1. Other than the factors discussed in the lecture, what do you think are other factors affecting maternal mortality rate in the Philippines?
The lecture stated that the factors affecting the maternal mortality rate in the Philippines are the lack of access to adequate antenatal, delivery, and postpartum care. Other than these, the following factors also further contribute to the maternal mortality rate in the Philippines:
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Low level of contraceptive use. As a predominantly Catholic country, the usage of birth control pills, condoms, and other forms are contraceptive use are considered topics of taboo. In turn, this led to limited access to contraceptives. As a result, many Filipinos are experiencing unplanned pregnancies and abortions, contributing to higher rates of maternal mortality.
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Poverty. Poor women are especially at a disadvantage when it comes to accessing sexual and reproductive healthcare. In fact, around 75% of the poorest quintile do not have access to a skilled birth attendant, who can assist them through their pregnancy. The lack of access to care due to limited resources contributes to an increase in the maternal mortality rate.
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Regional disparities. There are wide disparities observed among the regional mortality rates between urban provinces in Luzon and other underdeveloped provinces, like those in Mindanao. This is because of the unequal distribution of healthcare among more than 7,000 islands in the country. For instance, it was discovered that 90% of births are supervised by a skilled birth attendant in NCR, whereas in ARMM, the comparable figure is 24%. This can be attributed to the inaccessibility and lack of personnel in the area. This contributes to the high rate of maternal mortality rate in the Philippines.
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Poor healthcare delivery system. In some health facilities in the country, especially in underdeveloped areas, several obstacles are faced in the provision of adequate and appropriate care. Some of these include the lack of minimal life-saving equipment, personnel, and faulty patient management, which all can further heighten the maternal mortality rate in the country.
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The rise of the COVID-19 pandemic. The COVID-19 pandemic has disrupted access to life-saving reproductive and sexual health services in the country. In turn, this indirectly led to a significant increase in annual maternal deaths and unintended pregnancies.
2. What are the top 3 causes of maternal mortality ratio in the Philippines? Top 3 maternal morbidity?
The top 3 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.
As for maternal morbidity, the top 3 causes are (1) hemorrhage, (2) infection, and (3) unsafe abortion.
References:
Baccay, K.B. (2022). Prenatal Care and Safe Motherhood Lecture Video PART I. VLE. https://drive.google.com/file/d/1SXIWQpPevbtDjGVAOOlWiDtyE9CqJskQ/view
Department of Health. (2013). Maternal Deaths by Main Cause. https://doh.gov.ph/Statistics/Maternal-Deaths-By-Main-Cause
Rau, A. (2015). Maternal Mortality in the Philippines. https://borgenproject.org/maternal-mortality-philippines/
Sundari, T. K. (1992). The untold story: how the health care systems in developing countries contribute to maternal mortality. International Journal of Health Services, 22(3), 513-528.
The United Nations Population Fund. (2020). 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
United Nations Population Fund. (2009). Philippines: Maternal Mortality Rates Not Making Sufficient Progress to Meet MDGs. https://www.unfpa.org/news/philippines-maternal-mortality-rates-not-making-sufficient-progress-meet-mdgs