Practice Guidelines to be jointly promulgated by the Department of Health (DOH) and the Professional Board of Midwifery in consultation with AIPO and other midwifery organizations.

Sec. 29. Revocation and Suspension of Certificate of Registration and Cancellation.

- The Board shall have the power to revoke or suspend the validity of a certificate of registration of a midwife for any of the causes mentioned in the preceding section, or i n cases of: (a) unprofessional conduct, (b) professional malpractice, (c) clear professional incompetence, (d) serious ignorance or negligence, (e) assisting or performing abortion in the practice of midwifery or (f) using fraud, deceit or false statements to obtain a certificate of registration. From the final decision of the Board, appeal may be taken to the PRC whose decision shall be final and executory.

Sec. 30. Refusal to Issue Certificate of Registration. - The Board shall refuse to

issue a certificate of registration to any person convicted by the court of competent jurisdiction of any criminal offense involving moral turpitude, and to any person guilty of immoral or dishonorable conduct. The Board shall give the applicant a written 5 statement setting forth the reason or reasons for its action, which statement shall be incorporated in the records of the Board.

Sec. 31. Reissuance and Replacement of Revoked Certificates. -The Board may for

reasons of equity and justice and upon proper application therefore issue another copy of the certificate upon payment of dues, and in so doing, it may exempt the applicant for the requisite examination.

Sec. 32. Midwives Positions in Public Health facilities. - All public health facilities

such as Government Owned and Controlled Corporation (GOCC) with original charter, DOH-retained hospitals, Local Government Unit managed hospitals at the district level, shall have plantilla positions for midwives: Provided, That the compensation of midwives working in public health shall not be lower than Salary Grade 13 as entry salary for midwives, pursuant to Republic Act No. 6758 otherwise known as the "Compensation and Position Classification Act of 1989; Also, as provided for under the Civil Service Law, a government employee has to work eight (8) hours a day or forty (40) hours a week: Provided Further, That for midwives working in health facilities under local government units, adjustments to their compensation shall be in accordance with Section 10 of the same Act: Provided, Finally, That other benefits and entitlements shall also be provided to midwives by their public health employers in accordance with existing laws.

Sec. 33. Midwives in Private Health facilities. - Midwives employed or contracted

by private health facilities shall have salaries and benefits not lower than the minimum wage set by the Department of Labor and Employment (DOLE). Government midwives who practice in private facilities after their regular office hours shall comply with the existing guidelines being set by the Civil Service Commission and Department of Health.

Sec. 34. Midwives with Birthing Centers. - Midwives who shall establish and

manage their own birthing centers shall comply and be properly guided with the regulatory standards and operating procedures as defined by the Department of

1 Health; This shall take into consideration certain requirements such as to number of facilities providing maternal care services in a particular geographic or territorial 3 jurisdiction and based on an assessment of actual maternal care service requirement in a particular community. Midwives offering services in these facilities should likewise comply with PhilHealth 6 Certification and Accreditation standards. Midwives with birthing facilities and offering pregnancy and other reproductive health related services shall both be accredited as a service provider and a Modern Family Planning accredited facility to comply with 9 quality standards. Claims on maternal and newborn care packages and family planning 10 service must be paid on time.

Sec. 35. Creation of National Midwifery Office in the Department of Health. - There

shall be an establishment of a National Midwifery Office (NMO) under the Department of Health. The NMO in the DOH shall have the following functions: 1. The midwifery office shall be responsible for overseeing, and coordinating strategic management, financial and development, resource allocation, policies and Standard professional and organizational development to address midwifery personnel supply, demand, and distribution; 2. Provide expert advice to inform policy and decision makers relative to midwifery practice; 3. Ensure adequate demand with respect to health service delivery for primary health care and other population health priorities (1 midwife in every barangay) attract, recruit and retain midwives they are most needed; 4. Establish and strengthen senior leadership for midwifery workforce governance and management; and 5. Develop and share midwifery knowledge through a variety of processes such as peer review and research. Interpret and critically apply appropriate research findings to ensure that midwifery practice is evidence - based. ARTICLE VI PROHIBITED ACTS AND PENALTIES

Sec. 36. Prohibited Acts. - Any person who shall commit any of the following

acts shall be punished with imprisonment for a period of not less than to two (2) years but not more than seven (7) years, or a fine of not less than Fifty thousand pesos (Php 50,000) but not more than One hundred thousand pesos (Php100,000), or both, at the discretion of the court.: a) Practicing midwifery in the Philippines as defined in this Act without a certificate of registration issued in accordance herewith; b) Presenting, using, or attempting to use the certificate of registration of another person; c) Submitting or causing the submission of any false or forged document to the PRC in order to secure a certificate of registration; d) Using a revoked or suspended certificate of registration; e) Assuming, using, advertising, or representing oneself as a registered midwife or a registered nurse midwife, or appending to one's name the letters "R.M." without having been conferred such title by the PRC ; and f) Advertising, representing, or using any title, description, or statement that tends to convey, imply, or create the impression that one is a registered midwife when in fact not duly registered. ARTICLE VII FINAL PROVISIONS

Sec. 37. Appropriations. - The initial amount necessary for the implementation of

this Act shall be charged against the current fiscal year's appropriations of the PRC. Thereafter, such sums as may be necessary for the continued implementation of this Act shall be included in the annual General Appropriations Act.

Sec. 38. Implementing Rules and Regulations. - The PRC and the Board, in

coordination with accredited Integrated Professional Organization (AIPO) and national organization of Midwives, the Department of Health (DOH), the Department of Budget and Management (DBM) and other concerned government agencies, in consultation with relevant stakeholders in the private sector, shall, within ninety (90)

1 days from the effectivity of this Act, promulgate the rules and regulations to effectively implement the provisions of this Act.

Sec. 39

• Separability Clause. - If any portion or provision of this Act is declared unconstitutional, the remainder of this Act or any provisions not affected thereby shall remain in full force or effect.

Sec. 40 • Repealing Clause. - Republic Act No. 7392, otherwise known as the

7 "Philippine Midwifery Act of 1992" is hereby repealed. A Il laws, decrees, orders, instructions, rules and regulations and other issuance or parts therefore inconsistent with this Act are likewise repealed or amended accordingly.

Sec. 41. Effectivity Clause. - This Act shall take effect upon completion of its

publication in the official gazette a newspaper of general circulation. Approved,