Article # 1 Essay Example | Topics and Well Written Essays - 250 words - 1

Article # 1 - Essay Example There has been a need by health care providers to eliminate duplication, reduce hospitalizations and improve coordination; this has also played a role in escalating cost of financing health care operations. Introduction of point-of-care management case has been crucial in lowering the operational cost in health care facilities as there are few hospital readmissions. Anna (2012) indicates that the strategy has given solid return on investments. Health care providers with strong market heft can negotiate better on high physician services, unlike independent doctors. Despite efforts to conserve energy, there is still a high rate of energy consumption by health care providers, this leads to escalating operational cost because energy is a necessity in the provision of health care (Anna, 2012). Making a personal opinion, the health care facilities will cut down their operational cost by changing their business model to accommodate the changes in technology and the high patient rate. On a rather positive note, there has been a downwards forecast on the spending of Medicare, and this trend will continue for life sciences. Health care operations costs have been on the hike rating the increase at about 50 percent. Partnering by the health care providers would help lower costs and the quality of services (Anna,

Academic Models in Strategic Management Essay Example | Topics and Well Written Essays - 1000 words

Academic Models in Strategic Management - Essay Example There are numerous techniques and approaches that support strategic decision making, like PEST, SWOT, portfolio matrixes, life cycles, value chain concepts and many others. The most important aspect of these academic tools is to â€Å"what extent [these tools] enhance or inhibit creative competitive strategy making in organizations† (Clark, 1997, p. 417). Some authors argue (Eilon, 1980, cited by Clark, 1997, p. 418) that there is an absence of strong focus on academic tools because they play a secondary role being â€Å"the means to an end, not an end in [itself]†. Still, the usage of academic business models should not be underrated, because these promote the development of â€Å"strategic thinking in organizations† (Clark, 1997, p. 418). Strategic management tools perform basically a â€Å"support role† (Clark, 1997, p. 418) in the strategic management process. This is so, because academic instruments offer useful insights into the benefits of different strategies and suggest a more systematic approach towards strategy implementation. These tools provide information generation, framework for analysis, also coordination and control mechanisms (Clark, 1997, p. 418). Further on, schemes and visualized models have the benefit of presenting ideas, model relationships and help management identify opportunities and co nvict others about the usefulness of suggested strategies. 2. The use of tools during the different strategic management stages Academic models are visible throughout the strategic management process, from planning and defining of mission and purpose to crafting different strategies and strategy execution and evaluation (Thompson et al, 1996, p. 3). Situation analysis Analysis of the business environment is regarded "as a fundamental part of the strategic management planning process" (Pickton, 1998, p. 102), because academic strategists have realized that environmental changes are constant and unavoidable. A research undertaken by Clark (1997) points out that for many companies environmental analysis includes evaluation of remote environment, meaning PEST analysis; and evaluation of the companies' operating environment, meaning competitors, customers, markets, suppliers and stakeholders. PEST and Porter's five forces model are basically similar tools for environmental audit and are ranked in the top set of tasks in UK (Clark, 1997, p. 423). In an increasingly diverse competition, industries are no longer viewed as isolated independent markets. This makes the application of the Porter's model insufficient, because it "tends to be focused on the single industry or strategic business unit", which means that it's much narrower in its scope. Another largely used academic tool is SWOT analysis, which is regarded as the simplest "easy-to-use technique for getting a quick overview of a firm's strategic situation" (Thompson et al, 1996, p. 92). SWOT is praised for its simplicity and practicality and is widely adopted uncritically (Pickton et al, 1998, p. 101); it underscores the basic principle that strategy must be a good fit between a company's internal capabilities and its external situation. Authors like Farjourn (2002) observe that SWOT is only suitable to a stable and predictable world. Too simplistic adoption of SWOT is reflected by the fact that most academic papers review it as a static strategic framework (Pickton et al, 1998, pp. 102-103); academicians simplify it to a list of factors and fail to conduct further analysis, which limits the usability of the model. Another tool, the value chain concept is a "primary analytical tool of strategic cost analysis"; it identifies costs and value drivers for primary and

Deat Adam Smith and the Wealth of Nations Essay Example for Free

Deat Adam Smith and the Wealth of Nations Essay They would do this not as a means of benefiting society, but in an effort to outperform their competitors and gain the greatest profit. But all this self-interest would benefit society as a whole by providing it with more and better goods and services, at the lowest prices. To explain why all society benefits when the economy is free of regulation, Smith used the metaphor of the â€Å"invisible hand†: â€Å"Every individual is continually exerting himself to find the most advantageous employment for whatever capital he can command. It this own advantage, and not that of society, which he has in mind, but he is in this, as in many other cases, led by an invisible hand to promote and end which was no part of his intention, for the persuade of his own advantage necessarily leads him to prefer that employment which is most advantageous to society. † The â€Å"invisible hand† was Smith’s name for the economic forces that we today would call supply and demand, or the marketplace. He sharply disagreed with mercantilists who, in theft quest for a â€Å"favorable balance of trade,† called for regulation of the economy. Instead, Smith agreed with the physiocrats and their policy of â€Å"laissez faire† letting individual and businesses function without interference from government regulation of private monopolies. In that way, the â€Å"invisible hand† would be free to guide the economy and maximize production. The Wealth of Nations goes on to describe the principal elements of the economic system. In a famous section, Smith turned to the pin industry to demonstrate how the division of labour and the use of machinery increased output. One man draws out the wire, another straights it, a third cuts it, a fourth points it, a fifth grinds it at the top for receiving the head; to make the head requires two or three distinct operations. † Also modern technology has improved the methods by which pins are produced; the principles pertaining to the division of labour remain unchanged. Similarly, other section dealing with the factors of production, money and international trade are as mea ningful today as when they were first written. You can see, therefore, hat Thomas Jefferson’s Declaration of Independence and Adam Smith’s The Wealth of Nations have more in common that a birthday. More importantly, both contain some of the best descriptions of the principles upon which our political and economic systems are based. 2. Comprehension 2. 1. Fill in the gaps with the necessary prepositions. 1. The year of 1776 associates †¦ the signing †¦ The Declaration †¦ Independence. 2. It earned the author the title â€Å"the father †¦ economics,† Smith objected †¦ the principal economic believes †¦ his day. 3. He disagreed †¦ the mercantilists who measured the wealth of a nation †¦ its money supply, and who called †¦ government regulation of the economy †¦ order †¦ promote a â€Å"favorable balance †¦ trade. † 4. It this own advantage, and not that †¦ society, which he has †¦ mind, but he is in this, as †¦ many other cases, led †¦ an invisible hand to promote and end which was no part of his intention, †¦ the persuade †¦ his own advantage necessarily leads him to prefer that employment which is most advantageous to society. 5. †¦ that way, the â€Å"invisible hand† would be free †¦ guide the economy and maximize production. . Also modern technology has improved the methods †¦ which pins are produced; the principles pertaining †¦ the division †¦ labour remain unchanged. 7. Thomas Jefferson’s Declaration †¦ Independence and Adam Smith’s The Wealth of Nations have more †¦ common that a birthday. 8. Both contain some †¦ the best descriptions †¦ the principles †¦ which our political and economic systems are based. 2. 2. Answer the questions to the text. 1. When and where was The Wealth of Nations by A. Smith published? 2. What is a famous nickname of Adam Smith and why? 3. What economic issues did Adam Smith deny? 4. What does a nation’s wealth depend upon according to A. Smith? 5. What was the heart of his economic philosophy? 6. In what way did he explain why society benefits when the economy is free of regulation? 7. What is â€Å"invisible hand† in the text? How do we call it today? 8. What physiocrats’ policy did Smith agree with? 9. What is described in Adam Smith’s â€Å"The Wealth of Nations†? 10. How can the division of labour and the use of machinery increase output according to Smith? 11. Is there anything common in Thomas Jefferson’s Declaration of Independence and Adam Smith’s The Wealth of Nations? 2. 3. Find in the text English equivalents for: , 3. Lexico-grammatical exercises 3. 1. Find out the correspondent definition to the given English business colloquialisms. Give the Ukrainian variants. Make up a dialogue about your business using 5 of the given English business colloquialisms. ColloquialismDefinition All in everything included in the price Big notesa very important person Book of wordsgenerally

Lesser Sac Cystic Lymphangioma: Gastric Outlet Obstruction

Lesser Sac Cystic Lymphangioma: Gastric Outlet Obstruction Cystic Lymhangioma of the Lesser Sac in adult presenting with features of Gastric Outlet Obstruction A Case Report S Suresh Kumar Sri Aurobindo Prasad Das Vikram Kate Running title: Lesser sac cystic lymphangioma causing gastric outlet obstruction Key Words: Abdominal cystic Lymphangioma; Omental Bursa; Outlet Obstruction Article type: Case Report Section (speciality): Surgery- Gastrointestinal Surgery Abstract: Non- Structured (Case Report) ABSTRACT: Background: Cystic lymphangioma is a paediatric benign tumour, occurs commonly in head and neck region. Adult Intraabdominal lymphangiomas are uncommon and only few cases of lesser sac cystic lymphangioma are reported in the literature. Case presentation: We present a case of lesser sac cystic lymphangioma in a 26 year old lady who presented with features of gastric outlet obstruction. Clinical examination of the abdomen revealed 10 x 10 cm firm, non tender, mobile intraabdominal lump in the epigastrium. An upper gastrointestinal endoscopy showed possible external compression at the boy of the stomach. Ultrasound of abdomen demonstrated a multicystic lesion measuring 10.2 X 8 cm, with internal echoes in one locule. Contrast enhanced computed tomography of the abdomen showed a large multiloculated cystic lesion with hyper-dense content in the lesser sac extending up to the left lobe of the liver and indenting the stomach, lesser sac, and upper border of pancreas. On surgical exploration, a 10X8 cm multi cystic lesion with clear fluid was found in the lesser sac very close to the lesser curvature of stomach. The descending branches of left gastric which were found coursing through the cyst were ligated and the cyst was excised in Toto. Histopathological examination of the excised lesion showed features of cystic lymphangioma showing dilated lymphatic vessels with fibro-fatty tissue ingrained in the endothelial lining. Conclusion: Though intraabdominal cystic lymphangiomas are very rare, it should be considered in all atypical cases of gastric outlet obstruction. A reasonable knowledge about these benign lesions will aid in establishing the diagnosis and surgical management. Key Words: Abdominal cystic Lymphangioma; Omental Bursa; Outlet Obstruction Background Lymphagiomas are benign lesions generally occur as a result of lymphatic system malformation and infrequently reported after trauma. 90% of the cases are seen within the first two years of life and symptomatic presentation in adults is very rare. [1] Cystic lymphagiomas commonly involves neck and axilla but can occur anywhere in the body. Though Intraabdominal lymphangioma accounts for Case presentation A 26-year old lady presented to surgical outpatient department with complaints of early satiety, vomiting few hours after food intake and vague fullness of upper abdomen. She also had features of dyspepsia for the past one year. She had developed pain and had a feeling of a mobile lump in the upper abdomen for the past one month. There was no pancreatitis episode before. General physical examination was unremarkable. Clinical examination of the abdomen revealed 10 x 10 cm lump in the epigastrium which was firm in consistency. The lump was non tender, freely mobile and intra-abdominal. Investigations The haemogram and biochemical profiles were within normal limits. An upper gastrointestinal endoscopy was done which showed normal mucosa of stomach with possible external compression at the boy of the stomach. Ultrasound of abdomen was suggestive of a multicystic lesion measuring 10 X 8 cm, with internal echoes in one locule, present superior to pancreas adjacent to the left lobe of the liver. Rest of abdomen was unremarkable. Contrast enhanced computed tomography of the abdomen showed a large multiloculated cystic lesion measuring 10.2 X 8 cm with hyper dense content in some loculi in the lesser sac extending up to the left lobe of the liver and indenting the stomach, lesser sac, and upper border of pancreas with a few branches of left gastric vessels coursing through it. (Figure: 1) Correlating the clinical, USG and CECT abdomen findings a diagnosis of possible lymphangioma was made and the patient was planned for exploratory laparotomy as the symptoms were persisting. Surgical management On surgical exploration, a 10X8 cm multi cystic lesion with clear fluid was found in the lesser sac very close to the lesser curvature of stomach. (Figure: 2) The descending branches of left gastric which were found coursing through the cyst were ligated and the cyst was excised in Toto. (Figure: 3) A drain was placed in lesser sac and abdomen was closed in layers. Outcome and follow- up Postoperative course was uneventful. The drain was removed on the 3nd postoperative day and the patient was discharged on seventh post operative day. Histopathological examination of the excised lesion showed features of cystic lymphangioma showing dilated lymphatic vessels with fibro-fatty tissue ingrained in the endothelial lining. (Figure: 4) Patient was followed up at one month, six months, one year and two year after surgery. On each visit, clinical examination and USG was done which showed no evidence of recurrence. The lady is presently on regular follow up for past 2 years with no evidence recurrence till date. Discussion Intra-abdominal cystic lymphangiomas are uncommon benign tumours that can involve the mesentery, omentum, colon, spleen, pelvis, groin, and retroperitoneum [5, 6]. We had a case of cystic lymphangioma in the lesser sac which is very rare. Cystic lymphangiomas are considered to originate from malformed or malpositioned lymphatic tissue. Factors such as abdominal trauma, inflammatory process, lymphatic obstruction due to radiation therapy or surgery may lead to secondary formation of such tumors. Our patient did not have any of the mentioned inciting factors; the cause was probably congenital which had manifested late in life. Commonly known to present in childhood, lymphagiomas sometimes remain asymptomatic until late adulthood, and are discovered during evaluation of vague and chronic nonspecific symptoms like anorexia, nausea, vomiting, fatigue, and weight loss, which are secondary to mass effect [4]. This was seen in our patient who had early satiety and vomiting after food intake probably due to mass effect and had a vague feeling of mass in the abdomen. Other ways of presentation such as acute abdomen, mimicking acute appendicitis has also been reported [3]. Contrast CT done in our patient revealed multicystic lesion measuring 10.2 X 8 cm, present superior to pancreas, in the lesser sac adjacent to the left lobe of the liver. Cystic lymphangioma usually presents as a large multilocular cystic mass with enhanced walls with multiple thin septa containing uncomplicated fluid on abdominal ultrasonography and contrast enhanced computerized tomography which is very often diagnostic [7]. The differential diagnosis includes cystic lesions of, enteric urogenital or mesothelial origin. Pancreatic pseudocysts from trauma, dermoid cysts or teratomas and cystic degeneration of solid tumours are also to be considered before making this rare diagnosis. Management of intra-abdominal cystic tumours depends on the clinical symptoms, size of the cyst, and the degree of clinical suspicion for malignancy. Imaging usually provides useful information for the planning of treatment. Complete removal of the tumour offers an excellent prognosis and laparoscopic removal of lymphangioma also shown feasible in few reports. We therefore decided to perform a laparotomy and complete excision of the cyst was done. On the other hand, recurrence has been reported in 10% of patients in whom primary resection was incomplete.[9] If the feeding lymphatics are not completely ligated, chylous ascites may also occur. Conclusion: Though intra-abdominal cystic lymphangiomas are very rare, it should be considered in cases of gastric or biliary obstruction where the cause could not be recognized clearly. Reasonable knowledge about these benign lesions will aid in establishing the diagnosis during such instances. Complete surgical excision offers the best chance for cure and should be attempted in all the cases to avoid recurrence. Consent Written informed consent was obtained from the patient for publication of this Case report and any accompanying images. A copy of the written consent is available for review by the Editor of this journal. Competing interests disclosures The authors have no potential or real conflict of interests The authors have no financial support or ties to disclose The authors have no financial or non financial competing interests to declare Authors contributions Suresh Kumar S, Das S A and Kate V diagnosed and managed the case. Suresh Kumar S, Das S A did the literature search. Suresh Kumar S and Das S A collected the images. Suresh Kumar S and Kate V drafted the manuscript. All authors read and approved the final manuscript. References Hanagiri T, Baba M, Shimabukuro T, Hashimoto M, Takemoto H, Inoue A, Sugitani A, Shirakusa T. Lymphangioma in the small intestine: Report of a case and review of the Japanese literature. Surgery Today 1992; 22: 363-367 Roisman I, Manny J, Fields S, Shiloni E. Intra-abdominal lymphangioma. Br J Surg 1989; 76: 485-489 Benjamin HL Tan, Teegan Lim. Cystic lymphangioma of the lesser sac presenting as acute appendicitis: A case report. Cases J. 2008; 1: 147. Massoud Baghai-Wadji, Azadeh JalalKamali, ToorajReza Mirshekari. Cystic lymphangioma of the lesser sac. Can J Surg. 2006; 49: 292. Fernandez Hurtado I, Bregant J, Mulet Ferragut JF, et al. abdominal cystic lymphangioma. Cir Pediatr. 1998 ; 11: 171-3 Chuang-Wei Chen, Sheng-Der Hsu, Chien-Hua Lin, Ming-Fang Cheng, Jyh-Cherng Yu Cystic lymphangioma of the jejunal mesentery in an adult: A case report. World J Gastroenterol 2005; 11: 5084-5086 Angela D. Levy, Vito Cantisani, Markku Miettinen. Abdominal Lymphangiomas: Imaging Features with Pathologic Correlation. AJR 2004; 182: 1485-1491 8. Kenney B, Smith B, Bensoussan AL. Laparoscopic excision of a cystic lymphangioma. J Laparoendosc Surg. 1996; 6: S99-101. 9. Steyaert H, Guitard J, Moscovici J, Juricic M, Vaysse P, Juskiewenski S: Abdominal cystic lymphangioma in children: benign lesions that can have a proliferative course. J Pediatr Surg 1996, 31:677-680. 1

Functions of an OS Platform-(03) :: essays research papers

Functions of an Operating System Operating Systems is a computer program that controls the operation of the hardware of a computer and the execution of programs. The primary functions of an operating system include: 1) Managing and controlling the hardware of the computer, e.g., drivers 2) Interfacing between hardware and software, i.e. how programs and applications use hardware – keyboard, mouse, monitor. 3) Managing memory, i.e., multitasking, multiprocessing and threads 4) Managing and executing applications 5) Diagnosing problems with software and hardware 6) Managing Storage Devices and Files, e.g., NTFS and Netware file system 7) Providing a User Interface Additional Functions of a Network Operating System Where multiple hosts share the workload and resources, but each host executes its own programs 1) Connecting to the Network, e.g., network interface card drivers, communication protocols, and client services. 2) Enabling remote users to access and share resources, and user interfaces to use various share services, e.g., utilities, web access, SMTP. 3) Provide additional security to access shared resources, i.e., authorization (logon) and authorization (resources) services. 4) Provide applications for network use, e.g., Web, SMTP, and DHCP servers. 5) Provide network diagnostics utilities. Types of Network Operating Systems Peer-to-Peer or Workgroup Model Any computer can be a server or a client, or both. Examples of these NOS include Microsoft Networking and Windows 2k Member servers The security system is decentralized, and is stored in the local registry. Practical for networks up 5 to 10 computers with limited sharing and low security requirements. Every server maintains its own security system. this means that you must have a password on each server. Peer-to-Peer or Workgroups Advantages Disadvantages Easy-to-share resources No centralized control over resources Resources are distributed across all computers No centralized account management Little administrative overhead No centralized administration Simple to design No centralized security system Easy to implement Inefficient for more than 20 computers Convienent for small groups in close proximity Security must be configured manually Less expensive or free software, does not require a centralized server Increased training to educate users to use their computer as both a client and a server. Domain (Client/Server) Model The designation of one computer to centralize the administration of shared resources and security. It is generally recommended that a computer would be only used as either as a client or a server, but not both. For example, share files will be stored on the server. Windows NT/2K domain controllers, Active directory and Netware are examples of the client Server model. Client/Server or Domain Model Advantages Disadvantages Centralized resource sharing Significant administrative effort and overhead Functions of an OS Platform-(03) :: essays research papers Functions of an Operating System Operating Systems is a computer program that controls the operation of the hardware of a computer and the execution of programs. The primary functions of an operating system include: 1) Managing and controlling the hardware of the computer, e.g., drivers 2) Interfacing between hardware and software, i.e. how programs and applications use hardware – keyboard, mouse, monitor. 3) Managing memory, i.e., multitasking, multiprocessing and threads 4) Managing and executing applications 5) Diagnosing problems with software and hardware 6) Managing Storage Devices and Files, e.g., NTFS and Netware file system 7) Providing a User Interface Additional Functions of a Network Operating System Where multiple hosts share the workload and resources, but each host executes its own programs 1) Connecting to the Network, e.g., network interface card drivers, communication protocols, and client services. 2) Enabling remote users to access and share resources, and user interfaces to use various share services, e.g., utilities, web access, SMTP. 3) Provide additional security to access shared resources, i.e., authorization (logon) and authorization (resources) services. 4) Provide applications for network use, e.g., Web, SMTP, and DHCP servers. 5) Provide network diagnostics utilities. Types of Network Operating Systems Peer-to-Peer or Workgroup Model Any computer can be a server or a client, or both. Examples of these NOS include Microsoft Networking and Windows 2k Member servers The security system is decentralized, and is stored in the local registry. Practical for networks up 5 to 10 computers with limited sharing and low security requirements. Every server maintains its own security system. this means that you must have a password on each server. Peer-to-Peer or Workgroups Advantages Disadvantages Easy-to-share resources No centralized control over resources Resources are distributed across all computers No centralized account management Little administrative overhead No centralized administration Simple to design No centralized security system Easy to implement Inefficient for more than 20 computers Convienent for small groups in close proximity Security must be configured manually Less expensive or free software, does not require a centralized server Increased training to educate users to use their computer as both a client and a server. Domain (Client/Server) Model The designation of one computer to centralize the administration of shared resources and security. It is generally recommended that a computer would be only used as either as a client or a server, but not both. For example, share files will be stored on the server. Windows NT/2K domain controllers, Active directory and Netware are examples of the client Server model. Client/Server or Domain Model Advantages Disadvantages Centralized resource sharing Significant administrative effort and overhead

That Was Then, This Is Now :: essays papers

That Was Then, This Is Now As I grow older I find myself and my surroundings changing. Many things about my personality and appearance have altered greatly in the past decade. I've observed many of these same changes in my family as well as in my friends. Some of my likes and dislikes of certain things are the same as when I was six years old, but not all. From my love of children and every type of critter to my dependency on my parents, my life has changed. From a very young age I've always loved children. "Mom, can I have a little brother and sister to play with?" was a favorite question of mine. A little bit later I would learn the answer. I would eventually have both. Other mothers often commented on my 'motherly instinct' when it came to my younger siblings. I've always liked the feeling of being able to comfort someone smaller than I am. As a child I loved playing dolls and 'house', always pretending to be the mother. Now I work at a Nursery watching over real children. From my love of children derived my desire to become a pediatrician. Along with my love of children is my love of animals. A new pet every week was a regular around the Moody House. My friends were always amazed by the array of creatures crawling around my room and shimmying up the curtains. One week I'd have eight pet chickens and a guinea pig and the next it was a turtle and bunny rabbit. As I grow older I become a little less interested in having as many pets as possible and a little more content with just the ordinary dog and my pet Iguana. All throughout my life I have depended on my parents. As a young child I searched eagerly in the eyes of my mom and dad for the reassurance I needed whenever I did something new. Holding tightly onto my dad's hand as we crossed the street I trusted he would always take me safely across. In the same way I have always trusted they would guide me through life safely. Although I no longer hold their hands when I cross the street I know they are always there. I've grown into my own person, depending more on myself rather than searching for reassurance through them.

Filipinos and the Reproductive Health Bill Essay

The Reproductive Health Bill – more commonly known as the RH Bill – is one of the most controversial bills that are being discussed today. It was only recently, however, that much attention had been directed towards it. The implementation of laws provisioning almost the same contents as the RH Bill today dates back in the late 1960’s during the reign of former President Ferdinand Marcos. At that time, Family Planning was adopted by the government purely for the purpose of population reduction towards the alleviation of poverty, as is the government’s commitment to population control stated in The 1973 Constitution, â€Å"It shall be the responsibility of the state to achieve and maintain population levels conducive to the national welfare† (Likhaan and ARROW 17). Unfortunately, when the Marcos administration was replaced by the Aquino administration, the ground for the government Family Planning Program became shaky. It was attempted to be abolished twice but was saved through its transfer from the Department of Social Welfare to the Department of Health in 1988 due to both local and international pressures (17). During the Ramos administration, the Philippine approach towards population control shifted from the previous population control framework to the reproductive health approach (Likhaan and ARROW 17). This was a result of the Philippine participation to the International Conference on Population and Development (ICPD) held in Cairo, Egypt (17). It was also under this regime that Secretary of Health, Dr. Juan Flavier funded the purchase of contraceptives and launched an anti-AIDS campaign heavily featuring condoms despite fervent opposition from the rulers of the Catholic Church (17). A legacy that perhaps he passed on to his successor Dr. Carmencita Reodica who was the brain behind the implementation of an Integrated Reproductive Health Program within the DOH (17). As another change in administration took place however, the reproductive health programs stated above were abolished and while the new regime have tried to present newer programs for the improvement of Philippine reproductive health, none were implemented due to the ousting of Estrada which then brought us the Macapagal-Arroyo administration (Likhaan and ARROW 17-18). It is said that it was in this administration that government reproductive health programs previously implemented by former administrations â€Å"regressed† (18). Two big events happened during this time. First was the banning of the emergency contraceptive pill called Postinor which raised a torrent of rallies and protests from health and women’s NGOs and the second was Arroyo’s announcement that she would veto the proposed Reproductive Health Bill at that time even if it were passed because she believes that it is â€Å"a pro-abortion bill†(18). The struggle for the passage of the RH Bill, however, did not stop there. As the current regime led by Pres. Benigno Aquino, Jr. took over, the fire brought by this controversial debate has been lit once more. The bill has undergone a few revisions and the anti-RH and pro-RH factions have continued their unceasing debate. The anti-RH faction, supported by the Catholic Bishops Conference of the Philippines (CBCP), other so-called Pro-Life Organizations, and some famous personalities like Manny Pacquiao, argue that the bill is anti-Life, anti-Poor, unconstitutional and anti-God. The pro-RH faction – supported by Health and Women NGOs, International Organizations, and also various personalities like Lea Salonga and Sen. Mirriam Santiago – on the other hand, believes that the RH Bill is pro-Life, pro-Poor, pro-Choice, constitutional and NOT anti-God. On my part, I stand by the pro-RH faction. The Reproductive Health Bill is an important step towards the improvement of the quality of life of every Filipino, and I believe that it is the government’s responsibility to allow its people to take this crucial step forward. In what follows, I will explain why I think that the Reproductive Health Bill should be passed. Women Empowerment Many Filipinos are unaware of the real purpose behind the Reproductive Health Bill, or to be more exact, The Responsible Parenthood, Reproductive Health, and Population and Development Act of 2011. Most usually, debates between the anti-RH faction and the pro-RH faction end up with the topic of overpopulation and whether decreasing the population growth rate would solve most of the problems plaguing the Filipino nation. I myself had been misled by these recurrent arguments and thought that perhaps the point behind this bill was to decrease the rate by which our population grows. Further examination of the bill however proved me wrong. The purpose of the legislators in presenting this bill was not to decrease the population growth rate of Filipinos; rather it is to empower them most especially its most vulnerable sector, the Filipino women. Reproductive Health, as defined by the World Health Organization (WHO), is a state of complete physical, mental and social well-being that implies that people are able to have a responsible, satisfying and safe sex life and that they have the capability to reproduce and the freedom to decide if, when and how often to do so. Also, they added, it implies the presence of the right of access to appropriate health care services that will allow women to go through pregnancy and childbirth safely (WHO). Unfortunately for the Philippines, the lack of a comprehensive reproductive health law has drawn its toll on women producing a high Maternal Mortality Rate (MMR) of 162 per 100,000 live births (Pernia, et.al.). This means that about 11 women die every day during childbirth (NSO, 2006). Another effect of the absence of a comprehensive law that offers effective reproductive health care services is an Infant Mortality Rate (IMR) of 25 per 1000 infants (Dizon). In other words, there is a total of 62, 000 infant deaths every year, or 169 deaths every day (Dizon). Aside from those, there is an estimated 473,400 women who have abortion every year, 90% of them done by married women, producing a rate of 27 abortions out of 1000 women aged 15-44 years old (Pangalangan, Juarez, et.al). Also, 78,900 women among those who had abortion are hospitalized due to post-abortion complications (Juarez, et.al). What is sad about this is that all this deaths and complications could have been prevented and attended to if women were provided with proper and sufficient family planning and health care services. The Responsible Parenthood, Reproductive Health and Population and Development Act of 2011 aims to protect women from the aforementioned complications of having no readily available reproductive health and family planning services (HB 4244). In Section 5 of House Bill 4244, entitled Midwives for Skilled Attendance, the bill ensures the availability of full time, skilled and properly trained birth attendants for women at a ratio of one (1) birth attendant per a hundred and fifty (150) deliveries per year (HB 4244). Also in Section 6 of the same bill, each province and city, assisted by the DOH, would establish or upgrade hospitals with sufficient and qualified personnel, facilities and supplies that would enable them to provide efficient and effective emergency obstetric care (HB 4244). Aside from that, private and non-government reproductive health care service providers – including but not limited to gynecologists and obstetricians – are mandated in House Bill 4244â₠¬â„¢s Section 22 to provide at least 48 hours annually of reproductive health care services which involves information and education, and rendering medical services free of charge to indigent and low income patients, especially to pregnant adolescents (HB 4244). However, these are not the only provisions that the Reproductive Health Bill offers women and their children. In Section 8 of House Bill 4244, the government ensures that a Minimum Initial Service Package (MISP) for reproductive health – includes maternal and neonatal health care kits and services defined by the DOH – would be ensured for women in crisis situations such as disasters (e.g.; earthquakes, flood) and humanitarian crises (e.g.; famines, epidemics). The MISP will become a part of the initial response of government units and national agencies at the onset of crises and emergencies (HB 4244). Also, in House Bill 4244’s Section 14 maximum benefits as provided by PhilHealth programs would be given to serious and life threatening reproductive health conditions such as AIDS, breast and reproductive tract cancers, obstetric complications and other similar conditions. Aside from maternal health care services, the bill also promises to provide a full range of modern family planning methods to be available in all accredited health facilities which, for poor patients, shall be fully covered by PhilHealth Insurance and the government on a no balance billing (Section 7, HB 4244). These provisions of the bill are important in protecting women from the risks brought by pregnancy and from the difficulties caused by unplanned pregnancies. According to a research report published jointly by the Guttmacher Institute and the United Nations Fund for Population Activities (UNFPA): Better timing and spacing of births can reduce complications related to pregnancy and delivery, and improve the health of women and their infants (Singh S, et.al). Also, according to this same research, if contraceptive needs for women are met sufficiently, the number of induced abortions would decline by 70% in the developing world (Singh S, et.al).   Providing women with these reproductive health services also move in accordance to the Magna Carta for Women. In Section 13 of House Bill No. 4273, the law insures women the access to information and services related to their health. This includes maternal care which involves pre-natal and post-natal services that would address a woman’s pregnancy, and the health and nutrition of both the mother and the infant, and legal, ethical, medically safe and effective family planning methods (HB 4273). Despite the many advantages that the Reproductive Health Bill offers to women however, there are still those who desire to hinder the passage of this bill. One of these detractors is the CBCP who claims that the bill is anti-life and unconstitutional. What saddened me however is that in one of their statements, they have summed up choosing to defend the RH Bill as â€Å"choosing death† (Odchimar). I quote: We are at a crossroads as a nation. Before us are several versions of a proposed bill, the Reproductive Health bill or sanitized as a Responsible Parenthood bill. This proposed bill in all its versions calls us to make a moral choice: to choose life or to choose death (Odchimar). Reading this statement caused a moment of irritation which swiftly turned to sadness as I realized how misinformed my fellow Filipinos were. The Reproductive Health Bill is not anti-life; it is, through thorough examination, explicitly pro-Life (Pangalangan, Pernia et.al). The Reproductive Health Bill will not only protect a woman’s right to make a choice but also protect her life and the life of her child. Providing quality health care services to women will help fight the complications of pregnancy and even help avoid induced abortions (Pernia, et.al, Pangalangan, Lagman). Choosing the Reproductive Health Bill would never be equal to choosing death. In this same statement by the CBCP, they also shared one of the reasons why they specifically object to the RH Bill: Advocates also assert that the RH Bill empowers women with ownership of their own bodies. This is in line with the post-modern spirit declaring that women have power over their own bodies without the dictation of any religion. How misguided this so-called â€Å"new truth† is (Odchimar)! That women own their bodies is subject to each and their own beliefs. I myself, even as a woman, do not believe that I own this body with which I move and act. I acknowledge that this body of mine was something given to me by the Lord and therefore his, yet it must also be acknowledged that not all Filipinos share this same belief. First of all, not all Filipinos are Catholics and it is wrong to deprive them of the support they ask of the state simply because the religious leaders of the most prevalent religion disagree with it (Pangalangan, Pernia, et.al). Second, 90% among the 97% who claim that they want the RH Bill to be passed are Catholics which shows how pressing this matter is (Pangalangan). Whether or not our bodies were our own or just borrowed from the Lord, the fact that it needs protection, support and sufficient health services could not be denied. About 60% of Filipinos are dependent on the government for the provision of family planning services and it is the government’s responsibility to make it continuously and readily available for them (Pangalangan). The Reproductive Health Bill will provide women with sufficient, efficient and effective family planning and reproductive health care services. This will not only benefit women but their children as well. It would protect them in many ways and help preserve lives that need not be lost. Family Planning Methods Family Planning allows individuals and couples to anticipate and achieve their preferred number of children and the spacing and timing of their births (WHO). There are many mediums of contraceptives that have been invented and developed through time. Mostly, they are divided into two categories: Natural Family Planning (NFO) methods and Artificial Family Planning (AFP) methods. Natural Family Planning Methods mainly involves determining when a woman is fertile or not and having intercourse during days when fertilization would not occur (IRH). The effectiveness of this method is dependent on many factors however, these include faithful participation between sexual partners, accuracy in predicting the woman’s fertile days and ability to perfectly follow the methods they choose (IRH). Aside from that, there are women, in fact a lot of them, for whom Natural Family Planning methods may not work, considering this, the success rate of NFP methods are comparatively lower than Artific ial Family Planning methods (IRH). Artificial Family Planning Methods are methods that employ external factors. This involves pills, injectables, patches, vaginal rings, implants, Intrauterine devices (IUDs), male and female sterilization, condoms, etc (WHO/RHR). A variation of these methods may work depending on the situation of the women or men involved, however, most of the time the success rates of these methods are fairly higher than NFP methods (WHO/RHR). In the Reproductive Health Bill, a full range of Family Planning (FP) methods would be made available in all accredited health facilities (Section 7, HB 4244). Also, they would be labeled as essential medicines, which means that they would be part of the National Drug Formulary and would be included in the regular purchase of essential supplies of all public hospitals and health units (Section 10, HB 4244). This would help many Filipino families, especially the poor, in achieving only the size of the family they desire (Pernia, et.al). In recent statistics, evidences that the poor prefer smaller families but are incapable of achieving t his because of lack of accessibility of Family Planning Methods have been found (Pernia, et.al). Recently, a survey by the Social Weather Station showed that 97% of Filipinos want to be able to control their fertility and plan their families (Pangalangan). Allowing access to readily available Family Planning Methods would be an efficient response to this call. Aside from that there is good reason for promoting both Natural and Artificial Family Planning methods. In a discussion paper released by the UP School of Economics, they said that: †¦ensuring access to the full range of modern (â€Å"artificial†) FP methods cum appropriate information raises the success rate of achieving the desired family size. Limiting FP options to â€Å"natural family planning (NFP) methods only† fails to address the private and social costs of mistimed and unwanted pregnancies (Pernia, et.al). Providing both Artificial and Natural Family Planning methods would allow for greater success rate in achieving the desired family size of Filipinos. However, this is not the only good effect of Family Planning methods. Some Family Planning methods, when correctly used, may help prevent the transmission of HIV and other sexually transmitted infections (WHO). Use of Family Planning methods also reduces occurrences of induced abortions (WHO). This provisioning of FP methods also supports the recognition of the family as an autonomous institution that has the right to found a family in accordance to their desired number and spacing of children (WHO, 1987 Constitution). Despite the advantages of offering both Natural and Artificial methods of Family Planning however, there are those who say that only Natural Family Planning methods should be supported by the bill. This is because, for these anti-RH groups, Artificial Family Planning methods are abortifacients and are unsafe. First of all, there is a big difference between a contraceptive and an abortifacient. To put it in simple terms, a contraceptive is something used to prevent fertilization between a sperm and an egg while an abortifacient is something used to kill an already fertilized egg. Despite my belief that there is no need to elaborate further, I still shall reiterate it: Contraceptive methods are not abortifacients. Second, the provision of family planning metho ds requires counseling with a family planning provider (Magallon). These family planning provider/counselors function to advise a couple of the most appropriate method for their situation and also to screen those who wish to avail of these methods (Magallon). One of the things they require of the couple is information on whether the woman is pregnant or not, or if sexual intercourse happened between them inside a certain period of time (Magallon). If it so happens that sexual intercourse occurred and/or the woman were pregnant, the family planning counselor would either ask them to wait and confirm first if the woman is pregnant or not provide a method of family planning to the woman (Magallon). This they do to avoid any bad effects that a contraceptive might have on an already existing child (Magallon). Another claim against artificial contraceptives, especially of oral contraceptive pills, is that they have been found to be carcinogenic agents in a recent research conducted by the Women’s Health Initiatives and was classified so by the International Agency for Research on Cancer (â€Å"Position Paper on the RH bill†). In all fairness, further research on my side lead me to the conclusion that this information is true. However, while it is true that OCPs are Group 1 carcinogens, it is also true that use of OCPs prevent endometrial and ovarian cancers (Associated Press). Aside from that, I think it is worthy to point out that the dosages used in the studies from which the conclusion was made were, to quote Dr. Steven Goldstein, professor of the New York University Medical Center, â€Å"2  ½ to 4 times higher than the dosages I’m using today in most wo men [referring to the pills she provides her clients with]† (Associated Press). Also, according to director of analytic epidemiology of the American Cancer Society Eugene Calle, the evidence of increase in breast cancer risk is very small and transient, which means that it disappears as soon as the intake of the pills is stopped (Associated Press). Providing Filipinos with both Artificial and Natural Family Planning Methods may have a few disadvantages but I believe that the advantages of these actions outweigh all the cons. If the Reproductive Health Bill is passed, considering its main thrust is promoting full information and providing access to and choice amongst the full selection of family planning methods – whether natural or artificial – more unintended pregnancies would be prevented thus reducing the current MMR of the Philippines and saving the lives of not only women but children as well (Pernia et al.) Effects of the Reproductive Health Bill A lot of effects other than those mentioned before may come from the passage of the Reproductive Health Bill. One of these miscellaneous effects is that it would help reduce the population growth rate which would then produce a sort of chain reaction that would help alleviate poverty especially in the poorest areas here in the country (Alonzo, et.al, Pernia, et.al). This happens because parents who are able to space their children and acquire their desired family size are more capable to bear the cost of raising and educating their children (Pernia, et.al). Once educated, these children would then be able to help raise their families above poverty through work and business (Pernia, et.al). Another effect of the Reproductive Health Bill is it encourages women to exercise their right to choose and their free will (Lagman). Women would be given the chance to make informed choices on matters that affect them the most (Lagman). The promotion of an age-appropriate sex-education program would also help teenagers determine how to act in the face of sexual confusion (Lagman). It will promote â€Å"correct sexual values† and instill both consciousness of the freedom of choice and responsibilities of exercising one’s rights (Lagman). Knowledge on these matters is important because health risks associated with mistimed and unplanned pregnancies are higher for women who become pregnant while still in their adolescent ages (Pernia, et.al). Against all these good effects however, there are those who claim that if the RH Bill would be passed then a so-called â€Å"demographic winter† – inverse triangle population, with the old above and the young below – would occur in the Philippines (â€Å"Position paper on the RH bill†). This, according to some UP Professors of Economics has been greatly exaggerated and could only be considered as a scare tactic that intends to instill fear in people’s minds and which was probably spread by people who do not understand population dynamics â€Å"or worse, who intend to mislead† (Alonzo et al., also cited in Lagman). Conclusion The RH Bill empowers women. It reinforces the people’s freedom to choose and freedom to be informed. It protects not only the sanctity of life but the quality of life that a child will have once he is born. It is pro-life, pro-women and pro-choice. The Reproductive Health bill also aims to protect women from the many complications of pregnancy and childbirth. It also aims to provide better care for every child born. Aside from that, the RH Bill will enable Filipinos to protect themselves better form sexually transmitted diseases such as AIDS. Both Artificial and Natural Family Planning Methods are essential for the implementation of a comprehensive reproductive health law. These methods are scientifically proven safe and though some might have adverse effects, the advantages of these methods outweigh the risks they may present. The Reproductive Health Bill is a bill that allows spouses to plan their families and gain only the children they can provide for. It will help many poor families in investing more for their children and can alleviate poverty even if it cannot make it disappear altogether. The Reproductive Health Bill will also enable the youth to understand their rights and their responsibilities and promote proper sexual values. Understanding all this, I call for the immediate passage of the Reproductive Health Bill for the good of the Filipino nation. Works Cited â€Å"1987 Constitution of the Republic of the Philippines.† The LAWPHiL Project. Arellano Law Foundation, n.d. Web. 5 September 2011. Alonzo Ruperto P., Arsenio M. Balisacan, Dante B. Canlas, Joseph J. Capuno, Ramon L. Clarete, Rolando A. Danao, Emmanuel S. de Dios, Benjamin E. Diokno, Emmanuel F. Esguerra, Raul V. Fabella, Ma. Socorro Gochoco-Bautista, Aleli P. Kraft, Felipe M. Medalla, Nimfa F. Mendoza, Solita C. Monsod, Cayetano W. Paderanga, Jr., Ernesto M. Pernia, Stella A. Quimbo, Gerardo P. Sicat, Orville C. Solon, Edita A. Tan, Gwendolyn R. Tecson. Population and Poverty; The Real Score* (DP 2004-15). Discussion Paper. UP School of Economics; December 2004. Web. 5 September 2011. PDF. Associated Press. â€Å"Hormone pills added to list of carcinogens.† msnbc.com. 29 July 2005. Web. 5 September 2011. â€Å"Contraception.† Gale Encyclopedia of Medicine. 2008. The Gale Group Inc. Web. 5 September 2011. Lagman, Edcel. â€Å"Reproductive health bill: Facts, fallacies.† INQUIRER.net. 3 August 2008. Web. 5 September 2011. Retrieved from: Likhaan and ARROW. State of Filipino Women’s Reproductive Rights: 10 Years Post Cairo Shadow Report. Research in Brief. 2004. Print. Pernia, Ernesto M. Stella Alabastro-Quimbo, Maria Joy V. Abrenica, Ruperto P. Alonzo, Agustin L. Arcenas, Arsenio M. Balisacan, Dante B. Canlas, Joseph J. Capuno, Ramon L. Clarete, Rolando A. Danao, Emmanuel S. de Dios, Aleli dela Paz-Kraft, Benjamin E. Diokno, Emmanuel F. Esguerra, Raul V. Fabella, Maria Socorro Gochoco-Bautista, Teresa J. Ho, Felipe M. Medalla, Maria Nimfa F. Mendoza, Solita C. Monsod, Toby Melissa C. Monsod, Fidelina Natividad-Carlos, Cayetano W. Paderanga, Gerardo P. Sicat, Orville C. Solon, Edita A. Tan, and Gwendolyn R. Tecson. Population, Poverty, Politics and the Reproductive Health Bill (DP 2011-01). Discussion Paper. UP School of Economics; February 2011. Web. 5 September 2011. PDF. Retrieved from: Philippines. Cong. House. The Responsible Parenthood, Reproductive Health and Population and Development Act of 2011. 15th Cong., 1st sess. HB 4244. PDF. â€Å"Position Paper on RH bill: by Individual Faculty, Students and Alumni of the University of the Philippines.† iPetition.com. n.d. Web. 5 September 2011. Retrieved from: Singh S et al., Adding It Up: The Costs and Benefits of Investing in Family Planning and Maternal and Newborn Health, New York: Guttmacher Institute and United Nations Population Fund, 2009. (Suggested citation) WHO. â€Å"Reproductive Health.† World Health Organization. n.d. Web. 18 October 2011. Retrieved from: < http://www.who.int/topics/reproductive_health/en/> WHO. â€Å"Family Planning.† World Health Organization. n.d. Web. 18 October 2011. Retrieved from: WHO.