1. Other than the factors discussed in the lecture, what do you think are other factors affecting maternal mortality rate in the Philippines?
I think the overarching factor that significantly affects the maternal mortality rate especially in the Philippines is the social status of women and families. This is the root cause of most of the problems discussed in the lecture such as lack of access and distance from healthcare facilities and professionals, costs of healthcare services, problems concerning time and schedule, lack of information, and cultural beliefs and practices that may be harmful.
According to the World Health Organization (2019), poor women in remote areas are the least likely to receive adequate health care. This is apparent in south Asian countries including the Philippines where there is still a low number of skilled health workers and poor healthcare facilities that cater to rural communities. Compare this to the high-income and upper-middle-income countries in which more than 90% of all births benefit from the presence of a trained midwife, doctor, or nurse. This has a huge impact in terms of the maternal mortality rate because being treated by professionals ensures that pregnant mothers are treated in a scientific and experienced manner. This looks like an efficient response during emergencies such as occurrences of hemorrhage and eclampsia, proper observation of aseptic techniques to prevent infection, and proper counseling and education to prevent unsafe and illegal abortions and other complications.
One of the regions in the country that significantly manifests this huge socioeconomic gap and how it directly impacts the MMR is the Central Visayas region which recorded the highest MMR of 1.6 maternal deaths (DOH, 2018). As we know the Central Visayas region is one of the most remote islands in the country, and although it includes highly urbanized cities such as Cebu City, there is still a huge gap between the rich and poor which makes it harder for women in the rural communities to have sustainable, safe, and quick access to healthcare and maternal services.
Aside from socioeconomic status, another factor that is especially relevant these days is the rise of the COVID-19 pandemic. This health crisis not only revealed the poor and fragile health system in the country but also exacerbated the already dangerous situation. According to a study conducted by the University of the Philippines Population Institute (UPPI) and the United Nations Population Fund (UNFPA), pregnant women's utilization of facilities for ante-natal check-up and delivery is declining, because of service disruption, difficulty in commuting, and their fear of contracting COVID-19.
This can still be tied to the socioeconomic status of individuals in which the rich can have better access to health services and professionals while the poor remain within the periphery of our society even amidst the pandemic.
2. What are the top 3 causes of maternal mortality ratio in the Philippines? Top 3 maternal morbidity?
According to the Department of Health (2013), the top 3 leading causes of maternal mortality ratio in the Philippines are (1) complications related to pregnancy occurring in the course of labor, delivery, and puerperium, (2) hypertension complicating pregnancy, childbirth and puerperium, and (3) postpartum hemorrhage.
The top 3 leading causes of maternal morbidity on the other hand are (1) hemorrhage, (2) infection, and (3) unsafe abortion. Notice that unsafe abortion can still be linked to occurrences of hemorrhage and infection especially when mothers in the Philippines pursue and enter illegal abortion clinics where the procedures may be compromised and not properly regulated based on scientific information and understanding.
REFERENCES:
Department of Health. (2013). Maternal Deaths by Main Cause. https://doh.gov.ph/Statistics/Maternal-Deaths-By-Main-Cause.
Department of Health. (2018). The 2018 Philippine Health Statistics: Bureau of Epidemiology Department of Health. https://doh.gov.ph/sites/default/files/publications/2018%20Philippine%20Health%20Statistics.pdf.
World Health Organization. (2019, September). Maternal Mortality. https://www.who.int/news-room/fact-sheets/detail/maternal-mortality.
Reliefweb. (2020, August). Significant rise in maternal deaths and unintended pregnancies feared because of COVID-19, UNFPA and UPPI study shows. https://reliefweb.int/report/philippines/significant-rise-maternal-deaths-and-unintended-pregnancies-feared-because-covid.