Promoting newborn screening

MANILA, Philippines - For developed countries, newborn screening has been regarded as one of the most successful public health prevention programs. Allowing for the prompt identification of infants who are affected with certain genetic, metabolic or infectious conditions, the procedure makes it possible for health care providers to do what is needed for the afflicted children to survive and develop normally.

Work on the newborn screening system began about 50 years ago with the work of Dr. Robert Guthrie, a researcher in Buffalo, New York, USA. Guthrie was a father of a mentally handicapped son and his work started with a desire to create a simple and inexpensive mechanism for identifying phenylketonuria in newborns.

With the identification of the inborn error, babies with the condition could be placed on dietary control early to prevent mental retardation.

From a desire to create something for the benefit of many, newborn screening has since then become a reality for the US and further evolved into a responsibility of the public health system.

Locally, however, it was only integrated into the public health delivery system in 2004 with the enactment of Republic Act 9288 or the Newborn Screening Act of 2004.

“We are actually 40 years behind in implementation,” said Dr. Carmencita David-Padilla, founding president of the Newborn Screening Society of the Philippines.

Efforts in making the Newborn Screening System (NBS) a reality in the Philippines started in 1996 when a group of obstetricians and pediatricians from 24 Metro Manila hospitals, which was called the Newborn Screening Study Group, set out to gather enough data to support legislation for a national NBS program.

“Research was needed to convince the DOH (Department of Health) to look at newborn screening as a priority and the Philippine Council for Health Research and Development was instrumental in establishing the data for newborn screening,” said Padilla.

To convince local health institutions, the NBS Study Group had to first prove the necessity of newborn screening by establishing the incidence of the six metabolic conditions — congenital hypothyroidism, congenital adrenal hyperplasia, galactosemia, phenylketonuria, homocystinuria, and glucose-6-phosphate deficiency — and second, it had to make recommendations for the adoption of NBS nationwide.

Two years later, the group presented its research data to the DOH and in the year that followed, the DOH formally acknowledged the value of the data as it included newborn screening in Children’s Health 2025.

This DOH document is meant to be a plot for programs and interventions that promote and safeguard the rights of Filipino children to survival, development, protection and participation from 2000 to 2025.

“What we started as a research project is now used for policy-making,” said Padilla.

Currently, there are still some hospitals and facilities that have not made newborn screening mandatory, showing that there is still much that needs to be done before the procedure is deemed necessary throughout the country. This is a task for healthcare institutions that has proven to be difficult.

In spite of this, the DOH and other involved agencies are still pushing to reach the goals set for the NBS system.

Meanwhile, the newborn screening group is still working to promote awareness on newborn screening and increase the number of newborn screened in the community through the identification of groups that have a large impact on child health care such as midwives and women’s organizations.