INTEGRATED

HELMINTH
CONTROL
PROGRAM
Table of contents

01 02 03
BACKGROUND OBJECTIVES COVERAGE & SCOPE

04 05 06
IMPLEMENTATION
DEFINITION OF TERMS THE IHCP
MECHANISMS
 01
BACKGROUND
 BACKGROUND
Soil -transmitted Helminthiasis (STH) or
worm infections caused by Ascaris
Lumbricoides, Trichuris trichiura and
hookworms are among the most
widespread of all chronic human infections.
● Schistosomiasis is significant with at
least two billion people affected
worldwide.
● These parasites have been reported from
tropical to subtropical countries like
Philippines, where poverty, inadequate
sanitary facilities, inadequate safe
potable water supply, inadequate
behaviors and poor eating habits prevail.
 Factors that account for the slow and low
containment of the infection

1. Failure to comply with the recommended standards or technology.

2. Poor coverage of targeted populations
3. Weak promotion and advocacy
4. Lack of enabling environment that supports STH prevention and
control
5. Increased cost of intervention and ineffective implementation.

VULNERABLE SECTOR OF SOCIETY

● CHILDREN AGED 1 TO 12 YEARS OLD.
● ADOLESCENT FEMALES WHO LOSE ABOUT 35 ML OF BLOOD AND 15.5 MG OF
IRON DURING MENSTRUATION.
● PREGNANT WOMEN REQUIRING ADDITIONAL IRON AND LACTATING WOMEN.
 02
OBJECTIVES
This Administrative Order aims to:

● provide strategic directions for establishing an integrated

Helminth Control Program in the Philippines in line with the thrusts
of the health sector reform agenda, particularly the Fourmula One
Strategy;

● provide policy guidance for DOH offices, its attached agencies,

LGUs and other partners in the prioritization of related programs
and activities pertinent to STH prevention and control nationwide;
and

● establish guidelines and procedures for an effective and

efficient management and implementation of sustainable STH
prevention and control services
 03
COVERAGE & SCOPE
 COVERAGE AND SCOPE OF APPLICATION

● This Order covers the central and regional offices of the

Department of Health, hospitals and other attached agencies that
could provide the enabling environment for the effective and
efficient prevention and control of STH infections in the
Philippines.

● It also applies to other partners in the health sector, both public

and private, other national agencies, Local Government Units,
NGOs, academe and other partners involved in the prevention and
control of STH in so far as their operations are governed by
technical guidelines and standards mandated by the DOH.
 04
DEFINITION OF
TERMS
DEFINITION OF TERMS
● Soil-Trainsmitted Helminthiasis:
○ Refer to worm infections caused by Ascaris lumbricoides,
Trichuris trichiura and hookworms, known to be the most chronic
of all human infections
● Mass Treatment
○ refers to giving drugs to an entire group of people without prior
diagnosis of current infection
● Targeted Mass Treatment
○ refers to giving drugs to specific group in the community defined
by age, or other social characteristics, irrespective of the
infection status, e.g., children aged 1 — 12 years old
● Selective Treatment
○ refers to giving of antihelminthic drug to an individual based on
the diagnosis of current Infection
 05
THE IHCP
(Integrated Helminth Control Program)
 THE IHCP
(Integrated Helminth Control Program)

01 VISION
Healthy and Productive Filipinos in the 21st Century

02 GOAL
To reduce mortality and morbidity due to Soil-transmitted
Helminthiasis (STH) Infections
 THE IHCP
(Integrated Helminth Control Program)

03 General Objective
To reduce the prevalence of Soil-transmitted
Helminthiasis (STH) to below 50% among 1-12 year old by
2010 and lower STH infection among adolescent females,
pregnant women and other special population groups.
 THE IHCP
(Integrated Helminth Control Program)

04 Specific Objectives
1. To increase the coverage of deworming of target
population groups at risk to STH infection.

Indicators:
● treatment of at least 85.0% of all 1-12 year old children
through regular mass deworming campaign for
preschoolers and school age groups; and
● treatment of adolescent females, pregnant women,
farmers, food handlers, soldiers and indigenous peoples
consulting the health facility.
 THE IHCP
(Integrated Helminth Control Program)

04 Specific Objectives
2. To expand coverage of water, sanitation and hygiene

Indicators:
● increased access of households to safe water from 87.0% in
1998 (NDHS) to 94.0% in 2010; and
● increased sanitary toilet coverage from 75.0% in 2003 (NDHS)
to 80.0% in 2010.
 THE IHCP
(Integrated Helminth Control Program)

04 Specific Objectives
3. To increase the proportion of targeted population observing
healthy practices

Indicators:
● increased proportion of households aware of proper STH
prevention and control; and
● improved the practice of appropriate personal and food
hygiene of at least 75% of mothers/caregivers with 1-12 year
old children by the end of 2010
05

GUIDING PRINCIPLES

01 FOCAL TARGETING
➔ Preschoolers, school children
➔ Adolescent females
➔ Pregnant women
➔ Indigenous people
➔ Soldiers
➔ Farmers
➔ Food handlers
05

GUIDING PRINCIPLES

02 Appropriate & sound technology

➔ High Risk Groups -continuous regular and
periodic chemotherapy for 3 years
➔ Access to quality deworming products
➔ Safe water supplies, environmental sanitation,
personal hygiene
➔ Health education
◆ Identification of behaviors that promote
health practices
◆ Change/modify behaviors that deter healthy
practices
05

GUIDING PRINCIPLES

03 EVIDENCE-BASED
➔ Continuous update of STH-related policies and
guidelines in accordance to recommended
international standards proven effective and
applicable to the country
➔ Efforts to generate information to guide planning
and implementation of STH programs and
activities
➔ Research findings will be used to focus
interventions and approaches most responsive to
affected groups
05

GUIDING PRINCIPLES

04 MULTI-SECTORAL COLLABORATION
★ Networking with stakeholders proactively pursued
and sustained

★ Government agencies
★ Non-government organizations
★ Private volunteer groups
★ Religious and civic organizations
★ Educational institutions
05

GUIDING PRINCIPLES

05 INVOLVEMENT OF THE COMMUNITY AND FAMILIES

★ Prevention and control depends largely on the
commitment and participation of communities
and families
○ Personal hygiene
○ Safe water
○ Sanitary toilets
○ Proper waste disposals
★ Involvement in planning, implementation and
monitoring
 PROGRAM COMPONENTS
A. Chemotherapy

★ A safe and efficient intervention with immediate results.

★ Two approaches
○ Mass Targeted Deworming - Preschool and School children
○ Selective Deworming - Adolescents and Special Populations
★ Deworming Targets
■ Mass Targeted Deworming
● Children 1-5 Years old - Greatest morbidity when infected
● Children 6-12 Years old- Greatest load of infection
■ Selective Deworming Treatment
● Adolescent Females - Loss of blood during menstruation
● Pregnant Women - Blood loss can aggravate anemia
● Special Groups - Risk to worm infestation high due to exposure
 PROGRAM COMPONENTS
B. Frequency and Duration of Deworming

★ For children 1-12 years, it is recommended to do mass deworming twice a

year or every 6 months since re-infection rate in this group is almost 100% at
6 months after treatment.
★ Infective eggs remain viable in the soil and are able to infect people for a
maximum of two (2) years and mass chemotherapy should be done
consecutively for three (3) years. The worm prevalence would then be
below 50%, after which mass deworming is recommended only once a year.
★ Selective deworming for special population groups (adolescent females,
pregnant women, soldiers, food handlers/operators, & indigenous
peoples) must be done once a year anytime they consult the health facility.
 PROGRAM COMPONENTS
C. Drug Dosage and Frequency by Target Groups
 PROGRAM COMPONENTS
D. Schedule of Deworming
 PROGRAM COMPONENTS
E. Drug Requirements and Preparations

➢ Children 12 months and above: Albendazole or Mebendazole

➢ Female adolescents, pregnant women, and the special

population groups: Albendazole or Mebendazole but different
dosage to be administered
 PROGRAM COMPONENTS
2. Water, Sanitation and Hygiene
(WASH)

- The water, sanitation and hygiene

component of the IHCP, patterned
after the UNICEF WASH Strategies from
2006-2010 serves as the cornerstone
in reducing diseases especially those
related to intestinal parasitism.

water, sanitation and hygiene - Search Images (bing.com)

 PROGRAM COMPONENTS
a. Ensuring the Provision of Safe, Adequate and Sustainable Water Supply.
 PROGRAM COMPONENTS
b. Promotion and Installation of Low Cost Technology and Culturally -
Acceptable Sanitation Facilities
 PROGRAM COMPONENTS

3. Behavioral Approaches

Behavioral change is central to the control of intestinal parasitism. It has been

stated that the greatest culprit in the transmission of worms are the human
beings, for worms are transmitted through poor personal hygiene such as
neglecting to wash raw fruits and vegetables properly, eating with dirty hands
or not wearing slippers.

a. Identification of Behaviours That Promote Health or III-Health.

 PROGRAM COMPONENTS
DEVELOP AND IMPLEMENTATION OF ADVOCACY AND COMMUNICATION PLAN
● An overall advocacy and communication plan to support adoption of STH
preventive measures among the target audiences will be developed as the
basis in designing and conducting promotional activities to different
audiences

Promotion of hygiene as a family competency through six key habits

1. latrine/toilet utilization
2. Washing of hands before eating and after using the toilet
3. Wearing of slippers or shoes
4. Hygienic preparation of food
5. Drinking potable water
6. Clipping of fingernails
 PROGRAM COMPONENTS
Strengthen face-to-face communication
● Service providers in health facilities, schools and day care centers must be able to
effectively communicate the above key messages to target audiences, personal
communication skills of these staff need to be enhanced

Provision of IEC materials

● Appropriate promotion materials in the form of posters, leaflets CDS, flyers, games,
radio spots, etc, will be developed based on the results of the assessments
documents. Other mass media initiatives will be pursued if necessary
 PROGRAM COMPONENTS
Involvement of families and communities for behavioral change.
● Community-based IHCP management is considered for children aged 1-5 years old
and children below 12 years old who are out of school.

Advocacy and social mobilization

● Advocacy and social mobilization efforts must be pursued among various groups of
national and local stakeholders. These efforts must redound to their active
participation in implementing the STH program, increased budget allocation,
issuance of supportive policies and political will to act on issues and concerns that
prevent people from accessing the services
 KEY STRATEGIES
Improve Governance
- The successful control of STH infection lies on the commitment and support of
the leaders and officials responsible in implementing the STH prevention and
control. National and local officials have become accountable to their
mandates through;

A. The issuance of policies and guidelines that will set the overall direction of
the program
B. Allocating adequate funds to support the implementation of STH
preventive measures, and
C. Mobilizing all concerned sectors to perform their expected roles in STH
prevention and control.
 KEY STRATEGIES
Improve Quality and Scale-up Service Delivery
- The reforms in service delivery must aim towards the improvement in the quality
of deworming services and access of the targeted population through:

A. Reforms in the competencies of service providers

B. Setting standards and protocols, and
C. Provision of necessary logistic supplies and facilities\

1. Capacity Building
2. Development and Issuance of Protocols and Guidelines
3. 3. Expansion of Service Delivery Points
4. Availability and Affordability of Deworming Drugs
 KEY STRATEGIES
Financing Reforms
- Significant amount of resources are needed to realize the goals and objectives
of the IHCP

Regulatory Reforms
- Effective implementation of the IHCP also requires reforms in regulations
related to STH prevention and control

Management System Support

- Management support systems must be placed to ensure that reforms will take
place.
 06
IMPLEMENTATION
MECHANISMS
 ESTABLISHMENT OF ORGANIZATIONAL
STRUCTURES
IHCP AT THE NATIONAL LEVEL IS PLACED DIRECTLY UNDER THE INFECTIOUS DISEASE OFFICE OF
THE NATIONAL CENTER FOR DISEASE PREVENTION AND CONTROL (NCDPC) AND UNDER THE
HEALTH OPERATIONS CLUSTER AT THE REGIONAL LEVEL .

AN OVERALL IHCP MUST BE DESIGNATED AT THE NATIONAL LEVEL AND SIMILARLY IN THE
REGIONS AND PROVINCES

TWG WILL BE ESTABLISHED AND FUNCTIONS INCLUDE:

1. TO REVIEW AND RECOMMEND D STH PREVENTION AND CONTROL POLICIES ,

2. ENSURE TECHNICAL SOUNDNESS OF IHCP INTERVENTION MEASURES
3. COORDINATE THE ALLOCATION OF RESOURCES TO AVOID OVERLAP AND REDUNDANCY OF
INPUTS AND
4. ADVOCATE AND PROMOTE IHCP INITIATIVES
ROLES AND RESPONSIBILITY
1. National level – Department of Health

a. National Center for Disease Prevention and Control

b. Center for Health Development/Hospital

2. Local level – Local Government Units

a. Local officials
b. Provincial/City Health Office
c. Rural Health Units/Health Centers
ROLES AND RESPONSIBILITY
DEPARTMENT OF HEALTH
A. The National Center for Disease Prevention and Control team is
responsible for:
a. Updating policies and guidelines
b. Orient regional/provincial coordinators on these policies
c. Provide proficiency training to medical technologies on laboratory
diagnosis of parasites
d. Assist in procurement of deworming drugs for mass treatment
e. Advocate fund allocation among LGUs to augment supply of these drugs
f. Develop prototype IEC materials on STH
g. Monitor and evaluation mass treatment program
ROLES AND RESPONSIBILITY
DEPARTMENT OF HEALTH
B. The Field Implementation and Coordination teams headed by the
USEC/ASEC shall provide overall coordination and technical
support on the implementation of this program at the regional
level
ROLES AND RESPONSIBILITY
DEPARTMENT OF HEALTH
C. The Center for Health Development/Hospital shall be responsible
for the ff:
a. Provision of allocation for procurement of deworming drugs
b. Conduct orientation of provincial/municipal health workers on mass
treatment implementation guidelines
c. Coordinate with LGUs/RHUs for the program implementation
d. Advocation fund allocation for drug supply
e. Monitor implementation of this program and submit accomplishment
reports to central office
ROLES AND RESPONSIBILITY
LOCAL GOVERNMENT UNIT
A. Local officials
a. Allocation budget for procurement of deworming drugs
b. Coordinate with other concerned institutions (ex: schools, NGOs, church)
to support implementation of mass deworming
c. Provide support for advocacy, orientation of health workers, transport,
and other logistics support
ROLES AND RESPONSIBILITY
LOCAL GOVERNMENT UNIT
B. Provincial/City Health Office
a. Coordinate with LGUs and RHUs/health centers on mass treatment
implementation
b. Advocate among LGUs to allocate funds to augment supply of deworming
drugs
c. Record and submit accomplishment reports to CHDs
ROLES AND RESPONSIBILITY
LOCAL GOVERNMENT UNIT
C. Rural Health Units/Health Centers
a. Complete master lists of targeted populations for mass deworming
b. Implement the mass deworming program
c. Record and submit the accomplishment reports using the form Annex 3:
IHCP Recording and Reporting Forms to the PHO
END.
THANK YOU FOR LISTENING!
1.
QUIZ
Give 1 Helminth infection prominent in the Philippines
2. Give atleast 2 prevailing issues in the Philippines that contribute to occurrence of Helminth
Infections (ex: Poverty)
3. Give 1 vulnerable sector to Helminth infections
4. Refer to worm infections caused by Ascaris lumbricoides, Trichuris frichiura and hookworms,
known to be the most chronic of all human infections
5. refers to giving drugs to an entire group of people without prior diagnosis of current
infection
6. refers to giving drugs to specific group in the community defined by age, or other social
characteristics, irrespective of the infection status, e.g., children aged 1 — 12 years old
7. refers to giving of anti-helminthic drug to an individual based on the diagnosis of current
Infection
8. What does IHCP stand for?
9. Age group with greatest morbidity when infected
10. Age group with greatest load of infection
 QUIZ
11. Recommended treatment/mass deworming schedule for Children 1-12 years due
to reinfection rate of 100%?
12. Mass deworming should be done consecutively for __ years
13. Infective eggs remain viable in the soil and are able to infect people for a
maximum of __ years
14. Selective deworming for special population groups (adolescent females,
pregnant women, soldiers, food handlers/operators, & indigenous peoples)
must
be done __ a year
15. Drug/s given to Children 12 years old and above?
16. WASH stands for?
QUIZ
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