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| Photo courtesy of www.ph.undp.org |
The Philippine Government faces greater challenges in
meeting some of its UN Millenium Development Goals (MDG) as the deadline draws
near. One of these targets is to lower maternal morality rate (MMR) to 52 per
100,000 live births by 2015. The latest statistics indicate that instead of
dropping, MMR jumped from 162 in 2008 to 221 in 2011. And the Department of Health
(DOH) knows this only too well.
According to Dr. Diego Danila (national program manager of
DOH’s Maternal, Newbord, Child Health and Nutrition Task Force) reducing MMR is
indeed a tough task because it is such a complex issue. It requires the
national government and the local government units (LGU) to work hand in hand
and address the issue more efficiently.
Still, various programs are unceasingly conducted by the DOH
to improve health services for mothers and their babies, especially those who
belong to the poor communities. “It may be difficult but the efforts of the
government are continuous. The indicators show positive signs in some areas
like facility-based delivery going up both in public and private [health
units],” said Danila.
The doctor identified the top five factors that contribute
to the rise of MMR in the country: non-belief in pre-natal care because some
mothers were able to give birth successfully even without it; far distrance of
health centers; poverty; lack of moneu to buy pre-natal vitamins; and teenage pregnancy
(which are usually not being reported as
this is still a taboo in the Filipino society).
One of the initial steps taken by the DOH to lower down MMR
and encourage mothers to seek professional care during pregnancy and delivery
was the passage of the “No Home Birthing Policy” during the administraiton of
then-president Gloria Macapagal-Arroyo. Presiden Benigno Aquino III retained
the said policy and updated it to maternal, new-born, child health and
nutrition (MNCHN) stragegy.
But the policy faced opposition from various officials and
organizations. They argued that banning home birthing is not the right solution
for the rising toll of maternal deaths in the country for it would just make
birth-giving more difficult for poor mothers, especially those who dwell in
remote areas where health facilities are scarce.
Danila clarified that there is no law that prohibits mothers
to give birth in their homes if they want to. “What we have is an advocacy, a
recommendation which you can either follow or not,” he said.
Their message to mothers, however, is that if there is an
available health facility near them, make use of that. “We’re increasing the
number of facilities and trained doctors, nurses, and midwives; plus we enroll
you to Phil Health (a health card), “ Danila added.
He also said that if mothers really want to have their delivery
at home because they think they’re safe there, they could. “However, we can
tell you that studies sow that it is safer for mothers to give birth in a
health facility than in her house. Doctors, equipment, and medicines are
available in a facility,” the health official stated.
BRIGHT SIGNS
Despite the criticisms, the DOH pursues the strategy
together with programs aimed at improving and bulding more birthing facilities.
It also targets the training of more health personnel in basic as well as
comprehensive emergency obstetric and new-born care.
As of the latest DOH data, there are 1,598 basic emergency
obstetric and new-born care facilities in the country and 270 comprehensive
ones. Danila is positive that thes programs are encouraging a number of mothers
to give birth in birthing facilities.
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| Interview with Dr. Danila of the DOH |
Frequency of postnatal care received by mothers within the
first week of delivery also boosted to 84 percent, almost hitting the 2015
target of 85 percent, while the frequence of postnatal care received by
new-borns wthin first week of delivery registered at 86 percent.
The campaign has also reached indigenous communities that
observe tribal birth-giving rituals and preger delivery by trraditional birth
attendant (TBA) or hilot, and normally rejecting the modern and scientific way
of delivery. Danila cited the case of the Mangyan tribe in the mountains of
Mindoro. Traditionally, when a mother is about to give birth, all the members
of the tribe gets involved—making the situation too crowded for a common
birthing facility space to handle.
This custom is one of the reasons why mothers of the tribe
did not want to deliver in a birthing facilty. To address the issue, the DOH
and LGU build a huge hut near their community to serve as a bithing center. The
hut is equipped with facilities and medical professionals, and is spacious
enough to accomodate the accompanying tribesmen. “We respect their ways,”
Danila said.
Dr. Danila admits that hitting the MDG by 2015 is a hard nut
to crack but he is optimistic that the Philippines’ maternal and child health
will eventually improve further. But that would also depend on the political
will of the local government units. “In public health, you have to understand
all stakeholders. If you don’t, the beneficiaries will suffer. A lot of governors,
LGU executives in the country are not callous about health care; they just don’t
understand it. So you need to expalin it to them. The bottleneck also occurs
with municipal doctors who do not know how to advocate. Some of them are not
active in pushing [health] advocacies,” he said.
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